Estonia, officially known as the Republic of Estonia is a country in the Baltic region, to the north of Europe. The Gulf of Finland borders this country to the north and Latvia from the south. Estonia enjoys incredible progressions, high monetary pay and among the quickest developing economies in the European Union. The Estonian residents are all around furnished with widespread medical care, free education and one of the longest paid maternity leave in the OECD. Estonia is the first country in the world to launch an EHR system registering all the patients’ data from birth till death. Estonia’s quality of healthcare is very good.
Estonia is one of the most digitally progressive countries in the world. Estonia’s medical services information is 99% digitized. It is the first country which uses the blockchain in healthcare. Since 2008, ‘hash-linked time-stamping’ has been used in the public and private sector.
“In 2016, Estonian e-health foundation launched a blockchain technology to secure the health records of the patients.”
In 2011, the Estonia experts in association with Guardtime, a cyber-security enterprise based in Estonia in 2007, used the Keyless Signature Infrastructure (KSI) blockchain science to make the health records impenetrable . The essential reason for KSI is the exclusive use of hash-function cryptography which gives records validation rather than dependence on other centralized trust authorities. In 2016, Estonian e-health foundation launched a blockchain technology to secure the health records of the patients.
Residents of Estonia carry smart cards through which they can access over 1000 online government portals to check their health records. With conventional network protection like firewalls, attacks can go undetected for quite a long time, and it is also difficult to find the amount of the information that has been stolen or destroyed. Blockchain secures online health records by making information immutable. Hackers will not be able to make any changes in the data. All the Digital transactions made with Blockchain technology are recorded irreversibly. The records are difficult to change since they are shared across many computers in real time through a distributed ledger, globally.
“The blockchain technology utilized in Estonia is unique from standard block chains because of its adaptability.”
The blockchain technology utilized in Estonia is unique from standard block chains because of its adaptability. Blockchain technology can offer individual citizens a transparent and clear view of their clinical data for the first time ever. To keep up health data totally immune and time available to people, the electronic ID-card gadget used by the Estonian e-Health record utilizes blockchain technology for ensuring information integrity and protecting the data from the internal threats. In this manner, the forgery is easily detectable and damages to a person’s health can be avoided.
“Residents of Estonia carry smart cards through which they can access over 1000 online government portals to check their health records.”
The Estonian Government is joining hands with a company Guardtime to implement Blockchain. The company has been working with the government since 2011 to secure records. Ten main pharmaceutical agencies – initiated by way of Roche and co-ordinated by the Swedish Association of the Pharmaceutical Industry (LIF) – have partnered with Guardtime to enable the visibility of “real world data” in healthcare with the ultimate intention of realizing outcomes-based contracting. EY, Sensyne Health and Guardtime to use AI and blockchain to link health care reimbursement and actual patient outcomes.
Estonia makes use of blockchain technological know-how to put into effect the integrity of the government data and systems. Estonian Information Systems Authority (RIA) is a crucial provider company for the Government, they guarantee the admission to the blockchain network for the State Agencies via existing digital public service software known as X-Road to create the EHR network. Selected State Registries backed by using the blockchain technologies are: Healthcare Registry, Property Registry, Business Registry, Succession Registry, Digital Court System, Surveillance/Tracking Information System, Official State Announcements, and State Gazette. Estonia is leading the way in the blockchain revolution. Implementation of blockchain has secured certain records, facilitates better healthcare, more environment friendly transactions and empowers the patients.
Application of Blockchain technology in Estonian Healthcare
- Medical practitioners have unlimited access to the patient’s information and allocate the required time for each of their patients.
- The information is immutable and hackers cannot make any changes to information. Hence, the information cannot be tempered.
- A huge volume of records can be put under a secured ledger.
Challenges of Blockchain technology in Estonian Healthcare
- Blockchain technology suffers a security issue due to the past bitcoin breaches. As healthcare data has to be kept very confidential and safety is the primary concern. Break Level index reported 554 million lost or stolen records in the first half of 2016. Security is the major challenge.
- Management and transferring of the data from the existing system to a new system also poses a major problem in the implementation of blockchain. A lot of technology is required in rebuilding the existing data which is very expensive.
- Also, the mindset of people is hard to change for adapting a new technology. Few people were reluctant to get accustomed with the new technology.
“Composed by: Dr. Sunita, Simran Malhotra, Shradha Chandak are the students of International institute of health management Research, Delhi (IIHMR). They are currently pursuing PGDHM in hospital and healthcare management.”