Dalibor Stanimirovic and Mirko Vintar
implemented by the year 2023 facilitating fully integrated national IS enabling monitoring of the on‐going treatments and related costs, faster access to medical data, medical services as well as cost evaluation, online ordering and coordination of waiting lists, increase of efficiency and transparency of the health care system and optimization of the business processes( Ministry of Health 2005 and 2008). Based on the Strategy for informatization of the Slovenian health care system 2005‐2010 and Resolution on the National Health Care Plan for the period 2008‐2013( Ministry of Health 2005 and 2008), all development activities are focused on:
1. The establishment of basic ICT infrastructure including: network used for communication and data exchange, Diagnosis Related Groups( DRG) and standardized definitions of health and social data required for development and management of Electronic Health Records( EHR) and e‐prescription as well as improvement of the health care Smart card functionalities. Existing diagnosis as well as medical procedures are standardized and structured according to ICD 10 AM 1 classification, whereas EDIFACT 2, HL7 3 and XML 4 are current data standards for transfer of messages.
2. Integration and merging health and social IS into a national HIS and establishing a central, unified health information portal that will allow all stakeholders within the health care system secure and reliable exchange of data, execution of electronic services as well as standardized and transparent information and interoperability with similar systems in the European Union( EU).
3. Introduction of e‐business as standard way of conducting operations and processes in the Slovenian health care system and promoting and encouraging the use of e‐health applications by all health care system stakeholders.
The e‐health project is thus divided into three substantially separate, yet related areas. The first area is the establishment of a national HIS, comprised of Health Network( hNET), a health portal( hAOP) and EHR. The second area represents the establishment and operation of Centre for Health Care Informatics, undertaking the central role in governing of IS. This area also includes upgrading and maintenance activities of the entire project after its completion. The third area will enable the improvement of health care processes, access to health care services as well as education and training of target groups. Although e‐health project is still deep in the implementation phase, Figure 1 presents the projected infrastructure of e‐health, which should become fully operational sometime after 2020( Ministry of Health 2005). Implementation of e‐health will presumably initiate twofold changes. First, significant changes can be expected in the field of informing, empowerment and inclusion of patients in the health care process, and second, well‐designed e‐health should facilitate timely access to relevant data and information and consequently initiate better supported decision‐making at all health care, administrative and management levels. According to the project objectives, the fully functional version of e‐health should provide standardized bi‐directional connections between the designated entities of the health care system, network synergies and substantial improvements in information and resource flows. More specifically, this means that e‐health should allow monitoring of the patient throughout the medical process, recording of all the activities associated with the patient, as well as control over the costs incurred in the various stages of treatment. Moreover, large deficits in the Slovenian health care in recent years, on the one hand, and long patient waiting times on the other, require more rigorous monitoring of the health care professionals’ workload and related output, labour and material costs, as well as control over the utilization of health care resources and facilities such as operating rooms, expensive diagnostic devices and laboratory equipment. 1
International Statistical Classification of Diseases and Related Health Problems( ICD) is a medical classification list developed by the WHO. It codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases( WHO 2012). 2 Electronic Data Interchange for Administration, Commerce and Transport( EDIFACT) is the international standard developed under the United Nations. It comprises a set of internationally agreed standards, directories, and guidelines for the electronic interchange of structured data between independent computerized information systems( UN 2012). 3 Health Level Seven( HL7) is a set of international healthcare informatics interoperability standards developed by the Health Level Seven International. HL7 network provides a framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information( HL7 2012). 4 Extensible Markup Language( XML) is a markup language that defines a set of rules and standards for encoding documents in a format that is both human‐readable and machine‐readable. It is developed by the World Wide Web Consortium( W3C)( WRC 2012).
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