Health Min to issue tender for national computer system

The Health Ministry plans to issue by mid-year a tender for a national computer system that would register medical services and patients while tracking medical treatment costs. The concept for the nationwide database of medical services (ORUM) is still being worked out but the zł. 500 million ($119 million) system could be installed as early as the middle of 2003, according to the Health Ministry. "We should be able to formulate the concept by the end of March," said Dominik Żochowski, director of the IT systems center at the Health Ministry. "As for the tender I can't provide details; it would be better, though, if it were a two-stage tender. But it will be the minister who will make the final decision." The ministry has never before tried to build a national database - even when 1999's sweeping reform of the health care system was launched. But Health Minister Mariusz Łapiński has made the implementation of a national computer system one of his main goals since taking his post in October last year. The ministry's plans include making better use of a powerful computer, IBM's AS400, which is currently being used by the Mazowiecka Patients Fund. "Obviously, it's underutilized so we have plans to use it in the construction of the ORUM," Żochowski said.

Computers of this class are often used by banks to run entire IT systems while allowing 2,000-100,000 customers simultaneous access to their accounts. The Health Ministry is also working on a draft bill for the medical-services registration system, necessary for installing ORUM, according to Żochowski. Unofficial sources said there are at least two domestic companies, publicly traded ComputerLand and Katowice-based Spin, that would likely participate in the tender. ComputerLand's general director for the health sector, Krzysztof Groyecki, confirmed his company's interest in the project. "But please, don't assume there must be only one winner," he said. "I can imagine a situation in which participating IT companies may create consortiums to be able to handle this size of contract." Groyecki said the ministry's summer deadline was unrealistic. "One would need at least a year from the day the contract is signed to build and implement the system," he said. "It's a huge job because you need to build a network combining some 20,000 medical-service providers and about 10,000 pharmacies. Besides, we still don't know the entire concept of the system and the scope of legal changes that may be necessary to implement ORUM."

Groyecki said that the ministry's estimated cost of zł. 500 million for the system was realistic. "Provided that the medical-services providers and pharmacies buy their own hardware and the ministry provides software and smart cards," he added. Spin, which was recently acquired by domestic IT firm Prokom, was unavailable for comment at press time. Although the former government didn't introduce a national computer system, a number of Patients Funds managed to start setting up their own. The Śląska Patients Fund is close to finalizing the construction of such a system and plans to distribute 4.7 million smart cards to its patients by June. "It all started seven years ago with three Silesian cities: Chorzów, Pyskowice and Dąbrowa Górnicza, where the first monitoring system of medical services was introduced," said Jacek Kopacz, the fund's spokesman. "Then we simply absorbed that system into START, a regional system that we're completing now." Thanks to START, the fund is not only able to electronically register patients but settle accounts with medical-services providers online. The Silesian system connects about 3,000 medical-services providers and pharmacies. "I support the minister's idea to launch a national system but I would hesitate whether to do it in a centralized way," said Andrzej Sośnierz, director of the Śląska Patients Fund. "It might be better to set up standards for all the funds and then only monitor introduction of regional computer systems."

Meanwhile, it took two years to finish all the stages of START's implementation in Silesia. "But the global system should be simpler if it's to be successful," Groyecki said. ComputerLand, which built and implemented the system, is also working with seven other Patients Funds. "There are two other funds, Małopolska and Podkarpacka, that could potentially install smart cards but the appropriate tenders were annulled after the fall parliamentary elections," Groyecki said. "Otherwise, we could have already had 10 million patients with smart cards valid within three regional systems." The Health Ministry has not said what it will do about regional computer systems, like Śląska's, after the government abolishes the network of 17 Patients Funds next year. "We'll definitely benefit somehow from the experience gained during the implementation of START, but I don't know to what extent we'll actually use the system," Żochowski said. Groyecki said START could be easily integrated into the national system. "You'd need but minor corrections to do that," he added.