Apr 14

Estonia’s ehealth results


Estonia is a small northern European country on the Baltic Sea is achieving significantly more than its size would indicate. In July 2014, Estonia  set up the e-Health Working Group, whose mission is to develop the Estonian e-Health Strategic Plan until 2020, along with the e-Health Development Concept until 2025 and its detailed implementation plan 2015–2017. How have they been going? By all reports in the media it is amazing.




3 major achievements

  • Electronic health records system. All healthcare providers are required to send medical reports to the system, and the system is accessible to all providers and patients. Some information is still stored locally (digital and paper) such as billing information and images.
  • ePrescription – the project began running in 2010, in spite of startup problems, over ninety percent of Estonians used digital prescriptions in the first full year of operation and by 2013, 95% of all prescriptions in the country were being issued electronically.
  • Patient Portal – by logging into the Patient Portal with an electronic ID Card, the patient can review their past doctor visits and current prescriptions, control which doctors have access to their files, and even receive general health advice.

3 reasons why they have been able to achieve so much, as recently quoted by Estonia officials  in the Huffington Post

  • “We have no legacy policy. A legacy policy is a policy that is difficult to change because it has been a policy of the past. That is something that all the Western Europe countries and the United States are struggling with.”
  • “’In 1991, Estonia regained independence. At the same time, the Internet was born. The Estonian people wanted to leave everything old behind”
  • “The young age of Estonia’s government ministers — many people in high positions are under the age of forty. With youth came the propensity for bold decisions.

Last year former CEO of the Estonia eHealth Foundation Dr. Madis Tiik  reported that since Estonia implemented their Health Information Exchange (HIE) in 2009, it has been a resounding success. The HIE is used by over 98% of its population and national healthcare costs have fallen to 6% of GDP, making it Europe’s most cost effective. Remarkably, HIE cost a mere €10 million or €7.5 per citizen to establish.

While in many bigger countries it would be hard to recreate the political environment which made this happen so quickly, it is definitely an amazing example that a government approach to eHealth can be successful when the stakeholders are all onboard (private and public) and the major issues of security, privacy ( opt-out system) and  identity management  dealt with early and are consistently across eGovernment initiatives.  This success seems to be built on a foundation of a nation that prioritizes change in this area.


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