VISIONMoldova e-Health 2020By 2020, the citizens of the Republic ofMoldova shall benefit from improved, transparentand accessible health services, by intelligent use ofthe Information and Communication Technologies.The current vision presents the medium andlong term priority directions of the e-health. It isbased on 3 pillars.
VISIONMoldova e-Health 2020INFRASTRUCTURESERVICESMANAGEMENT&GOVERNANCEThe first pillarrepresents all theobjectives and actionsneeded for increasingthe number andquality of the healthservices to population.It includes the resources and procedures withsystems and easy access to them needed for anefficient and qualitative services provided byhealthcare system. Also services G2B & G2G.
VISIONMoldova e-Health 2020The second pillarrepresents all theactions needed toimprove the process ofmanagement andadministration of thehealth sector.It includes the tools, systems, skills,procedures and resources needed for an efficientand qualitative services provision.INFRASTRUCTURESERVICESMANAGEMENT&GOVERNANCE
VISIONMoldova e-Health 2020The third pillarrepresents theinfrastructure whichserves as a basis forthe upper levels.It includes information systems, databases,communication infrastructures, registries,hardware and data security of the health sectorinformation systems and services.INFRASTRUCTURESERVICESMANAGEMENT&GOVERNANCE
STRATEGYMoldova e-Health 2020FROM PROBLEMS … Limited and unequal accessibility of the publicto the high health services and qualitative medicalassistance also to information for prevention andhealth promotion; Reduced analytical capacity to evaluate,monitor and report on the health systemperformance; Insufficient use of modern technologies indiagnosis and treatment;
STRATEGYMoldova e-Health 2020…FROM MORE PROBLEMS … Fragmented systems of data collection andduplication of the date collected; Non-compliance of the collected datasets withthe reporting requirements of internationalorganizations; Outdated and inefficient use of the ICTinfrastructure of the medical institutions;
STRATEGYMoldova e-Health 2020…TO SOLUTIONS … Equal and unlimited high medical services topopulations; Assistance and information for health promotionand prevention by using electronic environment; High analytical capacity to collect, process,evaluate, monitor and report on the healthsystem performance based on decisionalautomated intelligent systems; Ultramodern technologies in diagnosis andtreatment;
STRATEGYMoldova e-Health 2020… RESPECTING PRINCIPLES …Safety: Avoiding harm to patients from the carethat is intended to help them.Effectiveness: Providing services based onscientific knowledge to all who could benefit andrefraining from providing services to those notlikely to benefit (avoiding underuse and misuse,respectively).
STRATEGYMoldova e-Health 2020… RESPECTING PRINCIPLES …Patient-centeredness: Providing care that isrespectful of and responsive to individual patientpreferences, needs, and values and ensuring thatpatient values guide all clinical decisions.Timeliness: Reducing waiting times and potentiallyharmful delays for both those who receive andthose who give care.
STRATEGYMoldova e-Health 2020… RESPECTING PRINCIPLES …Efficiency: Avoiding waste, including waste ofequipment, supplies, ideas, and energy.Equitability: Providing care that does not vary inquality because of personal characteristics such asgender, ethnicity, geographic location, andsocioeconomic status.
STRATEGYMoldova e-Health 2020… RESPECTING LAWS and STANDARDS …Laws: General legislation on health (healthcareservice providing, medical professions, compulsoryhealth insurance, health surveillance, etc.). Specificlaws: National Health Policy 2007 – 2021, Strategyfor Health System Development 2008 – 2021,Electronic Moldova 2020, etc.Standards: Reporting standards (e.g. HL7), civilstatus documents, digital signature, preventingand combating cybercrime, access to information…
STRATEGYMoldova e-Health 2020… TRANSPARENCY and CONFIDENTIALITY…Transparency: Make public all data regardingpolicy making, tenders, strategic decisions usingdebates, permanent dialogs and involving as muchentities as possible in the process.Confidentiality: Increase loyalty, addressability ofmedical institutions to the patients and citizensand increase the trust in medical institutions byimplementing a standard secure procedure ofwork.
STRATEGYMoldova e-Health 2020… WITH …Resources: m-Pass system for secure access toelectronic health services;e-Payment System to pay medical services;e-Government portal services (servicii.gov.md) forproviding access unified electronic health servicesto the population; State Budget; State Programs;External potential Resources: World Bank, WorldHealth Organization, European Union, otherpartners.
