E-experience from Tallinn

Kädi LeppValentina Hazinskaja, Raissa Zhmarjova,

Svetlana Lorvi-Talisainen

EUSUHM 2011 in Moscow

Backround information100% of schools and government organisations have broadband connection (e-school, e-libraries, e-state)Nearly 80% of families have a computer and

broadband connection at homeThere are more than a thousand public WiFi areas

for 45 227km²The state portal eesti.ee offers access to all state

sevices: e-Ticket, e-Tax system, e-Elections e-Bankinge-Healthcare

Why e-Healthcare?Lack of necessary health

informationOverview of patients´ medical

history: visits, diagnoses, examination, treatment

Standardization of documentsEnvironmental protection

Purpose of National Health Information System (NHIS)The main purpose of NHIS is to develop

nationwide framework that facilitates the exchange of diffuse health information.

To develope from institution-centered to

patient-centered health information system which is available across the country.

Main components of the National Health Information System (NHIS)Digital Health Record, containing personal

medical informationDigital appointment booking systemDigital prescription systemDigital medical image databaseDigital blood-bank databaseNational health registries

e-School Health System

Electronic Health Recordhas to contain

ALLmedical, nursing and

health‐related informationobservations of pupils`

lifestyle 

General Architecture

The access to E-system

ID-card for authentication and digitalsignature for medical workers and citizens.Access is enabled only to licensed medicalprofessionals.All access rights and data usage is regulated by the law.All data sent to NHIS must be signed by healthcare providers

Patient`s PortalPatient’s Portal allows patients`

representatives (adult patient, parent of an underage, legal representative, trustee) to browse patient’s health record, download documents, submit consents, update demographics data, review patient health record usage logs via Web.

The EHR will record information about when, how, and why the data was used (logging information).

The Electronic Health record —regression or progression?

According to the study provided in March 2010 100% of our staff was sure that E‐scoolhealth system is necessary for everyday work10% said that using E‐health is too time

demanding (authorization proccess, duplicating documentation)

In general attitude toward E-health is positive

Almost all our nurses use at least some functions of the system

Sustainable school healthcare 

Difficulties

The number of regular users of e-Services among healthcare workers is still rather small

Lack of trust in e-Health applications and missing technical equipment and training (mainly on the health professionals´ side)

Financial cuts have slowed down the development of e-Health in Estonia

 The lack of a comprehensive e-Health strategy for the country

E-Health impact in general has not been quantitatively assessed

Homo Informaticus

ConclutionsEvery innovation needs time for

implementation and adaptationCo-work with software providers is important

for development of most appropriate solutions for practitioners (simplifying it, making it more user- friendly)For users - training, training, training.

ConclusionsOverall, Estonia is planning to have a coherent

eHealth infrastructure in place by 2013. It needs a

significant effort from different counterparts.

Welcome to e-Estonia!

Thank you!www.kth.ee