Central Information Health System of the Republic of Croatia
Smart solutions for faster health information exchange
The development of the Central Information Health System of the Republic of Croatia began with a scientific research project in 2002. Ericsson Nikola Tesla was contracted by the Government of the Republic of Croatia for the delivery of the System the following year, and subsequently for maintenance and continuous upgrading of the System. The Central Information Health System, connecting healthcare providers in Croatia has been in production since February 2007, As per the Act on Health Data and Information of 2019, all exchange of health information within Croatia must take place through the Central Information Health System.
Over the years, the System enabled digitalization and transformation of numerous processes in healthcare and made healthcare more accessible to patients. A large part of the System’s services is made of integration interfaces that enable the communication of other systems and their users, which makes the Central Information Health System of the Republic of Croatia a national integration platform for all other information systems and applications in the country. Among different applications available to end users, we highlight the following two:
- Electronic Healthcare Record (EHR) – intended for authorized healthcare professionals; enables review of the patient’s medical data generated in different parts of the healthcare system in one place
- Health Portal – enables citizens to access their own medical data and provides them with numerous services such as sending requests for chronic therapy renewal, exchanging messages with selected doctors, managing orders, etc. Citizens can use the services of the Portal also for minors in their care.
The Central Information Health System of the Republic of Croatia is used daily by healthcare professionals across the whole country.
The web version of the Health Portal is used by over 800,000 people and is one of the most popular services within the Government’s eCitizens Portal (Source: e-Građani – statistika – Skupovi podаtаkа – CKAN (gov.hr)).
An Overview of the Most Important Functionalities of the Central Information Health System of Croatia Services and Applications
- Digitized exchange of structured data (referral, reservation and sending of findings)
- More than 15 million eReferrals issued annually
- In production since 2011, and functions as the only mode of medical referral since 2020,
- Medical reports are forwarded to healthcare professionals writing referrals and are available to patients through the Health Portal,
- Contains medical reports.
- Allows patients to see their medical record and manage the doctor’s access rights to their data and allow or prohibit the cross-border exchange of their medical data (prescriptions and medical summary).
- More than 800,000 users of according to eCitizens statistics (eGrađani statistika)
- More than 20,000 daily users
- Complemented by a mobile application (avialable from 2020)
- Enables retrieval of patient data, checking of insurance status and certain rights based on insurance (e.g. right to assistance)
- More than 1.5 million checks per day.
- Digitized process of prescription, approval, reservation and registration of the issuance of medical aids
More than 1 million devices a year are electronically prescribed in Croatia
- Medical records* of all patients in the Republic of Croatia are available to all registered doctors.
- contains information on diagnoses, visits to selected doctors, laboratory tests, prescriptions, referrals and findings from polyclinics and hospitals, discharge letters, allergies, special notes, etc.
- A mobile application available from 2022
*In the scope of data sent to CIS from all institutions from January 1st, 2016 and if the patient has not expressly prohibited access to his data.
- Enables digitized exchange of structured data (sending a referral, sending data about the sample – if the sample is taken immediately in the doctor’s office, and sending the findings)
- 15,000 people daily no longer need to collect their results from the laboratory to take them to their chosen doctor.
- Enables doctors to view lab results in the local EHR and is integrated with the Health Portal where patients and physicians can view their results
- In production in Croatia since 2011, when paper forms were abandoned.
- Digitized exchange of structured data (sending a prescription, booking a prescription and sending information about the medicine taken at the pharmacy).
- Patients pick up more than 61 million medicines a year.
- ePrescription has been in production in Croatia since 2011, when prescribing on a paper form was abandoned.
Institution
Employee
System
Persons (Patients)
Every report on the healthcare provided at home is available to the doctor who prescribed the therapy.
Registration of selected medical data in a structured format. The structure of EHR rests on these reports, which have been in production since 2007. More than 300,000 reports sent daily to CEZIH.
Payment to primary care providers in Croatia relies on these reports.
Helpdesk applications, used by the system operator, enable the monitoring of individual digital processes and the provision of the first-line support to end users.
Cancellation, which enables the correction of errors and going back a step in digitized processes, is built into all services.
Every report on the health care provided at home is available to the doctor who prescribed the care.
Authentication
Authorization
Audit Record
VPN
Digital Signature
PKI Infrastructure
The Republic of Croatia has been exchanging ePrescriptions and patient health summaries with other EU countries since 2014.
European Health Data Space
ICD10
ATC
DRG
National Lung Cancer Screening and Early Detection Program
National Cervical Cancer Early Detection Program
National Breast Cancer Early Detection Program
National Colon Cancer Early Detection Program
HL7 v2
HL7 v3
HL7 CDA
HL7 FHIR
IHE
- Report of a malignant neoplasm
- Notification of an infectious disease
- Onko+ message
- Croatian oncology database
- Free communication among doctors
- Recommendation of sick leave for a parent of a sick child
- Remote specialist consultation
- Register and repository of documents
- Abbreviated Pompidou form
- Vaccination register
- Contact information
Abbreviations
HL7 – Health Level Seven International
FHIR – Fast Healthcare Interoperability Resources
IHE – Integrating the Healthcare Enterprise