Improving citizens awareness of the healthcare system and encouraging activities for citizens to care for their own health, for the application of healthy lifestyle to reduce risk behaviour, to develop personal responsibility and efficient access to the resources of the health system are factors that positively affect coping with the increasing incidence of chronic diseases in ageing population. Strengthening the position of a citizen in the healthcare system is fully in line with the recommendations of the European Commission Health 2020, it is a way to develop a simple and efficient communication between citizens, healthcare professionals  and responsible public administration authorities.
Background and requirements to meet the strategic objective
It is necessary to create a system that would provide public services in which a number of entities (e.g. health insurance companies, professional associations, health service providers,...) will participate and which would become such a trustworthy source of information for citizens, while appropriately completing the systems of health insurance companies motivating their insured.
Services using the tools of information and communication technologies to support the activities of citizens are usually only a part of other specific systems. There is a comprehensive and purposely built a system that would support active participation of citizens in the prevention and care of their own health and integrated range of existing and newly developed electronic information resources and services.
Such a system will be simply called the National Health Information Portal that will be the main source of information on health and health services for a citizen and an important source of information for professional and managerial staff in healthcare. It should provide or convey comprehensive information in the field of healthcare, prevention and health promotion for both the general and professional public, for example:
- information on interactive prevention programmes aimed at improving health literacy,
- a navigator for advisory, consulting and intervention activities in the field of prevention of risk factors of lifestyle, taking advantage of links to trustworthy sources of information,
- epidemiological prevalence studies,
- mathematical modelling of prognoses of diseases, the effectiveness of prevention programmes;
- factually relevant analysis and legislation,
- mathematical modelling of prognoses of diseases, the effectiveness of prevention programmes;
- appropriate tools of social marketing,
- a navigator of community programs using a geographic information system.
National Health Information Portal uses (refers to) data from other data sources / sites and puts them in context and thus creates a comprehensive, transparent and credible public information source. Mediated information are either guaranteed or the source who is responsible for their accuracy is cited.
National Health Information Portal (hereinafter also referred to as "Portal") creates a protected channel of communication between patients and healthcare providers and creates a user-friendly environment for the utilisation of health services (ordering, consultation, extracts from documents, etc.).
The impacts of fulfilling the individual specific objectives in the context of the strategic goals
To ensure the operation of the portal it is necessary to create respectively to connect the entire ecosystem of subventors and editors and to determine their rights, duties and responsibilities. Here, as in the whole strategy, the objective is to enable the use on a voluntary basis, to provide information with an established fixed rate of expertise and by means of a single approach to electronic healthcare from different providers. It will be a guaranteed supplement to existing services in many cases, not their replacement.
Strategic objective consists of three specific objectives, namely:
- Ensuring easy and equal access to information about healthcare providers, ensuring availability of services with simple tools of electronic communication, which is implemented through three measures:
- a complete overview of healthcare providers, including quality parameters. Its output will be provision of a comprehensive and constantly updated information on all healthcare providers. This service enables a citizen to choose healthcare providers according to their needs and preferences,
- electronic ordering of medical services. Its output will be mediation citizens' access to individual ordering systems of healthcare providers and those who do not have them available will have a chance of using the central application for this purpose. This service will simplify citizens' access to health services depending on their needs and possibilities,
- distance electronic consultation of health. Its output will be a protected channel of communication between a patient and his/her physician. This service will enable to solve the needs of a patient for which his/her physical presence in the office is not required.
- Providing accurate information on state of health and treatment plans is realized within three measures:
- easy access to personal medical record. Its output is a protected access of citizens to information about their state of health, medications prescribed, the recommended treatment regime, on the dates and the type of check-ups arising from their individual health plans. This service will enable better control over citizens care about their own health,
- enabling access to the records of close persons (at the discretion of a patient or his/her duly authorized representative). For this purpose, a consents management and access of authorized persons system to inspect a patient record, respectively his/her medical records will be established. This service will enable authorized persons to access health information of a citizen and to improve the quality especially of informal care,
- open access to a personal account in the reimbursement system for health services. Its output is to enable / mediate authorized access of a citizen to his/her personal account held by a health insurance company.
