On May 1st of this year, Estonia will celebrate its twentieth anniversary in the European Union, with over 13 years of experience in a fully digital healthcare service.
Healthcare in Estonia
The Estonian healthcare system is based on the principle of solidarity through a social health insurance, which ensures equal quality of care for all insured individuals, regardless of socioeconomic status.
The goal shared by the Sotsiaalministeeriumi (the Ministry of Social Affairs), the Estonian Health Insurance Fund, the Agency of Medicines, the Ministry of Health (the Terviseamet), and the Institute of Health Development is to ensure a healthy and longer life for Estonian residents, reducing premature mortality, preventable causes of death (such as tobacco, alcohol, physical inactivity, unbalanced diet, etc.), and healthcare inequalities. This commitment translates into a system that focuses on the availability, quality, and safety of healthcare services, aiming to meet the needs and expectations of individuals. Additionally, all involved entities actively contribute to public health protection, improvement of living and learning conditions, and promotion of health at the national level.
The recent increase in the minimum wage of healthcare workers and the adoption of innovative technologies offer positive prospects for the future of the Estonian healthcare system
The Department for Health System Development is the cornerstone of planning, organizing, and implementing healthcare policy, guided by the Population Health Development Plan for the years 2020-2030. Through its implementation, the system focuses on individual-centered healthcare, ensuring a personalized approach attentive to patients’ needs.
Back in 2017, The New Yorker, in an article by Natan Heller, dubbed the gem on the Baltic Sea ‘The Digital Republic’, highlighting Estonia’s pioneering role in adopting digital solutions, including in healthcare. For over 13 years, the country has embraced complete digitalization of the healthcare system, becoming a benchmark for many European Union countries.
Challenges for the present and future
However, despite the successes, the Estonian healthcare system faces significant challenges, including population aging and a shortage of healthcare personnel. On the latter point, it is crucial to highlight the importance of the recent measure adopted by the Estonian Government. On April 1st of this year, the minimum wage for healthcare workers was increased by almost 10%, in response to sector needs. This measure was welcomed by Minister of Health Riina Sikkut, who emphasized the Government’s commitment to ensuring adequate remuneration for healthcare professionals, recognizing their fundamental role in patient care.
To gain a deeper perspective on the current status and future prospects of the Estonian healthcare system, TrendSanità contacted Heli Paluste, head of the Estonian Ministry of Social Affairs’ healthcare network, and Jana Holmar, Director of the Department of Healthcare Technologies at Tallinn University of Technology.
Paluste highlights one of the strengths of the healthcare service: «We have a strong healthcare funding system based on social insurance, which ensures targeted funding and does not depend on one-time political decisions; undoubtedly, this is a strength. This practice has also ensured that a relatively wide range of services is included in the insurance package».
Furthermore, Holmar continues, «additional strengths of our healthcare service include the national health information system and the use of innovative healthcare technologies and services, such as digital prescriptions and various remote services», further emphasizing the country’s digitalization and leadership in the healthcare sector.
Social insurance ensures targeted funding and does not depend on one-time political decisions
If notable are the strengths, Paluste cannot help but underline some challenging issues the country faces: «With a severe context of population aging, difficulties arise from expanding the healthcare tax base, currently mainly based on social tax paid by employers for the active population. Then there is the shortage of healthcare personnel, especially regarding nurses. The shortage of basic healthcare workers occurs mainly in sparsely populated areas (especially on the islands), although they could be very attractive places to live and work».
Furthermore, Holmar adds: «Even more extensive use of electronic services and personalized medicine could help shorten queues for care, prevent diseases, diagnose and monitor a person’s health journey, supporting the person in making right health choices. By personalized medicine, I do not mean only a disease risk score calculated based on a person’s genetic data or a drug prescribed specifically based on them. Personalized medicine also considers other health data, environmental factors, the patient’s lifestyle, and the health journey of their family members. Healthcare technologies and skilled health data analysis enable artificial intelligence to perform e-triage and diagnostics, assess the dynamics of patient health indicators, offer personalized options and treatments, and provide assistance during and after treatment».
Looking towards tomorrow
Despite the difficulties and challenges looming on the horizon, Estonia continues to demonstrate tangible commitment to promoting the health and well-being of its citizens, maintaining a leadership position in the field of digital and innovative healthcare. The recent increase in the minimum wage for healthcare workers and the adoption of innovative technologies offer positive prospects for the future of the Estonian healthcare system.
In conclusion, as emphasized by Holmar: «Technologies do not replace missing personnel in the healthcare system. However, they support those on the front lines, namely doctors and nurses, to perform routine tasks on their behalf, thus alleviating the personnel shortage». Hence the importance of integrating healthcare technologies to improve the efficiency and accessibility of healthcare services, while maintaining a focus on individual and personalized medicine towards patients.
