Patient-centered decision support

Since spring 2020, Estonian family physicians and nurses have been able to use the integrated clinical decision support EBMEDS within the physicians software, located on healthcare workers' desktops.

What is this?

The clinical decision support EBMEDS brings patient-centered recommendations to the family medicine desktop and helps make treatment decisions more quickly and effectively.

Patient information is extracted from the electronic health record, generating alerts and reminders, suggesting treatment options, and providing links to treatment recommendations.

The aim is to save healthcare workers' time, improve the quality of care, and enhance patient safety.

How does it work?

EBMEDS decision support is integrated into the software used by family doctors.

The decision support automatically analyzes patient-related information using algorithms and generates alerts and reminders based on machine-readable health data. This includes diagnoses, medications, tests, and procedures from the last five years, for example. The algorithms are based on medical evidence. Recommendations based on Estonian treatment guidelines have also been implemented into the service.

The decision support provides recommendations and warnings if there are deficiencies in the treatment documentation (e.g., blood pressure values are not correctly recorded) or if recommended activities are missing from the treatment guidelines (e.g., post-treatment plan tests have not been conducted). All alerts require clearly coded patient health data (e.g., age, gender, diagnosis, medication, weight, etc.).

In addition, healthcare workers have access to the Estonian-language EBM Guidelines database via a personal user account on the Synbase portal ( Access is linked to the Estonian Health Board's registration code.

What is the value of decision support?

  • Decision support allows saving the doctor's time and better leveraging existing health data for people's health,

  • It provides support to healthcare workers in patient management (e.g., prescribing treatment, monitoring treatment),

  • Availability of accurate information at the right time, in the right place, and in the right format,

  • Helps healthcare workers adhere to treatment guidelines,

  • Enhances patient safety by enabling more informed and evidence-based treatment decisions, 

  • Drug safety.

The patient-centered decision support project led by the Estonian Health Insurance Fund began in 2017 and was completed in collaboration with the Ministry of Social Affairs, Health and Welfare Information Systems Centre, and the Estonian Association of Family Physicians. The total cost of the project was 1 million euros, with 0.5 million euros contributed by the Health Insurance Fund and the Ministry of Social Affairs, and 0.5 million euros obtained from the European Regional Development Fund through Enterprise Estonia (project EU51573 "Healthcare Decision Support"). In early 2021, the project was selected as the best national digital service in Estonia's national digital services competition "Su(g".

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