The state of digital transformation in Slovenian healthcare is a topic of growing importance as the nation continues to make strides towards enhancing its healthcare ecosystem. While improvements have been made, challenges persist, particularly in terms of interoperability among various healthcare systems. However, are recent initiatives the steps in the right direction?  

 We had a discussion with Jelena Jecmenic from Endava, an IT HealthCare system provider in Slovenia.

 

How would you describe the Current Landscape?

 Slovenia has witnessed improvements in its healthcare digitalization, especially after COVID, however many solutions remain fragmented, and the need for greater interoperability is more and more apparent, actually rather essential if the end goal is fully integrated health ecosystem.

 Digital Health Strategy are for sure steps in the right direction, right steps towards improving interoperability on all levels in the HealthCare environment in Slovenia and along with further dedicated funding for digital health it can bring us closer to a national multivendor Health Eco System which will truly empower patients.

What are the Challenges and Bottlenecks from your perspective?

Disconnected health systems, data fragmentation, and the complexity of change management pose significant challenges. Every change or a functionality that should be available to all patients is complex and time consuming and involves multiple systems, not to mention maintenance.

There is a lot of data on patients also in legacy systems that is potentially obsolete, etc. but again the biggest part of the digital transformation projects is organizational change management and overcoming the natural resistance in people to the changes.

The change that is desired is a complex project, even more from the organizational perspective, that has to evolve gradually since it involves numerous systems along with 2 million users, so it will take time for the right actions to provide visible results.  

You are to celebrate 15 years in production with IRIS, the Endava Primary Healthcare Platform. What do you see as key benefits or trends that are emerging?

IRIS is built and is evolving in collaboration with the medical staff that uses it daily, so the key benefit is that the platform with it’s integrated front-end portal for patients and back-end system for medical professionals helps with reducing the time required for administrative tasks and thus leaves more time for patient care. Patients don’t have to wait in waiting rooms only to prolong a prescription, sick leave or a referral. To emphasize, the communication via IRIS portal is focused on administrative requests, not on remote treatment of patients. But, if  each interaction is structured, short and to the point as it is via the portal, it helps in reducing in person patient visits, that is a gain of time for all those cases that have to be treated in person. 

Also to mention the security, with a log in via a SI-PASS certificate, and with all transactions performed within the platform all interactions are secure, and identity confirmed for all participants, which is something that cannot be said for mail or text.

Coming back to the medical professionals, they have one interface and ease and traceability of activities per patient throughout the system, as opposed to multiple emails, texts or other. Each message is structured via the portal and triage is performed by the nurse, she responds or assigns a level of urgency if applicable and marks for further processing. The system routes to the first available doctor who has a more comprehensive patient view because the portal is integrated with patient health history and record from the back-end IRIS platform, bringing also better medication control.

Also, good practice that we implement is education and involvement of marginal groups, like continuous sessions with the elderly to help them to adapt and for us to adapt the solution to better include marginal user groups in general.

Since IRIS is in the largest Primary HealthCare institution in Slovenia, it logs close to 1 Mio patient visit per year, but since beginning of 2023 and introduction of the IRIS patient portal, there are also 132,000 active digital users, with that number growing, we can see the trend of the overall digital shift.

Regarding innovation on our side, current efforts focus on optimizing processes and exploring automation with Artificial Intelligence. Advanced analytics will provide a more accurate Patient 360 view and reduce the burden of patient record maintenance.

You have mentioned the education of elderly, but that is a process. How do you help those that can’t use digital technologies at all?

Besides providing education for elderly, we provide an option of an Authorized Person (Ovlašćenik, Poobčaščenec) who can perform needed tasks via the digital platform on behalf of an elderly or disabled person, who would also log-in via SI-PASS and thus confirm their identity.

Also, MJU will issue SICeP for central authorization (Centralno pooblaščanje) which Ministry of Health will use for zVEM portal as well.

To add that the idea is not to have all users on the portal, but as many as possible, so if let’s say 80% of all patients of given institutions would complete the admin tasks via the portal is it still a huge time gain for medical professionals, which was the goal with the IRIS portal.

Of course, it is not just this Patient Portal, as you know, a number of government or other services are now digital, and it is a necessity for us as a society to continuously invest in digital literacy in order to strive.

What do you see as the Path Forward?

By fostering modularity and scalability through multivendor platforms and implementing standards, Slovenia can empower patients and support healthcare professionals. This approach opens doors for both established companies and innovative startups, offering all stakeholders in the Eco System flexibility in choosing the right solution to their healthcare needs.

In conclusion, a journey towards digital health transformation is full of challenges, but there is more and more commitment to creating an integrated healthcare ecosystem. As stakeholders work collaboratively and stay committed to the course, we can look forward to a future where digital health solutions empower both patients and healthcare professionals.