STRATEGYMoldova e-Health 2020… TO ACCOMLPISH OBJECTIVESServices:General Objective: Improve the quality, efficiency,transparency and access to healthcare services;Management & Governance:General Objective: Improve health managementand governance by use of ICT;Infrastructure:General Objective: To ensure reliable and scalableinfrastructure for an efficient e-Health system.
STRATEGYMoldova e-Health 2020SERVICESSpecific Objective: Improve the efficiency andeffectiveness of processes in the healthcare sectorusing ICT in: PHC, SHC, Blood Service, Emergencyhealthcare, State Public Health Service, MedicalDiagnostic Centres;Specific Objective: Facilitate citizens’ access to e-health services;Specific Objective: Ensure open access to publichealthcare data.
STRATEGYMoldova e-Health 2020MANAGEMENT and GOVENRANCESpecific Objective: Increase ICT skills for personnelworking in the healthcare system;Specific Objective: Develop and implementmechanisms to ensure medical data quality (Crosschecks);Specific Objective: Provide qualitative and timelydata for the managerial decision-making process.
STRATEGYMoldova e-Health 2020INFRASTRUCTURESpecific Objective: Ensure, by 2020, single accesspoint to all information resources of health sectorfor specialists, management and population;Specific Objective: Standardize the procedures oftransmission of information operated in medicalunits in a single and agreed format for allstakeholders;Specific Objective: Ensure safety and security of e-health data through implementation of the properlegal framework.
Moldova e-Health 2020MASTER PLANCOMPONENTS Electronic Health Record (DES – unified EHR); The personal file of the citizen health - clinicalportal personal data (PHR); Planning and Notification Services for medicalconsultations, laboratory tests, functionalinvestigations, immunizations, etc.; e-Services for citizens, businesses and centralpublic authorities (e-Desk);
Moldova e-Health 2020MASTER PLANCOMPONENTS Alerts and notifications in emergencyprevention and improving communicationbetween doctors; Services of telemedicine and remote assistance; e-Library (medical encyclopedia with generalinformation about the prevention, diagnosis,treatment and rehabilitation of diseases,medications, studies, reports and specialists inthe healthcare system: medical protocols,manuals, studies and educational programs);
Moldova e-Health 2020MASTER PLANCOMPONENTS e-Prescriptions and monitoring of stocks ofmedicines; Registries and monitoring systems forcommunicable and non-communicable diseases(e.g. chronic diseases electronic records -diabetes, cancer, hepatitis, etc.). Statistical reporting services (including DRG andthe National Health Fund); National Register of Human Resources forhealth;
Moldova e-Health 2020MASTER PLANCOMPONENTS National Register of Inventory of MedicalEquipment; The Management of Budget Execution control inhospitals; Centralized Management Decision System,based on a flexible reporting and informationretrieval (tool for designing statistical andanalytical reports with the ability to store, sortand filter on different criteria, indicators formonitoring, advanced search, etc.).
Moldova e-Health 2020MASTER PLANMECHANISMS – Policy: Policy Commission
Moldova e-Health 2020MASTER PLANMECHANISMS – Regulations: NHMC
Moldova e-Health 2020MASTER PLANMECHANISMS – Management: e-Health Agency
Moldova e-Health 2020MASTER PLANMECHANISMS – Executive: CO, CTO
Moldova e-Health 2020MASTER PLANSTANDARDS – now & future ISO-15288: 2008, ISO-12207: 2008, RT-38370656-002: 2006, Government Decision no. 1123 of14.12.2010 on the approval Requirements for thesecurity of personal data to process them withinthe information systems of personal data,Technical Regulation order MITC 106 of 20December 2010 HL7, DICOM, ISO 13606-4, ISO 13606-5, etc. CEN - CONTSYS (EN 13940) CEN - EHRcom (EN 13606)
Moldova e-Health 2020MASTER PLANFLOWS and PROCESSES
Moldova e-Health 2020MASTER PLANINFORMATIONAL FLOWS
Moldova e-Health 2020MASTER PLANFUNCTIONAL ARCHITECTURE
Moldova e-Health 2020MASTER PLANTECHICAL ARCHITECTURE
Moldova e-Health 2020MASTER PLANTECHICAL ARCHITECTURE
Moldova e-Health 2020MASTER PLANIMPLEMENTATION STEPS1. Analysis institution - 1-2 months;2. Design solutions (network communications,software, streams, configuration required) 1-2months;3. Cost estimation detail - 1 month;4. Allocation of financial resources reservation - 1-3 months;5. Making documentation for purchase - 1 month;6. The procurement - 2-3 months;
Moldova e-Health 2020MASTER PLANIMPLEMENTATION STEPS7. Negotiating and signing - 1 month;8. Analysis for specific configuration - correlationbetween the tender documentation and reality onthe ground (the client request) -1 month;9. Achievement communications network - 1-3months;10. User Personal Training - 1-2 months;11. Install, configure applications - 1 month;12. Completed verification testing and acceptanceand commissioning -1 month.
