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All citizens now have access through a mobile device to their personal patient record and to all available electronic health documents in the National Health Information System (NHIS). This has become possible after the Ministry of Health and Information Service launched the "eZdrave" mobile application. It provides users access to examinations, referrals, prescriptions, vaccines, laboratory test results, general health information, etc. in the NHIS. The application was officially presented by Boris Kostadinov, Director of Software Integration at Information Services in the presence of the Interim Minister of Health, Dr. Asen Medzhidiev, and the Chairman of the Board of the Bulgarian Medical Association, Dr. Ivan Madjarov.
The eZdrave application facilitates at any moment users to have information on their examinations, prescriptions, issued referrals and other relevant health data," said Boris Kostadinov. According to him, the app is among the most innovative in Europe and is the first in Bulgaria that associates all patient data at national level.
One of the biggest advantages of eZdrave is that the information in it is presented in an understandable manner to patients. It is extremely easy to use and provides patients with all the necessary information about their health status. The application has access to all available modules in the NHIS that work with electronic documents that form the personal patient record.
The Record section includes separate categories for examinations, referrals, prescriptions, vaccines, and lab results. Each document in Examination section contains information on diagnosis, history, general status of the patient, treatment, as well as all related documents (if any) - referrals, prescriptions, immunizations. The document contains data on the type and purpose of the examination, in which medical institution it was performed, full official information about the medical specialist who performed the examination and provides easy contact with the doctor via phone number or email.
The Prescriptions section includes all e-prescriptions issued to the patient. Each prescription has a 2D barcode that enables the prescription to can be scanned and fulfilled in a pharmacy without additional information. The e-prescription states its term of execution, trade names of the medicines, as well as information about dosage and intake in an appropriate language for patients. A ranking has been created related to the status of the prescription - whether it is to be partially fulfilled or fully fulfilled.
In the Referrals section, the electronic referrals assigned to the patient can be found including deadline, main diagnosis, co-morbidities, etc. Laboratory test referrals have a barcode that contains the National Reference Number (NRN) and allows direct scanning from the mobile device
In Vaccines section can be found all immunizations registered in the NHIS. Vaccines with issued certificate (such as those for COVID) are marked with a special icon. They have a QR code that can be directly verified and the certificate may also be downloaded in PDF or PKPASS format.
In Results section, all results from performed tests, details of the tests, deviations from reference values, interpretation of diagnostic imaging, etc. are visualized.
At present the NHIS and the mobile application lack historical data related to past examinations and medical activities. Only the health records that GPs, specialists, medical institutions and laboratories have entered for each patient since the NHIS was put into operation are accessible.
The eZdrave app can be downloaded for free from the App Store and Google Play. Access to electronic health documents in eZdrave is done through a one-time pairing of the application with the personal patient record, available in the NHIS at my.his.bg through a computer browser.
Due to the high requirements for the security of personal and medical data, access to the personal patient record is done only through a qualified electronic signature (QES). The experts of Information Services are working on the introduction of additional secure methods of logging the electronic patient record, which are expected to be available soon.
In addition to the QES, the security of the information in the eZdrave mobile application is also guaranteed with additional biometric protection, which is activated at the user's request. NHIS records and stores every action that takes place in the electronic file, regardless of whether the action is by the patient, medical professional or other authorized person. A history with recorded actions can be viewed by the user through Audit log in the mobile application and the web version.
If the user decides that he will no longer use the mobile device on which the application was downloaded, he can deactivate his account. Deactivation erases all information from the device and leaves no trace of the file in the phone.
By the end of the year, the application will have additional functionalities, including electronic hospitalizations, history of the disease, display of notifications for planned hospital admission, decisions by Expert Medical Commissions, information about allergies, notifications for taking medications, panel for chronic diseases, etc. In the coming months, the plans are to launch functionality that provides parents with access to the patient record of their children or their elder relatives.
"The mobile application eZdrave gives a strong boost to electronic healthcare in Bulgaria. Through it, users can perform better control on their medical data, the possibility of erroneous transmission of information between a patient and a doctor is reduced, and it provides an opportunity for patients to receive better healthcare services," said Boris Kostadinov. In his words, in less than two years, Information Services has managed to digitalize the main processes in outpatient and hospital care and establish high-quality services for patients, doctors, pharmacists and all participants in the healthcare ecosystem.