How Estonia used open health data to fight Covid-19

By Yun Xuan Poon Justin Tan

Interview with Katrin Reinhold, Director of Estonia’s Health and Welfare Information Systems Centre (TEHIK).

Imagine a public health system as a busy corporate office (pre-pandemic). Patient information - much like an office secretary - flits between meeting rooms with medical professionals and patients.

Estonia strives to reduce the physical distance between these “meeting rooms”. Its open data policies have sped up its medical response in the pandemic.

“The biggest advantage of the Estonian health sector is that all health data in our country are collected centrally in the health information system, which was created already in 2009,” says Katrin Reinhold, Director of Estonia’s Health and Welfare Information Systems Centre (TEHIK). She shared more on Estonia’s vision for the future of digital health.

Open data

Pandemics need a whole-of-nation response. Estonia’s national laboratories shared Covid-19 test results in real-time with its central health information system. Doctors and patients were able to immediately see an overview of test results on an online portal.

“For the first time in the history of the Estonian health sector, we made open data public,” Reinhold says. This allowed research institutes, media and private sector to build on the data.

TEHIK also shared crucial statistics with the Estonian Health Board through the centralised health data system. This data included information on hospitalisation, recovery, death, and patient contact details. The data also supported the police’s quarantine inspections.

Estonia is not new to health data sharing. It set up the Estonian Electronic Health Record System (EHR) in 2009, which manages all health data in the country. Each citizen that has visited a doctor has an online e-Health record.

The central health system is integrated with other public IT services to increase convenience for citizens, says Reinhold. “Citizens and health care professionals can use EHR to enter or view a patient’s health-related data, make enquiries, book appointments and so on” to save time, she explains.

The EHR also standardises data across different healthcare providers. This helps doctors access “time-critical” information such as blood type or allergies in emergencies.

Patient-centric platforms

Image from TEHIK.

Estonia has designed its healthcare services to put patients at the centre. Citizens can access their health records by simply logging into an online portal with an electronic ID Card. This eliminates the need to deal with convoluted administrative procedures.

“Health data belongs to the patients”, believes Reinhold. That’s why citizens can “control which doctors have access to their information”, she says. This helps to foster a greater sense of trust with healthcare professionals.

Securing personalised medicine

TEHIK has also prioritised security, in particular for its genetic data. Estonia is the only country in the world where “knowledge of almost 20 per cent of the genetic data of the country’s population is available”, she remarks.

Genetic information is sensitive and plays an important role in developing personalised treatment and prevention plans, Reinhold explains. Estonia has taken “special attention” to protect it when building digital tools, she adds.

Security is especially important to maintain public confidence in the health system. A huge amount of personal data navigates the system daily.

“The Government uses Blockchain technology to ensure data integrity,” Reinhold says. The e-ID card keeps data secure by only allowing relevant parties to view the information.

Blockchain will be equally important for securing the nation’s vaccine certificates. Estonia’s VaccineGuard platform, which runs on blockchain, will issue secure and internationally verifiable Covid-19 vaccine certificates, wrote Biometric Update.

“Phase of transition”

Estonia was an early adopter of healthtech, but that also means its IT systems are now “a little out of date”, Reinhold shares. “We are in a phase of transition,” she adds.

The country is looking to put more power into citizens’ hands, by allowing them to access health records at any time and place. “In future, Estonia will provide point-of-care devices: equipment that patients can use themselves,” she notes. It is also looking to explore AI.

Estonia’s open health data has enabled a quick nationwide response against the pandemic. It will continue to prioritise simplifying the patient experience and security in its digital healthcare services.