‘Looking West’: Estonian IT firms consider the digitisation of US (and Canadian) healthcare

May 2021

by Justin Petrone

freelance journalist and writer

Can Estonian-style digital society really be transposed to a large, federated country like the US?

The answer is apparently yes, or at least Estonian firms welcome the dialogue and want to try. Estonian companies have an extensive background in digitisation efforts at home and abroad. Since the dawn of this century, they have worked hand in glove with the public sector to construct one of the world’s most advanced digital societies. The collaboration has yielded services as diverse as i-Voting and e-Residency. In healthcare, Estonia has gained a reputation for its versatile e-Health solutions, ranging from secure digitised electronic health records to e-prescription services. Now companies in the sector are looking to help US partners make a similar transition.

Eager to partner

Nortal, a digital transformation company headquartered in Tallinn, has been expanding into international markets, particularly throughout Europe, the Middle East, and the US.

In terms of e-Health solutions, it has worked with partners to craft e-services based on secure data exchange, electronic ID, analytics, and privacy. The company has undertaken e-health projects in Estonia, Finland, Germany, and Lithuania. While it has had a US office in Seattle since 2017, it hasn’t yet pursued healthcare-related projects in the North American market, but according to Taavi Einaste, head of digital healthcare at the company, that is likely to change.

“Nortal went to the US market in 2017 and our US presence has grown to more than 200 people, serving Fortune 500 companies mostly,” says Einaste. The company is also eager to serve the adjacent Canadian market and Einaste says Nortal has conducted exploratory workshops with Canadian public sector health authorities recently. “We have provided them with a crash course on Estonian digital health infrastructure and tried to map it to what they were doing,” he says.

A unique moment

The ongoing COVID-19 pandemic has the potential to open doors for Estonian IT companies. As mass vaccination efforts make it possible to reopen public places and restore international travel, authorities are faced with the challenge of managing vaccination certificates or health passports.

“At this unique moment, there is a readiness to change and start making use of health data in digital form at a larger scale,” notes Ain Aaviksoo, CMO of Guardtime Health. Founded in Estonia, Guardtime is now a multinational firm headquartered in Lausanne, Switzerland. Its solutions are based on its KSI blockchain technology, which allows the firm to build zero-trust systems that provide a verifiable mathematical proof of correct operations.

Last year the firm worked to develop VaccineGuard, a vaccination certificate platform that enables management of vaccination campaigns as well as distribution of vaccines. The platform could find use in the US market too, Aaviksoo points out.

“We support coordination of different entities and coordination of vaccine flow through the health system and through the supply chain for higher efficiency and higher quality vaccine management,” says Aaviksoo. “This epidemiological situation will go on for at least the next few years if not forever,” he says. “There needs to be a system which helps to maintain this cross-boundary health information exchange in a privacy-preserving and secure manner.”

Building backbone

Tallinn-based Cybernetica sees the potential for its solutions to make inroads in the US market. Kevin Tammearu, head of business development at the company, notes that its unified exchange platform or UXP can facilitate “user-friendly healthcare services” through interoperability.

“UXP enables seamless data exchange across a trusted ecosystem, including institutions, care teams, and patients,” notes Tammearu. “Time-critical data can also be used securely, increasing overall transparency around medical data,” he says.

Having such a secure data exchange is widely seen as the backbone to any digital transformation, adds Tammearu. “In healthcare, it’s the foundation for integrated health services, leading to a fully interoperable ecosystem and creating new business models.

Like Cybernetica, Helmes, another Estonian IT firm, has decades worth of experience in building that backbone. The company is responsible for Estonia’s e-prescription service, unveiled over a decade ago, now used by most citizens. It also has specialised in developing hospital information systems. That knowledge could be transferred to other countries, even larger, federated ones like the US. “Our main focus is on business efficiency,” says Meelis Lang, vice president of engineering and innovation at Helmes. “Hospitals and clinics tend to have complex software systems with legacy silos causing a lot of wasted work time,” Lang says. “Our expertise is in creating smart service flows that help hospitals to work considerably more efficiently even if they have an info system in place, to begin with.”

New(er)comers

Compared to Helmes and Cybernetica, the Estonian firms Certific and Viveo Health are relative newcomers. Certific CEO Liis Narusk has been leading the firm since last year. Certific’s core offering is a digital platform to certify remote COVID-19 testing. The company’s application manages an individual’s data relating to tests and health certificates issued by a doctor or medical testing provider. Certific is already on the market in the UK offering at-home PCR test verification. Narusk says the firm’s origins stem from the ongoing COVID-19 pandemic.

“It’s easy to go into a lockdown, but how do you get out of it?” she says. “We knew there needed to be a new infrastructure emerging that would enable people to be social again.” Narusk says that Certific would like to be part of this “brave new world opening up” where technology platforms like its own support some return to normalcy.

