IPCHS. Integrated People-Centred Health Services

Practices

 
Sept. 7, 2016 Leading practice Europe

Developing an integrated information system in the Former Yugoslav Republic of Macedonia

Summary

The Ministry of Health designed and implemented a web-based appointment platform to streamline information flows and reduce artificially-inflated waiting times. Additional features, such as e-referral and e-prescription applications, have since been incorporated into the information system; a comprehensive investigation at the beginning of the initiative supported the development of an informed solution to directly address key challenges; alignment with previous investments in technological infrastructure enabled rapid uptake of the new information system by providers and more economical use of existing resources; an effective communication plan, including public campaigns and efforts to gain public trust, helped ensure widespread uptake of the new information system.

Description of practice
City: Skopje Country: Macedonia, The Former Yugoslav Republic Of
The problem

In the early 2000s, lack of coordination and standardization in patient registration contributed to long waiting times for health services. Due to a general public distrust in the referral system and concerns over long waiting times, patients often registered multiple times in different locations for the same service. Paper-based referrals contributed to inefficiencies, limiting coordination between providers and preventing duplicate registrations from being addressed. While government reforms had successfully generated extensive investment in information technology across the health system, these efforts were largely unsystematised, which limited their ability to optimize service delivery. 

The solution

In 2006, the Government of the Former Yugoslav Republic of Macedonia launched an initiative to develop an integrated health information system. A comprehensive study of health system challenges and information exchanges informed the governmental Strategy for Development of an Integrated Health Information System, helping to establish the necessary framework to guide change. Within this Strategy, the Ministry of Health assumed a leadership role over the initiative and carried out a scoping investigation to further inform the specific design of the information system. As the Health Insurance Fund had existing electronic links with general practitioners, a partnership was formed between the Ministry of Health and the Health Insurance Fund to design a system compatible with the current infrastructure. Synergizing with the existing infrastructure is credited with accelerating the rollout of MyAppointment and minimizing investment costs. Shortly after the launch of MyAppointment, a reduction in waiting times was observed. Today, general practitioners continue to electronically register patients for services in MyAppointment, which helps to prevent duplicate service registrations, improve accuracy in measuring access and facilitate timely coordination of care. Patients also have access to the platform to monitor appointments and view waiting times. Additional features, such as e-referral and e-prescription applications, have since been incorporated and the information system continues to evolve under the guidance of the Ministry of Health’s new e-health department. Moving forward, focus is being placed on using the data collected by the information system to guide service delivery improvements at the stewardship level.

Implementation of practice
What stage is the practice currently in?

Fully implemented and scaled up

Who was/is responsible for the implementation of the practice?

Top-down leadership from the government, in partnership with the Health Insurance Fund and health providers, drove the initiative forward. The Ministry of Health formalized the overarching framework for the initiative and created an e-health department to support development, management and improvement of the new information system. The Ministry worked closely with the Health Insurance Fund to develop the information system and its associated applications. Additionally, the Health Insurance Fund played a key role in promoting providers’ use of the system through contractual agreements with general practitioners.

Impact

Improvements in waiting times were observed within just a few months of launching MyAppointment, with the effort to improve reporting and monitoring of patient flows generally regarded as being highly successful. Waiting list times dropped from as high as 17 months down to just a few days, with the longest waiting times down to around two weeks.

Additional information

This case was prepared as part of a larger effort by the WHO Regional Office for Europe and published (2016) in the document, "Lessons from transforming health services delivery: Compendium of initiatives in the WHO European Region".

© Copyright World Health Organization (WHO), 2016

The methodology used for the development of this case is slightly different from the templates used on the IntegratedCare4People web platform, in particular in the analysis of enabling factors and barriers to change.

 

Please click on the link below for more information about this practice. 

Contact information
Name:
Neda Milevska-Kostova
Organization:
Studiorum, Centre for Regional Policy Research and Cooperation (CRPRC Studiorum)
Email:
info@integratedcare4people.org
Phone:
Role:
None
Comments
 

Andrew Naomi 17/04/2022 02:17

I was infected with Herpes (HSV) two years ago and I was devastated. I visited different hospitals but they only gave me drugs to treat the symptoms. One day I was browsing through Dr. SEBI then I found a lady who introduced me to an Herbal Doctor called Dr. OJAMO. She explained to me how Dr. OJAMO cured her from herpes with natural herbs and root products, she gave me the doctor Email:: dr.ojamoherbalhome@gmail. com I contacted him and asked him questions about his product. He explained to me how the product works and also showed me those he has cured with his product. He told me he would prepare the product and shipped it to me, the product got delivered after 5 days of delivery. I took the product as instructed by Dr. OJAMO and after 21 days I was having diarrhea and constantly urinating. I went for a test and I was tested for Herpes Negative. The product worked exactly the way Dr. OJAMO instructed and now I am free from HSV. I am very happy, I will recommend this great testimony to save a lot of people suffering from Herpes. Contact: Dr. OJAMO Whats-app:: https://wa.me/2349077406037 also Email dr.ojamoherbalhome@gmail.com His website https://drojamoherbalhome.wixsite.com/welcometodrojamoherb

Monica Raymond 18/04/2022 09:44

One day I was reading an article online we’re I found about Dr. Ojamo and how people have been cured using his herbs and roots so I message Dr. Ojamo on WhatsApp  https://wa.me/2349077406037   and I got a reply. He told me with God everything is possible. Dr. Ojamo told me about plants/herbs and it’s purpose that when he told me no matter the situation you found yourself in there is always a solution. I decided to try Dr. Ojamo Healing Herbs. He made a fresh herb and told me the plant and root because his product is 100% plants and root cooked and packaged inside a container and he shipped it through UPS. I received it and finished the product exactly 21 days ago and before then I was having diabetes and difficulties in breathing, I went to the hospital and my doctor was surprised how I got cured from all these diseases then I said praise to God .  Share Dr. Ojamo email: dr.ojamoherbalhome@gmail.com or you can call and WhAtsapp him on  https://wa.me/2349077406037   if you are infected with HERPES virus or having any health problems contact Dr. Ojamo and he will help you. Share his email so that everyone will know there are herbs and roots that cures every diseases because there can never be a smoke without a fire; dr.ojamoherbalhome@gmail.com   Check his Website https://drojamoherbalhome.wixsite.com/welcometodrojamoherb

Add your comment


Sign in to add your comment.