Estonia wants to help the NHS move from analogue to digital

A single patient record for every citizen may still be an aspiration for the UK, but has been the reality in Estonia since 2008.

The global leader in healthcare is cited as a case study for digitisation in the NHS 10 year health plan with good reason.

Everyone in the country has an e-health record, 99% of health data is digitised and the country ranks number one in The Bertelsmann Foundation’s Digital Health Index for 2024.

The result is that whether speaking to a GP, consultant, paramedic or any other healthcare professional – citizens only have to tell their story once.

Now the Estonian government is keen to share its decades-long experience in implementing digital healthcare to help the NHS shift from analogue to digital.

But can the health system of a country with a population of just 1.3 million (around the size of Birmingham) translate to the UK?

Speaking at a HealthTech roundtable in London, Alar Karis, president of Estonia, said: “Britain has a lot to offer to Estonia, and Estonia has something to offer to Britain – our digital society, digital medicine and all these things we’ve been developing already for almost 30 years.

“Of course, nobody can copy what we did, but we are very welcome to share our experience.”

Unlike in the UK, where attempts at creating patient data sharing schemes such as the 2014 Care.data programme and the 2021 General Practice Data for Planning for Research System have fallen foul of public suspicion, in Estonia there is an inherent trust in digital.

Siim Saare, founder and chief executive of Estonian health tech startup Lifeyear, said: “In Estonia, we have a very high level of societal trust for new technologies and the key reason for this is that we’ve experienced the benefits.

“We see the added value and how it makes our lives easier every day.

“It outweighs any theoretical risks and there haven’t really been any major issues around our systems, so we’re very tech forward as a nation.

“I think there’s a lot of ways that we can try to bring that mindset here [in the UK] as well.”

This is in part due to a transparent system which means that citizens can see any time that their e-health record has been accessed.

Following a major cyber attack from Russia in 2007, Estonia developed tamper-proof blockchain technology to ensure the integrity of its national data. Plus every e-Health record is securely linked to a national electronic ID system.

“We learnt our lesson and built up our cyber security system. This should go hand-by-hand before putting in digitalisation or it’s not good,” said Karis.

Another of the ambitions of the 10 year health plan modelled by Estonia, is the shift from sickness to prevention.

The NHS anticipates that by 2035, half of all healthcare interactions will be informed at some level by genomic insights of the patient, with babies undergoing whole genome sequencing to inform a lifelong personalised prevention plan.

Estonia is already moving towards this, with its national genome centre storing 20% of the population’s genome data to be used for genetic research, personalised health and prevention.

Precision healthcare firm Antegenes is one of the companies which harnesses this data for precise screening to detect breast, prostate, and colorectal cancers earlier.

Dr Peeter Padrik, founder and chief executive of Antegenes, said: “Estonia started a governmental programme for personalised medicine 10 years ago to develop the Estonian Biobank and clinical services.

“Support from the governmental side has been the basis because the resources were directed for research and development.

“I think in that sense, the NHS 10 year plan is similarly very important to make those visions a reality.

“We are very glad if we can be part of those solutions because everything should be research-based and scientifically backed.”

Antegenes provides genetic tests to UK private clinics, which are registered with the Medicines Healthcare products Regulatory Agency and validated by UK Biobank data.

Other Estonian companies are also working in the UK: Kodality collaborates with the NHS to make data interoperable; Lifeyear raised £2.4m to launch its remote cardiac care platform in Oxford; and AI radiology firm Better Medicine and digital migraine care startup Migrevention are both running pilots in the NHS.

The message is clear – Estonian health tech companies are keen to share their expertise if the UK is willing to learn.