1. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Working Group for Chapter 10 – Information society and media Bilateral screening: Chapter 10 PRESENTATION OF MONTENEGRO Brussels, 21-22 January 2013

2. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA eHealth Denis Reković Deputy Director of IT development Health Insurance Fund of Montenegro denis.rekovic@rfzcg.co.me

3. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA  Relevant Acquis  Basic informations  Pubic Health Care Providers  Integral Health Information System (IHIS)  Key Health Information Systems  Application “Contact” for Chosen Doctor  Electronic Health Record  Electronic Receipt  Integrality Content

4. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA Relevant Acquis  Commission Recommendation 2008/594/EC of 2 July 2008 on cross-border interoperability of electronic health record systems 32008H0594 Commission Recommendation 2008/594/EC  Commission Communication COM (2004) 356 e-Health - making healthcare better for European citizens: an action plan for a European e-Health 52004DC0356 - old Action Plan Commission Communication COM (2004)  Commission Communication COM (2012) 736 final: eHealth Action Plan 2012-2020 - Innovative healthcare for the 21st century Commission Communication COM (2012)

5. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA  About 640.000 insured persons  21 Municipalities  System of health insurance in Montenegro, based on Bizmark’s model  Health Insurance Fund, the only one organisation of compulsory health insurance in Montenegro  Budget for 2013, 165.000.000€  Health ID card and electronic records of insurees (database of insurees in HIF) Basic informations

6. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA Public health institutions:  18 Primary health care centers – “Dom Zdravlja”  7 General hospitals  3 Special hospitals  Clinical Center of Montenegro  Institute for Public Health of Montenegro  Institute for Blood Transfusion  Institut for Emergency Medical Care  Pharmacy institution “Montefarm”  Pharmacy institution “Galenika Crna Gora” Contracts:  170 private dental ambulances Public health care providers

7. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA Medical stations Distant Ambulances within “Dom zdravlja” Primary Health Care Center “Dom zdravlja” General Hospitals Special Hospitals Clinical Center Health care centers,“on-line” mode - 57 Primary health care locations - 7 General Hospitals - 50 pharmacies Public health care providers

8. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA Integral Health Information System  Health Insurance Fund (ISHIF)  Primary Health Care (ISPHC)  General Hospitals (ISGH)  Emergency Medical Care (ISEMC)  Institute for Blood Transfusion (ISIBT)  Pharmacy Institution “Montefarm” (ISPIM)  Pharmacy Institution “Galenika Crna Gora” (ISGCG)  Dental Ambulances (ISDA)  Institute for Public Health (ISIPH)  Agency for Drugs and Medical Devices (ISADMD)

9. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA  IS Health Insurance Fund 2000 y.  IS Pharmacy Institution “Montefarm” 2004.  IS Health Insurance Fund (integral; on-line)2006.  IS Primary Health Care (pilot 3 PHC Centers)2007.  IS Dental Ambulances2008.  IS Primary Health Care (integral)2009.  IS Institute for Public Health (part)2009.  IS General Hospitals (integral)2010.  IS Emergency Medical Care2010.  IS Institute for Public Health (integral)2012.  IS Agency for drugs and medical devices2012.  IS Institute for Blood Transfusion2012. History of development

10. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA  Started with development in the 2000, with distributed database system in each 21 subsidiary in municipalities  In 2006. migrate to “on-line” with central servers and administration system  All bussiness processes are covered with IS  Integrated with Unified Collection Gateway IS – Tax Administration  Integrated with all developed information systems IS Health Insurance Fund (ISHIF)

11. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA  Fundament for developing Integral Health Information System –Database of ensurees –Database of employers (obligate payers) –Database of doctors –Database of pharmacists –Database of dentists –Database of health care institutions –Database of medicaments (positive list) according to ATC/DDD –Database of diagnoses – ICD revision 10 –Great number of code libraries and parameters IS Health Insurance Fund (ISHIF)

12. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA  Started on 01.01.2009. in all primary health care providers in Montenegro  World Bank credit line for Hardware equipment  All primary health care providers in Montenegro are included Bussines Information System (ERP)  Human Resource Management  Finance Management  Management of fixed assets  Management of inventory  Management of Pharmacie  Salaries (piece work agreement) Medical Information System (MIS)  Central software modul (common resources: databases, code libraries, registries, parameters, etc.)  Choosen Doctor - “Izabrani Doktor” (ID) –Choosing the Doctor –“CONTACT” – application for the doctor –evidence of services for centers, support centers, special ambulances, etc. –electronic refers inside and outside institution –electronic receipt prescription and printing –evidence of services in stationary health centers in some DZ  Scheduling  Immunisation, Organ donor card,...  Electronic adverse effects of drug registration to ISADMD  Electronic invoicing IS Primary Health Care (ISPHC)

13. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA Medical Information System (MIS)  Central software modul (common resources: databases, code libraries, registries, parameters, etc.)  Stationary health care evidence –administrative processing of patient (admission and discharge) –doctors’ work on the department –nurses’ wok on the department –Operations –electronic curing history –electronic discharge letter –electronic statistic notifications  Special ambulances (electronic specilalists report)  Parameters  DRG evidence  Electronic invoicing IS of General Hospitals (ISGH)  Started on 01.01.2010. in all public primary health care providers in Montenegro  All general hospitals in Montenegro are included  Integrated with ISPHC, ISHIF and ISIPH Bussines Information System (ERP)  Human Resource Management  Finance Management  Management of fixed assets  Management of inventory  Management of Pharmacie  Salaries (piece work agreement)

14. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA  Developed by Health Insurance Fund (HIF) in 2003. as project “Control of distribution and usage of drugs”  Started in production on 01.01.2004.  All bussiness processes are covered with IS –Software modul for central drugstore –Point of Sale software modul –Software modul for usage of medicaments –ERP software (employees, salaries, finance, etc.) –Automatic creation of electronic invoice to HIF –Electronic receipt realisation from 2008.  Integrated with Primary Health Care IS and ISHIF  Integrated with Health Insurance Fund IS IS Pharmacy Institution “Montefarm” (ISPIM)

15. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA IS of Dental Ambulances (ISDA)  Started in 2008. with registration of patients, evidences of services  Contract with 170 private dental ambulances in Montenegro  Central application, used by all ambulances  Electronic dental record from 2011. –All treatments on teeth –Graphical teeth presentation  Integrated with IS of Health Insurance Fund

16. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA IS of Emergency Medical Care (ISEMC)  Developed in 2010.  ERP  Evidences of services  Management of the pharmacy  Dispatcher center - pilot project Podgorica in 2012 –Application “Contact” for doctors - EHR –Call recording (124 number) –Geolocation tracking of vechicles  Integrated with IS of Health Insurance Fund  Integrated with IS of Primary Health Care

17. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA Scheduling Curing epizodes Anamesis and medical report Diagnose (ICD10 / ICPC2) Medical service general datas, employement status, profession personal anamnesis social datas risk fatcors and alergies Refer inside institution (DZ): to a specialist support center stationary in DZ Refer outside institution (DZ): to a specialist to hospitals or KCCG diagnostics medical consilium first level of medical comittee Ordering for interventions and procedures Receipt prescription Sick-leave (medical assignments) EHR Primary Health Care Center Application “CONTACT” in PHC Choosen Doctor Statistic data to IPH Adverse effects of drug registration to ISADMD

18. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA EHR  Patient general data  Data about insurance  Anamnesis  Epizodes of curing  Used medicaments  Ampouled medicins  Interventions and procedures  Imunisation record  Risk factors  Allergies  Hospital treatments  Organ donor data Electronic Health Record (EHR)

19. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA  From 2004, electronic evidence of all realised receipts in Montenegro  Databases of ensurees (patients), doctors, pharmacists, medicaments,...  Scanning of 4 bar-codes by the pharmacist  Choose the right diagnose  Processing - 10 sec per receipt Electronic receipt evidence

20. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA PHARMACY Electronic receipt  Implemented in 2008.  Generated and printed by the Choosen Doctor  Real-time visibility in all pharmacies of “Montefarm” and “Galenika Crna Gora” in Montenegro  Processing by one scanning and one click ~ 2 sec  Real-time information for Choosen Doctor about receipt realisation Electronic receipt Information about realization

21. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA  International Classification of Deseases, revision 10 (ICD10)  The Anatomical Therapeutic Chemical Classification System with Defined Daily Doses (ATC/DDD)  International Clasification of Primary care, second edition (ICPC-2)  DRG evidence (Australian system) International accordance

22. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA Health ID card Refer PHARMACY APPARATUS Invoice Refundment CONSILIUM STATIONARY HEALTH CARE SUPPORT CENTERS EHR ENSUREE Health Insurance Fund OUT OF PUBLIC HEALTH SYSTEM Integrality e e e e e e e e e e Specialist report Discharge letter

23. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA Integrality

24. Chapter 10: Information society and media M O N T E N E G R O Negotiating Team for the Accession of Montenegro to the European Union Chapter 10: INFORMATION SOCIETY AND MEDIA Thank you for your attention. QUESTIONS