Cuprins
ToggleFor eHealth solutions segment, SIMAVI has expertise in developing IT systems dedicated to health insurances (eHealth Insurance) and integrated IT systems for the management of healthcare systems (eHealth Care).
In the field of health, SIMAVI develops, through its specialized department, eHealth, complex solutions aimed at improving the quality of services for citizens and for the administration, by introducing IT tools on a national scale. These systems are integrated in the Health Insurance Informatics Platform (PIAS), managed by the National Health Insurance House (CNAS).
The national systems from the PIAS platform, developed in partnership by SIMAVI, are the following:
• SIUI – The Unique Integrated Informatics System, developed in partnership with HP Romania, ensures the management of the entire Romanian medical system financed from the Unique National Health Insurance Fund (FNUASS), by managing all flows of contracting, reporting, validation and settlement of medical and pharmaceutical services
• SIPE – The Electronic Prescription Informatics System, developed in partnership with HP Romania, provides all the functionalities for generating, validating and issuing in pharmacies the compensated and free medical prescriptions in electronic format, which has become mandatory in Romania since 2013
• CEAS – The Informatics System for the Electronic Health Insurance Card, developed in partnership with HP Romania and Novensys Corporation, ensures the management of information and authorization flows for medical services through the CEAS card, the patient identification tool for medical and pharmaceutical services in Romania
• DES – The Electronic Health File, developed together with UTI Grup, manages the data and flows related to the medical history of Relevant Medical Data (DMR) of the patient.
PIAS – Functional structure
In addition to these national systems, the eHealth department of SIMAVI has in its portfolio realizations of informatics systems for hospitals, composed by integrating a hospital medical solution (HIS), a hospital resource management system (ERP) and a portal for users to access hospital services. Also, a series of projects are carried out for the improvement of human resources in the field of health or for the research, in partnership with specialized institutes in the country or abroad, of new information technologies for the medical field.
Unique Integrated Information System (SIUI)
The Unique Integrated Informatics System is the basic component of the Health Insurance Informatics Platform (PIAS), providing the main IT resources for the entire platform. SIUI was designed and implemented in partnership with HP Romania and STS, providing all the necessary functionalities to the National Health Insurance House (CNAS) and the County Health Insurance Houses (CJAS) for the management of the Single National Fund of the Social Health Insurance (FNUASS).
General information
• SIUI ensures the validation and settlement from FNUASS of medical services and free and reimbursed medicines, thus allowing the functioning of the entire Romanian medical system
• The system has been operating continuously since 2008 at national level at CNAS and in all 42 County Health Insurance Houses (CJAS) in Romania
• The system was implemented together with 45 local partners and involved in the first years of operation teams of over 300 specialists
• The system is integrated with SIMAVI’s SIVECO Applications ERP product
• Beneficiaries at national level: the entire population of Romania
• A similar version of SIUI was implemented for the National Health Insurance Fund – Bulgaria.
Important objectives
• Management of expenses settled from FNUASS
• Management of all contracting and data collection functionalities regarding medical and pharmaceutical services performed by each health service provider in contract with CNAS / CJAS
• Validation against legislation and settlement of paid services from UNFPA
• Quality management of the insured for health services for the entire population of Romania
• Fraud prevention and detection
• Uniformity of application of health regulations throughout the country