Digest: Why does e-Estonia still not have centralised patient registration?

Patient registration at West Tallinn Central Hospital.
Patient registration at West Tallinn Central Hospital. Source: Mihkel Maripuu/Eesti Meedia/Scanpix

In an opinion piece published in daily Eesti Päevaleht (EPL), Kätlin Pääro, head of the secretariat of the Centre Party parliamentary group, asks how it is possible that Estonia as an e-state, dogged as it perpetually is by lengthy waiting lists to see a specialist, still lacks centralised, digital patient registration.

With waiting lists to see a specialist typically stretching into not just weeks, but months, many Estonians would be willing to drive across the country if it meant getting an appointment sooner, but as the country lacks a national, centralised patient registration system, there is no point in doing so, Pääro wrote.

These waiting lists remain a major problem in Estonia, despite the country's high quality of medical care and despite the extra millions of euros earmarked for healthcare. "This, in turn, means that on one hand, some make the most of registering for an appointment and, just in case, make appointments with multiple doctors, while on the other there are those who give up on getting treated — in three months, an injured leg will likely either heal itself or fall off anyway," she said.

Pääro noted that the Health Board has described an issue plaguing some medical institutions in which up to 50% of appointments booked are "empty" due to the aforementioned phenomenon of patients booking multiple appointments, which also exacerbates the issue of patients in need of care having to wait months to see a specialist. She observed that the issue, then, wasn't a matter of funding, but rather the fact that various medical institutions' patient registration systems are not centralised.

All in one place

According to her vision, a nationwide, centralised digital patient registration system would allow patients and family doctors alike to view various specialists' available appointments and book and cancel them all via one online portal. Not only would this be convenient for patients, but this would also help eliminate cases of unnecessary double-bookings, saving time and money for all parties involved. "The faster a health issue is treated, the fewer the complications, and treatment is significantly cheaper," she added.

Estonia lacking doctors and money could be made up for with smart solutions, however. "In light of e-schools, e-voting and delivery robots, the question arises why the most important thing — people's health — has ended up on the back burner," Pääro observed, adding that while centralised medical records and digital prescriptions are already in use, no headway has been made on introducing a centralised digital patient registration system.

Dragging its feet

The plan to introduce such a system is not new, she noted, but over ten years after a project for it was introduced in 2007, the platform has yet to be developed. "According to the new plan, the digital patient registration system should be launched next year, and hospitals will hopefully join the system by 2020," she said.

"We'll see," she continued, "but the lack of enthusiasm thus far indicates that the digital registration system needs to be included in campaign platforms and among political priorities." If this were to be the case, and if hospitals themselves also demonstrated initiative and contributed to solutions, patients could better be sure that the digital patient registration system project will actually finally be implemented.


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Editor: Aili Vahtla

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