- Development of information support to care for their own health and improving health literacy:
- open and transparent access to information on health promotion and preventative programs. Its output is an information channel to navigate a citizen towards trustworthy sources of information about healthcare and a healthy lifestyle. This service enables citizens to access the information needed for maintaining health and disease in time for its better handling,
- improving health literacy through qualified information. Its output is an information channel that will lead a citizen towards trustworthy education portals and will offer him/her assistance in dealing with various life situations. This service enables citizens to deepen their knowledge in the care of their health and makes their decision in dealing with life situations in the health and social areas more accurate,
- comprehensive communication and information support for care for the chronically ill. Its output is making the information about the best treatments for specific chronic diseases accessible and also the authorized citizens' access to their individual treatment plans. This service enables citizens to understand their disease better and to strengthen compliance with medical instructions and quality of self-care.
Outputs of the fulfilment of specific objectives
The portal as a tool for the professional information support of citizens, but also health workers and other healthcare workers will become an important tool for supporting and promoting their own health, citizens' awareness of the availability and quality of medical services and will have an impact on improving the quality of healthcare, patient safety and ultimately to increase the efficiency of the health system.
Creating a comprehensive, transparent and credible public source of information will contribute to the growth of health literacy, to limitation of the increase in health risks due to incorrect application of the recommendations in the management of their own lifestyle, to promotion of effective procedures for the care of the chronically ill.
National Health Portal will be operated and managed by MoH of the Czech Republic (or by the designated organisations, such as the National Centre for Electronic Healthcare). The main source of financing will be resources of ESI Funds and of the state budget. In some cases, the use of resources for health insurers companies and private entities, that will have to finance their own economic interests, will be effective. Involving citizens in care for their own health, care for the chronically ill, the use of means of telemedicine, etc. are factors that will be more often motivators for achieving higher efficiency of the healthcare system and therefore involvement of health insurance companies, whose services have portal duplicate, but in an appropriate manner complement and reinforce their positive effect on the health system can be expected. A part of implementation of the strategic objectives will be defining links to electronic services of health insurance companies, HP and many other subjects, for example regions, cities and municipalities, NPOs, etc., and defining the role of various actors in achieving strategic goals.
Indicators of achieving the strategic objective
The basic indicator of achieving this strategic objective "Increasing Citizen Involvement in the Care For Their Own Health" will be an increasing number of registered and unregistered users of the National Health Information Portal and the level of satisfaction of its users. The indicators which will be measured by greater involvement of citizens to care for their own health shall be chosen and set.
Major barriers and risks of implementation (impact of the zero version of the strategic objective)
A risk when achieving this strategic objective is primarily a complex organisation of subventors and editors and their willingness and involvement to provide valid information to the portal. If the insufficient level of support for the active role of the citizen would persist, the deepening of inequalities in access to health services can be expected as well as the reduction of impact of an otherwise well-designed prevention programmes. Voluntary participation of individual entities must be balanced with high motivation. But it is in many cases based on "public pressure and widespread service." In many cases, the initial motivation for the "first participants" and subsequently for other potential participants, who must expend some effort to enter the portal, is missing. For the successful implementation of the portal, it will be necessary to set up appropriate incentive factors for each target group and to set up their target states in the minimum values / numbers. While the area of identification of medical professionals will be dealt with in detail by the department of health, the identification of citizens is the responsibility of Ministry of the Interior and therefore solutions for citizens in the roles of the patients must be prepared in close cooperation with Ministry of the Interior. Any use of identity resources to meet the needs of electronic healthcare will have to be solved together so that an acceptable way to bridge the gap before the National Identity Area provides sufficient resources for all patients.
 Medical staff and other healthcare workers