Moldova e-Health 2020MASTER PLANTIMELINES• EHR local solutions with programming, alert andnotifications, reporting services:- Primary Healthcare: minimum 18 months- Hospitals: minimum 24-36 months- Emergency Healthcare (supplements and112): 24 - 32 months- Blood Transfusions (adjustments): 6-12 months- Integration alternatives (Public Health Centers,NHMC, PHNC, NDA, etc.): 24-36 months
Moldova e-Health 2020MASTER PLANTIMELINES• National Health Registers: 12 months• e-Prescribing: 18 months• e-Library: 24 months• PHR web Portal: 24 - 32 months• Management Decision System: 12 - 18 months• Telemedicine services: 48 months• e-Desk: 24 - 32 months• The centralization of all resources (CHRR + UHRR)- 24 months
Moldova e-Health 2020MASTER PLANESTIMATED BUDGETSNo. System type Hardware Software Totalestimated(euro)1 Centralized System 16.200.000 4.390.000 20.590.0002 Primary Healthcare 2.000.000 1.200.000 3.200.0003 Hospitals 3.000.000 30.650.000 33.650.0004 Emergency healthcare 165.000 275.000 440.0005 Blood Transfusion 50.000 65.000 115.0006 National HealthManagement Centre85.000 150.000 235.0007 National Drug Agency 45.000 50.000 95.000
Moldova e-Health 2020MASTER PLANESTIMATED BUDGETSNo. System type Hardware Software Totalestimated(euro)8. Transplant Agency 10.000 35.000 45.0009. Healthcare Centers 2.000.000 1.200.000 3.200.00010. National Public HealthCenter15.000 45.000 60.00011. Pharmacies - 1.500.000 1.500.00012. Treatment andDiagnostic Centers75.000 1.600.000 1.675.00013. Other Healthcareentities- 500.000 500.00014. TOTAL 23.645.000 41.660.000 65.305.000
Moldova e-Health 2020MASTER PLANESTIMATED BUDGETSNo. System type Hardware Software Totalestimated(euro)1. National HealthcareRegistries80.000 150.000 230.0002. e - Prescribing 675.000 3.000.000 3.675.0003. e-Library 250.000 2.500.000 2.750.0004. PHR 225.000 145.000 370.0005. Centralized DecisionManagement System150.000 3.000.000 3.150.006. Telemedicine 1.200.000 3.200.000 4.400.0007. e-Desk 200.000 1.500.000 1.700.000TOTAL EXTENDED 2.780.000 13.495.000 16.275.000TOTAL GENERAL 26.425.000 55.155.000 81.580.000
Moldova e-Health 2020MASTER PLANCHANGE & RISK MANAGEMENT - identified Fear of change, the possibility of job loss, fear ofthe unknown; High additional budget has to be alocated; Lack of confidence in the confidentiality of dataprocessed by these systems ; Bureaucratic processes with high degree ofinertia in adapting to change; Risk of discontinued actions, policy, etc.
Moldova e-Health 2020MASTER PLANCHANGE & RISK MANAGEMENT - planned Continuous dialog, debates, specific programs; Gradual implementation procedures with pre –allocated funds; Enforce laws and regulations amongstandardization implementation; Reducing and optimizing administrativeprocedures; Adopting a continuous implementation law,backup plans.
CONCLUSIONSFREE TRANSPARENT MARKETMEDICAL INSTITUTIONS : Good management andequipment, tools for medical personnel, real timedata for medical and administrative decisions.COMPANIES : Ensuring equal transparent accessto market. Reducing time and bureaucracy.CITIZENS: Eliminate corruption, equitable access.
CONCLUSIONSHIGH QUALITY SERVICESPOPULATION: Fast access at high quality medicalservices and information, including personalmedical and financial data.BUSSINESS: No more bureaucracy, no morecorruption, access to data of interest, competitiveenvironment.GOVERNEMENT: Real time decisions, continuity ofreforms, stability, unified approach.
CONCLUSIONSOPEN GOVERNMENTGOOD POLICY: related policies, coherent andcomprehensiveSTABILE ENVIRONMENT: continuity of strategiesand principles of good governance, economicgrow, responsible management of resources,transparency.FUNDAMENTED DECISIONS: decisions based onreal data and accurate, open national interest data.