Slovenian Healthcare Reform: Even in the Existing System There Are Many Good Practices but More Cooperation is Needed

Ljubljana, September 28, 2016
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Ljubljana, September 28, 2016: Numerous advances and examples of good practice in the digitalization and management of healthcare institutions presented at AmCham Focus prove that even under the current system hospitals in Slovenia can work effectively and be financially efficient. Healthcare is one of the most important socio-economic sectors and the effective functioning of the healthcare system is essential for the successful functioning of the social state.

An AmCham Focus entitled How would Slovenian healthcare be transformed by the people who "live" it every day? was held as part of the activities of the AmCham Health and Wellness Committee. The discussion drew attention to the importance of the digitalization and good management of healthcare institutions, with particular emphasis on the good practices introduced by those institutions that have already implemented changes, and recommendations from top experts, physicians, and managers who deal with Slovenia's healthcare system every day.

AmCham Slovenia Executive Director Ajša Vodnik underlined that we can create positive changes through dialogue and cooperation: "At AmCham Slovenia we inspire positive changes, including in healthcare. We believe in dialogue. Through the AmCham Health and Wellness Committee we aim to encourage dialogue, so thank you to everyone who supports us in our efforts. In this way we are changing Slovenia for the better."

Dr. Matjaž Homan, a Pediatric, Gastroenterologist and Hepatologist in the Pediatrics Department of the University Medical Center (UMC) in Ljubljana, explained how a good hospital information system can simplify the work of healthcare personnel. The UMC Pediatrics Department is the first hospital department in Slovenia to use a paperless system. All data on patients, all medicines, illnesses and the course of treatment are entered in an electronic treatment record. "The positive side of such a system is that we can check the patient's details at any time and know exactly what we need to look out for," explained Dr. Homan. Not only that, but the system is connected to an international database and is updated monthly. This really makes life easier for physicians, allowing them to prepare better and dedicate better attention to their patients." 

Surgeon, Entrepreneur and Manager Dr. Marko Bitenc, the founder and director of specialist surgical clinic Kirurgija Bitenc, offered us a presentation of the system he uses at his clinic – a system that is friendly for staff and patients alike. "The system enables us to calculate costs accurately and gives us an exact record of the number of patients currently undergoing treatment, and the amount of time that a surgeon spends with a patient and on operations. It also allows us to carry out a variety of analyses and comparisons with other businesses and hospitals With this type of management, we generate profits that we can then invest in the further development of the business," concluded Dr. Bitenc.

"We have to build positive changes into our existing system," emphasized Robert Cugelj, General Director of the University Rehabilitation Institute (URI) of the Republic of Slovenia. "We have to work in terms of processes, not by phases. Upgrading all our processes is also something we have tackled at the URI", he added. Above all, he is in favor of the idea of an integrated and unified healthcare system: "Slovenia is a small market and my personal view is that one solution would be to combine hospitals. We have to build an integrated system that facilitates the exchange of equipment and staff. Every hospital could then specialize in its own field. The URI, for example, is active in the rehabilitation of landmine victims."

The successful functioning of the healthcare system is, however, closely tied up with the good regulation of data and healthcare registers. Here, too, Slovenia is well on the way to achieving its objectives. Dr. Ivan Eržen, the Director of the National Institute of Public Health, emphasizes that we need to be better connected to each other if we want to communicate more effectively. More attention needs to be devoted to the e-health system. "We have already set up quite a number of applications that are helping to improve our healthcare system. One example is the e-prescription, while e-booking will also soon be available and will have the effect of reducing waiting lists while at the same time bringing transparency," Dr. Eržen explained. Regarding waiting times, all the speakers agreed that there is a need for a system that offers insight into where people are waiting, why and for how long. This would enable reallocation, which would reduce not only waiting lists but also costs, in this way avoiding non-transparent financing. 

There are two types of registers in Slovenia, which differ strongly from each other. The first type are clinical registers or population registers, which enable analyses of trends in the total population. The other type are hospital registers, which include data on each patient separately. Dr. Matija Tomšič of the Rheumatology Department at UMC Ljubljana explained that the focus has been on finding solution and on the development of a National Digital Patients Register. This is a program in which a patient can request a doctor to perform specific procedures and in which the doctor can verify a few months later if the aim of the treatment has been achieved. "Through standardization we have succeeded in changing the treatment of patients for the better," said Dr. Tomšič.

"Today's medicine is moving in the direction of personalization," believes Dr. Matjaž Fležar, the Director of Golnik Clinic. "Patients will soon be able to examine their own files, but it is important that we concentrate on the quality of the data that are entered in them." He also underlined the importance of improving cooperation between the Ministry of Health and the Ministry of Labor, Family, Social Affairs and Equal Opportunities. In his view, social affairs and healthcare are closely connected fields and better cooperation would bring benefits, particularly from the financial point of view.

Regarding the funding of the healthcare system in Slovenia, Dr. Marko Bitenc also pointed out that there is a prevailing belief in Slovenia that state will provide everything for its citizens, although this is not the case: "Quality healthcare would require a significantly greater share of public funds than is currently provided. In my view we will also need to introduce private sources of funding to healthcare in order for anything to change. Doctors would also have the opportunity to offer their services in accordance with business principles. The result of this might be that we have too many doctors, instead of too few."

All the speakers agreed that it is not easy to change things in Slovenia because bureaucracy greatly hinders the process. Not only that, but the healthcare field also needs regulating from the legal point of view, with the drafting of a new healthcare law in which the selection of managers should also be clearly defined. "These managers have to be suitable, with the right competences, and they must also be rewarded appropriately," concluded Robert Cugelj.

The discussion showed that Slovenian healthcare is moving in the right direction and that doctors are still prioritizing quality of services and patient health, which is something we can be particularly proud of.

You can find out more about the AmCham Health and Wellness Committee HERE.

An image gallery is available HERE.

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