Estonia as a pioneer: How digital health solutions can advance German hospital reform

Estonia as a pioneer: How digital health solutions can advance German hospital reform

Berlin/Tallinn, March 11, 2025 - The hospital reform in Germany, which began in January 2026, aims to modernize the healthcare system with a focus on digitalization, electronic patient records and more efficient processes. But fragmented IT systems and a lack of interoperability pose significant obstacles. Estonia, a pioneer in digital health solutions, offers proven solutions that could serve as a model for Germany.

In Estonia, 100% of patient records are digitally accessible and 99% of all prescriptions are issued electronically - well ahead of Germany, where only 0.1-5% of patient records are digitally available. Estonia's success is based on trust in digital services, the early introduction of the digital ID card in 2002 and cooperation between public and private sectors.

The formula for success: trust, technology and efficiency

A key factor for success in Estonia was the population's high level of trust in digital solutions. Transparent communication and the early involvement of private partners such as banks and the education system promoted the general acceptance of digitalization. The introduction of the digital ID card in 2002 also contributed to this. As a result, use of online government services rose from 3% in 2002 to nearly 40% within eight years.

"Trust in digital transformation in Estonia is one of the highest in Europe. A key factor in building this trust is ensuring citizens have real control over their data, so they can see who has accessed it and for what purpose," said Jaanika Merilo, Head of the Digital Health and Care Department at the Estonian Ministry of Social Affairs. "Experience in Estonia has shown that it is most effective to start with solutions that people use and value the most, such as electronic prescription or online booking of doctor's appointments, followed by electronic health record. This ensures public support for digitalization and the development of future solutions. Challenges may arise, but it is crucial to listen, communicate, be transparent and constructively look for common solutions. The experiences from Estonia and the lessons learned could also be useful for hospital reform in Germany.”

Estonia's digital solutions and successful cooperation with Germany

German hospital reform focuses on the digitalization of hospitals to improve efficiency and patient care. Estonia, one of the first countries in Europe to fully digitalize its public services, including healthcare, offers scalable solutions that can be quickly adapted in Germany. These include electronic health records that allow doctors and patients full access to health data at all times, telemedicine services that improve access to specialists in rural areas without traveling long distances, and blockchain-based systems that ensure secure and transparent data management.

A successful example of Estonian-German cooperation is the partnership between the Estonian company Nortal and the German company gevko GmbH, which laid the technical basis for the electronic patient record (ePR) in Germany. Kertti Merimaa, Vice President of Healthcare at Nortal, emphasizes that the Estonian experience shows how a well-integrated digital infrastructure can optimize workflows, improve patient care and drive the digital transformation of the German healthcare system.

Estonian health tech companies as partners for GermanySeveral Estonian health tech companies are already internationally successful and also work with German partners. This includes:

-Accelerate Estonia: The government initiative is developing solutions such as 24/7 pharmacies offering medication and advice via video calls, as well as AI-powered mental health programs. The mental health monitoring system, which was tested in over 10% of Estonian schools, involved 4,300 students and 800 staff.

-Migrevention offers the world's first digital headache clinic, providing holistic, digital care for patients with migraines and other headaches. The platform combines modern telemedicine with personalized treatment plans.

-Triumf Health developed the evidence-based mental health game “Triumfland Saga” for children to strengthen their resilience and mental health. The game was recognized as the best technology in health and well-being worldwide in 2022.

-CoNurse is a digital platform that supports nurses with simple instructions for clinical protocols and serves as a learning tool. The app also helps manage medical devices, increasing efficiency in clinical practice.

-Antegenes develops genetic tests to assess individual cancer risk and offers personalized prevention plans. The tests, validated with data from the UK Biobank and the Estonian Biobank, can reduce breast cancer mortality by up to 40% and sustainably improve cancer prevention.

Estonia as a strategic partner for German hospital reformWith its extensive experience in digital healthcare, Estonia offers a range of proven, scalable solutions that can be quickly implemented in Germany. The introduction of technologies to digitize healthcare could pave the way for sustainable and future-proof hospital reform.

Kertti Merimaa, Vice President of Healthcare at Nortal, emphasizes that efficient healthcare is enabled by an individualized treatment approach. This gives patients access to tailored information and treatment options, which strengthens their personal responsibility and promotes a healthier lifestyle. This, in turn, increases patient engagement and increases the likelihood that treatment plans will be consistently followed.

Market visit to Germany: German export program for Estonian health tech companies in March 2025

From March 10 to 12, 2025, Estonian health tech companies will participate in a market visit to Germany as part of an export program to promote international cooperation. This delegation offers opportunities for networking, knowledge exchange and partnership development with key players in the German healthcare sector. The agenda includes visits to Heidelberg University Hospital and the German Cancer Research Center as well as meetings with local companies from the fields of medical technology, pharmaceuticals and biotechnology. Participants will also attend an opening seminar with insights from economic development representatives and influential local partners to facilitate market entry in Germany.

Participating companies

-Better Medicine – AI tools for radiologists (e.g. kidney tumor detection).

-DocuMental – Mental health decision making software.

-EQUA – Manufacturer of medical products (e.g. massage tables).

-Net Group – AI-powered digital health solutions.

-Solis BioDyne – provider of life science reagents (PCR, DNA analysis).

-SpeakTX – Digital speech and language therapy platform.

-Webquer/OKIA – healthcare software solutions.

About Trade Estonia
Trade Estonia promotes international trade and supports Estonian companies in exporting their products and services. Estonia, which sees itself as a “digital nation”, is continuously developing innovative approaches to promote digital transformation in key industries such as education, healthcare and administration.
Co-funded by the European Union” – Investing in Your Future.

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