EBMEDS, The Evidence-Based Medicine Electronic Decision Support, has become an established part of primary healthcare in Estonia, where user research demonstrates high satisfaction, clear clinical impact, and significant efficiency benefits. The system has been in nationwide use since 2020 and plays a central role in supporting everyday clinical decision‑making.
User feedback highlights real‑world clinical value
The latest user survey shows strong overall results. Clinicians rate EBMEDS highly, with an average score of 8.3 out of 10, a Net Promoter Score of 44, and 89% of respondents rating its usefulness as 4–5 on a five‑point scale. According to Gerda Joa, Product Owner at the Estonian Health Insurance Fund, the positive feedback reflects the system’s practical value in daily work.
“The overall experience with EBMEDS has been very positive. The main value of EBMEDS lies in its practical impact on everyday clinical decision‑making.”
Gerda Joa, Product Owner at the Estonian Health Insurance Fund
“As a unique aspect in Estonia, we have developed a data aggregator that combines data from the national health information system, the e‑prescription system, and GP software, ensuring a more complete view of patient data,” Joa explains. “While integrating multiple data sources made the implementation more complex, it has created a strong foundation for high‑quality clinical decision support.”
Equally critical to success has been the adaptation of the solution to local needs, national clinical guidelines and local language content. This work is supported through close cooperation with partners such as Synbase and the Clinical Guidelines Council, ensuring that both technical implementation and clinical content are aligned with the Estonian healthcare context.
“In our view, localization is not a ‘nice to have’ but a ‘must have.’ It accelerates decision‑making, reduces the risk of errors, and enhances usability for healthcare professionals of all ages,” Joa emphasizes.
User research also highlights EBMEDS’s direct clinical impact. Two thirds of respondents report that the system has influenced treatment, diagnosis, or investigations. “The decision support helps clinicians reassess their initial decisions, supporting treatment choices, diagnostics, and selection of investigations,” Joa says. “User feedback also shows that decision support helps clinicians identify important details that might otherwise be overlooked, particularly in complex cases involving multimorbid patients.”
Time savings and workflow efficiency across professional roles
Efficiency gains are another key outcome highlighted by the survey. According to the results, 95% of users report full or partial time savings. By delivering relevant recommendations, calculators, and guideline links directly within the clinical workflow, EBMEDS reduces the need for separate information searches.
“EBMEDS helps save time primarily by delivering relevant information to healthcare professionals at the right moment and in the right context,” Joa notes. “In many cases, the algorithms already provide an initial direction for patient management, meaning there is not always a need to consult the full guideline separately.”
The survey results show particularly strong benefits for nurses, who consistently report slightly higher satisfaction than physicians. “The role of primary care nurses has grown significantly in recent years, and in many practices, the nurse is the first point of contact for the patient,” Joa says. “Decision support is particularly valuable, helping them assess the severity of a situation, make initial decisions, and determine when to involve a physician.”
This also improves efficiency across the care pathway. “When a patient is referred, the necessary preliminary steps are often already completed, making the process more efficient and allowing physicians to focus directly on the patient’s core issue,” Joa adds.
Looking ahead, support for EBMEDS remains strong, with 94% of survey respondents wanting the system to continue. EBMEDS is now an integral part of Estonia’s digital health strategy, with localization and alignment with national clinical guidelines seen as essential for continued success. Future development will increasingly focus on leveraging artificial intelligence to make decision support more intelligent and context‑aware, including the introduction of more advanced search capabilities.
“In my experience, EBMEDS is more than software. It is a valuable tool that brings timely and reliable knowledge into everyday practice, helping to prevent medical errors, save time, and improve both treatment outcomes and quality of care,” Joa concludes.
__________________
The agreement for the use of Duodecim’s EBMEDS in Estonia has been renewed to cover the next six years.