AOS: There will be an e-registration pilot. What benefits to start with?

The draft regulation sets out the rules for conducting a pilot program of central electronic registration for selected health care services in the field of outpatient specialized care and health programs, the purpose of which is to evaluate the effectiveness of the new solution of central electronic registration (central e-registration, CeR) implemented using the functionality of the information and communication system referred to in Article 7(1) of the Act of April 28, 2011 on the health care information system (Journal of Laws of 2023, item 2465), hereinafter referred to as the "P1 system". The proposed solution implements the need to verify the solutions adopted to:

1. Optimize the use of benefits and health care staff resources by reducing the number of patients' non-cancelled service appointments. Reducing the number of missed appointments will be achieved by providing appointment cancellation functionality in CeR
2. Relieve providers of the administrative burden; related to maintaining waiting lists and schedules, and handling notifications sent and received from recipients;
3. Increasing accessibility to health care services for the recipient (by making publicly available up-to-date information about available service dates, use of dates that have become vacant at the last minute, and more efficient management of service dates);
4. Ensure transparent management of waiting lists and the central waiting list (by having the IT system partially take over the maintenance of schedules and providing easy access to information on free appointments for recipients);

Ensure that recipients are able to find an available appointment in a modern, easy and fast way, sign up for a benefit date, as well as reschedule and cancel.

The purpose of the pilot program introduced is to evaluate the performance of central electronic registration in the implementation of health services covered by the pilot program, including:

1) the ability of the recipient to independently search for available appointments for selected health care services covered by the pilot program;

2) the possibility for the recipient to make central notifications;

3) the mechanism for assigning to the recipient the dates for the provision of health care services covered by the pilot program, taking into account the criteria referred to in § 9 (4), as determined by the recipient;

4) maintenance of a central waiting list;

5) making available by the implementers of the pilot program to the unit subordinate to the minister responsible for health care information systems the admission schedules and data on the timing of the provision of services for the ranges of health care services covered by the pilot program ;

6) maintenance and ongoing updating by the implementers of the pilot program of admission schedules for the ranges of health care services covered by the pilot program in the P1 System.

The pilot program covers health care services:

1) Cardiology;

2) cervical cancer prevention program for the primary stage;

3) Breast cancer prevention program for the primary stage.

The above coverages include benefits in areas that are a priority for health policy due to the nature and importance of the benefits and also due to the verifiability of the enrollment process for health care appointments.

The designed solutions will allow to test the adopted principles and functionality of CeR, in particular:

1) Cardiology services - cardiovascular diseases are the leading cause of death in the country, in addition, the inclusion of these services in the CeR will allow full verification of the functionality of the CeR, including in particular the central waiting list, and verification of the impact of the CeR on the admission schedules maintained by the pilot program implementers;

2) benefits for the cervical cancer prevention program and the breast cancer prevention program (cytology and mammography). These benefits will allow to verify the functionality of the CeR, in terms of registration for benefits in which there are no waiting lists. At the same time, it is anticipated that the inclusion of these benefits in the CeR will allow the expansion of enrollment opportunities for these benefits, resulting in an increase in the number of people participating in the prevention program.

The proposed regulation defines CeR as a functionality of the P1 System that allows a healthcare provider to make a central notification and assign a date for the provision of healthcare under the pilot program at the selected pilot program provider, to change or cancel the central notification made or the date for the provision of this service.

A detailed method for making a central notification and assigning a CeR health care term and any changes to it to the beneficiary is specified, as well as a detailed method for notifying the beneficiary of the assignment of a CeR health care term and any changes to it, and providing the beneficiary with other relevant information regarding it. It is proposed that the health care delivery date will be assigned to the recipient at the time of the recipient's central notification, which will entail its inclusion in the admission schedule of the selected pilot program implementer. If it is not possible to allocate such an appointment to the recipient at the time of notification due to the lack of available available appointments at that time that meet the criteria specified by the recipient, as referred to in § 9 (4), the recipient will be placed on the central waiting list maintained for the given range of health care services. In such a situation, the recipient will simultaneously receive information on the expected date of service.

The proposed regulation stipulates that central notification for health care services, may be provided:

1) via IKP;

2) by means other than those specified in point 1, including in person, by telephone or using electronic communication means, directly with the pilot program implementer, however, telephone or personal central notification may be made only during the days and hours of provision of services by these entities.

However, applications for services to be provided on the basis of a paper referral can only be made directly to the pilot program implementer. Such a solution is due to technical considerations related to the inability of the P1 System to validate the information about issuing the aforementioned referral to the beneficiary for the provision of a specific healthcare service, unlike in the case of referrals issued in electronic form collected in the P1 System.

It is the planners' assumption that the recipient will remain on the central waiting list until a free appointment is available and assigned to the recipient. As a consequence of the above, the respective pilot program implementer will be required to determine in the P1 System the relevant status of the electronic referral on the basis of which the healthcare service is to be provided.

It is proposed that the pilot program will run from the date of entry into force of the regulation until June 30, 2025, with two phases. The first will be the preparation and implementation phase of the pilot program, and the second will be the evaluation phase. Recruitment to the pilot program will be conducted on a first-come, first-served basis.

Participation in the pilot program will entail the allocation of additional funds to providers provided in accordance with the annex to the regulation.

Source: RCL