Paving the way for digital healthcare solutions

How to test digital solutions in a way that makes it easier for startups to operate and survive without burdening hospitals or test environments while ensuring meaningful actions with results for end-users? Representatives from the state, the Estonian Health Insurance Fund startups and test environments presented their views at the Connected Health seminar.

According to Connected Health Cluster Manager Piret Hirv, the healthcare sector generates many good ideas to improve or facilitate people’s daily lives: “Unfortunately,” said Hirv, “these ideas and solutions have a hard time making it to end-users. Funding is often one of the obstacles. Funding requires an assessment of the solution and this may involve time and costs that prove greater than planned at the start, causing many startups to lose their momentum. Careful planning of business models in the early stages of development helps prevent such situations.”

In addition to funding issues, testing of solutions is often also problematic. Thus, the seminar organised by the Connected Health Cluster, led by Tallinn Science Park Tehnopol, addressed the issue of taking good healthcare solutions to people and mapped potential improvement scenarios for problematic areas based on seminar discussions.

Priit Tohver from the Ministry of Social Affairs provided an overview of how the state views and what it expects from test environments. Tohver highlighted that testing should not be an annoying extra task, but convenient and fast as well as well thought out. The technological capacity to facilitate testing must exist and undertakings would also benefit from appropriate guidelines. He emphasised a balance between convenience and speed versus safety and lawfulness. Tohver admitted that the state cannot yet provide all the answers, but assured attendees that Estonia is open to new digital solutions.

Developers are looking for sustainable business models to improve the availability of digital solutions. However, services can only be offered with the support of the Estonian Health Insurance Fund if said services are listed in the services thereof. The Health Insurance Fund is working to finalise an assessment framework for healthcare technologies to assess and fund digital solutions on common grounds. Rõõt Palmiste from the Estonian Health Insurance Fund introduced a solution they are currently working on and adapting based on the example of NICE (National Institute for Health and Care Excellence). The assessment framework underway is designed for various digital solutions, including software. Solutions are divided into groups based on functionality, and required authentication consists of three levels. For example, a digital solution requiring level III authentication is an existing communication channel between the patient and the healthcare professional or peer support provider.

In addition to authentication, assessments should also take account of economic impact analyses and the level of financial risk for the person covering the costs, i.e. the Estonian Health Insurance Fund. Furthermore, the assessment must include a description of the user population, the existing treatment journey and the journey using the appropriate digital solution as well as highlight all involvement-related costs.

Palmiste confirmed that the Estonian Health Insurance Fund is certainly looking forward to more digital solutions. There are plans to complete the assessment framework in Q2.

Priit Kruus from Taltech introduced the health tech Master’s programme as a validation lab of digital solutions. Kruus referred to studies conducted among startups, stating that it may take up to a year and a half to get from a beta environment to a finalised solution and that there is a 55% chance of making their first euro immediately after this. The process could be easier and a living lab would help speed up the process of determining whether a solution works or not.

Kruus explained that Taltech’s goal is to solve the issue of validation with Tallinn Health Care College – in addition to teaching manual procedures, schools should also teach how to document or proceed when the e-Ambulance system is not working. This in turn serves as feedback for developers.

Kruus also drew from personal experience with developing a digital solution, further highlighting that companies could benefit from factors such as an assessment framework, clarity on business models and a safe environment for pilot projects to make it easier to test solutions.

Haapsalu Neurological Rehabilitation Centre has international testing experience as part of the Provahealth project. Kadri Englas shared Haapsalu Neurological Rehabilitation Centre’s experiences and brought out that clinical environments assume that testers come to them with specific questions, whereas the reality is that the wishes and needs of testers are much wider than assumed by Haapsalu Neurological Rehabilitation Centre. If cooperation is established, there is also the experience that the partner’s wishes will grow over time. Testers also look for advice on how to take their product or service to the Estonian market, raising the question: is it trustworthy and proper to answer such questions in a hospital environment? Once negotiations are started, there should be ideas on acquiring funding.

Kadri Haljas from Triumf Health admitted that even though Triumf’s game is in ORCHA’s (online platform assessing digital solutions) TOP 10 health solutions for child health, there are no paying customers in Estonia. According to Haljas, it is difficult to navigate the various regulations requiring clinical validation and randomised clinical trials, and the process leading to product launch is lengthy.

Haljas assured that Triumf is dedicated to involving children, parents and medical staff and considering their feedback. “We developed a separate desktop for medical staff,” said Haljas, “which we have tried to test in living labs in different countries, thus far unsuccessfully, even though all parties have been involved in the process from the very start.” Triumf’s solution was tested at Tartu University Hospital as part of the cluster’s joint development. Work is underway to list conditions that would help make testing in hospitals easier for startups.

Seminar Estonia – A Good Place for Testing Tech Solutions? organised by the Connected Health Cluster, led by Tallinn Science Park Tehnopol, took place at Tallinn Health Care College on 20 February. The seminar was held with the support of the European Regional Development Fund.

Click here for a gallery of the event.

Click here for a video recording of the seminar.

The Connected Health Cluster, led by Tallinn Science Park Tehnopol, is Estonia’s largest health technology community, bringing together health service providers, health technology companies and all other relevant stakeholders. The cluster’s support enables domestic cooperation projects and the export of health technological solutions to other countries.

The cluster’s activities are co-financed by Enterprise Estonia.