LOGO
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
eHealth Strategy in Republic of Moldova
Alexandru ROSIORU, Deputy Director in ICT,
National Health Management Center, Ministry of Health - [email protected],
Dr. Oleg LOZAN, Director of School of Public Health, [email protected]
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
Republic of Moldova
Geography: The country’s territory is 33,800 sq.km.
Population: 3.56 million people
Political system: Parliamentary Republic
Capital:
Chisinau
20 years of independance
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
Financing: - 112$ - Compulsory Health Insurance - State Budget- Local Public Administration- Private Investment
Resources: - Public Health Service- Primary Care- Hospital Care - National Emergency Service- Health Care Educationi. SUMP N. Testemitanuii. 5 nursing colleges and 2
nursing continuous education institutions
Health Care System in the Republic of Moldova
Selected indicators: (y.2010)Public HE/GDP – 4.8%Institutions - 250Health Care personnelDoctors – 29.8 per 10 000Nurses – 64.5 per 10 000Outcome indicators (MDG)Child Mortality – 11.8 per 1000TB incidence – 102.2 per 100 000e-Readiness117 Institutions are using broadband
connection (land/mobile)Doctors using i. Internet-connected PC at the work
place – 18%ii. PC at the work place – 21 %EPR – 8 institutions (accounting – 118)
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
International cooperation of Ministry of Health
Europea
n Commis
sion
UNDP
DFID
UNAIDS
World Bank
EuropeanCentral Bank
EuropeanCentral Bank
SIDASIDA
UNICEFUNICEF
SOROSSOROS
TACISTACIS
WHO
USAIDUSAID
Ministry of Health
Global FundGlobal Fund
International cooperation of the Ministry of Health
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
International cooperation of Ministry of HealthEuropean 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
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
Harmonized Strategic Framework National Development Strategy 2009-2011 National Health Policy 2007-2021 Health Care sector Strategy 2008-2017
http://www.gov.md , http://www.ms.gov.md E-Health Context
In 2005 Government adopted National Strategy on building Information Society e-Moldova
National Strategy on building Information Society e-Moldova contains a chapter dedicated exclusively for e-Health
Action Plan 2005-2010
http://www.e-moldova.md
National Strategy in Information Society Development “e-Moldova”
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
Main directions for – “e-Moldova Strategy”
Infrastructure
e-Governance
e-Democracy
e-Economy
e-Education
e-Health
e-Sciencee-Culture
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
eHealth Strategy in Moldova
Republic of Moldova has no
eHealth Strategy as a separate document
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
Main documents for eHealth development
Roadmap documents for ICT development in health sector:
Concept of Integrated Medical Information System, adopted by Government Decision Nr.1128 on 14 October 2004
Action Plan for its implementation, elaborated by Ministry of Health in January 2005 (http://www.ms.gov.md )
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
Integrated Medical Information System Structure
IMIS had to contain 15 Main Modules for:
Primary Health Care Secondary Health Care Hospital for all levels (district, regional, republican) infection diseases (TB, HIV, etc) National Blood Center Financing – National Health Insurance Company Electronic Health Record Emergency Service ...
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
Implemented information systems
SIME TB/ HIV, information system financed by Global Fund and other donors
Automated Information System for National Blood Center
Integrated Hospital Management System at the Institute of Neurology and Neurosurgery
Primary Care Medical Information System at the Medical University Primary Care Clinic
Problems: A low level of information system implementation in hospitals and primary health care.
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
European standards in Medical Informatics
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 Health Informatics vocabulary EHR standards Public key infrastructure in Health Care Exchange of medical documents and medical data Etc.
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
Distance learning
April 10, 2003 – first telemedical videoconferenceNationala weekly course in Health Management (Chisinau – Balti) - 2005series of nationwide lectures using mobile telemedical team PC - 2006web-based distant learning in the School of Public Health Management: http://www.public-health.md
InternationalOver 100 international telemedical videoconferences conducted since 2003 Regular telemedical lectures between East Carolina University and SUMP. Development of relations to enhance distant learning tools
eHealth in SUMP «N. Testemitanu» - experience
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
Telemedical consultationsFirst 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 resourcesOn-line access to several medical databases (from University premises and from home)
eHealth curriculaTest course of eHealth and Telemedicine for masters in public health management
eHealth in SUMP N. Testemitanu - experience
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
Main problems in eHealth domain
Lack of dedicated e-Health Policy;
Lack of knowledge;
Underdevelopment infrastructure in medical
facilities;
Operational costs and lack of financing;
Mentality barriers;
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
New challenges - eGovernance
Beginning from 2009 Republic of Moldova has new Parliament and Government with pro-European orientation.
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: Design a unified Public Sector ICT organization and governance
structure to mainstream the use of ICT within Government agencies;
Design and implement Government to business (G2B) and to Government to citizen (G2C) service portals by integrating workflows and dual use of systems;
Expand online and mobile service delivery to citizens and businesses, including the 20 basic e-services in EU classification;
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
eGovernance – Policy instruments
Assessment of citizen- and business-facing public services;
Design and institutionalize a unified Public Sector ICT organization and governance structure;
Design and implement Government service portal by integrating the workflows and minimizing duplication of systems;
Simplify the reporting for business by implementing e-reporting;
Expand online and mobile service delivery to citizens and businesses
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
New challenges - eHealth
It is time for new eHealth Strategy and action Plan.
Preconditions for eHealth servicies implementation
creation of correct "compatibility" between the e-Health and the existing problems of the health system;
use of technologies that have proven effective or those that are most easy to use;
implementation of the quick wins programs/ services for e-Health;
the design and implementation of programs / services for e-Health in accordance with the current policy in this area.
Establishment of eHealth task force
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
New challenges – 3 eHealth servicies for short term implementation
1.1 e-appointment service;1.2 m-Health service alert / reminder about the programming time for medical tests; 1.3 online access to results of medical investigations
2. National system of recording medical devices;
3. Telemedical servicies for Emergency Service
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
Areas
ToolsStrategy and
health care management
Health Care education and
research
HealthPromotion
Clinical ???
Working groups and
conferences+ + + + +
Web-platforms + + + + +
mHealth + + + +
Videoconferencing + + + + +
Imaging + + +
On-line databases + + + + +
??? + + + + +
Cooperation opportunities in eHealth
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
Strong political support at Government level in eHealth filed
Small country – flexible conditions – proved experience in goal achievement
Republic of Moldova
Opened, and, highly interested in developing cooperation for e-Health
Looking for partners – Government/Institutional/Corporate/non-Government
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
Wider access for citizens to health services and information
Compatible strategic and policy framework
Enhanced exchange of managerial, clinical, educational and scientific information and best practices between participating countries
Improved public health and health promotion programmes
Reduced costs due to cooperative approach
Outcomes expected from regional cooperation
Med-e-Tel, First Symposium on Global eHealth, Luxemburg, 6-8 April 2011
Thank you for your attention!
Questions?Comments?