Viveo Health is not quite as young as Certific, but still at just two years old qualifies as a startup. The company has endeavored to create a global digital health platform, bundling virtual visits, offline clinics, and private insurance into a single offering under the banner of digital health for a billion people. Its platform has experienced rapid uptake in markets like India, where it experiences triple-digit weekly growth.

“Whenever you need a doctor, you just call Viveo and we pretty much act like a concierge service for companies taking care of everything for their employees’ health,” says Gomti Shankar, chief revenue officer at the Tallinn-based company. “You don’t need to file for claims, keep invoices, or make upfront payments.”

Given its acceptance in India, Viveo Health is also keen to break into the US market, Shankar notes, where it seeks both investors and partnerships. “It’s the sheer size of the US,” says Shankar. “The digital health ecosystem in the US is the largest in the world, telemedicine has been there for years,” she says. She also notes that US investors are less conservative than their European counterparts. “In the US you have investors who invest in an idea, a belief,” she says. “All of those things make the US very attractive.”

Join us on June 3 at 12 PM EST (GMT-4)  for e-Estonia Digital Discussion on e-Health. All six companies featured in this article –  Nortal, Guardtime, Cybernetica, Helmes, Certific, and Viveo Health —  will share more about their innovative solutions. Register now by using the following link 👉  https://e-estonia.com/digital-discussions/

Resouce: e-estonia

Estonia’s e-residency programme makes global push

Estonia’s successful e-residency programme is now more accessible to entrepreneurs across the world, thanks to the launch of new collection points in four cities across three continents.

The Estonian government’s hugely successful e-residency programme, the world’s first digital residency initiative, has announced the launch of four new international pick-up points across three continents to accommodate for the increase in entrepreneurs as a result of the Covid-19 pandemic.

The new locations – São Paulo, Bangkok, Singapore and Johannesburg – meet rising demand from local entrepreneurs seeking to scale their businesses internationally and expand into the European market.

E-residents can open an Estonian company within a day and run it remotely, apply for a business banking account and credit card, conduct e-banking, use international payment service providers, declare taxes, and sign documents digitally. E-residency does not provide citizenship, tax residency, physical residency or the right to travel to Estonia or EU.

While anyone can apply for e-residency online, the kit needed to access Estonia’s digital services needs to collected from an approved pick-up point.

With the addition of the new pick-up points, e-residency cards are now available for collection at nearly 50 locations worldwide, and demonstrates Estonia’s continued commitment to empowering freelancers, entrepreneurs, business owners and location-independent workers from around the world.

Borders become meaningless

“Once you have e-residency, borders become meaningless,” says Lauri Haav, e-Residency’s managing director. “But you need to have it first, which is why we needed to open more collection points, especially in those countries in which Estonia does not have embassies. We had to become closer to our audience.”

“Expanding our digital and physical network and empowering businesses is always top of mind for us, and this launch has been in the works for some time. Entrepreneurs, business owners and freelancers from all over the world have so much to offer, and we hope that making the process easier for joining e-residency will encourage more of them to choose us to help grow their companies.”

E-residency was the Estonian government’s first ‘start-up’ and since 2014, the programme has become internationally renowned for revolutionising how governments think about and interact with foreign entrepreneurs.

The e-residency programme now includes over 80,000 digital entrepreneurs. The programme is built on Estonia’s vast of experience of providing digital public services for Estonian citizens.

The launch of four new pick-up points is indicative of the rising number of professional location-independent workers on an international scale, and demonstrates e-Residency’s commitment to increasing accessibility for those residing outside of Europe.

Brazil has the highest number of e-Residency applicants in South America and makes it into the list of top 50 application countries alongside South Africa and Singapore.

The cities of São Paulo, Bangkok, Singapore and Johannesburg also met criteria set out by e-residency which identified the regions as remote working hotspots; havens for start-up founders and borderless professionals that have emerged with increasing speed since the beginning of the Covid-19 pandemic.

“Although the global pandemic has limited our ability to travel, work and do business across borders, it has also accelerated digital transformation among governments, businesses and freelancers alike,” says Kersti Kaljulaid, the Estonian president.

“As more people choose to live and work without remaining tied to one place, there is increasing need for a location-free digital toolbox to support them. As world’s first digitally-transformed state, Estonia is pleased to be welcoming even more freelancers, entrepreneurs, business owners and location-independent workers from around the world to join our e-residency programme.”

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Resource: Emerging Europe

Estonian, Czech parlt speakers talk about ensuring data security in e-state

 2021-05-12 

BNS/TBT Staff

TALLINN – During a video meeting on Wednesday, speaker of the Riigikogu Juri Ratas and the president of the Chamber of Deputies of the Czech Republic, Radek Vondracek, discussed developing of e-governance services and ensuring security in the use of digital data.  

