E-health program launched

• Abstract
• Purpose of health policy or idea
• Characteristics of this policy
• Political and economic background
• Purpose and process analysis
• Expected outcome
• References

Abstract

E-health has been a 'priority' for several recent ministers of health in Slovenia. This time it appears that the steps undertaken are more decided and more binding. There are two main reasons for such a conclusion. The first is in the fact that a feasibility project has just been completed with involvement of all stakeholders. The second lies in the use of EU structural funds, which will be the biggest commitment of its kind in health care. This report describes the feasibility project outcomes.

Purpose of health policy or idea

There are several objectives of the e-health programme:

1. Setting up enhanced communications across the entire network of health care providers, thus facilitating patients' use of health services.
2. Enabling patients to interact with, seek and use health care providers by using the modern ICT.
3. Simplifying financial transactions in health care.
4. Promoting the use of health care data at an aggregate and analytical level for improvement of quality in health care.

The main characteristics of the e-health programme are:

1. Involvement of key stakeholders in health care for mobilisation of all available human and technical resources.
2. Interaction of health care with the public administration sector to benefit from the existing IT solutions enabling citizens to access administrative database and services.
3. Providing patients with secure instruments to access own health data through their own physician or independently. In this frame, the national electronic health record will be developed.
4. Catching up on the delay in the development of up-to-date ICT solutions for health care.
5. Use of structural funds as means to promote and facilitate the use of 'domestic' know-how and provision of solutions.

Expected outcomes:

1. A national health care network for data exchange, remote access to nationally relevant databases, provision of health data for patients and their treating health professionals.
2. A national health portal and national e-entry point into health care by patients/citizens and by primary care physicians and other authorised health care staff.
3. An electronic health record

Main points

Main objectives

 

Type of incentives

The main financial incentive for providers will be in assured funding of all key activities of the e-health program through EU structural funds and through the national budget. This will for the first time provide a stable base for the launch of several important solutions that will provide benefits to patients and citizens, to health care providers and to financiers. Many of these benefits will be non-financial, mainly in facilitating easier use of services, better access to data, enhancing quality of health care and better monitoring and evaluation of health care provision.

Groups affected

Patients/citizens, health care providers, health insurance

Innovationsgrad	traditionell		innovativ
Kontroversität	unumstritten		kontrovers
Strukturelle Wirkung	marginal		fundamental
Medienpräsenz	sehr gering		sehr hoch
Übertragbarkeit	sehr systemabhängig		systemneutral

 

Political and economic background

The decision to undertake the e-health program was already taken in 2005 with the adoption of the e-health 2010 strategy. There was only a need for finalization of the key elements in order to submit a full proposal for EU structural funds and to carry out a proper feasibility study for this purpose in Slovenia. E-health is one of the most important priorities of the present Minister of Health who took office in November 2008. This fact will also be reflected in the accompanying changes to the respective legislation.

Change based on an overall national health policy statement

e-zdravje 2010 (e-health 2010)

Purpose and process analysis

Current Process Stages

	Idee	Pilotprojekt	Strategiepapier	Gesetzgebung	Umsetzung	Evaluation	Veränderung/Richtungswechsel
Implemented in this survey?

Origins of health policy idea

The idea had been generated by the Health Sector Management Project (HSMP), sponsored through a loan of the International Bank for Reconstruction and Development. This project addressed reimbursement in the hospital sector and the shortcomings of the electronic business in health care in all its aspects. A design and implementation of a national data clearinghouse was envisaged but it never became a reality. Instead, in the government term 2004-2008, an Advisory Board to the minister of health was established, specifically dedicated to e-health. This Board adopted the strategic document called 'E-health 2010' and through its adoption a framework for future action in the field of e-health was set up. Two additional practical triggers were in the need to technologically support an online solution for waiting list management at the national level and to enable all health care providers to access data on providers and the network of providers and their contractual relationships with the different insurance companies.

Initiators of idea/main actors

• Regierung

Approach of idea

The approach of the idea is described as:
amended: Resolution on the national health care plan 2008-2013

Stakeholder positions

The exploration of the positions of individual stakeholders followed in the framework of the national feasibility project. Generally, all key stakeholders strongly support the need to establish a national data exchange authority, which would also adopt some difficult decisions on behalf of all stakeholders.

The Health Insurance Institute of Slovenia (HIIS) sees the implementation of the e-health program as the 'next step' of their health insurance care online project. In that sense they are supportive of the project.

The National Institute of Public Health (NIPH) was quite concerned about the possibility that all of its many databases would be moved away from the NIPH's structure, which is something that they strongly oppose.

Actors and positions

Regierung
Health care providers	sehr unterstützend		stark dagegen
Statutory Health Insurance Institute	sehr unterstützend		stark dagegen
National Public Health Institute	sehr unterstützend		stark dagegen
Ministry of Public Administration	sehr unterstützend		stark dagegen

Influences in policy making and legislation

This programme will lead to changes and restructuring of the main legal act defining health reporting - Law on health data collections (2000). This law will need to be revised and adapted in order to include the proposed changes, such as the new structures - Council on Health Informatics, Committee on health information standards and the Center for Health Informatics as new entities with clearly outlined roles and positions in the system.

The changes of this law will be triggered by the MoH but will involve the National Institute of Public Health as the responsible institution for health reporting, the Health Insurance Institute and the associations of providers.

Actors and influence

Regierung
Health care providers	sehr groß		kein
Statutory Health Insurance Institute	sehr groß		kein
National Public Health Institute	sehr groß		kein
Ministry of Public Administration	sehr groß		kein

Positions and Influences at a glance

Adoption and implementation

Implementation of the program will be an ongoing process leading to different outputs that will be piloted and then implemented along the way as the program will be running over 7 years in its initial phase.

Monitoring and evaluation

Monitoring and evaluation in the supervisory role will be the responsibility of the Council for Health Informatics but the actual work in these functions will be done by the professional team within the Centre for Health Informatics.

Results of evaluation

 

Expected outcome

This programme will achieve at least some of the proposed objectives, mainly as most of the key stakeholders agree on the need for change and are interested in the implementation of its outcomes.

The most important outputs that will be implemented soon are:

1. The secure health care network for exchange of data on treatment and reporting

2. Health portal and e-services within the statutory health insurance

3. Building up of renewed national reference databases.

Impact of this policy

Qualität	kaum Einfluss		starker Einfluss
Gerechtigkeit	System weniger gerecht		System gerechter
Kosteneffizienz	sehr gering		sehr hoch

There will be an important investment in e-health solutions through this programme - an estimated 31 million EUR. It will definitely have an impact, that is an easier and more equitable access to services, though there may be some limitations to the use of all these solutions for all patients. After the initial investment, it can be expected that savings will occur through the simpler processing of patient data and in patients better access to health services and to own data.

References

Sources of Information

1. Ministry of Health. E-zdravje 2010 (E-Health 2010) - national strategy on health information system development. Ljubljana, 2005.

2. Law on health data collections. Official Gazette of the Republic of Slovenia 2000;65.

3. Resolution on the national health plan 2008-2013 - 'Satisfied patients and health care providers'. Official Gazette of the Republic of Slovenia 2008;72.

Author/s and/or contributors to this survey

Albreht, Tit

 

Empfohlene Zitierweise für diesen Online-Artikel:

Albreht, Tit. "E-health program launched". Health Policy Monitor, April 2009. Available at http://www.hpm.org/survey/si/a13/2