engleski

Health Information Culture in Croatia

Data and information are critically important resources for planning, managing and evaluating healthcare systems. The application of ICT, due to the mostly non-competitive nature of healthcare, developed slower than in other sectors. ICT is nevertheless profoundly changing the way data is collected, analyzed and used. When approaching strategic planning and managment of healthcare data and information, it is crucial not to confuse managment of data and information with the managment of ICT systems. This paper/lecture points to a few examples of unsatisfactory managment of healthcare data and information due to the lack of strategic approach. Planning of the eHealth architecture in Croatia, as well as data and process standardization and certification, has mostly been entrusted to large ITC solution providers. eHealth solutions have even sometimes been initiated, controlled and implemented by providers themselves. These trends resulted in a system that is nontransparent, complicated and expensive to maintain, scale and upgrade. Consequently, interoperability of the system stakeholders became a huge issue. In the last years, majority of eHealth projects have been managed by Health Insurance Fund with focus on solutions relevent to the insurer aspect of the healthcare system. This resulted in very early and successful penetration of the ePrescription system, in opposite to despite the announcments so far never accomplished central EHR. Analyses also show that insurer-focused clinical processes skew the dana towards financial indicators and are of limited usability for public health and policy-making purposes. Inconsistencies in adhering to the defined institutional authorities and the involvement of relevant stakeholders in the design of new applications and processes in healthcare are clearly visible on a series of eHealth examples projects, where successful technical development was not accompanied by semantic, organizational and legal completion. Although some of those examples conceptually represent significat progres sin supporting the clinical work, in reality, new systems often lack definition, expert and stakeholder consensus, semantic standards and formalization. The examples clearly indicate a lack of data and information culture in the Croatian healthcare system with many serious ethical implications, which call for an urgent strategic re-focus. A new, comprehensive eHealth strategy is needed, based on stakeholder engagement, cooperation and accountability as well as a solid legal foundation. Only an inclusive and evidence-base strategic approach can lead to a functioning eHealth system, which is able to support production of knowledge, responsible allocation of resources and finally contribute to the improvement of population health and wellbeing.

health information, data reliability, eHealth ethics, interoperability

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