Bulgaria's great success in healthcare

The total number of registered examinations in electronic format through the National Health Information System (NHIS) has exceeded 47 million for the last 18 months. The data of Information Services shows that on average, over 130,000 electronic examinations are being registered per day from over 13,500 medical practices throughout the country, and the total number of doctors who use electronic documentation of the examinations performed exceeds 17,000. NHIS enables complete electronic documentation and storage of all performed medical examinations. The "E-examination" module is an essential part of each user's personal medical record and enables all citizens to have full traceability of diseases, diagnoses, prescribed therapies, examinations, etc. Patients no longer have to keep and carry all issued paper outpatient records, nor to remember what medications they had been prescribed and how they affected them. All data is available in electronic format and can be accessed at any time.

"The digitalization of processes in healthcare is entirely aimed at protecting the rights of patients," explained Information Services’ CEO Mr. Ivaylo Filipov. According to him, through the personal medical record, which is available in the web portal my.his.bg and the mobile application eZdrave, citizens can control the health system, protect it from abuses and siphoning of public funds. "Digitalization significantly improves the transparency and quality of healthcare services in Bulgaria," Filipov added. Through NHIS, the authorities receive structured medical data, used to perform various analyses, planning and forecasting.

Data from the NHIS shows that in less than 2.5 years, the total number of issued electronic prescriptions has exceeded 34 million. On average, the centralized online system for prescribing and dispensing medicinal products processes over 68,000 e-prescriptions per day. In less than a month, since the new functionality was introduced into the system, more than 410,000 electronic prescriptions for drugs containing narcotic substances have been issued. The "E-prescription" module is effectively used by nearly 3,600 pharmacies across the country and over 4,300 pharmacists. The online system for prescribing and dispensing medicines has drastically reduced the risk of incorrect dispensing of medicines and has given maximum comfort to patients, doctors and pharmacists. Digitalization of the process eliminates the possibility to fulfill wrong, duplicated, expired or fake prescription. Patients can monitor the execution period of the prescription, and check at any time the prescribed medication and the specific instructions for its administration.

The electronic referral platform, which was launched in early December 2020, also reports impressive results. Nearly 30 million e-referrals have been issued through NHIS, and on average the system generates over 72 thousand referrals per day. In the patient record, both the current issued referrals and those, that have already been completed, can be seen.

The performed electronic hospitalizations exceeded 2 million. The module for electronic processing of admitted patients allows medical institutions to submit electronically the performed activities of hospitalization, dehospitalization, laboratory tests, consultations, issuing epicrisis, etc. On average, 10,000 electronic hospitalizations are registered per day from 351 hospitals in the country.

"The introduction of electronic services in healthcare saves tons of paper, which was used to issue prescriptions, referrals, hospitalizations, epicrisis, etc.," said Mr. Ivaylo Filipov. According to him, the digitization of processes helps to save thousands of acres of wood and millions of liters of water that are involved in paper production. "Environmental protection and the reduction of harmful emissions are primary goals for Information Services,” added Ivaylo Filipov.

Despite the impressive numbers, the majority of registered electronic data in the system are still funded by the National Health Insurance Fund (NHIF), which limits the completeness of patients' medical histories. NHIS was created to serve all medical events of the patient - examinations, prescriptions, tests, immunizations, etc. documents regardless of the source of funding and each module in the system provides the necessary technical collateral.