The once-only principle aims at reducing the administrative burden for citizens and reusing data - Estonia has been doing just that with their e-Health solution since 2008. So how does their one personal health record work and how can public administrations and citizens profit from this approach?

Estonia has a central national database – the health information system. General practitioners and specialist doctors can and need to upload diagnoses, analyses and test results as well as treatment decisions and prescribed medicines, etc. to this national database. In emergency situations, first responders can collect the data for an electronic first-aid card in the ambulance if the patient can be identified. This allows the first aid personnel to respond better and more appropriate to the patient’s needs.  

But how does this data exchange work?

It is mainly using universal data transfer formats regardless of the type of doctor preparing the data or the medical condition described. Doctors can also draw up electronic referrals or referral responses. All the information must be entered into the central information system within one (ambulatory reception) or five (hospilatory) working days, as stated in the law. There is a standard in use for data exchange which lies under the responsibility of the Information Centre for Health and Wellbeing (Tervise ja Heaolu Infosüsteemide Keskus). The process is organized so that data only needs to be entered once. Each doctor in Estonia can use their own information system or the doctors’ portal developed by the state (Arstiportaal). From the doctors’ information systems, the patients’ data are transferred via a secure X-road to the central health information system, where the information is accessible to both the doctor and the patient.

The patient portal can be accessed with a Mobile ID or an ID card. It is clearly defined who can access the data and under what circumstances. Patients can also make their data inaccessible in the health information system, granting them full power over their own data.

This e-Health solution saves time, and allows data to be reused. The objective of the state is to help patients get the right treatment at the right time. The e-Health solution allows for doctors to access data more quickly and allows for more holistic treatment approaches.

For more information on e-Health solutions, the conference on e-Health “Health in the digital society. The digital society for health” in Tallinn was organized by the Estonian Ministry of Social Affairs as part of the Estonian Presidency of the Council of the EU, in collaboration with ECHAlliance and HIMSS Europe. It picked up the current trends and solutions in e-Health and focused on the impact that a digital transformation of healthcare systems could have on society as a whole.  

For more information: 

• Estonian e-Health solution (EE2017EU website) 
• Estonian Patient Portal (website)
• e-Health conference Tallinn 2017 (16/10/17 - 18/10/17)