3. VISION
Moldova e-Health 2020
By 2020, the citizens of the Republic of
Moldova shall benefit from improved, transparent
and accessible health services, by intelligent use of
the Information and Communication Technologies.
The current vision presents the medium and
long term priority directions of the e-health. It is
based on 3 pillars.
4. VISION
Moldova e-Health 2020
INFRASTRUCTURE
SERVICES
M
ANAGEM
ENT
&
GOVERNANCE
The first pillar
represents all the
objectives and actions
needed for increasing
the number and
quality of the health
services to population.
It includes the resources and procedures with
systems and easy access to them needed for an
efficient and qualitative services provided by
healthcare system. Also services G2B & G2G.
5. VISION
Moldova e-Health 2020
The second pillar
represents all the
actions needed to
improve the process of
management and
administration of the
health sector.
It includes the tools, systems, skills,
procedures and resources needed for an efficient
and qualitative services provision.
INFRASTRUCTURE
SERVICES
M
ANAGEM
ENT
&
GOVERNANCE
6. VISION
Moldova e-Health 2020
The third pillar
represents the
infrastructure which
serves as a basis for
the upper levels.
It includes information systems, databases,
communication infrastructures, registries,
hardware and data security of the health sector
information systems and services.
INFRASTRUCTURE
SERVICES
M
ANAGEM
ENT
&
GOVERNANCE
8. STRATEGY
Moldova e-Health 2020
FROM PROBLEMS …
Limited and unequal accessibility of the public
to the high health services and qualitative medical
assistance also to information for prevention and
health promotion;
Reduced analytical capacity to evaluate,
monitor and report on the health system
performance;
Insufficient use of modern technologies in
diagnosis and treatment;
9. STRATEGY
Moldova e-Health 2020
…FROM MORE PROBLEMS …
Fragmented systems of data collection and
duplication of the date collected;
Non-compliance of the collected datasets with
the reporting requirements of international
organizations;
Outdated and inefficient use of the ICT
infrastructure of the medical institutions;
10. STRATEGY
Moldova e-Health 2020
…TO SOLUTIONS …
Equal and unlimited high medical services to
populations;
Assistance and information for health promotion
and prevention by using electronic environment;
High analytical capacity to collect, process,
evaluate, monitor and report on the health
system performance based on decisional
automated intelligent systems;
Ultramodern technologies in diagnosis and
treatment;
11. STRATEGY
Moldova e-Health 2020
… RESPECTING PRINCIPLES …
Safety: Avoiding harm to patients from the care
that is intended to help them.
Effectiveness: Providing services based on
scientific knowledge to all who could benefit and
refraining from providing services to those not
likely to benefit (avoiding underuse and misuse,
respectively).
12. STRATEGY
Moldova e-Health 2020
… RESPECTING PRINCIPLES …
Patient-centeredness: Providing care that is
respectful of and responsive to individual patient
preferences, needs, and values and ensuring that
patient values guide all clinical decisions.
Timeliness: Reducing waiting times and potentially
harmful delays for both those who receive and
those who give care.
13. STRATEGY
Moldova e-Health 2020
… RESPECTING PRINCIPLES …
Efficiency: Avoiding waste, including waste of
equipment, supplies, ideas, and energy.
Equitability: Providing care that does not vary in
quality because of personal characteristics such as
gender, ethnicity, geographic location, and
socioeconomic status.
14. STRATEGY
Moldova e-Health 2020
… RESPECTING LAWS and STANDARDS …
Laws: General legislation on health (healthcare
service providing, medical professions, compulsory
health insurance, health surveillance, etc.). Specific
laws: National Health Policy 2007 – 2021, Strategy
for Health System Development 2008 – 2021,
Electronic Moldova 2020, etc.
Standards: Reporting standards (e.g. HL7), civil
status documents, digital signature, preventing
and combating cybercrime, access to information…
15. STRATEGY
Moldova e-Health 2020
… TRANSPARENCY and CONFIDENTIALITY…
Transparency: Make public all data regarding
policy making, tenders, strategic decisions using
debates, permanent dialogs and involving as much
entities as possible in the process.
Confidentiality: Increase loyalty, addressability of
medical institutions to the patients and citizens
and increase the trust in medical institutions by
implementing a standard secure procedure of
work.
16. STRATEGY
Moldova e-Health 2020
… WITH …
Resources: m-Pass system for secure access to
electronic health services;
e-Payment System to pay medical services;
e-Government portal services (servicii.gov.md) for
providing access unified electronic health services
to the population; State Budget; State Programs;
External potential Resources: World Bank, World
Health Organization, European Union, other
partners.
