1. Estonian Electronic Health Record System (EHR)
MD.Madis Tiik
CEO
Estonian E-Health Foundation

2. Architecture of Estonian healthcare IT
STATE AGENCY OF MEDICINES
- Handlers of medicines
- Coding Centre
HEALTH CARE BOARD
- Health care providers
- Health professionals
- Dispensing chemists
POPULATION REGISTER
BUSINESS REGISTER
HOSPITAL ( HIS) integration
2009
FAMILY DOCTORS
2009
PHARMACIS
2010 january
SCHOOL NURSES
2011 september
EMERGENCY MEDICAL SERVICE
2012
X-Roads, ID-card, State IS Service Register
eHealth Foundation EHR SYSTEM 2009
Health Insurance INSURANCE REGISTER CLAIMS & REIMBURSMENT PRESCRIPTION CENTRE
2010 january
PATIENT PORTAL HCP PORTAL
2011
XROADS GATEWAY SERVICE 2009
PHARMACIS AND FAMILY DOCTORS 2009

3. Situation in 01.05.2011 Availability of digital documents on the EHR
Discharge letters (epicrises) 90%
Out-patient consultation notes around 15%
Other documents in the EHR
Images raports
immunization note
Day surgery note
Referrals
Birth epicrises
There are ePrescriptions issued during 2010, it is more than 80% all prescriptions in 2010
100% of Radiological images (excl. dental) are digital and stored to the PACS
More than citizens have digital medical records in EHR – it is 47% of the population
citizens have viewed his/her data in EHR (Patient Portal)

5. Distribution of costs and benefits of Estonian e-Health platform (Digimpact study 2010):
Eesmärk: Miks on vaja toetada lõppkasutajaid- sest nemad ei ole otsesed kasu saajad, kuid peavad tegema olulise osa kuludest ja viima läbi muudatused. Kuna arstid on koolituselt konservatiivsed, siis on vastuseis ilmne
Total cost of EHR system development ( ) has been around 10M€ - it is 7.5€ per citizen

6. Estonian roadmap for eHealth
Local EMRs
Digital Claims & Reimbursement
1992
2010
2015
2020
Time
Impact
Simulation
Environment Tracking
Behaviour Tracking
Online Intervention
Lifestyle Value Added
Shared care
Personal Guidelines
Care Paths
Service Brokering
Integrated Statistics
Social Networking
Decision Support
Central EHR
Health Portal
Registries Integration Standardization
Information Exchange
Slaidi eesmärk oleks välja tuua etervise erinevad arenguetapid. Iga termin tahaks eraldi välja toomist ja enda jaoks spikrina kasutamiseks diskussiooni ajal

7. Healthcare transformation
Patient data available to any clinician who needs to see it
Legal reforms
Access protocols
Clinician engagement
Payment for value and for care coordination
Relationship between providers and payers
Metrics of value
Processes of coordination
Preventive health maintenance centred on the patient
Allocation of funding and staff
Patient engagement
E-Health is one thing that makes these transformations in healthcare possible, but it is not a substitute for the transformations!
Põhiline sõnum peaks olema sellel slaidil- poliitika soovitused

8. e-Health=healthcare management e-Health ≠ICT project
Thank you!
e-Health=healthcare management
e-Health ≠ICT project
wwww.etervis.ee