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13/08/2021

Estonia is well known as one of the forerunner countries in the field of eGovernment and eHealth. Everyone in Europe active in these two fields has heard about Estonia’s successes over the past 15 years. Examples include the roll-out of the country’s X-Road backbone infrastructure and the national deployment of eID.


Many early advances were made. Electronic health record services were proposed to Estonia’s physicians and patients in 2008 and ePrescriptions were put forward in 2010. Estonia was also in the lead in its cross-border exchange of data through its 2019 acceptance of ePrescriptions issued in Finland.

EHTEL’s working relationship with Estonia started early. In March 2014, EHTEL had the opportunity to organise a networking meeting in Estonia’s capital, Tallin, for Europe’s national eHealth Competence Centres. The start of the meeting was hosted by eTervis, the Estonian competence centre, and its second part by the Estonian Parliament. Seven years ago, on the meeting agenda, there were already topics such as electronic access to health data by patients and citizens. Some still very contemporary issues, such as digital skills for health professionals and data integration, also featured.

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A 2014 session in the Estonian Parliament introduced, through video, by the then President Toomas Hendrik Ilves.

Challenges remain, however. Despite this forerunner position – or perhaps because of it – the Ministry of Social Affairs of Estonia (MoSA) is now encountering difficulties in further developing the digital transformation of the health and care system. The Ministry has spotted the need to redefine eHealth Governance in the country by renewing its structure, processes and key performance indicators. To do this, MoSA obtained funding from the European Commission’s Directorate-General Reform. In March 2021, it launched a project to develop a new eHealth Governance Framework, with a view to complete it by mid-2022.

A team of EHTEL members has been contracted, as experts, to advise Ernest & Young on two reports, on As Is and To Be. The EHTEL experts are contributing to this governance refresh by analysing good practices from a sampling of other forerunner regions and countries (i.e. Belgium, Catalonia, Denmark, the Netherlands, Scotland, and Israel).

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