[{"data":1,"prerenderedAt":325},["ShallowReactive",2],{"slug-digital-healthcare-in-estonia":3},{"post":4,"relatedPosts":191,"relatedBooks":324},{"id":5,"date":6,"date_gmt":7,"guid":8,"modified":10,"modified_gmt":11,"slug":12,"status":13,"type":14,"link":15,"title":16,"content":18,"excerpt":21,"author":23,"featured_media":24,"comment_status":25,"ping_status":25,"sticky":26,"template":27,"format":28,"meta":29,"categories":30,"tags":33,"project_category":51,"contact_email_category":52,"yst_prominent_words":53,"class_list":63,"better_featured_image":89,"acf":126,"yoast_meta":135,"_links":138},23938,"2019-05-16T19:14:40","2019-05-16T17:14:40",{"rendered":9},"https:\u002F\u002Fmedicalfuturist.com\u002F?post_id=23938&_wpnonce=9c6d0a753c&status=auto-draft&type=post","2023-02-22T17:38:11","2023-02-22T16:38:11","digital-healthcare-in-estonia","publish","post","https:\u002F\u002Fmedicalfuturist.com\u002Fdigital-healthcare-in-estonia",{"rendered":17},"Healthcare In Estonia: Where Grandmas Go For Genetic Data",{"rendered":19,"protected":20},"\n\u003Ctable style=\"width: 100%; border-collapse: collapse; background-color: #eee; border-top: 4px solid #444;\" cellpadding=\"5px\">\n\u003Ctbody>\n\u003Ctr>\n\u003Ctd style=\"width: 100%;\">\n\u003Cp style=\"color: #555;font-size: 12px;line-height: 14px\">THIS ARTICLE HAS NOT BEEN UPDATED SINCE 2019. THE INFORMATION SHARED IN THE ARTICLE WAS ACCURATE AT THE TIME OF ITS PUBLICATION, BUT IT MAY BE OUT OF DATE NOW. \u003Ca href=\"https:\u002F\u002Fmedicalfuturist.com\u002Fmagazine\">BROWSE OUR LATEST ARTICLES HERE\u003C\u002Fa>\u003C\u002Fp>\n\u003C\u002Ftd> \u003C\u002Ftr>\u003C\u002Ftbody>\u003C\u002Ftable>\n\n\n\n\u003Cp>Imagine a country where citizens will have their genetic profiles integrated into the digital health system with individual risk scores and pharmacogenomic information, so when they go to the doctor, they will get fully personalized, genetic risk-based diagnosis, medication, and preventive measures. That’s where healthcare in Estonia will arrive soon. They started to build their digital health system 20 years ago, and within the next years, the Baltic country will start to reap the benefits of a transparent, blockchain-based, digital health system hooked on genetic data. The first fully digitized republic certainly sets the direction for other countries to follow. Pay attention, deep dive alert!\u003C\u002Fp>\n\n\n\n\u003Ch2 class=\"wp-block-heading\">\u003Cstrong>The common denominator of President, youngsters, and\ngrandmas? Genetic testing\u003C\u002Fstrong>\u003C\u002Fh2>\n\n\n\n\u003Cp>\u003Cstrong>“\u003Cem>Twenty percent of Estonians will have used\nour DNA analysis service by the end of this year and know which diseases they\nare susceptible to and how they can take appropriate precautions. I have an\nincreased risk of Type 2 diabetes, as I know from my analysis. So I will avoid\nbeing overweight\u003C\u002Fem>”, said \u003C\u002Fstrong>\u003Ca href=\"https:\u002F\u002Fwww.spiegel.de\u002Finternational\u002Fbusiness\u002Festonian-president-kersti-kaljulaid-our-government-is-more-innovative-a-1264358.html\">\u003Cstrong>Estonian\nPresident Kersti Kaljulaid in a recent\ninterview\u003C\u002Fstrong>\u003C\u002Fa>\u003Cstrong>\ngiven to the German Spiegel magazine\u003C\u002Fstrong>. That’s not political\ncampaigning, but the Estonian digital health system in action, urging any\ncitizen of the small Baltic country over 18 no matter how old to have their genetic\ndata analyzed.\u003C\u002Fp>\n\n\n\n\u003Cp>Why would an elderly person care about the latest “young people’s craze”, this time parading as the key to the secrets of their DNA? A 75-year-old lady from Tallinn told The Medical Futurist that at first she also thought that she was too old for this and doesn’t need it, but she still decided to do the genetic screening in the end for various reasons. As in Estonia, the government has been supporting gynecological screening tests, she said she was lucky enough to have her breast cancer diagnosed 15 years ago in a very early stage. She had an operation to remove the tumor, her breast could be saved, and she was followed up for the next 13 years to avoid any recurrence. “\u003Cem>Our family has a history with breast cancer for generations, so my daughter asked me to do the genetic screening. She has two daughters and my son also has two. It’s good to gain some information what risks we carry from our female line, how to pay attention and how often to go for control screenings. Now, we are waiting for the results, which they said will be ready within the next year\u003C\u002Fem>”, the woman added. Based on the genetic test, she hopes that it will be easier to take care of her entire family.\u003C\u002Fp>\n\n\n\n\u003Cp>Another Estonian woman, a 20-something currently studying for her masters at Central European University in Budapest, also said that the prospective benefits for her future health were a motivator in allowing her DNA to be analyzed; however, she mainly did it for the sake of advancing science. She mentioned that last year Estonia celebrated its hundredth anniversary of independence, and every institution had a special gift to the country – in a way, hand-in-hand with the government, the \u003Ca href=\"https:\u002F\u002Fwww.geenivaramu.ee\u002Fen\">Estonian Genome Center\u003C\u002Fa> presented 100,000 Estonians with free genetic analysis. Let’s stop here for a moment. \u003Cstrong>How do you explain that the government of a Baltic country of 1.3 million people gifts citizens with voluntary DNA screening as a grandiose gesture on the occasion of its “birthday” – instead of simply unveiling statues or building stadiums? How did they get here?\u003C\u002Fstrong>\u003C\u002Fp>\n\n\n\n\u003Cfigure class=\"wp-block-image\">\u003Cimg loading=\"lazy\" decoding=\"async\" width=\"512\" height=\"288\" src=\"https:\u002F\u002F1712507217.rsc.cdn77.org\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002FEstonia-digital-health-512x288.jpg\" alt=\"healthcare in Estonia\" class=\"wp-image-23939\" srcset=\"https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002FEstonia-digital-health-512x288.jpg 512w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002FEstonia-digital-health-370x208.jpg 370w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002FEstonia-digital-health-768x432.jpg 768w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002FEstonia-digital-health.jpg 1280w\" sizes=\"auto, (max-width: 512px) 100vw, 512px\" \u002F>\u003Cfigcaption class=\"wp-element-caption\">Source: www.youtube.com\u003C\u002Ffigcaption>\u003C\u002Ffigure>\n\n\n\n\u003Ch2 class=\"wp-block-heading\">\u003Cstrong>How did Estonians start to embrace personalized\nmedicine?\u003C\u002Fstrong>\u003C\u002Fh2>\n\n\n\n\u003Cp>While most countries have realized the power of\ndigital health technologies as well as genetics and genomics on a systemic\nlevel in the last 3-5 years, Estonia was a real early bird. “\u003Cem>I remember the end of the 1990s when I was a\nconsultant to the then-prime minister. As a small and then still very poor\ncountry, we realized that our opportunities lay in two megatrends — IT and\ngenetics. So we set up the Estonian Genome Foundation with startup funding of 3\nmillion euros ($3.3 million) to improve the health of our population and reduce\ncosts\u003C\u002Fem>”, explained Kaljulaid. Of course, that sounds easier than done.