Lithuania is taking important steps towards more open, interoperable, and future-proof healthcare systems. The partnership between Better and Varutis combines Varutis’ deep roots in the Lithuanian hospital landscape with Better’s openEHR platform and tools, helping to bring open standards from concept into everyday clinical practice.
We sat down with Evaldas Dobravolskas, CEO of Varutis, for this year’s edition of Mission, and talked about why openEHR became a strategic choice, what early implementations at Šiauliai and Klaipeda University Hospital are teaching them, and how this partnership could shape the future of healthcare data in Lithuania and beyond.
Varutis and Better have formed a partnership that introduced a new openEHR-based EHR and data platform in Lithuania. From your perspective, what makes this collaboration important for both companies and for the Lithuanian healthcare system?
As we began our partnership, we expected, and we received, a great experience in openEHR. All the ecosystem, tools, technical experience, knowledge transfer, and everything we got from Better was great. First, we completed a small pilot project at Šiauliai Hospital in Lithuania together, and we gained a real understanding of what openEHR is and how effective the Better tools are. We can now use these tools to develop our open care solution and platform based on Better tools and the overall CDR platform.
On the other hand, our partnership and activities in Lithuania also offer the possibility to be more present and closer to hospitals in Lithuania, as the majority of hospitals in Lithuania are our clients. So, the Varutis and Better partnership brings openEHR closer to the hospitals. We hope that these common actions, both international from Better and local from Varutis, will bring openEHR closer to government and national decisions to consider using openEHR or Better tools, as well as Varutis tools. However, first and foremost, we need to bring the final decision about openEHR to the Lithuanian government’s attention, and we believe we are quite close to achieving that. We have a common partnership agreement, and we are participating in some actions for which we hope to receive final decisions in tenders, and possibly achieve success.
Positioning openEHR in the Lithuanian healthcare is a strategic decision. Why did you decide on openEHR, and how is the process progressing?
The final decision was relatively easy, but the road to get here was quite long. We have quite an old hospital information system, and we needed to decide how to rebuild a next-generation system, so we evaluated different approaches. We had numerous discussions with FHIR experts, openEHR experts, and your team, and ultimately decided that openEHR was the best approach for Varutis. We believe that our partnership is the best way to initiate the redevelopment of our existing OpenCare product and to transition our current clients to a new system.
At the national level, we were uncertain about how it would proceed in the future, but we have seen some promising signs. We are attempting to implement pilot projects at the national level to test the technology and establish openEHR as a standard in hospitals, and we hope it will be successful. We have currently completed one pilot and are working on two projects. One is at Klaipeda University Hospital, which is the third largest in size in Lithuania, and they have decided to adopt openEHR as a long-term project, not just a pilot. They will develop their own team, train on openEHR technologies, and we hope that this will serve as a good example for hospitals in Lithuania.
How do you see Better platform and tools like Better Studio, Portal, and Clinical Data Repository helping you deliver on your goals for Lithuanian hospitals?
We have excellent references from Better customers in other countries, and we can see the benefits not only as tools but also in effective use cases for hospitals and regions, such as the UCP and other projects. We are pleased that these reference sites and tools are currently the best available on the market. We see that the low-code studio and platform, along with their compatibility between these separate tools, are a very essential advantage compared to other competitors. So it’s a great ecosystem of openEHR tools.
And what do you see as the benefits these tools bring both to patients and clinicians?
The primary benefit of openEHR usage is data openness, data quality, and the potential for closer alignment with a physician’s logic, rather than technological logic. The core of clinical data in openEHR enables more precision in the medical process, and the openness of openEHR allows for the introduction of different solutions for physicians. And I hope and believe that in the future, they will have a relatively easy possibility to choose the best solution they want, not being tied to one vendor and having to work with their solution. If openEHR is implemented in their hospital, they will have the option to choose which tools to use, and patients will benefit from receiving better services from the physician’s side. Therefore, the primary benefits will come to physicians, who, in turn, will pass these benefits to patients.
We have already mentioned Klaipeda University Hospital, which is the first one to implement your system.
Klaipeda is the second one we have worked with, but the first University Hospital. It is the first hospital to have its own team working with Better Studio, utilising Better tools, and will conduct its own development activities on openEHR together with the Varutis team. Our first common deployment was at Šiauliai Hospital, where we initiated the EuroHeart project, the first openEHR project in Lithuania. It was an interesting project, because it is a European-wide clinical register, and it was based on a Swedish dataset. We introduced openEHR data modelling across the overall dataset, and all data is now stored in openEHR. Now, it may be easier to spread solutions to countries or hospitals that already have openEHR, as we are a part of the EuroHeart register within Europe. It will be an interesting future.
Do you see potential for OpenCare to expand beyond Lithuania, and if so, what markets or regions do you have in mind?
Our primary goal is to accomplish all that needs to be done in Lithuania. We hold more than 50% of the Lithuanian market share, and we need to transfer or transform the sector to openEHR. We hope to achieve this within the next two years, approximately. In parallel, we see opportunities for partnerships within one or more projects to share our experience in solutions like EuroHeart or similar. And, of course, we are looking to our neighbours; we know that Latvia and Estonia also have some opportunities. The openEHR community enables us to view it not as a market, but rather as a competency-sharing platform across different sectors or areas of openEHR. As a relatively small company, we can be a partner in some of these actions. Currently, we are focusing on Lithuania, but we see potential opportunities for exchanging work with you and your partners, as well as with our possible future partners.
How do you see our partnership evolving, and what role do you expect Varutis and Better to play in the next years?
We hope to be the partners who can share the best knowledge, both our local understanding of regulatory expectations in the Lithuanian market, as well as the international experience and expertise that Better brings. We aim to be the best-known openEHR partners in Lithuania and possibly the number one choice for hospitals and national solutions. We are confident that our local experience and Better experience will enable us to do so.
And from your perspective, what are the main challenges in the digital healthcare market today?
In Lithuania, as in other countries, our main challenge is reaching a consensus. OpenEHR is one of the topics discussed over the last three years, but currently, most actions are pilots and tests. We need to agree whether openEHR should be present at the national level, at the hospital level, at the regional levels, and also what the long-term directions are. The main challenge will be to choose a direction that is a common agreement among hospitals, the government, and politicians at the national level, one that will not change after the elections and with the change of government.
Looking ahead, what trends do you expect will most influence the future of healthcare and health IT in Lithuania over the next years?
I believe that the ecosystem surrounding openEHR and what Better aims to build on the Marketplace of openEHR-based solutions will be the most influential, as this openness and the possibility of not depending on a single large vendor will allow us to have different choices. AI solutions will also transform healthcare. It is still quite sensitive, and the outcome will depend on how we wisely integrate AI into the treatment process. It’s not written text; it’s medical decisions on patient treatment, so it’s challenging to predict how quickly it will be adopted into daily practice and to what extent physicians and medical staff will trust AI solutions. However, some existing use cases demonstrate that there is potential for assistance in the treatment process. We can see that openEHR may be the best choice for data management in AI-based solutions, as it has clear modelling and data coding, which are essential for AI to be seen as a trusted solution.
