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07 January 2025 | Country Update
ePrescription helps patients avoid excessive pharmaceutical co-payments -
09 November 2024 | Country Update
Advancements in healthcare digitalization
2.6. Health information systems
Almost every health care provider in Czechia uses a computerized information system to charge HIFs for services, pharmaceuticals and materials provided. All HIFs follow a standardized procedure for transmitting claims data from providers and use an information structure managed by VZP. Reimbursement databases have recently been used also for economic analyses, though the data (due to their structure) are not readily suitable for disease management and other health-related analyses.
Data for health policy and research purposes are collected by ÚZIS, whose main tasks are to manage and refine the NZIS. By collecting and processing information concerning health status and care, and providing information for research purposes, the NZIS ensures compliance with data privacy laws and has 12 health registers. These include the National Cancer Register, the National Register of Hospitalized Patients, the National Register of Healthcare Providers, the National Register of Health Professionals and the National Register of Reimbursed Health Services. Data in the registers are periodically provided by providers, administrative authorities, HIFs and educational facilities (usually monthly, quarterly or annually) (MZČR, 2016).
The National Register of Healthcare Providers contains publicly available information on all health services (though not information on health workers); it also includes social care providers who, under specific legal circumstances, provide health services. Data from other registers are available to lawfully listed institutions (MZČR, medical chambers, SÚKL, etc.). ÚZIS also makes some information available via its analyses, and some data can be requested (according to the guarantee on free access to information) (Act no. 106/1999 Coll.).
ČSÚ determines the Programme of Statistical Surveys, which lists the reports that MZČR (through ÚZIS) annually requires from all providers (both public and private), mainly including aggregate data on treated patients, information about available personnel and physical resources, including wages of health workers, and the provider’s economic situation (only for inpatient facilities). The reports are customized for around 60 segments of outpatient care (including the number of examinations, registered and treated patients) and inpatient care (including categories of services provided and average waiting times for chosen services, though these data are not systematically collected, meaning that inpatient facilities rely on estimates); not all information from these reports is made publicly available, however. ČSÚ publishes data on health accounts (health expenditures) in the System of Health Accounts structure. Some public health data are also gathered by RPHAs and SZÚ, and are analysed and published by SZÚ, such as data on infectious diseases, health-risk factors and environmental measures (such as bathing water quality).
Quality indicators, like performance success rates for individual providers, are generally not available to patients, even though both internal (obligatory) and external (voluntary) quality assessments take place. The Health Insurance Bureau (Kancelář zdravotního pojištění, HIB) runs the Quality Indicators Portal, making measurement and monitoring indicators accessible to target stakeholders (for example, HIFs, providers, state authorities and professional organizations) for better decision-making and quality improvement – at the time of writing, these included measures related to treatments in gynaecology, surgery, neurology and prescriptions. In the future, the HIB would also like to publish selected data (such as number of services performed) to improve the orientation of the general public regarding health services in Czechia (HIB, 2021).
External quality and safety assessments are voluntary and used to assess the organizational level of care provision in inpatient facilities, based on assessment standards. These are performed by certified individuals or organizations and are valid for three years (Health Service Act, 2011). A comprehensive review of health care quality in Czechia was last conducted by the OECD (2014).
Some providers (mainly inpatient facilities) also distribute patient satisfaction questionnaires for their own purposes. In 2020, MZČR launched the National Patient Satisfaction Assessment, the aim of which was to standardize part of the internal quality assessment. The evaluation takes the form of a questionnaire and the provider participation is voluntary; results are intended for internal management use rather than public rankings.
Further advances in information technology (IT) and eHealth are discussed in section 4.1.3.
Starting from January 2025, patients only pay deductible co-payments for partially reimbursed medicines at the pharmacy up to the protective limit relevant to them. Prior to this, people also encountered co-payments exceeding this limit and were quarterly refunded by their health insurance fund (HIF).
This change was possible due to improvements in the monitoring of protective limits for deductible co-payments. Deductible co-payments are now registered online in the ePrescription system, and so pharmacists know when dispensing whether patients have reached their set limit based on their age. From 2025, the ePrescription system will also contain information on recipients of invalidity pensions. From 2026, it will contain information on the degree of invalidity as well.
Patients will continue to pay the non-reimbursable part of the co-payment, as well as the price of medicines that are not covered by statutory health insurance, as they do today.
In October 2024, the government approved an amendment to the Act on eHealth (passed in 2021), to fundamentally modernize healthcare and make access to health information more efficient. The amendment includes important digitisation projects that will enable easier management of health data for citizens and medical personnel and will contribute to improving the functioning of the entire system. This motion now has to pass through the Chamber of Deputies and Senate (in both, the government coalition currently holds the majority) and be signed by the president to be effective.
The amendment will bring a whole range of new tools, including eŽádanka (eReferral), further development of the EZKarta application (see below), as well as the addition of data in the patient registers, such as information on the ability to drive motor vehicles or hold a firearms license (linked through the departments of the interior and transport). All of this will follow on from the already approved and currently tested functions of electronic healthcare.
New functions of the eHealth application
The electronic health application EZKarta newly includes vaccinations administered between 2010 and 2022 and reimbursed from statutory health insurance. This is an addition to records that have already been displayed in the application: all vaccinations since 2023 (both reimbursed and not reimbursed from statutory health insurance) and all COVID-19 vaccinations. Vaccinations paid out-of-pocket between 2010 and 2022 are not displayed.