Country profile: Czech Republic

The Czech healthcare system is based on a universal social health insurance system, which finances public hospitals as well as private ambulatory care providers directly. The Ministry of Health governs policy and manages hospitals with supra-regional spheres of influence, while most smaller hospitals are privatized.

ICT use and eHealth strategy

ICT equipment of Czech GP practices is slightly below average, with about two thirds connected to the Internet, of which than half have a broadband connection. The practices with ICT equipment tend to utilize them at least as often as the EU average, although, with Decision Support Systems being especially commonplace, the tendency to store patient data electronically remains slightly below the EU average. The electronic transfer of patient data remains a rare ocurrence, with the notable exception of laboraty results, which are transferred electronically to one quarter of all Czech GP practices.

The Czech eHealth strategy was first published in 2007; before that, all eHealth initiatives originated from the numerous and fragmented private health care providers. Since the establishment of the Interdepartmental Coordinating Committee for eHealth implemention in the Czech Republic, a number of goals for national eHealth policy (some of which are based on individual eHealth initiatives preceding the establishment of national policy) have been identified (and partially met to date):

• Standardised (electronically signed) electronic health documentation. The Czech Republic already utilizes an electronic health record framework containing data on all insured patients. This infrastructure, operated by IZIP Inc., must be adapted to comply with new international/EU standards.
• ePrescription/eID cards for patients as well as HCPs. Currently, only non-chipped cards are used for identification in the health sector. To adress this issue, the Czech Republic is involved in several large scale pilot programs such as NETC@RDS.
• Health registers. A number of registers, such as hygienic registers, evaluation registers and disease information registers, are currently in use.
• A unified, standardised communication interface for health data (XML-based),  has already been established and adapted to comply with EU standards.
• Classification schemes / decision and technology assessment, aimed at the optimization of healthcare quality. The widespread use of decision support systems in Czech GP practices necessitates the creation of mechanisms of comparision and technological assessment.
• A health portal for educational / telemedical purposes

Legal framework

In the Czech Republic, legislation regarding eHealth is sparse. While several laws, such as the Act on Pharmaceuticals, were devised to allow the implementation of eHealth services to a certain degree (as in the Act on Pharmaceuticals: ePrescription), most other aspects of eHealth are regulated through more general laws, such as the Act on People’s Healthcare from 1966. A notable exception is the decree on Data Exchange with the National Health Information System, which regulates data entry into electronic health registers.

Patient identification issues are tackled through the Act on Citizen’s Evidence and Birth Numbers and the Act on Electronic Signature, which, together with the more global Personal Data Protection Act, provide a cohesive privacy framework in accordance with corresponding European directives.