Taking the innovation leap: Tervisekassa boosts security and innovation with SAP on Azure

Tervisekassa, the Estonian Health Insurance Fund, is dedicated to ensuring health security for Estonian citizens. Its main goal is to consolidate national health insurance information to provide insured people with access to necessary healthcare services, medicines, medical equipment and cash benefits. The fund is also advocating for disease prevention, health promotion and e-health development, fostering a healthcare system grounded in unity and equitable health provision.

To achieve its strategic goals of improving health management, Tervisekassa recognized the need to modernize its infrastructure. It was especially struggling to effectively manage its SAP system—a suite of enterprise resource planning (ERP) software operating on SAP HANA, an in-memory database—through local partners.

This setup limited innovation and capped the potential for improving security and scalability. “SAP is a large and complex system, and in Estonia, very few companies can manage it,” says Karl-Henrik Peterson, Chief Digital Transformation Officer at Tervisekassa. ”To deliver world-class service to our citizens, we need world-class partners. And certain tasks, such as ensuring security or maintaining data center infrastructure, cannot be performed locally at the same level as hyperscale cloud providers. This is why we needed to transition from outdated data centers to a cloud-based system and migrate our SAP ERP on HANA to Azure.”

Preparing for the migration

For Tervisekassa, ensuring data security is paramount. “We have to make sure that our data is not accessible to third parties while simultaneously enabling people abroad to access their health records,” Peterson elaborates. This led Tervisekassa to adopt a new security framework, enabling meticulous risk assessment ahead of its move to the cloud.

Next came the challenge of finding experienced partners. Peterson explains, “We couldn’t take any risks because we run mission-critical infrastructure. So, we needed a partner who had a proven track record in technical migration. Microsoft is not just another cloud provider; it comes with a set of services, partners, and support that are crucial for us.”

Tervisekassa also needed to make sure they got the right legal support for the migration. For an extended period, Microsoft has been in collaboration with the Estonian Government to facilitate the advancement of the public sector through the use of cloud computing and AI. This partnership helps clarify allowable activities in the cloud, pinpoint potential risks, and formulate effective strategies to counteract those risks. As a part of the evaluation process, Microsoft's implementation partner Fujitsu Estonia has been selected, due to their expertise and experience, which ensured smooth migration.

The team structured the migration process in two parts: the actual migration and a hyper-care period. During this time, Tervisekassa identified areas requiring additional configuration and relied on the support from both Microsoft and Fujitsu to address these issues effectively. This structured approach ensured a smooth transition without compromising performance and the availability of healthcare services to Estonian citizens.

Unparalleled infrastructure scalability

And so, Tervisekassa became the first institution in Estonia to migrate highly regulated and sensitive public data domains to the cloud. As a result, Tervisekassa gained unparalleled scalability. “We were able to increase our Azure resources fourfold to test throughput,” says Peterson. “Typically, you can’t just scale up four times with on-premises resources and switch that off once you’re done testing. Thanks to Azure, we could do it.” Since quality assurance systems and tests only run for short periods, the company can save resources and reduce greenhouse gas emissions when they aren’t in use. What’s more, since its systems run in different geographic locations, Tervisekassa is protected from local natural disasters and geopolitical risks. Finally, the fund has saved about EUR100,000 in infrastructure and maintenance costs as a result of the migration.

With less IT infrastructure roadblocks, Tervisekassa can support new business initiatives at a higher pace. “We have been able to triple the rate of innovation by combining Azure's capabilities with organizational change,” adds Peterson. This has resulted in more accessible healthcare services for Estonians. “We were able to add 21 additional customer-oriented services with the same number of employees and resources,“ Peterson adds.

With Azure, Tervisekassa's service is even more efficient and reliable. Peterson emphasizes, “When a citizen goes to a hospital, if they are covered by health insurance, they expect not to pay anything except their co-payment. If our systems are down, they might have to pay the full amount or go without care. With Azure, we can ensure that our systems are available to citizens when they need it,” adds Peterson.

After the migration, Tervisekassa also finds it easier to safeguard its systems. “Previously, we spent a lot of time verifying and ensuring security with our partners. In Azure, the picture is clear. We can clearly see the patterns of malicious activities and act on them,” adds Peterson. This has also brought more security to citizen data. “Citizens do care about what happens to their data,” Peterson adds. “That’s why having some of the world's leading companies as partners builds trust."

Looking ahead for more innovation

Tervisekassa aims to continue leveraging technology to enhance healthcare services. “Next, we want to focus on data analysis, specifically with Microsoft Fabric and Purview,” Peterson remarks. “AI is also a big part of our future plans.”

Reflecting on Tervisekassa’s journey, Peterson concludes, “We are just getting started and there is still so much more we want to do. Azure opened new possibilities which we plan to use to increase our rate of innovation. This, in turn, will benefit all Estonians.”