Advances in Hospital and Clinical Informations Systems

1. Advances in Hospital and Clinical Informations Systems Entela ZEQO National Center of Bimedical Engineering Email: entzeqo﹫yahoo.it

2. OBJECTIVES • Future: Best Health Care Syatem in developing the quality components in health • Based: Best Practice • Ensure support and increase development in terms of safety and costs

3. ALBANIA • Population 3 milion • Sip. 28.000 km² • Regional Hospitals 12 • University Hospita l 4 • District Hospitals 26

4. Health System • Financing models State Health Insurance Free market • Organization Primary Secondry Tertiary • Ownership (State – Public) State Health insurance Private

5. Organizational Health System in Albania • The health system is organized on three levels of Primary Health Care • Secondary care – District Hospital • Tertiary care– University Hospital The system coverage, access and utilization of health care services. In capital Tirana Regional Health Authority which is responsible for planning and managing primary health care services and public health programs in Tirana, through the system of 10 Policlinics.

6. Organizational Health System in Albania • Health System in Albania is mainly public. The great part of the services are offered by state. • Part of the population services offerd in the field of promotion, prevent, diagnostic and treatment. • Private sector is offer in hospitals and cover mostly the pharmaceutical service, stomatology and some of hospitals specialized which are placed in Tirana. • In the public sector the lieder is the MoH which is responsible for the strategies and policies of the health system sector and budget.

7. National Health System • ISKSH • Primary Health Care • MoH • Secondry Health Care (District Hoapital) • Tertiar Health Care (University Hospilal)

8. Implementation Projects in Hospital • Hospital Management in Albania have involve project as opportunity to: - Manage the health care delivery system introducing up-date methods and modern . - Administrative techniques into hospitals being able to offering better service in safety and in time to the patients. - Managers more control improves their service maintain proper clinical standards, enhance control costs at their facilities.

9. Clinical Service Information System in Primary Health Care

10. SISP Information Health System • SISP – is one of the information system which is started in colaboration with the MoH and National Agency of Technology Development . The project have started in october 2010. • SISP is project –started in French Hospital in the receptions which is consisting in automatization of Health System. • In 2011 SISP – was present in organised 16 recetions of Mother Teresa Hospital Second Phase • In 2011 the implementation of the project was in function the informatisation of 11 Pharmacies of the hospital.

11. Applied SISP • During 2012– February 2013 is done the informatisation of all (pavione) in Hospital. The sitem consist in ambulatory patient are registerd in the reception of Ward • The systemis offering on time chef Nurses the information notonly to the patient but even the situation of drug situation inventory. The quantity of medicines is daily consume in ward. • This system give the Institution of Health Care the possibility to analyse the real costs for the patient insured and have in real time pharmaceutical expenses second wards.

12. Applied SISP Thired Phase • Consist in registring and monitoring the movement of the patient: the data base to the clinical chart (like generalities of the patient like name, date of birth, place of birth, adress, Id, blood, cod of national institution of health insurance etc.) • Working inthe system is used diagnostic cods based on the ICD-9 sugested by WHO codification and approved by MoH. The MoH is evaluated to developed the system (use of the ICD – 10 or 11).

13. Aplication and report in SISP system • The system allow trasparency, shared work adaptation for better use of exsistin reports core model in automatisation of Health System • The conectivity in network to all point and have an secure system. • The software application for difrent clinical process in the hospitals. • Aplication of the system for managment of Clinical charts adaptable.

14. SISP in Tertiar Hospital «Mother Teresa» Tirana University Hospital Center have 1442 beds. Is the center of professional leader in health and hospital care of Tirana and tertiary level of care for whole Albanian population. Tirana University Hospital Center is as a centre of excellence with main academic teaching facility in Albania and as a center of innovation, assimilation and introduction new technologies. The health care system is financed from a number of sources like the Health Insurance Institute. Ministry of Health remains the major player in terms of the allocation of investment and capital expenditure to hospital providers. Ministry of Health have introduce a new “request” system in which we have SISP system implementation

15. Working SISP System • The reception OP Mother Teresa Hospital OP Reception Number of Visits: 120 OP per day Number of consult rooms (for OP) : 27 Specialties covered:: ORL, OMF, oculist, professional disease, alergology, examination (view, oudiometry) There are 3 new pc + 1 printer there. There is a camera’s monitor inside the reception. Admission room Number of visits: 60 IP Only IP folder Emergency Number of visits: 321 ER per year and 60 IP per month

16. TELEMEDICINE • One other project is Telemedicine which is presented by one year in 6 centers allocated the centers in the 6 regional hospitals like Tirana, Durres, Shkoder etc. • The 6 centers are connected in internet supported by AKSHI • Telemedicine is developing mostly telecommunication, distance continuous medical education and electronic library

17. Iniciatives and Devepolments E - Health For the creation of e-health, the Ministry of Health is negotiating with the World Bank for a comprehensive credit where the e-health component is an integral part of the negotiation package. The Ministry of Health in collaboration with some of its institutions of dependency has started creating some projects in the field of informatisation of the health system:  • The e-prescription project: • The Track & Trace project • Hospital Management System • Inventory of biomedical equipment. • Health Facility Inventory List