Telemedicine pilot projects
On 9 November 2020, the Estonian Health Insurance Fund (EHIF) announced a call for competition for telemedicine pilot projects to accelerate the introduction of user-friendly and high-benefit telemedicine services. The competition will support the development, early implementation, and healthcare impact assessment of new integrated service models including telemedicine services. In addition, new remuneration models will be tested that would allow the introduction of telemedicine service models following the successful completion of a pilot project.
Projects submitted to the pilot project competition must meet one or more of the following development needs of the Estonian healthcare system: prevention of exacerbation of chronic diseases, improvement of treatment continuity, improvement of the availability of mental health support services.
The indicative budget for the competition is 1,000,000 euros. Pilot projects are funded by the EHIF's Innovation Fund. Beneficiary pilot projects have been selected through a two-stage application round. The applications were evaluated in both rounds by a broad-based evaluation committee that in addition to the Health Insurance Fund and the Ministry of Social Affairs, also included the representatives of the Estonian Association of Young Doctors, the Patients' Union, the Estonian Chamber of Disabled People, research institutions, as well as innovation and health system experts.
The deadline for submitting the application for the first round was 30 November 2020. 33 project ideas were submitted to the Health Insurance Fund. In the first round, 10,000 euros were allocated to ten projects for the preparation of the design plan, including further development of the idea, engaging of cooperation partners and preparation of a detailed action plan and schedule. For its part, the EHIF offered the teams the support program consisting of a service design workshop, an impact assessment training, a mentoring day, and opportunities for project teams to exchange their experiences.
The deadline for submitting the application for the second round was 1 April 2021. The grant amounts to be provided in the second round was not determined, but depended on the activities required to achieve the project objectives. In the second round, 4 telemedicine pilot projects received support, which can be read about here. The second round is divided into two stages: preparation for the implementation of telemedicine model (1 May 2021 to 31 December 2021) and implementation (12 months, 1 January 2022 to 31 December 2022). In the preparatory stage, grants will be provided for the development of a telemedicine model, the conduct of a feasibility study and the preparation of an impact assess of the telemedicine model. In the implementation stage, grants will be provided to cover the administrative and development costs related to the impact assessment of the telemedicine model.
The minutes of the evaluation committee meeting, and the resolution of the Board of the Health Insurance Fund on the grant in both rounds can be found in the list of documents at the end of the page.
More information and instructions: naidisprojektid [at] haigekassa.ee
Jaarika Järviste, project manager,jaarika.jarviste [at] haigekassa.ee 56479928
Liis Kruus, project manager, liis.kruus [at] haigekassa.ee 55678689
- Procedure of the Estonian Health Insurance Fund remote service demonstration project competition
- First round application form
- Second round application form
- Establishment of an evaluation committee
- Digital Health Technology Assessment Framework
- Decision of the Board of the Estonian Health Insurance Fund on granting support in the first round
- Minutes of the evaluation committee meeting
- Explanation of the first round evaluation process
Proactive digital designer of a health journey
We are creating a digital solution for effective communication between patients and primary health centres for care planning, monitoring and supporting. The main goal of the solution is not only to prevent exacerbations and complications of chronic diseases but also to prevent diseases in case of patients with health risks. The pilot solution will be based on evidence-based health technologies and will use decision support opportunities from the treatment instructions.
A primary care centre will prepare a care plan for the patient using a motivating interview. The care plan will include specific goals and activities to follow. The role of a family physician and his/her team is to empower their patients to take an active role in managing their health and involving other health centre specialists according to the needs (physiotherapist, clinical psychologist, mental health nurse, midwife).
The methodology of the care plan has been developed in the framework of a risk patient care management project. In this project, a distant service model will be developed for primary care centres, and the research partner will measure its impact. The involved technology partner will create a telemedicine solution that is an add-on to the existing solution. It is a secure communication and collaboration tool for family physicians and patients including features to keep and raise patient’s motivation to take care of his/her health.
