Duodecim’s system that warns physicians about potential mistakes receives notable recognition in Estonia

A large national project was executed in Estonia, within the limits of which Duodecim’s Clinical Decision Support EBMEDS® service was implemented into the country’s health care. The project took first place in the Estonian Ministry of Economic Affairs and Communications’ contest that searched for the best digital public service. The widely used digital service, which is developed in Finland, is a system used by physicians and nurses that promotes patient safety and improves the quality of treatment. In practice, the service warns physicians about, for example, mistakes.

Seventy-five applications were submitted to Estonia’s digital services contest, and 10 were chosen for the final. A project aimed at introducing the winner, Duodecim’s EBMEDS service (Evidence-Based Medicine Electronic Decision Support), began in May 2020.   The Estonian Health Insurance Fund acquired Duodecim Publishing Company Ltd’s Clinical Decision Support for the family doctors practising in Estonia in order to improve the quality of treatment. Based on research, the quality of care varied because, due to their heavy workload, physicians did not have enough time to learn about new clinical practice guidelines or the patient’s earlier medical history: their diagnoses, performed examinations and medications.

“The Clinical Decision Support for health care, which was chosen as the winner, will solve an important problem, and its technical level is extremely high. The Clinical Decision Support will significantly reduce the administrative burden of both service providers and users. In addition, it is user-centered, safe and it has the potential to be a pioneer in the world,” says Siim Sikkut, the Chair of the Contest Committee and the Undersecretary for Ministry of Economic Affairs and Communications.

The Clinical Decision Support system, which has been adapted to Estonia’s needs, speeds up working and improves patient safety. The system has been used by general practitioners and nurses. In Estonia, there are plans to expand the use of the Clinical Decision Support system also in hospitals.

In addition to Duodecim, the Estonian Health Insurance Fund, the Ministry of Social Affairs, the Family Physicians Association of Estonia, the Health and Welfare Information Systems Centre, Duodecim’s local partner Synbase and the developers of the electronic health record were involved in the cooperation project. 

EBMEDS service speeds up working and improves patient safety

The EMBEDS service receives information describing the patient from their patient record and produces warnings and reminders, proposes treatments and provides links to treatment recommendations. The system significantly improves medication safety by reminding the professional about, for example, the harmful drug interactions of medications prescribed for patients.  The system also speeds up and makes the use of electronic forms and other programs easier as the required information can be automatically extracted from the patient record. In addition to real-time clinical decision support, EBMEDS can also be utilised for solving treatment problems related to groups of patients.

The Clinical Decision Support is in use in all domestic public sector electronic health record systems. Besides Estonia, the system has users, for example, in Italy and Belgium.

“I am very pleased about the award that has been given to Clinical Decision Support,” says the project’s Director of Development and physician Ilkka Kunnamo, who has been involved in the development of the system from the very beginning.

 “The credit for almost 10 years of work goes to the whole development team and the active customers. Especially our Estonian representative Synbase has, with expertise, applied Clinical Decision Support to local treatment recommendations and as part of the national cloud service.”

The service can be connected to all electronic patient record systems that store structured patient data.

See the Estonian Health Insurance Fund’s press release about the competition (in Estonian).

More information:

Export Manager Timo Haikonen, Duodecim Publishing Company Ltd, tel. +358 50 528 2568,

Communications Manager Outi Romero, The Finnish Medical Society Duodecim, tel. +358 40 756 7134,