Since 2017, the provision of care at a number of hospitals in the Republic of Moldova has been transformed by the introduction of an automated information system enabling hospitals to manage in real time the information on the flow of funds, supply of medicines, sanitary materials and even data on the health condition of each patient.

The Automated Information System ‘Hospital Medical Assistance’ (AIS HMA) now operates successfully in 15 hospitals across the country, ensuring efficient communication between doctors, and efficient medical administration.

According to the director of the Institute of Emergency Medicine, Mihai Ciocanu, the electronic platform is an invaluable tool. The system monitors a patient’s hospitalisation from admission until discharge, with all the activities related to the patient’s stay in the medical institution. 

“It is a good programme for us, which helps us a lot in everything related to patient records, the flow of patients in the hospital,” says the director.

The information system allows for the creation of an electronic file for each patient in the hospital, where all the information on the evolution of the person’s health is collected over time, facilitating the work of doctors.

“This allows us to maintain databases for the patients we treat, especially those who come repeatedly to the medical institution. We have patients who come twice, even ten times. Whenever it is necessary, we have the whole history. This is important to establish the diagnosis and take into account the concomitant diseases that the patient has,” explains Mihai Ciocan.

At the same time, the institution has access to an image transmission system from the imaging laboratories, such as magnetic resonance imaging or computer tomography, ultrasound and radiology. All these images are sent directly to the doctor’s desk.

“All the offices that provide tomography, resonance and ultrasound have this information system. At the beginning of the month, I check available time slots for patient appointments, depending on the type we choose. Before, everyone used to call us for these appointments. Now, no one bothers us, we open the system and see which patients are scheduled, we do the investigations, after which we introduce the conclusion in the result space and press save,” said the head of the imaging department, Diana Zagadailov.

The electronic platform also ensures the complete tracing of medicines, consumables and para-pharmaceutical products – from the moment of entry into the hospital stockpiles to their consumption by the patient. In this way, medical institutions can be sure they have the necessary quantities of medicines in stock. Moreover, the information system allows for the automatic and real-time calculation of hospitalisation costs for each patient.

“The benefits are much more visible.  It facilitates not only the work of the medical staff, but also of the administration of the institution. In our hospital, we have several modules related to record keeping and monitoring of medicine use, protective materials and everything that is used for a patient. These are accounted for on this file, everything from the cafeteria to the pharmacy, we can practically access any information. Any report, expenses per patient, per section, per department, we can compare them, the current data and even with those of five years ago,” says Igor Curov, head of the Emergency Medicine Department.

AIS HMA ensures a very high confidentiality of data, as they are kept on a government platform. Regarding the development of the system, the director says that it would be useful to create a connection between the automated systems in hospital and primary care, but also between hospitals.

“We would like in the future to be able to exchange information with the Automated Information System ‘Primary Health Care’ (AIS PHC), because we could then transmit to them the results of the treatment we carry out in hospital, and what they should do with this patient once the patient is back home. And, obviously, the exchange of data with other hospitals would really help – when patients transfer to us from other hospitals, we would like to know what tests were done, what was the treatment at the previous hospital,” said Mihai Ciocan.

Over the years, the electronic platform has undergone a continuous process of improvement in order to facilitate the work of hospital employees.

“The basic software, which was installed at the beginning, was quite basic, with not so many functionalities, but it was developed over time. When an idea arises to make the work of the medical staff easier, we discuss it with the IT department and develop an additional module to the main software,” said Igor Curov.

Both the hospital administration and doctors benefit from the integrated data system. For example, the head of the Septic Trauma Department, Veaceslav Cemirtan, says he now saves a lot of time thanks to the system: “It helps us to reduce the writing time, to fill in the files. Especially now, with COVID-19 patients, more indications come every day and we can order all the investigations we need without having to write a lot or run from one office to another.”

The head of the Spinal Surgery Department, Victor Ungureanu, agrees. Doctors can access the electronic patient file with all the examinations and tests performed over time, and no longer have to run around the hospital for information, he says.

“A very serious patient is coming to the ward, such as a patient with COVID-19. He has an aggravation and to get acquainted with the patient’s history I had to go to the radiology office, find the radiogram, then to another office to see the tomography. Now I enter the system and in a minute I find out everything,” explained Victor Ungureanu.

The head of the Spinal Surgery Department has had the opportunity to use several types of information systems, but AIS HMA stands out by its data access mechanism.

“In other software, one had to extract the information from the system, then open it in another software. Here we have an easier mechanism,” he said.

Starting with 2017, 15 hospitals in the country started operating on the basis of an Automated Information System, which allowed medical institutions to manage in real time information on the flow of funds, stockpiles of medicines, medical supplies and data on the health of each patient. 

AIS HMA has been implemented in those medical institutions in which the Ministry of Health has the status of founder: the Mother and Child Institute, the Republican Clinical Hospital, the Institute of Emergency Medicine, the Oncology Institute, the Institute of Neurology and Neurosurgery, the Institute of Cardiology, the ‘Chiril Draganiuc’ Institute of Phtisiopulmonology, the ‘Toma Ciorba’ Clinical Hospital of Infectious Diseases, the Clinical Hospital of Traumatology and Orthopedics, the Clinical Hospital of Psychiatry, the Republican Dispensary of Narcology, the Dermatology and Communicable Diseases Hospital, the Clinical Hospital of the Ministry of Health, the Balti Psychiatric Hospital, and the Orhei Hospital for Psychiatry and Phthisiopulmonology.

The value of the project was almost 10 million lei; the funds were allocated from the state budget.

EU support for a future of seamless integration

The European Union’s EU4Digital initiative is working with the Republic of Moldova, as well as other countries in the Eastern Partnership region, to ensure that health information exchange and management systems, like the Automated Information System implemented in Moldovan hospitals, are in harmony with EU best practices and with neighbouring countries. This would mean that data conforming to the same norms is interoperable among various organisations, stakeholders and even across borders, which is important in providing better care for patients, no matter where they are.

“Interoperability will improve the health of every citizen in the Eastern partner countries,” explains Martynas Daugirdas, eHealth expert for the EU4Digital facility. In this way, systems would communicate not only across health institutions withing the country, but across borders. “Our vision is that in 10 years’ time, when a patient from Country A needs urgent care in Country B, healthcare providers will have immediate access to information on which medications the patient is sensitive or allergic to. This summary of a patient’s health condition is crucial when making urgent life or death choices that characterise the healthcare sector.”

To support this effort, the EU4Digital eHealth team has conducted an analysis of the current state of play of eHealth in the Eastern partner countries, and identified each country’s challenges and priorities. The set of guidelines will serve as a basis for establishing cross-border standards, considering legal, organisational, semantic and technical interoperability categories and related aspects. 

“The health care of the future can be imagined as seamless patient mobility from provider to provider, country to country, as well as health care provision continuity and informed decision making for better health outcomes,” says Daugirdas. “Cross-border eHealth infrastructure will allow a Moldovan citizen travelling abroad to receive prescribed medication from a local pharmacy. The sharing of patient summaries will help doctors to understand patients’ medical history and avoid mistakes when prescribing medicine.” 

EU4Digital aims to extend the benefits of the European Union’s Digital Single Market to the Eastern Partner states, channelling EU support to develop the potential of the digital economy and society, in order to bring economic growth, generate more jobs, improve people’s lives and help businesses in the Republic of Moldova and the other Eastern partner countries – Armenia, Azerbaijan, Belarus, Georgia and Ukraine.

Find out more about EU4Digital at https://eufordigital.eu/

The full story was published on agora.md.