E-health in Slovakia is not a single monolithic system, but an interconnected ecosystem of people, processes, and technologies. Its heart is the NCZI, but it beats thanks to doctors, patients, insurers, and dozens of vendors. The goal is clear: more transparent care and faster, more cost-efficient processes.
E-health as an ecosystem, not a product
Panelists emphasized that the most important “component” is people—doctors, patients, technicians, and vendors. About 24,000 doctors operate in the ecosystem, roughly three quarters of them are connected, across nearly 14,500 clinics and 129 hospitals. Health insurers and other public institutions that exchange data with the NCZI also play an important role.
E-health is a living organism that evolves and connects through various modules and services. The NCZI manages multiple thematic “domains,” and their number grows according to practical needs. The patient is at the center—services make sense when they bring faster service and a better-informed doctor.
Electronic agreement: free choice of doctor without running around with paperwork
The electronic agreement has replaced the original paper contract between the patient and the provider. It applies to general practitioners for adults, for children and adolescents, and for gynecologists, and is recorded in the national register of agreements. According to the NCZI, almost every provider in the given specialties uses it; exceptions exist only in cases of technical or other legitimate obstacles.
The benefit for the patient lies mainly in the easy change of doctor and the rapid setup of access to medical records for new providers. The system automatically notifies the previous doctor to hand over the documentation, which significantly shortens the process. There are more agreements than residents, since, for example, women usually have two—one with a general practitioner and one with a gynecologist. If someone temporarily does not have a new doctor, their documentation remains archived with the last provider.
Connections, ePN, and cooperation with the state
According to the discussants, electronic sick leave (ePN) revealed room for improvement in the process and brought significant savings to the Social Insurance Agency. Assessing physicians gained access to medical records and can reassess some cases, which helped reduce both the number and the length of sick leave. A specific service for entering an assessment is still missing, but the assessment can be saved as a regular medical record if the assessing physician acts in the physician role.
The “jungle of interconnected systems” includes, besides the NCZI, the information systems of vendors, health insurers, the Social Insurance Agency, or the labor office, and other state institutions. The patient accesses their health record via the state portal using an eID. The NCZI today operates approximately 11 domains and is preparing more, while integrating as many as 72 different vendors. Diversity brings innovation, but sometimes also inconsistent updates that the state cannot directly influence.
