National Healthcare Data Networks Serbia

1
National Healthcare Data Networks - Serbia

• Pavle Vuletic, UoB
• pavle.vuletic_at_rcub.bg.ac.yu

Copenhagen, Health Data Networks Meeting, January
9th 2007.
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Belgrade University Computer Centre

• Part of the University of Belgrade
• Two departments
• Networking
• Responsible for the development, maintenance and
  management of the Serbian NREN (no separate legal
  entity)
• Main NREN node is in BUCC, all international
  connections
• Member of Terena, CEENET, LIR in RIPE
• SEEREN 1,2, SEEGRID, SEEFIRE projects
• Consulting activities related to healthcare -
  Involved in the design of the network of Health
  Insurance Fund
• Software development activities related to
  healthcare
• Involved in the design of several healthcare
  applications and information systems for Health
  Insurance Fund, hospitals.

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e-health strategy in Serbia

• A part of the e-society strategy approved by the
  Government in October 2006.
• E-health Strategy defines creation of several
  workgroups
• Health Information Management Group
• Health ICT Infrastructure Group
• Medical Informatics Standardisation Group
• Health Informatics Application Group
• Health Informatics Legal Framework Group
• Workgroup for privacy and security
• Ministry of Health formed Department for
  International cooperation and Project
  Coordination
• Through that department and donations or credits
  from EAR, UNDP, USAID, World Bank several
  projects moved parts of Serbian Healthcare
  towards e-health vision

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Healthcare networks in Serbia

• No single national healthcare network
• Network of Health Insurance Fund
• Connecting over 190 locations (Headquarters,
  Branch and Sub-branch offices of HIF)
• Network will be completed by the end of February
  2007
• Financed by HIF
• Hospitals attached to Serbian NREN
• More then 60 hospitals (majority of them in the
  campus of the Faculty of medicine of the UoB)
• All connected with dark fibre, access speed
  typically 1Gbps.
• Financed by Ministry of Science
• No payment for the participants of the network

5
Services in healthcare networks

• HIF
• Centralized evidence of all insurants in Serbia
• Interface towards hospitals, pharmacies
• Pharmacies already using remote access
  technologies to submit electronic invoices

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Services in some hospitals

• Hospital IS Implemented in Universitys Children
  Hospital
• In preparation for the regional health centre in
  Kraljevo
• Key features
• Encounter planning, scheduling and tracking
• Patient notifications using voice, email and SMS
• Electronic patient record with episodes
• Interface towards finances, procurement and HIF
• Encounters, interventions are documented using
• Parameters defined in examination archetype
• Attachments e.g. DICOM files from devices
• Reports supported by parameterized templates
• Role-based access control
• Video streaming from operating rooms

7
Communication services in HIF network

• Based on available telecommunication services
• Two level hierarchy
• MPLS VPN in core (between BO)
• Frame Relay, DSL VPN, GPRS in SBO
• No traffic protection between HIF locations
  (trusted network)
• Connected to the Internet
• Equipment supports features for IPsec VPN, which
  are seen as a way to create extranet connections
  towards external
• Bandwidth from 128kbps for small SBOs to 100Mbps
  for the Headquarters

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Communication services in NREN

• All regular Internet services
• No special purpose connections between hospitals
• HIS is closed software used inside the hospital
  LAN
• Bandwidth 1Gbps over dark fibre
• All prerequisites are met to build secure VPN
  connections over NREN

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Future directions

• Securing HIF network
• Providing seamless connection between hospitals
  and HIF network
• Connecting other healthcare institutions
• Development of new services