Researchers at the University of Tartu and their partners have developed Andmering, a methodological framework that turns routinely collected health data into actionable feedback for clinicians, supporting continuous improvements in the quality of care. Estonia has been collecting digital health data for many years.
Its national Health Information System (TIS), developed by the Health and Welfare Information Systems Centre (TEHIK), has been in use since 2008. However, these data have so far been used only to a limited extent to provide clinicians with regular feedback on patients’ subsequent care pathways and treatment outcomes.
A new article in Eesti Arst describes Andmering, a methodological framework that shows how routinely collected healthcare data can be used to assess the quality of care on an ongoing basis and provide clinicians with regular feedback. The framework builds on the OMOP Common Data Model, an open international standard that harmonises data from different sources into a common analytical format.
Researchers at the University of Tartu’s Institute of Computer Science, including Marek Oja and Jaak Vilo, have been converting Estonian health data into the OMOP format across projects and datasets for more than a decade. The framework also draws on the experience of clinicians who established and developed disease registries to track patients’ outcomes over time.
The framework’s first application focuses on cardiovascular diseases. The pilot study covers acute myocardial infarction, atrial fibrillation, heart failure, valvular heart disease and familial hypercholesterolaemia. It examines which quality indicators can be calculated and validated using existing data and then used to provide feedback to clinicians.
The authors of the article are Riina Raudne, Artur Novek, Taavi Lai, Kerli Mooses, Monika Prits, Raivo Kolde, Patrick Pihelgas, Sulev Reisberg, Jaak Vilo and Alar Irs.
Andmering took shape over the past year within the TeamPerMed Centre for Data-Enriched Personalised Medicine. It was co-developed with the Estonian Health Insurance Fund (Tervisekassa), which has been involved from the outset.
With support from Eesti.ai, Tervisekassa and TEHIK are now building a nationwide OMOP data layer within STEEL, with data updated nightly. Data scientists at the University of Tartu are providing methodological support. According to Raudne, the first version is expected by the end of the year.
The EST-Health-30 research dataset, co-funded by TeamPerMed, serves as the development environment. The forthcoming European Health Data Space (EHDS) also adds momentum to this work.
Raudne emphasises that Andmering is not yet complete:
The whole point is to go through the full cycle. We have done a lot to collect health data and store it securely, but learning from them is the real next challenge, and it is a very large organisational one. We have not been through that yet, but we want to get to a point where we can learn faster and at scale.
Riina Raudne, first author of the article
Andmering is the result of collaboration between researchers, clinicians and public-sector partners. TeamPerMed acknowledges the article’s authors — Riina Raudne, Artur Novek, Taavi Lai, Kerli Mooses, Monika Prits, Raivo Kolde, Patrick Pihelgas, Sulev Reisberg, Jaak Vilo and Alar Irs — as well as the leadership teams at Tervisekassa and TEHIK and partners at the Ministry of Social Affairs for their trust and willingness to experiment.
Image: Riina Raudne presenting the Andmering framework.