\u003C\u002Fp>\n\n\n\n\u003Cp>However, as a starting point, it’s not a disadvantage\nif you have a \u003Ca href=\"https:\u002F\u002Fwww.newyorker.com\u002Fmagazine\u002F2017\u002F12\u002F18\u002Festonia-the-digital-republic\">digital democracy\u003C\u002Fa>. During the last, approximately twenty years, project\ne-Estonia has wired up the entire Baltic nation. The normal services that the\ngovernment is involved with, legislation, voting, education, justice, banking,\ntaxes, policing, and, naturally, healthcare, have been digitally linked across\none platform, X-Road. Citizens can vote through their laptops, sign contracts\nwith their digital signature, or use their chip-IDs when surfing around in the\nbusiness and land registry – knowing that their data is secured through the\nblockchain and open to everyone. By having \u003Ca href=\"https:\u002F\u002Fwww.spiegel.de\u002Finternational\u002Fbusiness\u002Festonian-president-kersti-kaljulaid-our-government-is-more-innovative-a-1264358.html\">78.1 percent of public bureaucracy digitized\u003C\u002Fa>, the country also saves around 2 percent of its gross\ndomestic product.\u003C\u002Fp>\n\n\n\n\u003Cp>\u003Cstrong>In the last 20 years, healthcare went through a similarly astronomical transformation. Many factors had to be put in place to offer a trustworthy, safe, and efficient healthcare system for citizens, pointing in the direction of personalized, preventive medicine based on DNA analyses – and approximately twenty years after the start, the process is still in the making\u003C\u002Fstrong>.\u003C\u002Fp>\n\n\n\n\u003Cp>“\u003Cem>Already towards the end of the 90s, we started to do digital billing, but the proper transformation to a digital system began at the beginning of the 21\u003Csup>st\u003C\u002Fsup> century. In 2008, we launched the national EHR, two years later we added digital prescriptions, another two years went by, and we included e-consultations. In 2015, e-ambulances were introduced, and a drug interaction decision support system was launched in 2017. So, it’s been a continuous journey\u003C\u002Fem>”, told Priit Tohver, Junior Doctor and Digital Services Advisor at the Ministry of Social Affairs in Estonia to The Medical Futurist. And that’s still not the end-point of that journey – and before you say that you can never reach such an absolute, let’s just take a look at the direction where Estonia wants to go.\u003C\u002Fp>\n\n\n\n\u003Cfigure class=\"wp-block-image\">\u003Cimg loading=\"lazy\" decoding=\"async\" width=\"512\" height=\"288\" src=\"https:\u002F\u002F1712507217.rsc.cdn77.org\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002FDigital-Prescription-512x288.jpg\" alt=\"healthcare in Estonia\" class=\"wp-image-23940\" srcset=\"https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002FDigital-Prescription-512x288.jpg 512w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002FDigital-Prescription-370x208.jpg 370w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002FDigital-Prescription-768x432.jpg 768w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002FDigital-Prescription.jpg 1280w\" sizes=\"auto, (max-width: 512px) 100vw, 512px\" \u002F>\u003Cfigcaption class=\"wp-element-caption\">Digital Prescription In Operation. Source: www.youtube.com\u003C\u002Ffigcaption>\u003C\u002Ffigure>\n\n\n\n\u003Ch2 class=\"wp-block-heading\">\u003Cstrong>Personalized,\nanalytic and close to the patient\u003C\u002Fstrong>\u003C\u002Fh2>\n\n\n\n\u003Cp>\u003Cstrong>The Estonian e-Health vision 2025 sums up the efforts in a rather short, but powerful four-word-sentence: “\u003Cem>better information – more health\u003C\u002Fem>”. That means the Baltic country is striving to collect high-quality data in a secure and transparent way about the past, present and genetically predictable future health state of patients in a highly personalized way through staying in close proximity. \u003C\u002Fstrong>\u003C\u002Fp>\n\n\n\n\u003Cp>One of the most important goals of the Estonian healthcare\nsystem is to build an ecosystem where genetic data-based, personalized and\npreventive solutions are at the center. The personalized medicine project has\nalready been ongoing since 2002, the foundation of the Estonian Genome Center, but\nit is going to take years and years to fully reap its benefits, remarked Priit\nTohver. As with other big data-based projects, the more data you have, the\nhigher precision and better solutions could be reached. Now, approximately 10\npercent of the population has their genetic data in the Estonian biobank, and\nthat number will reach 20 percent or even more by the end of this year, added\nTonu Esko, Vice Director of the Estonian Genome Center. He added that since\n1,500 people join the Estonian biobank every single week, he hopes that the\nentire population’s genetic profile can be drawn up within the next ten years,\nor even the next 5-7 years. \u003C\u002Fp>\n\n\n\n\u003Cp>In line with strengthening genetic capabilities, “\u003Cem>data analytics has to take on a much bigger\nrole in the future, which means that we will have more feedback from treatments\nand we become a ‘learning health ecosystem’ essentially, continuously analyzing\nwhat we’ve done, how that’s worked and how we can do better\u003C\u002Fem>”, explained\nPriit Tohver. He added that artificial intelligence and machine learning will also\nassume a much more significant aspect, especially sustainable automation. \u003C\u002Fp>\n\n\n\n\u003Cp>All the while, the third keyword for the future Estonian system would be ‘remote’ or ‘community-based’. Data analytics, genetics\u002Fgenomics, and digital health technologies enable healthcare services to move close to the patient – and that’s also what the Baltic country aims to do through telehealth services and taking special care of the elderly who don’t want to go to the hospital, but rather stay home – with the assurance that someone will look after them. This attitude also strengthens the proactive patient approach and gently pushes people into the direction of taking care of their own health and preventing diseases – while the healthcare system only steps forward in case of emergencies.\u003C\u002Fp>\n\n\n\n\u003Cfigure class=\"wp-block-image\">\u003Cimg loading=\"lazy\" decoding=\"async\" width=\"512\" height=\"288\" src=\"https:\u002F\u002F1712507217.rsc.cdn77.org\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002FEstonian-healthcare-system-512x288.jpg\" alt=\"healthcare in Estonia\" class=\"wp-image-23941\" srcset=\"https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002FEstonian-healthcare-system-512x288.jpg 512w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002FEstonian-healthcare-system-370x208.jpg 370w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002FEstonian-healthcare-system-768x432.jpg 768w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002FEstonian-healthcare-system-1536x864.jpg 1536w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002FEstonian-healthcare-system.jpg 1600w\" sizes=\"auto, (max-width: 512px) 100vw, 512px\" \u002F>\u003Cfigcaption class=\"wp-element-caption\">Source: www.qz.com\u003C\u002Ffigcaption>\u003C\u002Ffigure>\n\n\n\n\u003Ch2 class=\"wp-block-heading\">\u003Cstrong>How\ncan Estonia finance the genetic analysis for 100,000 people?