Many healthcare providers send patients an SMS or email reminder ahead of an upcoming doctor's appointment. However, not all hospitals do so, prompting the Estonian Health Insurance Fund to test sending notifications through the national health portal to ensure that every patient receives appointment information 72 hours in advance, regardless of the healthcare provider.

However, this meant that patients attending appointments at hospitals that already send their own reminders received duplicate notifications from both the Health Insurance Fund and the hospital.

Evgeni Nikolaevski, product manager of the national health portal, told ERR that the purpose of appointment notifications is to help people remember their upcoming appointments and give them enough advance notice to cancel if they are unable to attend.

"On the other hand, not all healthcare providers currently send patients appointment reminders or the notifications do not reach patients early enough. That is why we tested the option of sending notifications through the health portal, with the aim of sending patients a reminder 72 hours before their appointment, regardless of which healthcare facility they are visiting. This is intended to ensure that all patients are treated equally when it comes to receiving notifications," Nikolaevski said.

The Health Insurance Fund wanted to use the initial notifications to assess how well the system worked and gather feedback from patients and healthcare providers. Nikolaevski acknowledged that because some healthcare providers already send their own reminders, patients could indeed receive two notifications about the same appointment.

"The aim of these notifications is not to duplicate existing reminders, but to ensure that patients who do not receive notifications from their healthcare provider or do not receive them early enough also get a reminder," Nikolaevski said.

During testing, cases emerged in which appointment information submitted to the national digital appointment booking system was not entirely accurate.

"Because notifications sent through the health portal are generated based on information submitted to the digital appointment booking system, incorrect information in the original records may also appear in notifications sent to patients. For this reason, we have now suspended the sending of appointment notifications," the health portal's product manager said.

Before the Health Insurance Fund resumes sending notifications, Nikolaevski said it will need to work with healthcare providers to improve data quality and find a solution that also takes into account reminders sent by other providers.

"The goal is for patients to receive accurate, timely and clear notifications, regardless of which healthcare provider they have an appointment with," he said.

The development work cost the Health Insurance Fund nearly €4,200.

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