IBM Helps Government of Slovenia to Build Smart Health Insurance System

LJUBLJANA, Slovenia .- The Health Insurance Institute of Slovenia today announced that it will roll out a new electronic health insurance card system based on IBM (NYSE: IBM) technology across the country.

The new system enables healthcare providers to instantly and accurately check a patient’s health insurance status and allows for health claims to be processed online.

The decision to implement the new electronic health insurance system nationwide comes after the successful completion of a pilot program at Dr. Franc Derganc General Hospital in the Nova Gorica region of Slovenia.

The system is based on an IBM integrated IT infrastructure solution, which links healthcare providers to both public and private health insurance organizations. It uses an electronic health insurance card that will be carried by every Slovenian citizen and presented at the point of healthcare delivery.

Each electronic card carries a digital certificate which identifies the patient and enables the healthcare provider to access the patient’s health insurance data online. During home visits, doctors can even check the health insurance data remotely by sending the patient’s health insurance number as an SMS message.

“Our decision to implement the electronic health insurance card system across the country will give Slovenia one of the most advanced health insurance systems in the world,” said Samo Fakin, General Manager of the Slovenian Health Insurance Institute. “Although a number of countries across the globe have electronic health insurance systems, Slovenia is the first to integrate both public and private insurance organizations -- all national partners in healthcare.”

With the former system, the patient’s insurance data was stored on the actual insurance card rather than on a remote server. Patients were required to update their insurance data on the card every few months at self-service terminals. The former system, from today’s perspective, was costly, inefficient and inaccurate for health insurance providers as well as being inconvenient for patients. With confidential data stored on the cards, it was also less secure. Over the next six months this system will be phased out.

Since the completion of the pilot at Franc Derganc General Hospital in March 2009, the new system has been extended to over 100 healthcare institutions in the Gorenjska and Primorska regions. Planned to be fully operational by January 2010, the new system will be used by approximately 30,000 health professionals and more than two million patients in health institutions across Slovenia.

Implementation of the new electronic health insurance system and the creation of the integrated IT infrastructure pave the way for additional functionality such as electronic prescriptions and electronic medical records.

“IBM has extensive global experience in helping governments to create smarter systems that save money, create operational efficiencies and improve the quality of life for citizens,” said Roman Koritnik, General Manager of IBM Slovenia. “The infrastructure created for the new electronic health insurance system provides a strong platform for further development of Slovenia’s healthcare system.”

IBM provided the hardware, software and services in order to create the central IT infrastructure for the project. The solution is based on IBM System z10 hardware running WebSphere and DB2 software. The main software components include modules for identifying, authenticating and authorizing health professionals to ensure a secure communication channel between the healthcare provider and insurer.