\u003C\u002Fstrong>\u003C\u002Fh2>\n\n\n\n\u003Cp>For a layperson, it might seem that beyond\nstrengthening the digital technological side, one of the costliest measures of\nthe Estonian government must have been the providing of free genetic analysis\nfor hundreds of people. Although you can order a genetic test online already\nfrom around 100 dollars, that’s only for certain genes and certain conditions, \u003Ca href=\"https:\u002F\u002Fmedicalfuturist.com\u002Fhow-could-genomics-bring-precision-medicine-to-healthcare\">whole\ngenome sequencing, the process of mapping out your entire genome with each base\npair and ten thousands of data points, costs around 500-1,000 dollars\u003C\u002Fa>.\u003C\u002Fp>\n\n\n\n\u003Cp>As Tonu Esko told The Medical Futurist, Estonia uses the \u003Ca href=\"https:\u002F\u002Fwww.illumina.com\u002Ftechniques\u002Fmicroarrays\u002Fhuman-genotyping.html\">technology of genotyping with arrays\u003C\u002Fa>. That means that they have done 3,000 full genome sequences for the Estonian population and they use that as a reference genome. So, the next 150,000 samples could get genotyped so that they get around 800,000 different loci in the genome, which will differ for everyone, and then the missing data gets imputed from the reference genome. This way the cost of sequencing can fall from 1,000 to 1,00 dollars. Moreover, it’s a cost-efficient way to identify carriers of mutations that can increase the risk, for example, for hereditary breast cancer, sudden death syndrome, Alzheimer’s, or Parkinson’s disease.\u003C\u002Fp>\n\n\n\n\u003Cfigure class=\"wp-block-image\">\u003Cimg loading=\"lazy\" decoding=\"async\" width=\"512\" height=\"288\" src=\"https:\u002F\u002F1712507217.rsc.cdn77.org\u002Fwp-content\u002Fuploads\u002F2018\u002F10\u002F044_genomics-512x288.png\" alt=\"genomic data\" class=\"wp-image-22219\" srcset=\"https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F10\u002F044_genomics-512x288.png 512w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F10\u002F044_genomics-370x208.png 370w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F10\u002F044_genomics-768x432.png 768w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F10\u002F044_genomics.png 870w\" sizes=\"auto, (max-width: 512px) 100vw, 512px\" \u002F>\u003C\u002Ffigure>\n\n\n\n\u003Ch2 class=\"wp-block-heading\">\u003Cstrong>Precision medicine based on genetics\u003C\u002Fstrong>\u003C\u002Fh2>\n\n\n\n\u003Cp>\u003Cstrong>In a population, approximately 5. 5 percent of the people carry high-impact mutations, so out of the 1.3 million it’s around 60,000 people that the Estonian Genome Center plans to identify and then take preventive measures, explained Tonu Esko. \u003C\u002Fstrong>Taking a closer look at diseases where precision medicine could be a game changer, the mentioned conditions, \u003Ca href=\"https:\u002F\u002Fmedicalfuturist.com\u002Fprecision-medicine-best-hope-fight-cancer\">cancer care\u003C\u002Fa>, and rare disease treatments seem to be at the forefront.\u003Cstrong> While Estonia has been doing research on breast cancer and cardiovascular diseases as well, the main focus is gradually shifting towards complex diseases. As Priit Tohver noted, “\u003Cem>that’s going to be a major contributor to how we move forward because this hasn’t been done anywhere in the world\u003C\u002Fem>”, so now they are experimenting with it before applying it on a bigger scale. \u003C\u002Fstrong>\u003C\u002Fp>\n\n\n\n\u003Cp>What\ndoes it mean in practice? Take, for example, the disease called familial\nhypercholesterolemia, where people have very high levels of cholesterol from an\nearly age. It’s a heritable trait and can be detected by genomic data. Moreover,\nif you diagnose someone with the condition, and they start lowering their\ncholesterol level, they have a very good chance of survival. Instead of ending\nup with a stroke at 25 out of the blue, the person could reach old age through\nhealth management. So, the Estonian Genome Center conducted a study where they\nlooked both for people who might have this risk and also for their relatives. They\nended up with a group of about 50 people – 7 percent of whom had a diagnosis for\nfamilial hypercholesterolemia. The researchers ran all the gold standard tests\non them, and at the end of it, 93 percent had a diagnosis for the condition.\nNow, that’s a huge jump based on genetic data alone. \u003C\u002Fp>\n\n\n\n\u003Cp>However, not only the risks for high-impact mutations will be mapped out, but also the Estonian Genome Center plans to construct polygenic risk scores or risk profiles for every single disease – in case of every single Estonian citizen, explained Tonu Esko. Moreover, they want to integrate it into the electronic health record system so that every time a patient goes to the doctor, the physician will see the individual disease risk score in the EHR. That’s the way the Estonian healthcare system will move from reaction to prevention and early detection of diseases.\u003C\u002Fp>\n\n\n\n\u003Cfigure class=\"wp-block-image\">\u003Cimg loading=\"lazy\" decoding=\"async\" width=\"512\" height=\"345\" src=\"https:\u002F\u002F1712507217.rsc.cdn77.org\u002Fwp-content\u002Fuploads\u002F2018\u002F10\u002FGenomic-Big-Data-min-512x345.jpg\" alt=\"genomic data\" class=\"wp-image-22213\" srcset=\"https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F10\u002FGenomic-Big-Data-min-512x345.jpg 512w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F10\u002FGenomic-Big-Data-min-768x517.jpg 768w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F10\u002FGenomic-Big-Data-min.jpg 870w\" sizes=\"auto, (max-width: 512px) 100vw, 512px\" \u002F>\u003Cfigcaption class=\"wp-element-caption\">Source: https:\u002F\u002Fblogs.technet.microsoft.com\u002F\u003C\u002Ffigcaption>\u003C\u002Ffigure>\n\n\n\n\u003Ch2 class=\"wp-block-heading\">\u003Cstrong>Pharmacogenomics and the promise of personalized\npainkillers\u003C\u002Fstrong>\u003C\u002Fh2>\n\n\n\n\u003Cp>Another strand in personalized medicine aims to revolutionize how we think about medication. \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC2014592\u002F\">Pharmacogenomics\u003C\u002Fa> deals precisely with this issue area. It is defined as the study of variability in drug response due to the genetic code. It argues that despite general sentiments, medications do not have the same effect on people. There are already some who expressly recommend genetic testing before any prescription of, e.g. Warfarin, a type of anti-blood clotting drug takes place.\u003C\u002Fp>\n\n\n\n\u003Cp>Some Estonians already have the sense that painkillers in personalized doses could be the next step. The CEU-student we interviewed mentioned that she heard about some research on options to prescribe medicine in personalized ways since, as far as she understood, the same medicine has a different impact on different individuals. She believed that would be a useful trend to pursue. Priit Tohver said that currently, at the point of prescribing, the physician gets a warning if they are prescribing something that might have an interaction with another medicine that the patient is taking. Based on this warning, they may decide to change the medicine. \u003C\u002Fp>\n\n\n\n\u003Cp>\u003Cstrong>With a pharmacogenomic layer, medical professionals would not only be receiving warnings if they’re prescribing something for potential substance interactions but they would also be getting a warning if the medicine they’re prescribing somehow interacts with the genetics of that person. He added that this is going to be one of the first use cases in the personalized medicine project, so the pharmacogenomic application is only some years away in Estonia. \u003C\u002Fstrong>\u003C\u002Fp>\n\n\n\n\u003Cfigure class=\"wp-block-image\">\u003Cimg