1. Countrywide implementation of Patient Appointment Reservation System in Lithuania Romualdas Jonas Kizlaitis Informatics and Development Centre Vilnius University Hospital Santariskiu Klinikos 6th Virtual Seminar, Vilnius, 2011-11-23

2. Lithuania: Area: 62,500 square km Population: 3.5 Million Capital: Vilnius Language: Lithuanian

3. www.santa.lt Some facts about Lithuanian Health Care: Information provided by Lithuanian Health Information Centre ~160 Hospitals (~100 legal institutions) >400 Outpatient Clinics (~190 legal entities) ~1500 Private Health Care Institutions (~900 odontologists)

4. PATIENT APPOINTMENT RESERVATION SYSTEM EU supported project 2005 – 2008 The Main Purpose of the Project: To design and implement Electronic Patient Appointment Booking System in the largest health care institutions of Lithuania. After successful implementation expand System to the rest of the country and make it National Patient Appointment Reservation Service.

5. PATIENT APPOINTMENT RESERVATION SYSTEM 7,4 Million Lt – about 2,1 MEUR (¾ EU support) 3 years, starting from 1 st of September, 2005 20 Partners – largest health care institutions: covering 8 of 10 regions, 51 municipalities ~740 000 primary care patients (about ¼ of all population) Handling over 6 000 000 appointments per year

6. 20 Project partners: VU ligoninės Santariškių klinikos KMU Klinikos Šiaulių ligoninė Alytaus apskrities ligoninė Telšių apskrities ligoninė Utenos apskrities ligoninė Kauno apskrities ligoninė Panevėžio ligoninė Klaipėdos Jūrininkų ligoninė M.Marcinkevičiaus ligoninė Kauno Raudonojo kryžiaus ligoninė Alytaus poliklinika Šeškinės poliklinika Vilniaus raj. centrinė poliklinika Vilniaus miesto Centro poliklinika Kauno Centro poliklinika Kauno Šilainių poliklinika Kauno Kalniečių poliklinika Panevėžio miesto poliklinika Klaipėdos miesto PSPC 2 University Hospitals 6 Regional Hospitals 3 City Hospitals 9 Largest Policlinics and Primary Care Centres

7. PATIENT APPOINTMENT RESERVATION SYSTEM Paper based (obsolete) reservation system – operator simultaneously works with several registration journals

8. PATIENT APPOINTMENT RESERVATION SYSTEM Paper based (obsolete) reservation system – operator must handle telephone calls and direct appeals simultaneously as journals can not be multiplied

9. University Hospital GP Primary level Specialist Secondary level Specialist Secondary level Specialist Secondary level University Hospital Specialist Reservations among specialists inside institution, including instrumental investigation Patient appointment reservations, assisted by secondary level specialist Reservations among specialists from different health care institutions Primary Care Physician assisted Patient appointment reservation to various specialists PATIENT Patient is able electronically book appointment to his GP or any health care specialist Information about all reserved visits SMS reminders SMS confirmations PATIENT APPOINTMENT RESERVATION SYSTEM

10. Investment into the Hardware (>50% of the budget): 580 patient registration and outpatient offices were equipped with modern computers; Central and Satellite Data centres were equipped with new servers; necessary computer network equipment (routers, switches, ups and cabling) was installed in all partner institutions; central call centre was equipped with conversation recording hardware and software; IP-based telephone servers with conversation recording features where installed in partner institutions. Call operators were equipped with SIP based phone hardware (150 workplaces); Virtual Private Network (VPN) connection was established between 20 health care institutions – project partners;

11. PATIENT APPOINTMENT RESERVATION SYSTEM

12. Possibility to control status of booked appointments Search reservation by speciality Search reservation by physician name

13. PATIENT APPOINTMENT RESERVATION SYSTEM Available visits Date and time

14. PATIENT APPOINTMENT RESERVATION SYSTEM Overview of special features: Specialist search in all health care institutions simultaneously (centralized Internet portal) Web-services for integration with local systems SMS acknowledgment and visit reminder SMS feedback, appointment cancellation Referral letter attachment to the appointment Telephone conversation record attachment to the appointment Secure networks

15. PATIENT APPOINTMENT RESERVATION SYSTEM Other reservation methods Internet reservation APPOITMENT RESERVATIONS EXTENDS TO NON-BUSINESS HOURS

16. PATIENT APPOINTMENT RESERVATION SYSTEM TODAY: 40 health care institutions connected 2011 Jan-Aug 2’129’030 pacients registered, 278’680 – using internet ~35k pacients use internet for booking every month 1815 phone service is used ~2000 times per month ~70k of SMS sent every month

17. PATIENT APPOINTMENT RESERVATION SYSTEM NEW PROJECT: PARS-2 870k EUR 25 additional health care institutions 3 years, starting February 2012

18. PATIENT APPOINTMENT RESERVATION SYSTEM NEW PROJECT: PARS-2 Additional functions for booking: Inpatient clinic; rehabilitation centre; small private institution. Automated tools for booking with electronic referral. Tools for appointment queuing, when no times available. New technologies: vCalendar, vCard, iPhone and Android apps Intellectual electronic wizard, helping patients to refer for appropriate specialist, collecting actual health information and anamnesis Tools for more simple family members assistance Electronic self-service tools for easier contracting and setup of the new health care provider Integration with external national information systems.

19. Thank You for Attention! Romualdas.Kizlaitis@santa.lt Vilnius University Hospital Santariskiu klinikos