When a child is diagnosed with a complex or long-term condition, the diagnosis is only the beginning. While the clinical conclusion is carefully established and recorded in the health record, parents and caregivers are often left to figure out what happens next beyond healthcare. Too often, that means weeks of searching, phone calls, repeated explanations to different institutions, and new assessments along the way. As a result, connecting families to the right support can take time – and the work of navigating services becomes part of the care itself.
In Estonia, a new cross-sector event service closes that gap. It enables local social care authorities to reach out proactively – while keeping medical data protected.
The service links two national systems: the National Health Registry and the Social Services and Benefits Registry. When a qualifying record is entered in the Health Registry, the social sector receives a safe signal that outreach is needed. This happens without requiring additional steps from clinicians at the point of care. Families, in turn, can be connected to non-clinical support earlier – without having to navigate the system from scratch.
In collaboration with Estonian Health and Welfare Information Systems Centre, Kodality supported the initiative by building a new module for cross-sector event notifications, along with the necessary integrations and the secure event-delivery API between national health and social systems.
The problem: when support is available but not reachable
Before this service existed, families often had to navigate fragmented processes to access social support – even when the healthcare need was clear.
A typical “before” journey looked like this:
1. A child receives a diagnosis that implies persistent support needs, but the family does not have a clear overview of what support exists beyond clinical care.
2. The family must independently find out which institutions to contact and which services might apply.
3. Information related to the child’s health condition is submitted repeatedly across services, alongside repeated assessments.
4. Needs-based support is delayed, and help can remain fragmented across sectors.
The shift: from reactive paperwork to proactive outreach
The new service introduces a proactive model: a qualifying health-related record triggers a safe notification to the social sector, enabling early outreach.
In practice:
1. A diagnosis from a predefined list is recorded in the National Health Registry – nothing changes for the clinician.
2. An automated cross-sector notification is sent to the local municipality.
3. A municipal social worker can now proactively contact the family and guide them through relevant social services and benefits, explaining available options and next steps.
It is not about moving medical care into social care. It is about making sure families get to the right door sooner.
The privacy boundary
The service is designed around strict data minimisation. The social system receives only what is needed to act – and nothing more.
Through the new API, the module can retrieve:
- a unique reference to the event,
- the time the event occurred,
- the child’s identifier needed to route the case correctly.
What is not exposed through the same interface:
- diagnosis codes (ICD-10),
- clinical summary content.
What we delivered: the exchange that makes it work
Kodality supported the initiative end-to-end with a focus on interoperability, product delivery, and safety-by-design across organisational boundaries.
Our team built a dedicated microservice, the Social Registry notification, to encapsulate the logic for detecting qualifying paediatric cases from clinical summary events and managing event state.
Our developers also implemented secure cross-system event delivery over X-Road REST API, enabling the Social Registry to retrieve undelivered events and mark events as delivered – with audit logging on event retrieval and resilience to interruptions through the undelivered-events pattern.
To make the service safe and maintainable in production, we established the required integrations and controls.
A blueprint for cross-sector services
This cross-sector exchange was developed in collaboration with the Estonian Health and Welfare Information Systems Centre and has been in operation for new cases since 8 December 2025.
This is a specific service for a specific group, but the pattern is broadly applicable wherever early action matters and clinical confidentiality is non-negotiable:
- Event-triggered outreach – a qualifying record in the Health Registry triggers action in the social sector.
- Data minimisation by default – escalation only when needed and consented.
- Data privacy – linked identifiers handled via MPI and explicit authorisation.
If you are considering event-driven exchange across sectors, we would be glad to share our practical implementation learnings from Estonia. Let’s discuss how automated data sharing can turn weeks of waiting into immediate support for those who need it most.