loading=\"lazy\" decoding=\"async\" width=\"512\" height=\"288\" src=\"https:\u002F\u002F1712507217.rsc.cdn77.org\u002Fwp-content\u002Fuploads\u002F2018\u002F11\u002F053-pharmacogenomics-512x288.png\" alt=\"pharmacogenomics\" class=\"wp-image-22433\" srcset=\"https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F11\u002F053-pharmacogenomics-512x288.png 512w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F11\u002F053-pharmacogenomics-370x208.png 370w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F11\u002F053-pharmacogenomics-768x432.png 768w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F11\u002F053-pharmacogenomics.png 870w\" sizes=\"auto, (max-width: 512px) 100vw, 512px\" \u002F>\u003C\u002Ffigure>\n\n\n\n\u003Ch2 class=\"wp-block-heading\">\u003Cstrong>The\nfoundations of a strong digital health system: the blockchain…\u003C\u002Fstrong>\u003C\u002Fh2>\n\n\n\n\u003Cp>\u003Cstrong>How come that the Estonian citizens are willing and eager to give their most personal data, their health, and genetic information into the hands of the state voluntarily? Are they not aware of the privacy risks or not worried that someone could steal the data and misuse it? The answer is that the government created such a regulatory framework alongside with technologies of trust that make the average citizen believe that their data is in safe hands.\u003C\u002Fstrong>\u003C\u002Fp>\n\n\n\n\u003Cp>Blockchain-based technology is just one, although a very important element in the system. In March 2017, the Baltic country’s \u003Ca href=\"http:\u002F\u002Fpwc.blogs.com\u002Fhealth_matters\u002F2017\u002F03\u002Festonia-prescribes-blockchain-for-healthcare-data-security.html\">eHealth Authority signed a deal\u003C\u002Fa> with \u003Ca href=\"https:\u002F\u002Fguardtime.com\u002F\">Guardtime\u003C\u002Fa>, an Estonian company developing K.S.I. blockchain technology, to secure the health records of Estonians. When The Medical Futurist asked Ivo Lohmus from Guardtime \u003Ca href=\"https:\u002F\u002Fmedicalfuturist.com\u002Fwhat-the-hell-is-blockchain-what-does-it-mean-for-healthcare-and-pharma\">to explain how the blockchain works\u003C\u002Fa>, he said it is to be imagined as a shared book of records, or in more technical terms, a distributed database that’s designed in such a smart way that whatever is added to this database, that’s immutable. As if it’s carved into stone. What makes it more secure is that the blockchain does not directly deal with the data. Through the cryptographic process, a unique identifier, a hash, is created, which functions similarly to the biological fingerprint. While you can identify anyone based on his or her fingerprint, you cannot “reconstruct” the whole person.\u003C\u002Fp>\n\n\n\n\u003Cfigure class=\"wp-block-image\">\u003Cimg loading=\"lazy\" decoding=\"async\" width=\"512\" height=\"288\" src=\"https:\u002F\u002F1712507217.rsc.cdn77.org\u002Fwp-content\u002Fuploads\u002F2018\u002F03\u002Fblockchain-in-healthcare-512x288.png\" alt=\"digital health trends\" class=\"wp-image-17555\" srcset=\"https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F03\u002Fblockchain-in-healthcare-512x288.png 512w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F03\u002Fblockchain-in-healthcare-370x208.png 370w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F03\u002Fblockchain-in-healthcare-768x432.png 768w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F03\u002Fblockchain-in-healthcare-444x250.png 444w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F03\u002Fblockchain-in-healthcare.png 870w\" sizes=\"auto, (max-width: 512px) 100vw, 512px\" \u002F>\u003C\u002Ffigure>\n\n\n\n\u003Ch2 class=\"wp-block-heading\">\u003Cstrong>…secure identities, laws, checks and\nbalances = general trust\u003C\u002Fstrong>\u003C\u002Fh2>\n\n\n\n\u003Cp>Priit Tohver added that beyond the blockchain, it’s also the question of having secure identities. Estonia has the ID card, the mobile ID, and the smart ID, which means that every piece of data has the citizen’s identifier on it, so they digitally sign or stamp every piece of data that the central health services gather in the e-health system. That means the patient can always know where the data is coming from, and you also know that this data cannot be tampered with because that would tamper with the digital sign or stamp.\u003C\u002Fp>\n\n\n\n\u003Cp>Moreover, \u003Cstrong>attempted data breach or misuse has consequences. Both Ivo Lohmus and Priit Tohver mentioned that in some cases, nurses or doctors looked up health data for patients – in one case a famous person’s health information – that they were not supposed to look at. As the system logs every access, their actions immediately became visible (even the patient can view the logs on their patient portal having full access to their data) – and they were fired from their respective medical institutions within a short period of time or got fined.\u003C\u002Fstrong>\u003C\u002Fp>\n\n\n\n\u003Cp>The Estonian constructors of the new digital system were also very thoughtful when it came to establishing the regulatory and legal framework. Tonu Esko said that in 2000, the Estonian parliament approved the \u003Ca href=\"https:\u002F\u002Fwww.riigiteataja.ee\u002Fen\u002Feli\u002F531102013003\u002Fconsolide\">Human Genes Research Act\u003C\u002Fa> that regulates genetic research, the activities of the biobank, but more importantly, it protects the citizens against any discrimination by their employer, by health insurance or law enforcement units. That means if any Estonian learns that they carry an Alzheimer or Parkinson’s disease mutation, an employer or a health insurance company doesn’t have the right to know that, or in case of getting this information in any legal way, it’s illegal to discriminate on this basis – to change risk scores or employer status, for example. \u003C\u002Fp>\n\n\n\n\u003Cp>In light of rec\u003Ca href=\"https:\u002F\u002Fwww.wndu.com\u002Fcontent\u002Fnews\u002FLife-insurance-company-to-require-health-trackers-493876661.html\">ent efforts of insurance companies to include fitness tracker data into their policies\u003C\u002Fa> to incentivize healthy lifestyles, it’s easy to see how that might be stretched to genetic information and be turned around. Thus, Estonia aims to go against insurance Big Brother before it shapes up.\u003C\u002Fp>\n\n\n\n\u003Cfigure class=\"wp-block-image\">\u003Cimg loading=\"lazy\" decoding=\"async\" width=\"512\" height=\"288\" src=\"https:\u002F\u002F1712507217.rsc.cdn77.org\u002Fwp-content\u002Fuploads\u002F2018\u002F09\u002FBlockchain-and-healthcare-512x288.jpg\" alt=\"digital health\" class=\"wp-image-21738\" srcset=\"https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F09\u002FBlockchain-and-healthcare-512x288.jpg 512w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F09\u002FBlockchain-and-healthcare-370x208.jpg 370w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2018\u002F09\u002FBlockchain-and-healthcare.jpg 640w\" sizes=\"auto, (max-width: 512px) 100vw, 512px\" \u002F>\u003Cfigcaption class=\"wp-element-caption\">Source: www.nashvillepost.com\u003C\u002Ffigcaption>\u003C\u002Ffigure>\n\n\n\n\u003Ch2 class=\"wp-block-heading\">\u003Cstrong>Not everything’s nice and shiny\u003C\u002Fstrong>\u003C\u002Fh2>\n\n\n\n\u003Cp>However, before you would totally immerse yourself in a land with perfect digital healthcare, we have to disappoint you – it’s not all nice and shiny in the Baltic country either. The global phenomenon that hits hard every country, did not avoid Estonia either. The 75-year-old lady from Tallinn told us how negatively the population is affected by the increasing lack of physicians. Many \u003Ca href=\"https:\u002F\u002Fwww.politico.eu\u002Farticle\u002Fdoctors-nurses-migration-health-care-crisis-workers-follow-the-money-european-commission-data\u002F\">doctors migrate to Sweden or Finland to work as the salary is 3-4 times higher\u003C\u002Fa>, while the Finnish doctor shortage is also significant, so there’s a demand for highly skilled physicians there too.