Patient monitoring in case of psoriasis and preventing worsening of the disease
In Estonia, more than 42,000 people suffer from psoriasis. Psoriasis is a chronic relapsing skin disease and has many comorbidities. Although the patient cannot be cured from psoriasis, on-going and personalized treatment approach can significantly increase the quality of life of such patient. Thus, decreasing periods of skin inflammation and early detection and treatment of related diseases important. The project will create new service model that will provide the patient with access to care in case the symptoms worsen, and will be able to share disease-specific risk data and medical photos of the skin from distance. Doctors can evaluate treatment progress; compare risk scores and photos of the skin. The project implements a care pathway approach, including remote monitoring and enabling doctors to decide whether treatment regimen should be changed, a face-to-face appointment or a referral to another specialist is needed. The approach will help to prevent exacerbations of psoriasis and enable early detection and effective treatment of co-morbidities. The implementation of the new model is enabled by Dermtest medical photo management software.
OnKontakt - e-support for cancer patient
Every year there are about 8800 new cancer cases in Estonia and it´s expected to grow up to 11 000 for the year 2030. Oncological treatment consists of many different treatment modalities (systematic therapy, radiotherapy, surgical treatment), which may induce significant side effects.
Telemedicine service “OnKontakt - e-support for cancer patient” is a collaboration model that enables cancer patients to report treatment-related side effects to their care team.
Timely knowledge about the patient’s side effects allows early intervention and treatment by the patient’s care team. Therefore, serious, potentially life-threatening side effects and need for hospitalization can be reduced. Platform also collects structured patient-reported outcome data, which can be used to change future treatment strategies (in both cancer clinics and primary care).
Purpose of the telemedicine service:
- To maintain/improve patient’s quality of life during treatment.
- To reduce the number of unnecessary ER visits done by cancer patients.
- To ensure early intervention in case of complications.
- To improve treatment compliance, which is a prerequisite for an improved treatment outcome overall.
- To increase collaboration between the general practitioners and the cancer clinic.
- To use patient-reported data in treatment-related decision-making.
- To conduct active patient counseling, which can reduce treatment-related anxiety and increase the patient’s sense of safety.
Patient and the care team are connected through a digital health platform. The pilot in the year 2022 entails up to 250 breast and colorectal cancer patients receiving systematic treatment. Pärnu Hospital, a partner of the North Estonia Medical Center, is participating in the project to test the coordinated action of the patient, the cancer center and the treatment team of the partner hospital in treating side effects and advising the patient when performing cancer treatment close to home.
Pre-visit is an important link that complements the family physician's work process and enables for a comprehensive primary care level service. It begins with the patient describing the problem for which the most appropriate course of treatment is found. The service is available 24/7 and is based on a triage module: self-diagnostics, a symptom questionnaire and a workflow management module that helps find a solution to the problem quickly and determine the urgency of the service to be provided. The solution allows to make reservations for different services according to the complexity of the problem and the category of the triage and to conduct consultations via chat and video call.
This tool reduces the number of physical contacts by addressing some issues through patient instructions and enables the use of a variety of communication channels. Triage reduces staff time and empowers them and patients with quality structured information.
Kevin John Dean, UK
Kevin, a Fellow of the Royal Society of Medicine and of The Chartered Institute for IT, is the Managing Director of Smart Health Science Limited www.smarthealthscience.com and has been named by the Health Services Journal as one of the 50 Top Innovators in Healthcare. Since 2012, Kevin has been Adjunct Professor of Telehealth at the Maersk Institute, Denmark, and is also Senior Research Fellow at RAND Europe. Kevin was a member of the Advisory Board of Patient@Home, Denmark's largest welfare-technological research and innovation initiative, focusing on new technologies and services aimed at rehabilitation and monitoring activities within the Danish public health sector.
