Estonia, Good for Business, Internet, Medicine, Technology

"The North Estonia Medical Center (PERH) will join the digital registration system as a pilot in November, and when the other hospitals as well will join it next year, we will have moved one step forward," the board chairman of the Estonian Health Insurance Fund, Rain Laane, said.

He said that in enacting change, it is always possible to use both the carrot and the stick approach, and that his preference is cooperation.

"But it doesn't unfortunately work always," Laane said.

Eva Lehtla, media relations adviser to the Ministry of Social Affairs, said that a hospital digital registration system would benefit patients only when appointments with doctors at more than one hospital can be made with it. In order to motivate also other hospitals to join the system, the Health Insurance Fund will write a requirement for joining the digital registration system within one year after the launch of the nationwide system, that is, by 2020, into its contracts with hospitals.

"Under the earlier arrangement, hospitals were required to upload their available doctor appointment times into the system. The new system will retrieve information about available appointment times from the hospital's information system instead," said Monika Soosaar, coordinator for international relations at the TEHIK center of information systems for health and welfare.

The new system would enable also family physicians to make inquiries about available appointment times with specialist doctors at hospitals and book an appointment.

The new version of the digital registration system can be joined by all hospitals and hospitals are not required to relinquish the previous system.

"Joining the digital registration system requires additional development work to be done in the information systems of hospitals," Soosaar added.

The initial version of the hospitals' digital registration system, developed in 2007-2008, cost nearly 200,000 euros but was never widely adopted due to hospitals' unwillingness to accept the system that they found to be incomplete. The new system would allow patients to book an appointment with a physician nationwide and would also include a payment option.