\u003C\u002Fp>\n\n\n\n\u003Cp>The 75-year-old said that the lack of medical professionals is really painful in the case of family doctors, especially in the countryside. Practices in small villages and towns are not particularly popular among primary care physicians, as it is more difficult to fill up the practice with patients so that their income would make it worth to move there. In addition, the lack of physicians does not only show in the primary care sector, but also when it comes to specialists. If someone wants to get an appointment to a specialist but doesn’t arrange it through the family doctor, the waiting period can reach even two months, she added.\u003C\u002Fp>\n\n\n\n\u003Cp>Although the e-prescription services started to unburden the family doctors as patients don’t have to “run” to them every single time they have their prescription medication refilled, \u003Cstrong>it seems that even in a highly forward-looking and digitized democracy, such as Estonia, it takes time and effort to find the most efficient ways to counter the problems of doctor shortages, brain-drain and remote practices. We hope that in the next years, artificial intelligence, automation, genetics-based personalized medicine and other technologies of scale will also offer viable solutions to such problems. If a digital democracy cannot find the way, we don’t know who can. \u003C\u002Fstrong>\u003C\u002Fp>\n\n\n\n\u003Ctable style=\"width: 100%; border-collapse: collapse; background-color: #eee; border-top: 4px solid #444;\" cellpadding=\"10px\">\n\u003Ctbody>\n\u003Ctr>\n\u003Ctd style=\"width: 100%;\">\n\u003Cp>\u003Cstrong>At The Medical Futurist, we are building a community for making a bold vision about the future of healthcare reality today.\u003C\u002Fstrong>\u003C\u002Fp>\n\u003Ciframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\u002F\u002Fwww.youtube.com\u002Fembed\u002FFIbMejImnxs\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\">\u003C\u002Fiframe>\n\u003Cp>If you’d like to support this mission, we invite you to \u003Ca href=\"https:\u002F\u002Fwww.patreon.com\u002Fthemedicalfuturist\">join The Medical Futurist Patreon Community\u003C\u002Fa>. A community of empowered patients, future-oriented healthcare professionals, concerned health policymakers, sensible health tech developers, and enthusiastic medical students. If there were ever a time to join us, it is now. Every contribution, however big or small, powers our research and sustains our future.\u003C\u002Fp>\n\u003Cp>\u003Ca href=\"https:\u002F\u002Fwww.patreon.com\u002Fthemedicalfuturist\">\u003Cstrong style=\"background-color: #e71d3299; color: #000;\">Click here to support The Medical Futurist from as little as $3\u003C\u002Fstrong>\u003C\u002Fa> – it only takes a minute. Thank you.\u003C\u002Fp>\n\u003C\u002Ftd>\n\u003C\u002Ftr>\n\u003C\u002Ftbody>\n\u003C\u002Ftable>\n\u003Cp> \u003C\u002Fp>\n",false,{"rendered":22,"protected":20},"\u003Cp>Imagine a country where citizens will have their genetic profiles integrated into the digital health system with individual risk scores and pharmacogenomic information, so when they go to the doctor, they will get fully personalized, genetic risk-based diagnosis, medication, and preventive measures. That’s where healthcare in Estonia will arrive soon.\u003C\u002Fp>\n",6,23942,"closed",true,"","standard",{"_acf_changed":20,"footnotes":27},[31,32],521,800,[34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50],608,206,207,820,246,824,260,1336,262,1337,271,1338,275,1339,353,1340,355,[],[],[54,55,56,57,58,59,60,61,62],1571,1617,1681,1693,1883,1969,3825,5475,5477,[64,14,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88],"post-23938","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-future-medicine","category-healthcare-policy","tag-precision-medicine","tag-digital","tag-digital-health","tag-pharmacogenomics","tag-future","tag-digital-health-strategy","tag-genetics","tag-estonia","tag-genomics","tag-digital-democracy","tag-health","tag-digital-healthcare","tag-healthcare","tag-digital-health-system","tag-personalized","tag-analysis","tag-personalized-medicine",{"id":24,"alt_text":90,"caption":27,"description":27,"media_type":91,"media_details":92,"post":5,"source_url":125},"healthcare in Estonia","image",{"width":93,"height":94,"file":95,"sizes":96,"image_meta":123},1920,1080,"2019\u002F05\u002F084_estonia_v2.png",{"medium":97,"large":103,"thumbnail":108,"medium_large":112,"1536x1536":113,"2048x2048":118},{"file":98,"width":99,"height":100,"mime-type":101,"source_url":102},"084_estonia_v2-370x208.png","370","208","image\u002Fpng","https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002F084_estonia_v2-370x208.png",{"file":104,"width":105,"height":106,"mime-type":101,"source_url":107},"084_estonia_v2-768x432.png","768","432","https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002F084_estonia_v2-768x432.png",{"file":109,"width":110,"height":110,"mime-type":101,"source_url":111},"084_estonia_v2-150x150.png","150","https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002F084_estonia_v2-150x150.png",{"file":104,"width":105,"height":106,"mime-type":101,"source_url":107},{"file":114,"width":115,"height":116,"mime-type":101,"source_url":117},"084_estonia_v2-1536x864.png","1536","864","https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002F084_estonia_v2-1536x864.png",{"file":119,"width":120,"height":121,"mime-type":101,"source_url":122},"084_estonia_v2-2048x1152.png","2048","1152","https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002F084_estonia_v2-2048x1152.png",{"aperture":124,"credit":27,"camera":27,"caption":27,"created_timestamp":124,"copyright":27,"focal_length":124,"iso":124,"shutter_speed":124,"title":27,"orientation":124},"0","https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2019\u002F05\u002F084_estonia_v2-scaled.png",{"related_posts":127,"related_posts_footer":131,"cta_type":27,"cta_color":27,"subtitle":27,"related_books":20},[128,129,130],17208,17644,22156,[132,133,134],22083,23021,17293,{"yoast_wpseo_title":136,"yoast_wpseo_metadesc":137,"yoast_wpseo_canonical":15},"Healthcare In Estonia: Where Grandmas Go For Genetic Data - The Medical Futurist","With free genetic testing, pharmacogenomics, the first fully digitized republic sets the direction for the future. Let's peek into healthcare in