Germany’s hospital reform aims to modernize healthcare with a focus on digitalization, electronic patient records, and more efficient processes. Yet, fragmented IT systems and a lack of interoperability present significant obstacles. Estonia, a pioneer in digital healthcare, offers proven solutions that could serve as a model for Germany.

In Estonia, 100% of patient records are accessible digitally, and 99% of all prescriptions are issued electronically—far ahead of Germany, where only 0.1–5% of patient records are digitally available. Estonia’s success is built on trust in digital services, early adoption of the digital ID-card in 2002, and collaboration between public and private sectors.

The formula for success: trust, technology and efficiency

A key success factor 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 overall acceptance of digitalization. Also, the country’s digital ID-card introduced in 2002, contributed to this. As a result, the use of online government services rose from 3% in 2002 to almost 40% within eight years.

FACTS
Estonia is #1 in The Bertelsmann Foundation’s Digital Health Index, we are the leading country in digital health for 2024.
99% of Estonia´s health data created today is digitised and everyone has an e-health record.

“Trust in the digital transformation in Estonia is one of the highest in Europe. A key factor in building this trust is ensuring individuals have true control over their data, allowing them to see who has accessed it and for what purpose.” said Jaanika Merilo, Head of Digital Health and Care in Ministry of Social Affairs of Estonia.

“Estonia’s experience has shown that the most effective approach is to start with solutions that people use and appreciate the most, for example e-prescription or booking doctor’s appointments online, followed by electronic health records. This ensures public support for digitalization and the development of future solutions. Challenges may arise, but it is crucial to listen, communicate and be transparent and search constructively for joint solutions. The experience of Estonia, as well as lessons learned, might be useful also for hospital reform in Germany.”

Estonia as a strategic partner for German hospital reform

The 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 digitize its public services, including healthcare, offers scalable solutions that can be quickly adapted in Germany. These include electronic patient records that give doctors and patients full all-time access to health data, telemedicine services that improve access to specialists in rural areas without having to travel long distances, and blockchain-based systems that ensure secure and transparent data management.

“Estonia’s experience has shown that the most effective approach is to start with solutions that people use and appreciate the most, for example e-prescription or booking doctor’s appointments online, followed by electronic health records. This ensures public support for digitalization and the development of future solutions.”
Jaanika Merilo, Head of Digital Health and Care in Ministry of Social Affairs of Estonia 

A successful example of Estonian-German cooperation is the partnership between an Estonian company Nortal and a German company gevko GmbH, which laid the technical foundation for Germany’s electronic patient record (ePA). Kertti Merimaa, Vice President of Healthcrae at Nortal, emphasizes that Estonia’s experience shows how a well-integrated digital infrastructure can streamline workflows, enhance patient care, and drive the digital transformation of Germany’s healthcare system.

“Efficient healthcare is made possible by an individualized treatment approach. This gives patients access to tailored information and treatment options, which promotes their autonomy and encourages a healthier lifestyle. This strengthens patient engagement and increases the likelihood that they will adhere to treatment plans more consistently,” added Kertti Merimaa.

Estonian health tech companies as partners for Germany

Several Estonian health tech companies are already operating successfully on an international level and are also working with German partners. These include:

• Accelerate Estonia: This government initiative program develops solutions like 24/7 pharmacies offering medication and advice via video call and AI-supported mental health programs. Its mental health monitoring system, tested in over 10% of Estonian schools, involved 4,300 pupils and 800 staff. It also focuses on digital platforms to improve patient treatment and therapy planning.
• Migrevention offers the world’s first digital headache clinic that provides holistic, digital care for patients with migraines and other types of headaches. The platform combines state-of-the-art telemedicine with personalized treatment plans to help patients manage their symptoms more effectively and improve their quality of life.
• Triumf Health developed the evidence-based mental health game “Triumfland Saga” for children to help them build resilience and strengthen their mental health. The game was recognized as the best health and wellbeing technology in the world in 2022.
• CoNurse is a digital platform that supports nursing staff with simple instructions for clinical protocols and serves as a learning tool. The app also helps with the management of medical devices and thus increases efficiency in everyday clinical practice.
• Antegenes develops genetic tests to assess individual cancer risk and offers personalized prevention plans. The tests, validated by data from the UK Biobank and Estonian Biobank, can reduce breast cancer mortality by up to 40% and sustainably improve cancer prevention.

With 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, future-proof hospital reform.

GOOD TO KNOW 

• From March 10th to 12th, 2025, Estonian health tech companies will participate in a market visit to Germany as part of an export program aimed at enhancing international collaboration.
• This delegation will provide opportunities for networking, knowledge exchange, and partnership development with key stakeholders in the German healthcare sector.
• Participating Companies are: Better Medicine – AI tools for radiologists (e.g., kidney tumor detection); DocuMental – software for mental health decision-making; EQUA – manufacturer of medical products (e.g., massage tables); Solis BioDyne – supplier of life science reagents (PCR, DNA analysis); SpeakTX – digital speech and language therapy platform and Webquer/OKIA – Healthcare software solutions.
• The agenda includes site visits to Heidelberg University Hospital, as well as meetings with local medical device, pharmaceutical, and biotech companies. Participants will also attend an opening seminar featuring insights from economic development representatives and influential local partners, all designed to facilitate entry into the German market.

This content is funded by the European Union – NextGenerationEU

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