17. STRATEGY
Moldova e-Health 2020
… TO ACCOMLPISH OBJECTIVES
Services:
General Objective: Improve the quality, efficiency,
transparency and access to healthcare services;
Management & Governance:
General Objective: Improve health management
and governance by use of ICT;
Infrastructure:
General Objective: To ensure reliable and scalable
infrastructure for an efficient e-Health system.
18. STRATEGY
Moldova e-Health 2020
SERVICES
Specific Objective: Improve the efficiency and
effectiveness of processes in the healthcare sector
using ICT in: PHC, SHC, Blood Service, Emergency
healthcare, State Public Health Service, Medical
Diagnostic Centres;
Specific Objective: Facilitate citizens’ access to e-
health services;
Specific Objective: Ensure open access to public
healthcare data.
19. STRATEGY
Moldova e-Health 2020
MANAGEMENT and GOVENRANCE
Specific Objective: Increase ICT skills for personnel
working in the healthcare system;
Specific Objective: Develop and implement
mechanisms to ensure medical data quality (Cross
checks);
Specific Objective: Provide qualitative and timely
data for the managerial decision-making process.
20. STRATEGY
Moldova e-Health 2020
INFRASTRUCTURE
Specific Objective: Ensure, by 2020, single access
point to all information resources of health sector
for specialists, management and population;
Specific Objective: Standardize the procedures of
transmission of information operated in medical
units in a single and agreed format for all
stakeholders;
Specific Objective: Ensure safety and security of e-
health data through implementation of the proper
legal framework.
22. Moldova e-Health 2020
MASTER PLAN
COMPONENTS
Electronic Health Record (DES – unified EHR);
The personal file of the citizen health - clinical
portal personal data (PHR);
Planning and Notification Services for medical
consultations, laboratory tests, functional
investigations, immunizations, etc.;
e-Services for citizens, businesses and central
public authorities (e-Desk);
23. Moldova e-Health 2020
MASTER PLAN
COMPONENTS
Alerts and notifications in emergency
prevention and improving communication
between doctors;
Services of telemedicine and remote assistance;
e-Library (medical encyclopedia with general
information about the prevention, diagnosis,
treatment and rehabilitation of diseases,
medications, studies, reports and specialists in
the healthcare system: medical protocols,
manuals, studies and educational programs);
24. Moldova e-Health 2020
MASTER PLAN
COMPONENTS
e-Prescriptions and monitoring of stocks of
medicines;
Registries and monitoring systems for
communicable and non-communicable diseases
(e.g. chronic diseases electronic records -
diabetes, cancer, hepatitis, etc.).
Statistical reporting services (including DRG and
the National Health Fund);
National Register of Human Resources for
health;
25. Moldova e-Health 2020
MASTER PLAN
COMPONENTS
National Register of Inventory of Medical
Equipment;
The Management of Budget Execution control in
hospitals;
Centralized Management Decision System,
based on a flexible reporting and information
retrieval (tool for designing statistical and
analytical reports with the ability to store, sort
and filter on different criteria, indicators for
monitoring, advanced search, etc.).
30. Moldova e-Health 2020
MASTER PLAN
STANDARDS – now & future
ISO-15288: 2008, ISO-12207: 2008, RT-38370656-
002: 2006, Government Decision no. 1123 of
14.12.2010 on the approval Requirements for the
security of personal data to process them within
the information systems of personal data,
Technical Regulation order MITC 106 of 20
December 2010
HL7, DICOM, ISO 13606-4, ISO 13606-5, etc.
CEN - CONTSYS (EN 13940)
CEN - EHRcom (EN 13606)
36. Moldova e-Health 2020
MASTER PLAN
IMPLEMENTATION STEPS
1. Analysis institution - 1-2 months;
2. Design solutions (network communications,
software, streams, configuration required) 1-2
months;
3. Cost estimation detail - 1 month;
4. Allocation of financial resources reservation - 1-
3 months;
5. Making documentation for purchase - 1 month;
6. The procurement - 2-3 months;
37. Moldova e-Health 2020
MASTER PLAN
IMPLEMENTATION STEPS
7. Negotiating and signing - 1 month;
8. Analysis for specific configuration - correlation
between the tender documentation and reality on
the ground (the client request) -1 month;
9. Achievement communications network - 1-3
months;
10. User Personal Training - 1-2 months;
11. Install, configure applications - 1 month;
12. Completed verification testing and acceptance
and commissioning -1 month.
