Slovenian eHealth (eZdravje)
The digital transformation of the Slovenian healthcare system (eHealth) follows national and European strategies and the guidelines of the World Health Organization on how to improve the quality and efficiency of healthcare systems. The main goals of the digital transformation initiative are to introduce effective and user-friendly digital solutions into the Slovenian healthcare system and enforce well-established semantic and technical standards enabling the interoperability of diverse local information systems. Connection via a common national eHealth platform enables citizens and health professionals to overcome numerous obstacles when searching for relevant information concerning the patient treatment process. Slovenian eHealth streamlines diverse and fragmented hospital and outpatient information systems, and provides the relevant medical, economic and administrative data. Accordingly, eHealth is the ultimate enabler of digital transformation, enhancing the quality of healthcare treatment, assisting evidence-based decision-making and supporting the management of the healthcare system. Furthermore, eHealth keeps the focus on patients, enforcing patient rights and encouraging them to actively participate in maintaining their health and well-being.
Rant, Ž., & Stanimirović, D. (2019). Analysis of e-Health solutions in Slovenia : a usage perspective. Uporabna Informatika, 27(4), str. 135-142. Retrieved from https://uporabna-informatika.si/index.php/ui/article/view/58/64
Rant, Ž. (2021). Telemedicine in Slovenia. 34th Bled eConference Digital Support from Crisis to Progressive Change: June 27 – 30, 2021, online : conference proceedings. – p. 87-96. DOI: https://doi.org/10.18690/978-961-286-485-9 . https://press.um.si/index.php/ump/catalog/book/581
Stanimirović, D., Drev, M., & Rant, Ž. (2022). Digital Transformation as One of the Instruments for Overcoming the Public Health Crisis: The Role and Use of Ehealth Solutions during the Covid-19 Pandemic in Slovenia. Medicine, Law & Society, 15(1), 169-192. doi:10.18690/mls.15.1.169-192.2022, https://journals.um.si/index.php/medicine/article/view/1889
Rant, Ž., Stanimirović, D., & Janet, J. (2022). Functionalities and use of the zVEM patient portal and the central registry of patient data. In A. Pucihar, M. Kljajić Borštnar, R. Bons, A. Sheombar, G. Ongena, & D. Vidmar (Eds.), 35th Bled eConference Digital Restructuring and Human (Re)action: June 26 – 29, 2022, Bled, Slovenia (pp. 65–79). University of Maribor, University Press. doi:10.18690/um.fov.4.2022.4. https://press.um.si/index.php/ump/catalog/view/691/927/2367-1
The National Institute of Public Health (NIJZ) took over the governance of eHealth solutions on 1 December 2015 after the completion of the EU-funded eHealth project, which was led by the Slovenian Ministry of Health. NIJZ faced a variety of challenges when introducing complex eHealth solutions into the country’s heterogeneous healthcare environment. However, the general success of the implementation of eHealth solutions in Slovenia was recognised by the national authorities (Assessment of the Ministry of Public Administration, 2019) and the European Commission. Indeed, Slovenia was placed sixth in eHealth Services for 2019 in the Digital Economy and Society Index Report (https://ec.europa.eu/digital-single-market/en/desi).
Benefits for citizens and the national healthcare system
The complete digital transformation of the Slovenian healthcare system has led to a strong improvement in the quality of patient treatment and to the swift and secure management of health information. It has also facilitated further development of the Slovenian healthcare system and helped it to integrate competitively into the European healthcare arena.
Advantages of eHealth
The Slovenian eHealth system has brought about a long-term reduction in administrative costs and facilitated the efficient management of health-related data and information. Digital transformation enables seamless and uninterrupted communication and the secure and traceable exchange of data and electronic documentation between healthcare providers.
Digital certificate for access to eHealth services
A digital certificate must be obtained if users are to be provided with secure access to eHealth services. As a modern alternative to traditional personal identification documents, digital certificates are an integral part of state-of-the-art technological services, offering a high level of privacy and confidentiality through data encryption and digital signatures, and ensuring secure and authenticated electronic transactions. There are several issuers of digital certificates in Slovenia (certification authorities) and the process of acquiring a certificate is a straightforward one.
The eHealth website (https://www.ezdrav.si) is the official Slovenian eHealth website. It provides all necessary information about Slovenian eHealth solutions and individual eHealth services. The website is managed by the NIJZ, and contains descriptions of all eHealth solutions, current developments related to Slovenian eHealth, promotional materials, and a Q&A about eHealth generally and about specific digital solutions.
Slovenian eHealth solutions at a glance
The eHealth Project (2008–2015) introduced eHealth services at a national level, with considerable progress having been made since then in terms of deployment, availability and use. eHealth services are available to all healthcare providers and patients in Slovenia.
Central Registry of Patient Data (CRPD)
The CRPD is the core of the Slovenian eHealth. It is designed for exchanging and sharing electronic health records nationally. All Slovenian healthcare providers are obliged to submit medical records to the CRPD promptly and are entitled to use them for the purpose of providing healthcare. Patients have full access to their CRPD data via the zVEM (https://zvem.ezdrav.si) patient portal. The content of the CRPD comprises various types of healthcare documentation and structured patient summary records. In addition to the data provided within the healthcare process, patients’ statements, such as advance healthcare instructions and privacy consents, are stored in the CRPD.
CRPD implementation is based on IHE XDS integration profiles and OpenEHR information models, extended with proprietary services and APIs according to national regulatory and organisational requirements. In addition to defining semantic and technical standards, the CRPD is compliant with the highest personal data protection and data security standards.
The zVEM portal is a ‘one-stop shop’ portal for patients. Patients authenticated by digital certificate can access the data that is stored on them in the eHealth databases. The zVEM portal provides patients with full access to their healthcare documentation, referrals, appointments, prescriptions and records of medication dispensed.
ePrescription is designed to support the fully electronic prescribing and dispensing of medications. It also provides doctors and pharmacists with access to drug interaction databases.
eAppointment and eReferral
The eAppointment system enables referral documents (eReferrals) to be processed and appointments booked. An online waiting list is available for healthcare services, automatically updated by healthcare providers’ own information systems. Patients can book appointments via an online portal.
zNET – Healthcare Network infrastructure
The healthcare network (zNET) provides a secure and reliable communication to all healthcare providers.
eHealth Users Database (EUEZ)
The eHealth Users Database is the central entity of trust for eHealth applications. It authenticates, authorises and manages eHealth users, and stores their eIDs. Patients and healthcare professionals are registered by means of digital certificates. The eHealth Users Database is linked to the National Registry of Healthcare Providers and Professionals. User roles are derived from professional qualifications and working positions at the respective healthcare provider.
Electronic Registry of Vaccinated Persons (eRVP)
The Electronic Registry of Vaccinated Persons is the national vaccination database and enables the comprehensive planning and surveillance of vaccination. Adverse reactions are recorded, along with details of the vaccinations themselves, and population vaccination data by disease, age group and geographical area is also included. The registry is linked to the CRPD so that patient vaccinations and adverse reaction histories are entered promptly in the patient summary.
Family medicine model practices
The eHealth solution for family medicine model practises supports protocols for the treatment of chronic patients, extended and regular preventive screenings, the establishment of registers of chronic patients, and the assessment of treatment quality by means of quality indicators. The model family medicine practice is a standard general practitioner’s office with an expanded medical team.