At the beginning of the meeting, Ratas emphasized that Estonia and the Czech Republic enjoy excellent mutual relations, and recalled that this year is a special year in the relations between  the two countries, as they celebrated 100 years since the establishment and 30 years since the re-establishment of diplomatic relations, spokespeople for the Riigikogu said.

Ratas expressed hope that it is possible to do even more in the field of digital cooperation.

The speaker of the Czech parliament noted that their country is interested in developing e-services and in the experiences of the Estonian X-Road.

Ratas talked about the importance of the security of data use, and about cybersecurity in a wider context. He described the participation of the Czech Republic in the NATO Cyber Security Center of Excellence in Tallinn as another good example of fruitful cooperation.

The speaker of the Riigikogu thanked the Czech Republic for their contribution to ensuring the security of our region and for the contribution of Czech troops to NATO’s enhanced Forward Presence in Lithuania. Ratas described the first air policing mission of the Czech Air Force at Amari Air Base as historic, and said that Estonia would be very grateful if the Czech Republic again participated in the Baltic air policing mission.

Ratas invited his Czech counterpart to participate in the Three Seas Parliamentary Forum, which will take place in Estonia in June. Ratas said that since the Three Seas Initiative (3SI) has evolved as a practical cooperation format, it is important to also increase cooperation between parliaments.

“We see an opportunity for the parliaments in facilitating achieving the practical goals of the Three Seas Initiative,” he said. “Wider involvement of parliaments can also add an important contribution to raising the visibility of the format and provides an excellent opportunity to reconfirm the countries’ commitment to the format.”

The speaker of the Czech Chamber of Deputies gave an overview of the latest developments in relations with Russia. Ratas assured his counterpart that Estonia follows the situation closely.

“Estonia has expressed its solidarity and full support to the Czech Republic. We think that with its actions, Russia have manifestly violated Czechia’s sovereignty,” the speaker of the Estonian parliament added.

Resource: Baltic Times

Estonia planning a country-wide digital system to monitor waste management

May 2021

by Helen Wright / ERR News

Truly smart cities deal with everything, even their waste, in a smart way. Plans are being drawn for a fully digital real-time waste management system to cover the whole of Estonia.

Estonia is planning to be the first country in the world with a fully digital real-time monitoring system for waste management which will also help assess people’s garbage sorting behaviour.

The new system will help reduce people’s fears that their carefully sorted garbage is not being taken to the right place. The data will help create new business models of waste management and for companies to better plan their own activities.

As data will be received in real-time, it will be possible to quickly see where problems occur and then fix them. The new system will also be more transparent for the public.

Digitalising the waste movement

Undersecretary of the Ministry of the Environment Kaupo Heinma outlined the plans to ERR.

“When a garbage truck arrives, the movement of waste will be automatically sent to the system, similar to a courier’s movement with a parcel – what went where and when. Similar to how the Marine Traffic app can track the movement of ships and Flight Radar the flights of aircraft. The aim is to digitalise the waste movement as a whole,” he said.

55% of municipal waste to be recycled by 2025

Estonia’s goal is to recycle 55 percent of municipal waste by 2025 and Heinma hopes the waste management system will be digital by then. The first step is to add GPS trackers to garbage trucks to see exactly where garbage is taken and how much.

“We will not only make changes to the law with new, stricter requirements, but we will also make a turnaround in green management,” Heinma said.

Being small helps making big changes easier

The plans will also clearly define what should be done by national and local governments. People’s recycling habits could also be monitored and they could be penalised or incentivised to do more.

“These solutions exist individually in other countries. But Estonia can make this big change because Estonia is so small. It would add a lot to the transparency of waste management and show that it is not a dark place where no one knows what is going on,” Heinma said.

The article was originally published in the Invest in Estonia blog. 

✈️  Can’t travel but want to hear the e-Estonia story or implement e-services in your country or company? Take a look at our services and get in touch – we’ve got you covered!

Resource: e-estonia

10 principles for creating digital public services

May 2021

Everyone wants to create good digital services based on user needs. Unfortunately, knowledge and understanding vary, and so does the quality of services. So what should be kept in mind when developing digital public services?

The Estonian Ministry of Economic Affairs and Communications came up with the basic principles for developing digital services, i.e., the so-called “10 Commandments”. Many people contributed to this – service owners and managers and technology, data protection, cybersecurity, and legal specialists.

1. Identify the user’s actual problem and need

The most important thing to keep in mind when carrying out this command is not to assume that you know. If users are dissatisfied with the service, the problem may lie elsewhere than it seems at first glance. Even if users do not complain about the service, but it fails to create broader value, something may have been overlooked. Perhaps this service solves only a tiny part of the users’ concerns? Are there other parties involved in the service? A solution must never be created until the actual problem and needs are clear. There are several tools and methods you can find in the toolbox to provide this clarity in the near future.

