E-consultation service
With the e-consultation service, a family physician can consult a medical specialist via the Health Information System to clarify the diagnosis and prescribe treatment. The family physician consults the medical specialist and prepares the appropriate digital referral for the e-consultation. The family physician sends the referral to the e-consultation provider of their choice via the Health Information System. The medical specialist examines the referral, makes a decision, draws up a proper response to the referral, and sends it to the family physician via the information system. The response must be drawn up within four working days of sending the e-consultation referral to the Health Information System. The family physician then decides on the next steps based on the response.
Funding for e-consultations and referral and response requirements have been agreed for the following specialities (links in Estonian):
- allergology-immunology
- endocrinology
- gastroenterology
- haematology
- cardiology
- neurology
- oncology
- orthopaedics
- otorhinolaryngology
- paediatrics
- pulmonology
- rheumatology
- urology
- nephrology
- psychiatry
- internal medicine
- gynaecology
- vascular surgery
- pain management
- rehabilitation
- dermatovenerology
- child psychiatry
- andrology
- general surgery
- infectionist
- medical genetics
- neurosurgery
- maxillofacial surgery
- paediatric surgery
Once the resources have been updated in the software of the family physician, the e-consultation providers in the selected speciality will be displayed. To do this, the family physician needs to update the resources at the start of each working day.
When interfacing with the service, we recommend that you choose the software that enables the e-consultation service and contact its manufacturer.
Once a family physician has decided that a person needs an e-consultation, they must assess whether the person meets the conditions for referral to an e-consultation. Descriptions of the conditions can be found here (in Estonian): ‘Procedure for the assumption of the obligation to pay a fee by the Estonian Health Insurance Fund’.
Annexes 19–23, 27–29, 31–38, 40, 42–45, 47, 50, and 52–57.
The e-consultation referral must be completed thoroughly enough to give the medical specialist a complete picture of the health concerns of the person. The reason for the referral and the purpose of the e-consultation request should be clearly described. Information about irrelevant examinations, etc. should be avoided.
The Health Insurance Fund will pay the family physician ONLY for duly provided e-consultations. In all cases, the medical specialist must prepare a response to the referral and send it to the Health Information System within four working days. No fee is charged for e-consultations that do not receive a response.
Currently, the family physician has to request answers one by one from the medical history of the person. Unfortunately, there is no automatic query that would display all the latest responses yet.
Depending on the health problem, the family physician can select the speciality and the INSTITUTION they are requesting consultation from. It is not possible to choose a specific medical specialist by name.
If the family physician decides that they need a second opinion from a medical specialist, they will write a referral for an e-consultation. If the medical specialist decides that the person needs to be invited to an appointment, the medical specialist will contact the person to arrange an appointment and book a suitable time. The family physician must make sure that the contact details of the person in the system are correct. The family physician will then inform the person (or, if necessary, their guardian or family members) that they may be contacted within the next four working days to arrange an appointment with a medical specialist.
The Health Insurance Fund finances the service from its operational fund. The medical specialist will invoice the family physician for the e-consultation service. The family physician then submits the invoice to the Health Insurance Fund to pay for the service. The Health Insurance Fund will pay the family physician for duly provided e-consultations.
You can get more information from your Health Insurance Fund administrator or from the websites of the Health Insurance Fund and the health care provider.
Patients can see the referrals for e-consultations in the health portal under ‘Valid referrals’ and the responses under ‘Responses to referrals’.