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Digital Discussion: The likelyhood of digitalizing the U.S. healthcare ecosystem

While healthcare digitalization in Europe and the U.S. may be on different levels, the main interoperability and policymaking issues to be resolved are the same.

Our partner and digital healthcare expert, Taavi Einaste, took part in an e-Estonia Digital Discussion on healthcare focusing on the U.S. and Canada.

The former President of the Republic of Estonia, Mr. Toomas Hendrik Ilves, kicked off the event with a keynote encouraging investment in secure digital healthcare systems as the healthcare costs in the U.S. have already risen to 19% of GPD per capita. However, he admitted that there is a significant amount of distrust in digital technologies, which is also perfectly justified considering the importance of privacy and security and the possibility of data leaks and ransomware. Mr. Ilves put forth the Estonian solution to these issues, a broad ecosystem that was established in 2001 and is based on three pillars:

  • a unique, secure personal digital identity for all that can access services using two-factor authentication and end-to-end encryption;
  • a digital data exchange layer;
  • data integrity.

We have been part of building about 40% of e-Estonia, including the digital healthcare ecosystem. In his presentation, Taavi Einaste emphasized that we use one principle across all the domains where we work: we only design and implement user-centric systems. “It’s a principle that is especially important in healthcare, be it patients, medical workers, or other specialists who work in the healthcare sector,” Einaste said.

In a time of crisis, everything gets tested, and so did the Estonian digital healthcare ecosystem. Einaste gave an example of how, amid a Covid pandemic and panic, the Estonian digital healthcare ecosystem flexibly changed, scaled up, and supported the most important – the patients and the doctors.

Einaste also mentioned how Nortal and its partners developed, in just a couple of months, a platform to share COVID test and vaccination data called SimplyGo.

Interoperability on both sides of the Atlantic

In a panel with Mr. Toomas Hendrik Ilves and companies Helmes and Cybernetica, Einaste talked about the possibility of data interoperability in the U.S. He noted that a large share of U.S. healthcare is provided in insurance-created silos. “Some of the silos are very large, it could easily be 30–40 million people, and you have huge discrepancies between the quality of the digital ecosystem of those silos,” Einaste described. “We have very good examples from some of those insurance providers where the data is moving between the patient, the pharmacies, the healthcare providers. The challenge comes the moment you leave that heavenly space and want to go to another provider.”

Taavi Einaste also said there is hope because sometimes technological innovation can help policymakers and industries change. Namely, an interoperability framework called HL7 FHIR has gained a lot of traction on both sides of the Atlantic. “We are seeing major countries following this standard, and we see many of the federal agencies involved in the policymaking for U.S. healthcare embracing the FHIR standard,” he noted. “This enables companies to build solutions that can work on both markets, and that can be an enabler for the policymakers. Because as soon as the technical tools are available, it’s easier for the policymakers to follow through on interoperability as well.”

Watch the whole event here and read more about Nortal’s digital healthcare experience here.

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