Bulgarian National Health Information System - Digitalizing Healthcare with Centralized Electronic Health Records

The National Health Information System (NHIS), is a digital platform created to collect, process and store medical data and information about the health of citizens in Bulgaria. It is part of the efforts to modernize and digitize the healthcare system in the country, and its main goal is to facilitate access to healthcare services and information for both medical professionals and citizens.

How does the National Health Information System (NHIS) function?

• Electronic health file - with the first medical event entered into the system, an electronic health file is automatically created for every Bulgarian citizen (or resident).
• Up-to-date patient information - All medical and non-medical professionals working in healthcare facilities are required to submit electronic health records of patients to the National Health Information System (NHIS). This ensures that patient records contain the most up-to-date information on the patient's condition. In carrying out their duties, dentists have the right to unrestricted access to all health records in the electronic health dossier of their patients.
• Correction of data - within 7 days after the creation of a health record, it can be corrected by the health facility at the initiative of a specialist or at the request of the citizen. After this period, corrections can only be made through a procedure approved by the Minister of Health.

The main objective of NHIS is to modernize and improve the efficiency of health services in the country by providing a centralized system for managing and storing health information. Ordinance No. H-6 of December 21, 2022 of the Ministry of Health regulates relations related to the functioning of the system. The creation of a unified health information portal is a stage of the digital transformation of healthcare in Bulgaria.

For the medical activities performed by them, the medical and non-medical specialists in the treatment and health facilities will generate electronic health records of the citizens. Regardless of the way medical activities are financed, all electronic health records of citizens will have to be sent to the NHIS.

All electronic health records for a person in NHIS form their electronic health record. The electronic health record is automatically generated with the generation of the first electronic health record for the citizen and must be kept until 50 years after his death.

Health records can be corrected. Within 7 days of the generation of the health record, the medical or health facility that has performed it, on its own initiative or at the request of the citizen, subject of the data, has the right to independently correct the record, without the need for notification or intervention on the part of the system administrator. After the expiration of the seven-day period, the correction is carried out according to a correction procedure approved by order of the Minister of Health.

NSIS sets a uniform format for all incoming data using mandatory samples, formats, nomenclatures, standards and specifications. Treatment and health facilities provide the health documentation to the NHIS in the form of an electronic document, signed with a qualified electronic signature (QES), in accordance with the requirements of Regulation (EU) No. 910/2014 of the European Parliament and of the Council of July 23, 2014 and the Law on the electronic document and electronic authentication services.

Access to NHIS is provided through the health information web portal https://his.bg/. Citizens can access their electronic health record through the portal https://my.his.bg/login or through the eHealth mobile application. Parents and guardians of persons under the age of 18 are automatically granted access to the electronic health records of their children and wards.

Conclusion

NHIS is a key step in the digitization of the health system in Bulgaria, providing centralized management and storage of health information. The system was created to improve the efficiency of health services and facilitate access to health data for both medical professionals and patients.