Med-e-Tel Conference luxemburg. Moldova eHealth Strategy


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Med-e-Tel Conference luxemburg. Moldova eHealth Strategy

  1. 1. eHealth Strategy in Republic of Moldova Alexandru ROSIORU, Deputy Director in ICT , National Health Management Center , Ministry of Health - arosioru @mednet .md , Dr. Oleg LOZAN, Director of School of Public Health, [email_address]
  2. 2. Republic of Moldova Geography: The country’s territory is 33,800 Population: 3.56 million people Political system: Parliamentary R epublic Capital: Chisinau 20 years of independance
  3. 3. <ul><li>Financing: - 112$ </li></ul><ul><li>Compulsory Health Insurance </li></ul><ul><li>State Budget </li></ul><ul><li>Local Public Administration </li></ul><ul><li>Private Investment </li></ul><ul><li>Resources: </li></ul><ul><li>Public Health Service </li></ul><ul><li>Primary Care </li></ul><ul><li>Hospital Care </li></ul><ul><li>National Emergency Service </li></ul><ul><li>Health Care Education </li></ul><ul><li>SUMP N. Testemitanu </li></ul><ul><li>5 nursing colleges and 2 nursing continuous education institutions </li></ul>Health Care System in the Republic of Moldova <ul><li>Selected indicators: (y.2010) </li></ul><ul><li>Public HE/GDP – 4.8% </li></ul><ul><li>Institutions - 250 </li></ul><ul><li>Health Care personnel </li></ul><ul><li>Doctors – 29.8 per 10 000 </li></ul><ul><li>Nurses – 64.5 per 10 000 </li></ul><ul><li>Outcome indicators (MDG) </li></ul><ul><li>Child Mortality – 11.8 per 1000 </li></ul><ul><li>TB incidence – 102.2 per 100 000 </li></ul><ul><li>e-Readiness </li></ul><ul><li>117 Institutions are using broadband connection (land/mobile) </li></ul><ul><li>Doctors using </li></ul><ul><li>Internet-connected PC at the work place – 18% </li></ul><ul><li>PC at the work place – 21 % </li></ul><ul><li>EPR – 8 institutions (accounting – 118) </li></ul>
  4. 4. International cooperation of Ministry of Health International cooperation of the Ministry of Health European Commission UNDP DFID UNAIDS World Bank European Central Bank SIDA UNICEF SOROS TACIS WHO USAID Ministry of Health Global Fund
  5. 5. International cooperation of Ministry of Health European cooperation in the area of eHealth Prague Declaration - Participation in eHealth Ministerial Conference – February 2009 “ eHealth for Individuals, Society and Economy” - Participation in First South-East eHealth European Networking Conference – September 2009, Bosnia and Herzegovina EFMI ISfTeH
  6. 6. <ul><li>Harmonized Strategic Framework </li></ul><ul><li>National Development Strategy 200 9 -2011 </li></ul><ul><li>National Health Policy 2007-2021 </li></ul><ul><li>Health Care sector Strategy 2008-2017 </li></ul><ul><li> , </li></ul><ul><li>E-Health Context </li></ul><ul><li>In 2005 Government adopted National Strategy on building Information Society e-Moldova </li></ul><ul><li>National Strategy on building Information Society e-Moldova contains a chapter dedicated exclusively for e-Health </li></ul><ul><li>Action Plan 2005-2010 </li></ul><ul><li> </li></ul>National Strategy in Information Society Development “e-Moldova”
  7. 7. Main directions for – “ e- Moldova Strategy ” Infrastru cture e-G o verna nce e-Democra cy e-Econom y e-Educa tion e- Health e- Science e-Cultur e
  8. 8. eHealth Strategy in Moldova <ul><li>Republic of Moldova has no </li></ul><ul><li>eHealth Strategy as a separate document </li></ul>
  9. 9. Main documents for eHealth development <ul><li>Roadmap documents for ICT development in health sector: </li></ul><ul><li>Concept of Integrated Medical Information System , adopted by Government Decision Nr. 1128 on 14 October 2004 </li></ul><ul><li>Action Plan for its implementation, elaborated by Ministry of Health in January 2005 ( ) </li></ul>
  10. 10. Integrated Medical Information System Structure <ul><li>IMIS had to contain 15 Main Modules for : </li></ul><ul><ul><li>Primary Health Care </li></ul></ul><ul><ul><li>Secondary Health Care </li></ul></ul><ul><ul><li>Hospital for all levels (district, regional, republican) </li></ul></ul><ul><ul><li>infection diseases (TB, HIV, etc) </li></ul></ul><ul><ul><li>National Blood Center </li></ul></ul><ul><ul><li>Financi ng – National Health Insurance Company </li></ul></ul><ul><ul><li>Electronic Health Record </li></ul></ul><ul><ul><li>Emergency Service </li></ul></ul><ul><ul><li>... </li></ul></ul>
  11. 11. Implemented information systems <ul><li>SIME TB/ HIV, information system financed by Global Fund and other donors </li></ul><ul><li>Automated Information System for National Blood Center </li></ul><ul><li>Integrated Hospital Management System at the Institute of Neurology and Neurosurgery </li></ul><ul><li>Primary Care M edical I nformation S ystem at the Medical University Primary Care Clinic </li></ul><ul><li>Problems: A low level of information system implementation in hospitals and primary health care. </li></ul>
  12. 12. European standards in Medical Informatics <ul><li>Starting 2008, 85 European and international standards in Medical Informatics area were accepted in Moldova as pre-standards. Preliminary plan stipulates implementation and adoption of these within following 5 years </li></ul><ul><ul><li>Health Informatics vocabulary </li></ul></ul><ul><ul><li>EHR standards </li></ul></ul><ul><ul><li>Public key infrastructure in Health Care </li></ul></ul><ul><ul><li>Exchange of medical documents and medical data </li></ul></ul><ul><ul><li>Etc. </li></ul></ul>