Estonia.",{"self":139,"collection":145,"about":148,"author":151,"replies":154,"version-history":157,"predecessor-version":161,"wp:featuredmedia":165,"wp:attachment":168,"wp:term":171,"curies":187},[140],{"href":141,"targetHints":142},"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fposts\u002F23938",{"allow":143},[144],"GET",[146],{"href":147},"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fposts",[149],{"href":150},"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Ftypes\u002Fpost",[152],{"embeddable":26,"href":153},"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fusers\u002F6",[155],{"embeddable":26,"href":156},"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fcomments?post=23938",[158],{"count":159,"href":160},10,"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fposts\u002F23938\u002Frevisions",[162],{"id":163,"href":164},49529,"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fposts\u002F23938\u002Frevisions\u002F49529",[166],{"embeddable":26,"href":167},"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fmedia\u002F23942",[169],{"href":170},"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fmedia?parent=23938",[172,175,178,181,184],{"taxonomy":173,"embeddable":26,"href":174},"category","https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fcategories?post=23938",{"taxonomy":176,"embeddable":26,"href":177},"post_tag","https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Ftags?post=23938",{"taxonomy":179,"embeddable":26,"href":180},"project_category","https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fproject_category?post=23938",{"taxonomy":182,"embeddable":26,"href":183},"contact_email_category","https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fcontact_email_category?post=23938",{"taxonomy":185,"embeddable":26,"href":186},"yst_prominent_words","https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fyst_prominent_words?post=23938",[188],{"name":189,"href":190,"templated":26},"wp","https:\u002F\u002Fapi.w.org\u002F{rel}",[192],{"id":134,"date":193,"date_gmt":194,"guid":195,"modified":197,"modified_gmt":198,"slug":199,"status":13,"type":14,"link":200,"title":201,"content":203,"excerpt":205,"author":23,"featured_media":207,"comment_status":25,"ping_status":25,"sticky":26,"template":27,"format":28,"meta":208,"categories":209,"tags":211,"project_category":218,"contact_email_category":220,"yst_prominent_words":221,"class_list":232,"better_featured_image":242,"acf":270,"yoast_meta":280,"_links":282},"2023-06-08T10:00:00","2023-06-08T08:00:00",{"rendered":196},"http:\u002F\u002Fmedicalfuturist.com\u002F?p=17293","2023-06-13T09:45:18","2023-06-13T07:45:18","digital-health-best-practices-policy-makers-free-report","https:\u002F\u002Fmedicalfuturist.com\u002Fdigital-health-best-practices-policy-makers-free-report",{"rendered":202},"Digital Health And AI Best Practices For Policy Makers: A Free Report",{"rendered":204,"protected":20},"\n\u003Cdiv class=\"wp-block-group is-vertical is-layout-flex wp-container-core-group-is-layout-8cf370e7 wp-block-group-is-layout-flex\">\n\u003Cdiv class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n\u003Cdiv class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\">\n\u003Cp>Regardless of how advanced our healthcare technologies are, no matter how well-educated our doctors are, or how digitally literate our patients become, without a robust and supportive regulatory framework, progress can only go so far. In essence, the true effectiveness of digital health technologies hinges largely on the strength of the regulations in place. No matter how groundbreaking these innovations might be, their potential can be undermined if the regulations aren’t up to par.\u003C\u002Fp>\n\n\n\n\u003Cfigure class=\"wp-block-image size-full\">\u003Ca class=\"img\" href=\"https:\u002F\u002Fleanpub.com\u002Fdigital-health-and-ai-best-practices-for-policy-makers\" target=\"_blank\" rel=\"noreferrer noopener\">\u003Cimg loading=\"lazy\" decoding=\"async\" width=\"1391\" height=\"783\" src=\"https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2023\u002F06\u002FPolicy-report.jpg\" alt=\"AI and digital health policy\" class=\"wp-image-51215\"\u002F\u003C\u002Fa srcset=\"https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2023\u002F06\u002FPolicy-report.jpg 1391w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2023\u002F06\u002FPolicy-report-370x208.jpg 370w, https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2023\u002F06\u002FPolicy-report-768x432.jpg 768w\" sizes=\"auto, (max-width: 1391px) 100vw, 1391px\" \u002F>\u003C\u002Fa>\u003Cfigcaption class=\"wp-element-caption\">\u003Ca href=\"https:\u002F\u002Fleanpub.com\u002Fdigital-health-and-ai-best-practices-for-policy-makers\" target=\"_blank\" rel=\"noreferrer noopener\">Click here to download the report\u003C\u002Fa>\u003C\u002Ffigcaption>\u003C\u002Ffigure>\n\n\n\n\u003Cp>Thus, the continuing digital health and AI revolution depend fundamentally on our policymakers. It is important to understand that weak or non-existing regulatory frameworks will not stop tech adoption, it will urge patients to take matters into their own hands and start using available technology anyways. The #wearenotwaiting movement of diabetes patients perfectly illustrates what happens in such an environment. \u003C\u002Fp>\n\n\n\n\u003Cp>Recognising the vital role of policymakers in shaping the landscape of digital health, we’ve put together \u003Ca href=\"https:\u002F\u002Fleanpub.com\u002Fdigital-health-and-ai-best-practices-for-policy-makers\" target=\"_blank\" rel=\"noreferrer noopener\">this comprehensive free guide\u003C\u002Fa>. Our goal is to inspire and inform those who have the power to drive change with examples of best practices already in place around the world. Our aim is to show that there’s no need to reinvent the wheel, as there are many tested and successful solutions just waiting to be discovered and implemented.\u003C\u002Fp>\n\n\n\n\u003Cp>We’ve made this guide freely accessible because we believe in the power of shared knowledge and learning from each other’s successes.\u003C\u002Fp>\n\n\n\n\u003Ch2 class=\"wp-block-heading\">A double paradigm shift is breathing in our necks\u003C\u002Fh2>\n\n\n\n\u003Cp>We know that healthcare is on the verge of a paradigm shift. The doctor-patient relationship is changing due to digital health technologies, patients are becoming (supposed to become) partners in their own care, delivering valuable data and insights to the medical team. \u003C\u002Fp>\n\n\n\n\u003Cp>But before we have even internalized this trend, we need to welcome \u003Ca href=\"https:\u002F\u002Fmedicalfuturist.com\u002Fpreparing-for-ai-driven-medicine-6-crucial-questions-for-tomorrows-doctors\">another new member to the care team\u003C\u002Fa>: artificial intelligence. The centuries-old notion that the source of ultimate medical knowledge resides in the heads of medical professionals is disappearing. \u003C\u002Fp>\n\u003C\u002Fdiv>\n\u003C\u002Fdiv>\n\n\n\n\u003Cp>Moreover, with the rise of lifestyle diseases like diabetes and obesity, healthcare costs are projected to escalate even further. As humanity can manage chronic diseases with increasing efficiency, life expectancy increases, paradoxically leading to even more severe shortage in healthcare access.\u003C\u002Fp>\n\u003C\u002Fdiv>\n\n\n\n\u003Ch2 class=\"wp-block-heading\">Responsible governments prepare for this change\u003C\u002Fh2>\n\n\n\n\u003Cp>In such turbulent times, it is the responsibility of regulators and policymakers to keep all stakeholders in line in order to truly leverage the potential of technologies for healthcare and avoid dystopic outcomes. It is a difficult task to undertake. Governments should listen to people, technology companies, drug producers, healthcare providers and shape policy according to real needs while keeping pace with innovation. Policymakers must find a balance between safety and innovation. They should promote the safe use of digital health technologies while offering regulations to separate the wheat from the chaff. Besides, they should think about all the potential legal consequences of the usage of healthcare technologies, including data protection.