INFORMATIZATION OF SCHOOL MEDICINE IN CROATIA

Strategy of the health system reform in the Republic of Croatia given by the Ministry of Health in 2000 stated that integrated health care information system is needed. The primary health care was recognized as a gate keeper for saving costs in health care system and was the starting point of introducing the Information and communications technology (ICT) in health system. Some important reasons were rationalizing of prescriptions and savings through decreased use of specialist consultations and hospitalization. Other reasons were better cooperation between levels of health care systems in a form of data sharing, information-based decision making and improvement of quality. Computerization of school medicine as a part of primary health care in Croatia has started in year 2008 primarily to facilitate the work of nurses and doctors and rising of quality. Computerization of services is designed on a model that enables mobility of school doctors and nurses-to work in schools, not only in offices. Data base is primarily aimed to create a virtual medical record which allows monitoring and exchange of information within the different levels of health care system. In Croatia, health care of school children is organized on primary level trough "dual" system. School doctor is responsible for preventive care and general practitioner, family doctor or paediatrician is responsible for curative care. Informatization of primary care, including school medicine, enable exchange of data or information about the patient, primarily between school doctor and selected (chosen) doctor for curative care. Electronic health record of students is designed on the way that allows distribution of active records (those who are currently in care), archival records and "sent" records" (for those who change schools and record is sent to designated school doctor). In this way, there is a possibility of continued access to medical records and is the easiest way to follow-up the students. In addition, data could be grouped according to different criteria: by sex, school grades, class groups which allows flexibility and visibility of data. Electronic health record includes all general information about the student: details of the family and personal history, dates of vaccination (including type, series, vaccine maker), data on systematic examinations, check-ups, screenings, health education and health promotion activities, counselling and all other parts of plan and program of specific preventative measures in school medicine. Entering of data on planned and executed activities allows preparation of monthly and annual reports including plan of future activities. All types of certificates and referrals also could be issued according to entered data. The flexibility of database enables continuous refinement and input of new data and use for scientific research.