The EHR is built on Estonia's X-Road network, Mr Tiik told the presentation audience. X-Road is a secure gateway service architecture that hosts 3 000 eServices available to Estonian citizens. In January 2010, the eHealth Foundation launched a companion health insurance system for claims, reimbursement and prescription management.
"In many countries, I have seen that the task is to integrate the healthcare system," he said. "There is also the concept of the personal health record. In Estonia, we decided that all this functionality will be in our national EHR."
All end users of Estonia's EHR system can access their full personal health records. Physicians and patients have equal viewing access. And with nearly half the country's residents using the system within two years of its launch, the project appears viable for the long term.
To date, the rate of ePrescriptions in Estonia's healthcare system is around 80 %. A full 100 % of radiological images, excluding dental, are now stored in the picture archiving and communication system (PACS). More than 95 % of the country's doctors are currently using the EHR.
The true difference in scale for a small country's EHR project is discernible in the price tag. Estonia's entire EHR project costs € 10 million, or a mere €7.50 per citizen. When revealing concrete metrics, Tiik encouraged attendees not to fixate on the numbers, acknowledging the diminished set of challenges for a country of Estonia's size (1.37 million residents according to a 2010 census).
Mr Tiik listed the challenges ahead: sustainability; chronic disease management; efficiency of patient pathways; and innovation in health models. In addition, he identified areas where the Foundation could have improved on, such as to analyse business processes in healthcare and to support end users with financial incentives.
Mr Tiik concluded his presentation with a summary of the work ahead for nations looking to emulate Estonia's model: "eHealth is just healthcare management of the 21st century. It's not an ICT project."
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Quelle/Source: epractice, 07.06.2011
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