\u003C\u002Fp>\n\n\n\n\u003Cp>Fortunately, several governments are already consciously preparing for the future. Canada, New Zealand, Denmark or Estonia are on the way to an entirely digital healthcare system – every one of them being at a different stage of development, delivering already implemented good practices for other nations. \u003C\u002Fp>\n\n\n\n\u003Cp>Recognizing that issues vary across countries, regions, and medical specialties; we have strived to include as many exemplary cases as possible in this policy report. They are grouped together around the four most important topics: 1: patient design replacing patient centricity, 2: the regulation of digital health, 3: national policies and 4: regulating AI.\u003C\u002Fp>\n\n\n\n\u003Cp>Let’s see a few examples from the report!\u003C\u002Fp>\n\n\n\n\u003Ch3 class=\"wp-block-heading\">\u003Ca href=\"https:\u002F\u002Fwww.jmir.org\u002F2022\u002F8\u002Fe39178\" target=\"_blank\" rel=\"noreferrer noopener\">Patient design vs patient centricity\u003C\u002Fa>\u003C\u002Fh3>\n\n\n\n\u003Cp>A paradigm shift is underway in the patient-clinician relationship, driven by irreversible changes in information access, yet the model under which clinicians are trained, care is conducted, and care delivery is designed has not changed significantly even though we call it “patient-centered.” It is increasingly important to understand the crucial difference between patient design and the illusory “patient-centric” approach that keeps patients in passive roles and means nothing more than “we might think about you when we make decisions”.\u003C\u002Fp>\n\n\n\n\u003Cp>Patient design \u003Ca rel=\"noreferrer noopener\" href=\"https:\u002F\u002Fmedicalfuturist.com\u002F3-reasons-why-patient-design-must-replace-the-patient-centricity-illusion\u002F\" target=\"_blank\">is a different concept\u003C\u002Fa>, one that invites patients as active participants – and stakeholders – in the highest levels of decision-making in healthcare. This is called a “co-design” approach and is defined as “a creative practice that can be used to improve customer experience and enhance value”.\u003C\u002Fp>\n\n\n\n\u003Cp>To build this new world of practice and workflow, we simply must engage with patients as true partners. To achieve medicine’s new potential, it must be optimised around the wants and priorities of the ultimate stakeholder—the party that has the most at stake in how it all plays out: the patient. Patient design is the approach that can make it happen.\u003C\u002Fp>\n\n\n\n\u003Ch3 class=\"wp-block-heading\">Regulating digital health – how to handle digital therapeutics\u003C\u002Fh3>\n\n\n\n\u003Cp>Digital health applications and solutions are increasingly becoming part of our healthcare experience. Partially because they offer fast and convenient solutions for problems arising from capacity shortages of traditional medical systems (like skin-checking apps), or because they enhance the capabilities of doctors, medical personnel, or hospitals (like sepsis watch algorithms or AI diagnostics models).\u003C\u002Fp>\n\n\n\n\u003Cp>While these apps are available in many medical specialties, channelling them into state-run healthcare systems to harness the benefits on population-wide scales is challenging. \u003Ca rel=\"noreferrer noopener\" href=\"https:\u002F\u002Fmedicalfuturist.com\u002Fdiga-how-germany-channeled-digital-health-apps-into-its-healthcare-system\" target=\"_blank\">Germany’s DiGA system\u003C\u002Fa> tackles this issue.\u003C\u002Fp>\n\n\n\n\u003Cp>Based on the Digital Healthcare Act, 73 million Germans covered by statutory health insurance (approximately 90% of the total population) are entitled to use DiGAs, provided they have a prescription or an attested diagnosis. This means that digital healthcare has made it into primary care.\u003C\u002Fp>\n\n\n\n\u003Cp>Statutory health insurers reimburse the associated DiGA costs, with prices negotiated in advance with the umbrella association of German health insurance companies.\u003C\u002Fp>\n\n\n\n\u003Ch3 class=\"wp-block-heading\">National policies – New Zealand gets outside input into government policy\u003C\u002Fh3>\n\n\n\n\u003Cp>The Government of New Zealand has a public health strategy, a health technology strategy and they invited people to give feedback on the upcoming digital health strategy too. They create the report with the digital health sector through literature review, briefings to sector groups, face-to-face workshops and online collaboration.\u003C\u002Fp>\n\n\n\n\u003Cp>Their opinions will be incorporated into the final report and will be published under a Creative Commons license meaning that anyone can freely access them.\u003C\u002Fp>\n\n\n\n\u003Cp>The Strategy is not meant to be a detailed plan, nor a document to sit on a bookshelf, but aspirational goals and enabling strategies, priorities, frameworks, guidelines and resources that will evolve and change over time in response to the changing digital world that New Zealanders live in.\u003C\u002Fp>\n\n\n\n\u003Cp>They also expect continual revision of the Strategy as the digital future emerges, which is an excellent approach to address the changing needs of patients.\u003C\u002Fp>\n\n\n\n\u003Ch3 class=\"wp-block-heading\">Regulating artificial intelligence – Large language models\u003C\u002Fh3>\n\n\n\n\u003Cp>The rapid progress in artificial intelligence (AI) has given rise to advanced large language models (LLMs) like GPT-4 and Bard. These LLMs have already gained significant interest in the realm of healthcare due to their wide-ranging use cases such as aiding in clinical documentation, expediting insurance pre-authorization, summarizing scientific studies, and functioning as chatbots to respond to patient inquiries about their personal data and worries.\u003C\u002Fp>\n\n\n\n\u003Cp>Despite their immense transformative potential, it’s crucial to approach LLMs with caution. Their training methodology differs from other AI-powered medical technologies that have already undergone regulation, a distinction that becomes particularly significant in the sensitive arena of patient care.\u003C\u002Fp>\n\n\n\n\u003Cp>The latest iteration, GPT-4, introduced in March 2023, escalates the potential and risks of this technology in supporting various medical tasks. Alongside the inherent risks of misinterpreting its outputs due to inconsistent reliability, GPT-4 showcases advanced capabilities such as interpreting text within images and analysing their context.\u003C\u002Fp>\n\n\n\n\u003Cp>The task of regulating GPT-4 and other generative AI in the healthcare sector without stifling their revolutionary potential is a pressing and critical challenge. This is necessary to ensure patient safety, uphold ethical standards, and safeguard patient privacy. We propose that regulatory supervision should reassure medical professionals and patients of the safe use of LLMs, without jeopardizing their data or privacy.