1. Estonian experience E-Prescription and other e-Solutions Helen Hoyer helen.hoyer@haigekassa.ee 19.06.2013

2. E-services in public sector X-Road – data exchange environment e-Prescription Taxpayers’ declaration of income Internet voting Establishment of a company

3. E-Prescription 1 All of the prescriptions end up at the central database 95% of prescriptions are digitally prescribed Paper-prescriptions are digitalized by the pharmacists

4. E-Prescription 2 Prescriptions issued electronically – Assumed 45% by the end of the 1st year – Actual result 73% Customer satisfaction – Assumed 75% by the end of the 2nd year – Actual 95%

5. Improving the quality of medical treatment (1) Decreasing the cost sharing – Technical tool: active ingredient vs. brand-name – Campaigns for patients - > higher awareness Patients’ co-payment decreased 17.3% 2009: € 8.02 per prescription 2012: € 6.65 per prescription

6. Improving the quality of medical treatment (2) Assessing the compliance – Monitoring patients’ all prescriptions – Detecting the interactions

7. In progress: e-prescription Active feedback for doctors – Statistic about the their prescribing patterns – Comparison with other doctors Decision making tool for doctors – Clinical guidelines

8. In progress: e-health 1 E-waiting list + e-referral A tool managing recourses of the health care providers E-consultation More effective time consumption of specialist

9. In progress: e-health 2 Standardization Unstructured data - unable to process and incompatible Communication Awareness of e-services

10. Components of success Public demand Political decision Data exchange environment Standards-> structured data In-house IT competence/close collaboration Working system -> availability

11. How to make an impact? E-Health is powerful tool to achieve the sustainable and cost-effective health-system. In order to make an impact we need all of the e-solutions to work robustly. Critical number of users

12. Thank you! Questions? Helen.hoyer@haigekassa.ee Estonian Health Insurance Fund