“Why don’t we launch the defense shields?” asks a character named Cat in the British series Red Dwarf to the android Kryton sitting behind the stick of an endangered spaceship. “That is an excellent suggestion. It has only two minor flaws. First, we have no defensive shields. Second, we have no defensive shields. In theory, this is one flaw, but I considered it so significant that I listed it twice,” Kryton replies.
A very similar dialogue could be conducted on the immortal topic of electronicization (or, if you prefer, digitization) of the Czech healthcare system. The 2021 Act on the Electrification of Healthcare assumed that from the beginning of 2024, i.e. in about three months, all healthcare facilities in the Czech Republic were to connect to a unified secure communication environment that would enable sharing of health data across the system – safely, efficiently, without much paperwork and in real time.
The basic building block of the new Czech electronic healthcare system was to become the so-called tribal registers, i.e. comprehensive databases from which healthcare professionals could draw the data needed for treating patients and communicating with them. Specifically, it is a register of health service providers (i.e. health facilities), a register of health workers and a register of patients. According to the aforementioned law, the state should have established them on January 1 of this year.
So why, ask Kocour, don’t we start tribal registries? It’s an excellent proposal, let’s answer with Kryton, it has only two minor flaws. First, we have no tribal registries. Second, we have no tribal registries. In theory, it is one flaw,… and so on.
The delay of the Czech electronic project was pointed out a few days ago by the professional fortnightly Medical Tribune based on the speech of the legislative deputy minister of health, Radek Policar, at a meeting of the parliamentary health committee. More precisely, the fact that we don’t have any tribal registers since January of this year has been noticed by more people. But the ministry is now moving through the legislative process an amendment to the Electronic Act, which will abolish the obligation of medical facilities to use these non-existent registers from the beginning of next year.
Currently, the Supreme Audit Office also dealt with this project with the same conclusion. The SAO checked, among other things, the fulfillment of the goals of the National Electronic Health Strategy and states: “A total of CZK 159 million spent on the fulfillment of the selected strategic goals of the electronic health sector did not lead to their fulfillment, and the Ministry of Health postponed this task until 2026. The SAO finds significant risk.”
It must be recognized that the process of electronicization according to the cited national strategy and the aforementioned law was quite strongly affected by covid. According to the auditors, the Institute of Health Information and Statistics purchased hardware for 122 million crowns, which was supposed to be used to operate the so-called information and data departmental interface, but canceled the software part of the contract in mid-December 2021 and used the new “iron” to solve problems related to anti-epidemic measures in faced with Smart Quarantine 2.0.
Other problems followed with the issuing of contracts for the provision of registers and other elements of eHealth, which could be discussed at length and with great complexity in terms of competition law, but the result is only one – despite the national strategy and the approved law, the Czech healthcare system will not be any more digital from next year. thus also no more efficient, user-friendly and modern. The whole thing will just be postponed, for two years to begin with.
It’s just another demonstration that even if he can rustle the paper nicely, strategy isn’t enough. However much can be blamed on the pandemic, this does not in any way diminish the political responsibility of the current and past leadership of the Ministry of Health and the Institute of Health Information and Statistics, whose leadership is still the same.
On the other hand – why be surprised? When even Prime Minister Petr Fiala reports that “the Czech Republic has missed a bit of a train”, why shouldn’t it also miss the field of electronic health care? We will therefore be catching up with him in this area as well. The expected delay time is two years, but as we know from the station honchos, this can easily change.