2. Involve innovative people who have varied knowledge in the team

Once the real problem and need have been identified, this knowledge must also be transferred to the level of the institution’s managers. Understanding and support from decision-makers are critical to moving forward. The team should invite the best colleagues and, if possible, help from outside. When assembling a team, we must not forget the main idea of this command: let people with different competencies be involved in searching for a solution from the very beginning. Then no legal nuance is ignored (or changed), and also, the choices made will be the best technologically. You will save yourself the painful experience where the work done has to be redone halfway.

3. Play through the possible solutions and choose the best one

Have the alternatives been considered, and in what way did the chosen solution outweigh the others? This will undoubtedly be asked by decision-makers when an application for IT funding or draft legislation related to the development of services arrives on their desk. Naturally, comparing different solutions and ideas reveals the best. However, it is also vital to remain sensible: assess the costs and benefits and examine whether a similar problem has already been solved. At the same time, you have to be inventive and creative when looking for the best solution, and therefore playfulness is written into this command. By giving freedom of thought, you get rid of the past legacies and can come up with a completely unexpected – but brilliant – idea. But don’t forget to test it with users!

4. When considering solutions, look to the future, too

The world around us, especially the world of technology, is changing rapidly. If the solution is made thinking of tomorrow only, the service may be out of date the day after tomorrow. Therefore, it is essential to consider general trends and broader changes and consider innovative technological solutions. A team with diverse knowledge and innovative mindset has good prerequisites for this, and the toolbox can offer fresher methodological help. One thing to keep in mind when implementing this command is that we cannot anticipate all changes, and when planning the so-called future, we must also think about change management.

5. Create a necessary and easy service

The most important thing to remember here is that the service must be necessary and easy for users in particular. If the work of public institutions becomes easier and less costly at the same time, it will undoubtedly be an added value. It is important not to copy the logic of the paper world into digital services – neither in the view of the user nor in the view of the official. Saving the user from submitting the same data (once-only policy), providing services (proactivity), automation and event-basedness are the keywords. If data protection and cybersecurity requirements are not forgotten, the service will be reliable and straightforward.

6. Develop the service with users and other parties

It is necessary to work closely with others if the service being developed is part of a set of services related to a life or business event, i.e., it is part of an event service. But not only that. Cooperation should be a matter of course in the development of all services. The users of the service give valuable feedback both when planning developments and throughout the process. Representatives of the private sector and civil society are ready to contribute their time and good ideas. The involvement of other authorities is essential to avoid duplication or overly diverse solutions and when the development of a good service is hampered by outdated legislation in another area.

7. Ensure interoperability, reuse existing ones, and open your creation to others

The peculiarity and strength of Estonia is the information system of our state. We have technological solutions and a legal environment that allows data to be exchanged and reused securely. In addition, solutions have been created – such as an authentication service – that is for everyone’s use and do not have to be developed separately for each information system. All this makes the life of the service users easier and saves costs. Assuming that the interoperability requirements of information systems should be followed and no duplicate developments made. You must also pay attention to the other side of this command and allow others to use your own software (code, reusable components) and data, including the open data.

8. Work agilely

The word agile is not in Estonian and is used mainly in IT developments, but we found that it conveys the meaning best when formulating the command. It is essential not to take too big of a “bite” when developing services but to move to the final solution in small steps, each of which creates new value for the user. Moving gradually ensures flexibility, especially if during testing of the solution feedback from users reveals that the original goals need to be changed. This should not be considered a failure, as the necessary changes can be made quickly and without higher costs. Lessons learned, as well as successes, should be shared.

9. Create and keep the service secure and transparent

Data protection and cybersecurity risk assessments and the protection measures proposed based on them must have a place in developing digital services. Risks need to be assessed throughout the life cycle of the service, including, in particular, when introducing new technologies. The Estonian public sector has been a reliable custodian and user of data, and this trust must not only be maintained but also increased. In addition, people need to have a clear understanding and ability to control how and for what purpose their data is used. The service process must also be understandable and transparent to all parties.

10. Run your own service

Work on the service does not end when the users’ needs are known and the prototype of the solution is made. Work on the service will not end even if the developments are completed and the service goes live, i.e., it is open to users. Service management is a cyclical activity, which means that it is necessary to monitor how the service works, whether users still reach it and are satisfied with the latest developments, the expected change, etc. Sometimes it is necessary to start over, and sometimes – if the service (no longer) fulfills its goals – end providing it instead. The service manager or “owner” is responsible for the quality of the service until the end of its life cycle.

✈️  Can’t travel but want to hear the e-Estonia story or implement e-services in your country or company? Take a look at our services and get in touch – we’ve got you covered!

Resource: e-estonia