EHR S ystems U se and Q uality in Bulgaria

EHR EHR SSystems ystems UUsese and and QQualityuality in Bulgariain Bulgaria

Latchezara Maneva, Head of Application software department, NHIF

Tzvetan Georgiev, expert NHIF

EHR Systems Quality Labelling and Certification21 - 22 November 2011, Belgrade

National Health Insured fundNational Health Insured fund (NHIF)(NHIF)

NHIF carries out the obligatory health insurance in Bulgaria.

It was founded as an independent public

institution;Separated from the structure of the social

healthcare system; It has its own bodies of management.


The obligatory health insurance in Bulgaria is implemented on the basis of the following Major principles:

Obligatory participation in the contributions recruitment; Participation of the state, the insured persons , and the employers

in the NHIF management; Solidarity of the insured persons in using the funds; Equality in the use of medical care; Equality of the medical care providers on signing contracts with

NHIF; Self government of NHIF; Publicity in the NHIF activities.


NHIF contract partners - 2011NHIF contract partners - 2011

◦ GP practices 4030, doctors 4700;◦ Specialists practices 3050; doctors 11400;◦ Dental practices 5432; dentists 5775;◦ Laboratories – 650;◦ Hospitals – 330; ◦ Pharmacies – 2040.

NHIF pays out each month of its contractual partners for

the carried out health care (for Bulgarian citizens or EU citizens).


Integrated information system (IIS)

Since 2009 NHIF designed, developed, and brought into operational level its own

integrated information system.

The system is about to input, process, and store the complete medical information of

performed medical care from the NHIF contractual partners.

The information in the system is entered

and processed on a monthly basis.


Personalized information system (PIS)


As a health insurance authority, NHIF obtained medical and personal information about patients as a prerequisite for payment of the activities performed by hospitals, partners of the NHIF.

This information is stored centrally in the National Health Insurance Fund and it is used to build a unified single patient's file for health insured persons in Bulgaria.

Patient's file integrates and store historical information for the patient’s registration with GP, its diseases, allergies and immunizations, and all medical services which were provided by various medical institutions (hospitals, laboratories, pharmacies, primary outpatient care, specialized outpatient care, etc.).

The Personalized Information System is build up on the basis of information contained in the integrated system of the NHIF.

Personalized Information System was developed as a system of Data Warehouse type.

Electronic Health RecordCategories of data stored on individual EHR are:

• Personal data of the patient (identification, names, addresses, contacts);• Medical data of the patient (allergies, immunizations, blood type, Rh blood group system);• Registration with GPs;• Dispensary;• Risk groups;• Prescribed and dispensed drugs, medical food and supplies;• History of the medical, diagnosis, outpatient sheets issued;• Laboratory tests;• Made of highly specialized procedures, physiotherapy activities, and other medical manipulations;• Dental care;• Hospitalization.


Portal of the NHIF


Integrated Information System

Portal of the NHIF

Personalized Information System

Contract partners

Insured persons Government and state Institutions

• Ministry of health;• National revenue agency;• National social security Institute;

Single patient's file for health insured persons


EESSI (Electronic Exchange of Social Security Information)

Regulation no. 883/2004 (EC) from 29th April 2004 on the coordination of social security systemsRegulation 987/2009 of the European Parliament and Council (EC) from 16th September 2009

According to the regulations 883/2004, and 987/2009, the obligation of all EU member states is to secure international electronic data exchange in the area of social security within the framework of the entire European network.

The electronic data exchange should gradually completely replace paper communication between the institutions of the member states. Every member state accesses the EESSI system via a so-called Access Point which consists of a national and an international part.

An Access Point is understood as being any electronic contact point designated by the appropriate organ for one or more of the areas of social security.

Bulgaria will have 4 Access Points to cover the areas of social security of Regulation 883/2004. The APs are:

◦ the National Health Insurance Fund, ◦ the Agency for Social Assistance, ◦ the National Revenue Agency, and ◦ the National Social Insurance Institute.


NHIF and EESSI

Branches of social security which EESSI applies:

Sickness benefits - NHIF; Benefits for maternity and equivalent paternity - NHIF; Disability benefits; Security in old age; Survivors' benefits; Benefits for occupational accidents and diseases - NHIF; Death grants; Unemployment benefits; Pre-retirement benefits; Family benefits.


EESSIEESSI

List and present the public initiatives / projects, if any ◦To promote / enforce the use of EHR systems◦To assure quality of the systems◦To improve interoperability◦To recognise quality labelling and certification


Future plans: What should be done Future plans: What should be done in the next year?in the next year?

Day to day reporting of contractual partners;

Get information by email/or SMS, that a change has occurred in the patient's file;

Notification by e-mail/or SMS of upcoming immunizations on immunization calendar of the Republic of Bulgaria in a specified format and frequency of communication;

Notification by e-mail/or SMS of upcoming screening in a certain format and frequency of communication;

Notification by e-mail/or SMS of upcoming screenings according to the programs or expiration of programs (dispensary observation, maternal, child health care) in a specified format and frequency of communication.


Closing slide Closing slide

National Health Insurance FundAddress: 1 "Krichim" str., 1407 Sofia, BulgariaPhone/+359 2 9659 217; +359 2 9659 218Portal: www.nhif.bg

Thank you


Documents

EHR S ystems U se and Q uality in Bulgaria