How Estonia Is Harnessing The Power Of Data For An Aging Population

This post originally appeared on

In previous articles in my series on health and aging, I talked about the importance of healthcare coordination and caring for elders in their homes and outside of traditional hospital environments. These efforts are an important factor to improve health outcomes for the elderly. Yet these initiatives will always fall short of achieving maximum impact when they are not tied together by integrated information technologies that allow for real time data sharing and analysis.

The best example of a government developing and implementing streamlined digital health services is found far from traditional centers of technological innovation. Estonia is a small country in northern Europe with a population of just over a million people. The government of Estonia has created one of the most successful eHealth systems in the world, offering streamlined, online access to healthcare services and closely linking health services to other government services, like driver’s licenses, citizenship cards, and child benefits.

At the root of the Estonian eHealth system is the Estonian national ID card. Much more than a photo identification card, the mandatory national card provides digital access to all of Estonia’s secure eServices. Each card has an encrypted chip that carries embedded files with the personal information of the card owner. The card can be used for a variety of services, including logging into personal bank accounts, voter registration, and traveling within the European Union.

The card is also the link to a person’s medical records. When a person goes to the doctor in Estonia, all their test results, prescriptions, and other relevant health files are automatically uploaded to the encrypted chip. Because a patient uses their card for all health transactions, doctors can closely track patient progress. For example, doctors can check whether patients have picked up their prescriptions or whether they have been prescribed new medications from other health providers. The doctor can also find out if an older person living alone has received a recent home visit from social services or if a home visit needs to be scheduled.

All information in the eHealth system is centralized and cannot be altered once the doctor digitally signs the patient record. Whenever a person visits a new healthcare provider, the new provider can easily review the patient’s full medical background simply by scanning the patient’s identification card. The eHealth system has also significantly improved emergency services across the country. Each emergency vehicle is now equipped with an iPad on which the eHealth program is run. Emergency personnel can obtain patient records while working on an injured person en route to the hospital. Police and firefighters use a similar system.

By linking medical records to other government services through the digital identification card, the government is able to streamline a wide array of other public services. For example, if a person needs to renew their driver’s license, they can present their digital identification card to the Department of Transportation to show that they have passed all necessary medical examinations. If a person requests medical leave from their job due to an injury, the identification card makes it easy for employers to verify the validity of the request.

The eHealth system also allows for real time collection and analysis of national health statistics. All data is coded and made completely anonymous before being made available for analysis. Once anonymized, researchers can extract any statistics they need, be it about medications, diagnoses, treatments, or specific health problems. This allows healthcare leaders to continually examine and improve healthcare systems and service offerings.

The digital overhaul of the Estonian health system is transformative for elders and all people in need of healthcare alike. While other countries with larger populations and weaker digital infrastructure may not be able to implement all these changes on such a grand scale, each of us can look to Estonia as a blueprint for what can be achieved with the right mix of government leadership, innovative technology, and widespread commitment to improving efficiencies in health.