38. Moldova e-Health 2020
MASTER PLAN
TIMELINES
• EHR local solutions with programming, alert and
notifications, reporting services:
- Primary Healthcare: minimum 18 months
- Hospitals: minimum 24-36 months
- Emergency Healthcare (supplements and
112): 24 - 32 months
- Blood Transfusions (adjustments): 6-12 months
- Integration alternatives (Public Health Centers,
NHMC, PHNC, NDA, etc.): 24-36 months
39. Moldova e-Health 2020
MASTER PLAN
TIMELINES
• National Health Registers: 12 months
• e-Prescribing: 18 months
• e-Library: 24 months
• PHR web Portal: 24 - 32 months
• Management Decision System: 12 - 18 months
• Telemedicine services: 48 months
• e-Desk: 24 - 32 months
• The centralization of all resources (CHRR + UHRR)
- 24 months
40. Moldova e-Health 2020
MASTER PLAN
ESTIMATED BUDGETS
No. System type Hardware Software Total
estimated
(euro)
1 Centralized System 16.200.000 4.390.000 20.590.000
2 Primary Healthcare 2.000.000 1.200.000 3.200.000
3 Hospitals 3.000.000 30.650.000 33.650.000
4 Emergency healthcare 165.000 275.000 440.000
5 Blood Transfusion 50.000 65.000 115.000
6 National Health
Management Centre
85.000 150.000 235.000
7 National Drug Agency 45.000 50.000 95.000
41. Moldova e-Health 2020
MASTER PLAN
ESTIMATED BUDGETS
No. System type Hardware Software Total
estimated
(euro)
8. Transplant Agency 10.000 35.000 45.000
9. Healthcare Centers 2.000.000 1.200.000 3.200.000
10. National Public Health
Center
15.000 45.000 60.000
11. Pharmacies - 1.500.000 1.500.000
12. Treatment and
Diagnostic Centers
75.000 1.600.000 1.675.000
13. Other Healthcare
entities
- 500.000 500.000
14. TOTAL 23.645.000 41.660.000 65.305.000
42. Moldova e-Health 2020
MASTER PLAN
ESTIMATED BUDGETS
No. System type Hardware Software Total
estimated
(euro)
1. National Healthcare
Registries
80.000 150.000 230.000
2. e - Prescribing 675.000 3.000.000 3.675.000
3. e-Library 250.000 2.500.000 2.750.000
4. PHR 225.000 145.000 370.000
5. Centralized Decision
Management System
150.000 3.000.000 3.150.00
6. Telemedicine 1.200.000 3.200.000 4.400.000
7. e-Desk 200.000 1.500.000 1.700.000
TOTAL EXTENDED 2.780.000 13.495.000 16.275.000
TOTAL GENERAL 26.425.000 55.155.000 81.580.000
43. Moldova e-Health 2020
MASTER PLAN
CHANGE & RISK MANAGEMENT - identified
Fear of change, the possibility of job loss, fear of
the unknown;
High additional budget has to be alocated;
Lack of confidence in the confidentiality of data
processed by these systems ;
Bureaucratic processes with high degree of
inertia in adapting to change;
Risk of discontinued actions, policy, etc.
44. Moldova e-Health 2020
MASTER PLAN
CHANGE & RISK MANAGEMENT - planned
Continuous dialog, debates, specific programs;
Gradual implementation procedures with pre –
allocated funds;
Enforce laws and regulations among
standardization implementation;
Reducing and optimizing administrative
procedures;
Adopting a continuous implementation law,
backup plans.
46. CONCLUSIONS
FREE TRANSPARENT MARKET
MEDICAL INSTITUTIONS : Good management and
equipment, tools for medical personnel, real time
data for medical and administrative decisions.
COMPANIES : Ensuring equal transparent access
to market. Reducing time and bureaucracy.
CITIZENS: Eliminate corruption, equitable access.
47. CONCLUSIONS
HIGH QUALITY SERVICES
POPULATION: Fast access at high quality medical
services and information, including personal
medical and financial data.
BUSSINESS: No more bureaucracy, no more
corruption, access to data of interest, competitive
environment.
GOVERNEMENT: Real time decisions, continuity of
reforms, stability, unified approach.
48. CONCLUSIONS
OPEN GOVERNMENT
GOOD POLICY: related policies, coherent and
comprehensive
STABILE ENVIRONMENT: continuity of strategies
and principles of good governance, economic
grow, responsible management of resources,
transparency.
FUNDAMENTED DECISIONS: decisions based on
real data and accurate, open national interest data.
