From January 1, 2021, to April 30 of this year, the “My Appointment” platform remained without maintenance contracts for a total of 738 days, accounting for 37.9 percent of the period under review. Maintenance agreements were signed annually, without continuity of service being guaranteed.
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During the same period, 333.3 million denars (€5.42 million) were spent on maintaining “My Appointment” and related systems at the PHI. Of this amount, only 9 percent was allocated to the national health information system, while 91 percent went to other public health systems.
These findings come from the final report of the State Audit Office, which focused on information systems under the title “My Appointment: Optimizing healthcare processes and improving the quality of healthcare”.
The analysis did not include the costs of the application software or its maintenance by primary care physicians or private healthcare institutions. It also found that 48 percent of total investments in other information systems at the PHI were concentrated among three software companies, signaling a high concentration risk and limited competition.
Because no functional analysis of staffing needs was conducted at the Electronic Health Administration, only 29 percent of the planned number of employees has been filled. Some of the needs are covered through employment contracts that are renewed annually.
Regarding institutional management, the audit found that the Electronic Health Administration, although responsible for developing and advancing the integrated health information system, does not have the legal authority to conduct public procurements related to “My Appointment”.
Another problem identified is that the name “My Appointment” was not registered and protected by state institutions, but by a private economic operator with which the Ministry of Health signs maintenance contracts. This means that the Ministry does not own the copyright to the name, while a private entity controls it, creating a risk of disputes over the intellectual property of “My Appointment”, the report states.
The central system for electronically recording working hours and the national system for material, financial and accounting operations in public healthcare institutions have not yet been created. Meanwhile, the system for registering medical equipment is not operating at full capacity because of incomplete data, while the lack of functional national systems is directly linked to the shortage of healthcare staff.
The Electronic Health Authority and the Ministry of Health have not established standards for certifying and approving software solutions in public healthcare, nor mechanisms for verifying and controlling the data entered into the system. During an on-site inspection, it was found that several public healthcare institutions lacked lists of scheduled examinations.
These practices create a risk that people without a scheduled appointment, by using priority referrals without an appointment or emergency referrals, could be seen before patients who have properly booked an appointment and waited for a longer period of time.