  13. 13. eHealth in S U MP « N. Testemitanu » - experience <ul><li>Distance learning </li></ul><ul><li>April 10, 2003 – first telemedical videoconference </li></ul><ul><li>National </li></ul><ul><li>a weekly course in Health Management (Chisinau – Balti) - 2005 </li></ul><ul><li>series of nationwide lectures using mobile telemedical team PC - 2006 </li></ul><ul><li>web-based distant learning in the School of Public Health Management: </li></ul><ul><li>International </li></ul><ul><li>Over 100 international telemedical videoconferences conducted since 2003 </li></ul><ul><li>Regular telemedical lectures between East Carolina University and SUMP. </li></ul><ul><li>Development of relations to enhance distant learning tools </li></ul>
  14. 14. eHealth in SUMP N. Testemitanu - experience Telemedical consultations First international multipoint tele-consultation – 2004 (Moldova, Russia, Kazakhstan, Armenia) Telemedical videoconferencing system at the Institute for Neurology and Neurosurgery – multipoint/supported by Hospital Information System/integrated PACs/connected to CT/digital radiology/Laboratory (needs DICOM integration) Access to medical resources On-line access to several medical databases (from University premises and from home) eHealth curricula Test course of eHealth and Telemedicine for masters in public health management
  15. 15. Main problems in eHealth domain <ul><li>Lack of dedicated e-Health Policy; </li></ul><ul><li>Lack of knowledge ; </li></ul><ul><li>Underdevelopment infrastructure in medical facilities; </li></ul><ul><li>Operational costs and lack of financing ; </li></ul><ul><li>Mentality barriers ; </li></ul>
  16. 16. New challenges - eGovernance <ul><li>Beginning from 2009 Republic of Moldova has new Parliament and Government with pro-European orientation. </li></ul><ul><li>According with politics of Alliance of European Integration – eTransformation is a priority for Government. This is mentioned in widely accepted document – “ Rethink Moldova ”. Our Government undertakes to: </li></ul><ul><ul><li>Design a unified Public Sector ICT organization and governance structure to mainstream the use of ICT within Government agencie s ; </li></ul></ul><ul><ul><li>Design and implement Government to business (G2B) and to Government to citizen (G2C) service portals by integrating workflows and dual use of systems ; </li></ul></ul><ul><ul><li>Expand online and mobile service delivery to citizens and businesses, including the 20 basic e - services in EU classification ; </li></ul></ul>
  17. 17. eGovernance – Policy instruments <ul><li>Assessment of citizen - and business - facing public services ; </li></ul><ul><li>Design and institutionalize a unified Public Sector ICT organization and governance structure ; </li></ul><ul><li>Design and implement Government service portal by integrating the workflows and minimizing duplication of systems ; </li></ul><ul><li>Simplify the reporting for business by implementing e - reporting ; </li></ul><ul><li>Expand online and mobile service delivery to citizens and businesses </li></ul>
  18. 18. New challenges - eHealth <ul><li>It is time for new eHealth Strategy and action Plan. </li></ul><ul><li>Preconditions for eHealth servicies implementation </li></ul><ul><ul><li>creation of correct &quot;compatibility&quot; between the e-Health and the existing problems of the health system; </li></ul></ul><ul><ul><li>use of technologies that have proven effective or those that are most easy to use ; </li></ul></ul><ul><ul><li>implementation of the quick wins programs/ services for e-Health; </li></ul></ul><ul><ul><li>the design and implementation of programs / services for e-Health in accordance with the current policy in this area . </li></ul></ul><ul><li>Establishment of eHealth task force </li></ul>
  19. 19. New challenges – 3 eHealth servicies for short term implementation <ul><li>1.1 e-appointment service; </li></ul><ul><li>1.2 m-Health service alert / reminder about the </li></ul><ul><li>programming time for medical tests; </li></ul><ul><li>1.3 online access to results of medical </li></ul><ul><li>investigations </li></ul><ul><li>2. National system of recording medical devices; </li></ul><ul><li>3. Telemedical servicies for Emergency Service </li></ul>
  20. 20. Cooperation opportunities in eHealth   Areas Tools Strategy and health care management Health Care education and research Health Promotion Clinical ??? Working groups and conferences + + + + + Web-platforms + + + + + mHealth   + + + + Videoconferencing + + + + + Imaging   +   + + On-line databases + + + + + ??? + + + + +
  21. 21. <ul><li>Strong political support at Government level in eHealth filed </li></ul><ul><li>Small country – flexible conditions – proved experience in goal achievement </li></ul>Republic of Moldova Opened, and, highly interested in developing cooperation for e-Health Looking for partners – Government/Institutional/Corporate/non-Government
  22. 22. <ul><li>Wider access for citizens to health services and information </li></ul><ul><li>Compatible strategic and policy framework </li></ul><ul><li>Enhanced exchange of managerial, clinical, educational and scientific information and best practices between participating countries </li></ul><ul><li>Improved public health and health promotion programmes </li></ul><ul><li>Reduced costs due to cooperative approach </li></ul>Outcomes expected from regional cooperation
  23. 23. Thank you for your attention! Questions? Comments?