February 25th 2026
Estonia is frequently described as a digital leader, particularly in health care. But what has it actually done, and what can the UK learn from it?
As part of our Digital Care in Focus series on interoperability, we are looking beyond the UK to understand how other countries are connecting data across services.
Estonia’s electronic health record system is often presented as a model of national interoperability. As outlined in Estonia’s digital health revolution, the country has built a nationwide system in which clinical data from across the health service feeds into a shared electronic record. Clinicians can access up to date information wherever a person presents for care, and citizens can log in to see their own data.
It is important to recognise, however, that Estonia’s most mature achievement is in interoperable health care data systems. Social care data is managed through a separate national platform, known as STAR, with integration between the two continuing to evolve.
A national electronic health record built for sharing
Estonia launched its national electronic health record in 2008. All health care providers are required to submit key clinical information to the national health information system, creating a longitudinal record for every citizen. This includes discharge summaries, test results, diagnoses and prescribing information.
The technical foundation for this system is X Road, a secure data exchange layer used across Estonian public services. Rather than storing everything in one central database, X Road enables different systems to exchange data securely when needed. This architectural choice has allowed Estonia to scale digital services while maintaining strong data protection controls.
Citizens access their health information through a national patient portal linked to Estonia’s digital identity system. Individuals can view their own records and see who has accessed them. As described in Estonia’s digital health revolution, this transparency has been central to building public trust.
Estonia’s progress is reflected in European comparisons. According to Digital health across Europe: which country leads access to electronic health records?, Estonia ranks among the leading countries for access to electronic health records and digital prescribing. Electronic prescriptions are now standard practice and are embedded within the same national infrastructure.
In practice, this means clinicians can make decisions based on a complete and accessible health history, reducing duplication and improving continuity of care.
Social care data through the STAR system
While Estonia’s health record infrastructure is widely recognised, its approach to social care data receives less attention.
Social care information is managed through STAR, the social services and benefits registry. As explained in Estonia’s STAR system implements and monitors case management methodologies, STAR was introduced to support structured case management across municipalities. It enables social service providers and local government bodies to record needs assessments, develop case plans, allocate services and monitor delivery.
STAR is not only a frontline practice tool. It also generates national level data for oversight and performance monitoring. The European Commission report The organisation and financing of social protection in Estonia highlights how digital systems have supported coordination and consistency in Estonia’s social services and benefits administration.
In effect, STAR combines functions that in England are often spread across multiple systems. It supports case management, reporting and regulatory oversight within one national framework. The underlying principle is that information should be recorded once and reused where appropriate, reducing duplication and administrative burden.
Although STAR and the electronic health record system were developed separately, both reflect Estonia’s wider commitment to interoperable public services.
Strengthening links between health and social care
Estonia recognises that effective support for people with complex needs requires coordination across sectors. According to the European Observatory health systems monitor: Estonia’s plan to integrate health and social care systems, the Ministry of Social Affairs published plans in 2025 to improve integration between health and social care systems.
The proposals focus on aligning regional planning structures, improving coordination mechanisms and using digital tools to better identify and support vulnerable groups. The ambition is to move beyond parallel systems towards more coherent care pathways.
At present, Estonia’s health and social care data systems remain distinct. However, both are nationally standardised and designed for data sharing, creating a foundation for closer interoperability in the future.
Lessons for the UK health and care system
Estonia’s experience offers several practical lessons for the UK.
Interoperability requires strong national infrastructure. Estonia’s early investment in secure data exchange and digital identity created a platform on which multiple services could build.
Transparency supports trust. Allowing citizens to see their own records and track access has strengthened confidence in digital data sharing.
Social care data infrastructure matters as much as health data. STAR demonstrates that national systems can support frontline practice while also enabling oversight and performance monitoring.
Finally, integration is an ongoing process. Estonia’s electronic health record system is mature and widely embedded. The work to bring health and social care information closer together is still developing.
References
- Estonia’s digital health revolution
- Digital health across Europe: which country leads access to electronic health records?
- European Observatory health systems monitor: Estonia’s plan to integrate health and social care systems
- Estonia’s STAR system implements and monitors case management methodologies
- The organisation and financing of social protection in Estonia