Implementation of Personalised Medicine in Estonia

In 2016, the Estonian Genome Centre was established as a first step to enable personalised medicine in Estonia. The 5-year programme for the Implementation of Personalised Medicine in Estonia was launched in 2019. This programme is based on two previous projects, estPerMed and Clinical decision support system (see Figure below), and its main goal is to create the fundament to employ genetic data more extensively in clinical practice, e.g. for personalised genetic risk-based prevention.

Overview about the aims and expected achievement of the  Implementation of Personalised Medicine in Estonia programme.

What is personal medicine and why is this project important?

Personalised medicine is an approach that helps to find the most individual possible prevention or treatment plan for each person by analyzing the health data of the person and their relatives together with lifestyle and environmental data.

The personal medicine implementation project will help to increase the use of one part of health data in personal medicine - genetic data. The prerequisites for their introduction will be created by the end of 2022, and the provision of first personal medicine service(s) can be started in 2023. The first service to include genetic data more widely is related to breast cancer prevention and early detection, preparations are also made to employ personalised drug recommendations. 

To enable the right cure at the right time to the right person, comprehensive automated IT-systems have to be developed to support clinicians in their everyday work. To reach and engage more people, empowering prevention and healthcare services have to be developed and implemented. To this end, a consistent personalised medicine approach is currently being developed: a tight collaboration between the Central E-Health system, scientists and doctors who make use of the genomic data of 20% of the adult population.

The Implementation of Personalised Medicine in Estonia programme is expected to:

  • Enable the combination of genomic and health data in the national health information system to provide personal risk calculations for selected complex diseases 
  • Apply clinical decision support systems to automatically visualise the disease risks and provide suggestions that could be used to reduce this risk towards disease prevention or improved, personalised patient treatments
  • Provide a sustainable framework for the implementation of a personalised approach in future national screening and prevention programs.

Therewith, Implementation of Personalised Medicine in Estonia will lead to a healthier society, improved treatment outcomes and in the long-term to a reduced economic burden for the Estonian health care system. 

Henk-Jan Guchelaar

 

Annika Veimer
Director
Estonian National Institute for Health Development

„To our knowledge, the nationwide approach we aspire to implement in Estonia is unique worldwide. This requires safe storage and use of genetic data by various parties, solving legal and ethical issues and training of healthcare professionals to ensure that new services work smoothly and efficiently. A complete system to provide professional care throughout the patient’s journey is also needed. Creating an integrated system means tackling novel and complex issues in the medical system and working together with many stakeholders, so that personalised medicine could create value for our people, doctors and society, and add healthy life years.”

The programme is led and coordinated by the Estonian National Institute for Health Development but the infrastructure involves a variety of other partners shown below. More information can be found at: https://www.tai.ee/en/personalisedmedicine

Project participants and their roles

The project is carried out by the National Institute for Health Development in collaboration with the University of Tartu, the Health and Welfare Information Systems Centre, the Estonian Health Insurance Fund and the Ministry of Social Affairs.

National Institute for Health Development

  • Project management
  • Heading the development of a quality management system
  • Organisation and coordination of training courses
  • Communication

Health and Welfare Information Systems Centre

  • Improvement of the Health Information System, interfaces
  • Improvement of the Patient Portal
  • Integration of the Consent Management System
  • Development of the  Health and Treatment Recommendation System
  • Hosting and administration of solution parts

University of Tartu

  • Creation of software and applications:
    • Genetic Data Information System
    • Monitoring and management platform for genetic risk models
    • Computation Environment for Personalised Medicine
  • Development of and carrying out training courses

Estonian Health Insurance Fund

  • Development of the Decision Support System
  • Digital prescription management

Ministry of Social Affairs

  • Development of the legal framework