\u003C\u002Fp>\n\n\n\n\u003Cdiv align=\"center\">\n\u003Cfigure>\u003Ca class=\"img\" href=\"https:\u002F\u002Fleanpub.com\u002Fdigital-health-and-ai-best-practices-for-policy-makers\" src=\"https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2023\u002F06\u002F0605_policy_report_cover.png\" alt=\"digital health and AI best practices for policy makers\" width=\"458\" height=\"139\"\u003C\u002Fa>\u003C\u002Fa>\u003C\u002Ffigure>\u003Cp>\u003C\u002Fp>\n\u003Cp> \u003C\u002Fp>\n\u003C\u002Fdiv>\n\n\n\n\u003Cp>There are many more great examples in The Medical Futurist Institute’s \u003Ca href=\"https:\u002F\u002Fleanpub.com\u002Fdigital-health-and-ai-best-practices-for-policy-makers\">report\u003C\u002Fa>. Please feel free to download it and share it with anyone who might be interested. We encourage you to send it also to your policy-makers if you think that more should be done with regard to healthcare policy in your country. We hope everyone will get access to digital health!\u003C\u002Fp>\n\n\n\n\u003Ctable style=\"width: 100%; border-collapse: collapse; background-color: #eee; border-top: 4px solid #444;\" cellpadding=\"10px\">\n\u003Ctbody>\n\u003Ctr>\n\u003Ctd style=\"width: 100%;\">\n\u003Cp>\u003Cstrong>At The Medical Futurist, we are building a community for making a bold vision about the future of healthcare reality today.\u003C\u002Fstrong>\u003C\u002Fp>\n\u003Ciframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\u002F\u002Fwww.youtube.com\u002Fembed\u002FFIbMejImnxs\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\">\u003C\u002Fiframe>\n\u003Cp>If you’d like to support this mission, we invite you to \u003Ca href=\"https:\u002F\u002Fwww.patreon.com\u002Fthemedicalfuturist\">join The Medical Futurist Patreon Community\u003C\u002Fa>. A community of empowered patients, future-oriented healthcare professionals, concerned health policymakers, sensible health tech developers, and enthusiastic medical students. If there were ever a time to join us, it is now. Every contribution, however big or small, powers our research and sustains our future.\u003C\u002Fp>\n\u003Cp>\u003Ca href=\"https:\u002F\u002Fwww.patreon.com\u002Fthemedicalfuturist\">\u003Cstrong style=\"background-color: #e71d3299; color: #000;\">Click here to support The Medical Futurist from as little as $3\u003C\u002Fstrong>\u003C\u002Fa> – it only takes a minute. Thank you.\u003C\u002Fp>\n\u003C\u002Ftd>\n\u003C\u002Ftr>\n\u003C\u002Ftbody>\n\u003C\u002Ftable>\n\u003Cp> \u003C\u002Fp>\n\n\n\n\u003Ch2 class=\"wp-block-heading\">\u003Ca href=\"http:\u002F\u002Fthemedicalfuturist.us8.list-manage.com\u002Fsubscribe?u=5b42ebb547c75ff669a6572d3&id=efd6a3cd08\">\u003Cb>Subscribe To The Medical Futurist℠ Newsletter\u003C\u002Fb>\u003C\u002Fa>\u003C\u002Fh2>\n\n\n\n\u003Cul class=\"wp-block-list\">\n\u003Cli>News shaping the future of healthcare\u003C\u002Fli>\n\n\n\n\u003Cli>Advice on taking charge of your health\u003C\u002Fli>\n\n\n\n\u003Cli>Reviews of the latest health technology\u003C\u002Fli>\n\u003C\u002Ful>\n",{"rendered":206,"protected":20},"\u003Cp>Regardless of how advanced our healthcare technologies are, no matter how well-educated our doctors are, or how digitally literate our patients become, without a robust and supportive regulatory framework, progress can only go so far. \u003C\u002Fp>\n",51217,{"_acf_changed":20,"footnotes":27},[210,32],798,[38,212,44,46,213,214,215,216,217,36,39],827,289,313,425,548,707,[219],952,[],[222,223,54,58,55,224,225,60,56,226,227,228,229,230,231],1739,1803,2261,1631,3829,1683,1715,1723,1729,1735,[233,14,65,66,67,68,69,234,71,76,235,82,84,236,237,238,239,240,74,77,241],"post-17293","category-digital-health-research","tag-health-policy","tag-innovation","tag-medicine","tag-technology-2","tag-healthcare-policy","tag-digital-innovation","project_category-policy-makers",{"id":207,"alt_text":27,"caption":27,"description":27,"media_type":91,"media_details":243,"post":134,"source_url":269},{"width":93,"height":94,"file":244,"filesize":245,"sizes":246,"image_meta":268},"2023\u002F06\u002F0605_policy_report_cover.png",269134,{"medium":247,"large":251,"thumbnail":255,"medium_large":259,"1536x1536":260,"2048x2048":264},{"file":248,"width":99,"height":100,"mime-type":101,"filesize":249,"source_url":250},"0605_policy_report_cover-370x208.png","48094","https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2023\u002F06\u002F0605_policy_report_cover-370x208.png",{"file":252,"width":105,"height":106,"mime-type":101,"filesize":253,"source_url":254},"0605_policy_report_cover-768x432.png","147565","https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2023\u002F06\u002F0605_policy_report_cover-768x432.png",{"file":256,"width":110,"height":110,"mime-type":101,"filesize":257,"source_url":258},"0605_policy_report_cover-150x150.png","25018","https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2023\u002F06\u002F0605_policy_report_cover-150x150.png",{"file":252,"width":105,"height":106,"mime-type":101,"filesize":253,"source_url":254},{"file":261,"width":115,"height":116,"mime-type":101,"filesize":262,"source_url":263},"0605_policy_report_cover-1536x864.png","446631","https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2023\u002F06\u002F0605_policy_report_cover-1536x864.png",{"file":265,"width":120,"height":121,"mime-type":101,"filesize":266,"source_url":267},"0605_policy_report_cover-2048x1152.png","720130","https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2023\u002F06\u002F0605_policy_report_cover-2048x1152.png",{"aperture":124,"credit":27,"camera":27,"caption":27,"created_timestamp":124,"copyright":27,"focal_length":124,"iso":124,"shutter_speed":124,"title":27,"orientation":124},"https:\u002F\u002Fcdn.medicalfuturist.com\u002Fwp-content\u002Fuploads\u002F2023\u002F06\u002F0605_policy_report_cover.png",{"related_posts":20,"related_posts_footer":271,"cta_type":275,"cta_color":27,"subtitle":27,"related_books":276,"key_takeaways":20},[272,273,274],51051,50987,24217,"subscribe",[277,278,279],47427,30419,24759,{"yoast_wpseo_title":202,"yoast_wpseo_metadesc":281,"yoast_wpseo_canonical":200},"The Medical Futurist Institute collected great digital health policy examples worldwide. We hope to inspire policy-makers to take steps towards the future!",{"self":283,"collection":288,"about":290,"author":292,"replies":294,"version-history":297,"predecessor-version":301,"wp:featuredmedia":305,"wp:attachment":308,"wp:term":311,"curies":322},[284],{"href":285,"targetHints":286},"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fposts\u002F17293",{"allow":287},[144],[289],{"href":147},[291],{"href":150},[293],{"embeddable":26,"href":153},[295],{"embeddable":26,"href":296},"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fcomments?post=17293",[298],{"count":299,"href":300},59,"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fposts\u002F17293\u002Frevisions",[302],{"id":303,"href":304},51315,"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fposts\u002F17293\u002Frevisions\u002F51315",[306],{"embeddable":26,"href":307},"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fmedia\u002F51217",[309],{"href":310},"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fmedia?parent=17293",[312,314,316,318,320],{"taxonomy":173,"embeddable":26,"href":313},"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fcategories?post=17293",{"taxonomy":176,"embeddable":26,"href":315},"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Ftags?post=17293",{"taxonomy":179,"embeddable":26,"href":317},"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fproject_category?post=17293",{"taxonomy":182,"embeddable":26,"href":319},"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fcontact_email_category?post=17293",{"taxonomy":185,"embeddable":26,"href":321},"https:\u002F\u002Fapi.medicalfuturist.com\u002Fwp-json\u002Fwp\u002Fv2\u002Fyst_prominent_words?post=17293",[323],{"name":189,"href":190,"templated":26},[],1789987453182]