Transhis based software in Serbia

Overview, Scope and Challenges

Beginnings - 2002

• Start with one pilot practice

Oh, no!! Not

now!!!!

Well… Wrong!!@%!

Basic Health Services Pilot Project 2002-2005

• Immediate growth– Kraljevo Municipality– 24 Facilities– 50 GP Teams– 70,000 records– 2 SW versions

Step-by-step Rollout

10 51 53 79 132196 203 228

500

1000

0

200

400

600

800

1000

1200

2002 2003 2004 2005 2006 2007 2008 2009 MOHPlanfor

2010

MOHPlanfor

2011

No of Facilities

No of GPs

Advantages of SW Concept

• Very fast training process• Good mapping with ICD and HIF price

lists• Excellent data model for any additional

reporting and scientific analysis• Good ergonomics and work flow control• Fast data entry and information structure• Compliance with international e-health

standards

Disadvantages of SW Concept

• Lack of institutional support to ICPC-2, data analysis and benefit evaluation

• Comprehension of data acquisition vs. usability of data

• Sophistication vs. lack of resources

• Sophistication vs. laconic competition

ICPC – Status in e-health

• No MoH participation• No academic support• No awareness on data available, no data

analysis mechanism in place• Embedded in policy documents

– Standards for EPR development– Conceptual model of e-health

• Mapping between HIF electronic invoice price list and intervention codes

Plans

• One of 3 certificated and recognized PHC SWs

• National Roll-out from World Bank funds

• Application service providing

• MoH/HIF funding for maintenance and support

Transhis based SW

• In public domain

• Technology – web application

• Adequate for off line regime and limited connectivity

• Centralized maintenance

• Functional framework goes beyond GP

Practice Management Support

• Shift scheduling and team work

• Appointment system – no bottlenecks

• Repeated prescription – 42% of RfE

• Stock management

• Electronic referrals

• Electronic Health Record connectivity

Acquired Data (so far)

• Users – 600 (230 GPs)

• Patients – 197,000

• Encounters – 3.9 millions

• Prescriptions – 6.4 millions

• Episodes – 550,000

What Should Be Done?

• Institutional agreement

• User group organization

• User support

• Data analysis tools implementation

• International Transhis collaboration