Claus Duedal Pedersen, DK
Claus has more than 20-years’ experience in development and implementation of innovative technologies in healthcare. His experience goes from the implementation of the first EMR system in Denmark in 1996 towards national implementation of standards for communication and the national Danish IT-infrastructure for healthcare to the transformation process of the University Hospital towards the new facilities with significantly less bed capacity.
In 2012, Claus was in charge of establishing the Center for Innovative Medical Technologies, a joined innovation and research center between OUH and the University of Southern Denmark. CIMT has especially been working with collaborative projects between healthcare organization and industry to bring new products and services to the market.
As director of the Sentinel Unit, Claus is in charge of the development and implementation of a national quality and research infrastructure for the primary care sector in Denmark.
Maritta Perälä-Heape, FIN
Maritta is a professor of practice in data-driven health care and innovation ecosystems and a director of Centre for Health and Technology (https://www.oulu.fi/cht/) in University of Oulu, Finland.
She is facilitating the strategic R&D&I collaboration between academia, business and public healthcare sector in Ouluhealth ecosystem (https://ouluhealth.fi/ ), which is a multi-partner ecosystem to accelerate digital transformation.
Maritta is also facilitating strategic cooperation through national and international networks and partnerships. Her interest areas are personalized health and care, digital health and data-driven care innovations, and she is driving the change for the successful evolution towards a predictive, personalized, preventive and participatory healthcare system.
She has experience in business idea coaching and in evaluating project proposals for national and EU programs.
Linnar Viik, EST
Linnar is one of the founders of Estonian e-Governance Academy and Program Director of Smart Governance.
He has advised Estonian and many other governments on ICT and innovation policy and is recognized as an IT visionary. He has been instrumental in the rapid development of Estonian computer and network infrastructure, as well as the Estonian internet voting and electronic signature projects.
Linnar lectures innovation management at Tartu University. In 2019 he was elected Chairman of EIT Digital Council.
He’s a former executive at several mobile communications, broadband and software companies such as Skype and Fortumo, advisor at the Nordic Investment Bank, and Board Member of the European Institute for Innovation and Technology.
Linnar is co-founder and member of the board of the mobile services and software development company Mobi Solutions and the start-up Pocopay.
Terje Peetso, EST
Terje is a member of the management board in the North Estonia Medical Centre in Tallinn since April 2018. Among other tasks she is responsible for the coordination of research and innovation activities in the hospital and cooperation with other hospitals and clinical partners in Estonia and abroad.
Terje worked in the European Commission (2003-2018) on digital health, tobacco control and risk assessment. She was the Head of Sector on eHealth and Ageing Policy in the European Commission`s DG CONNECT. She also participated in the preparation of workplans of Horizon 2020, evaluation of digital health project proposals and monitored the implementation of funded projects. In 2014 she was the EU Fellow in the University of Southern California, USA, where her research focus was on the obstacles which hinder the introduction eHealth in healthcare systems.
Terje holds a diploma in medicine from the University of Tartu, Estonia.
Erki Mölder, ESTErki graduated from Tartu University in the field of investments and banking in 1997. As a CEO of Quattromed (from 1999 to 2013) he helped the company to grow from UT spin-off company to biggest regional laboratory operating in three countries and employing over 200 employees. Quattromed was acquired in 2013 by Synlab.
Since 2013, Erki has been investing in business models of today and tomorrow in healthcare. Among others, Erki has the following companies in his portfolio: Unimed (dentistry), Qvalitas (occupational health), Cognuse (CoNurse and kõneravi.ee), Capster (sinus treatment device), LungPass (digital stethoscope), Transformative AI (early detection platform of CVC events) and Activate Health (novel health management platform).
Since 2013 Erki is a member of Estonian Association of Business Angels (EstBAN) and a venture partner for a Singapore based healthtech investment fund Verge HealthTech Fund I.
Erki is the founder of Health Economy Association (established in 2019) and first healthtech-related business accelerator HealthFounders (established in 2020).
Since 2020 Erki serves as the Supervisory Council member of the biggest hospital in Latvia - Riga East University Hospital.