General Questions

1What is the Digital Health Agenda?
The Agenda for the Digital Health Transformation of the Health Sector (Digital Health Agenda) describes the objectives and key lines of action for the digital transformation of the health sector in Suriname. The vision and actions outlined in this document were developed through a series of multi-stakeholder workshops that included not only representatives from across the public and private health sector, but also from national partners such as e-Gov and the State Health Fund (SZF), supported by international partners, including the Pan-American Health Organization (PAHO), and the Inter-American Development Bank (IDB). The Digital Health Agenda is initially focused on the digital transformation of the publicly funded primary level of health care and public health programs but will be expanded in future phases to include private primary care providers, as well as secondary and tertiary care providers in both the public and private sectors. This Digital Health Agenda identifies activities and products that will strengthen IS4H and drive digital health transformation in Suriname for the next several years. The main objective of the Digital Health Agenda is to maintain an integrated and shared vision of the desired future state and to coordinate multistakeholder actions and financing to ensure a cohesive and effective approach to the digital transformation of the health sector.
2Why is Digital Transformation of the Health Sector Needed?
The Government of Suriname has recognized that the digital transformation of the health sector will be critical to achieving these policy priorities. Evidence from global experience shows that the digital transformation of the health sector has the potential to improve efficiency, quality, and equity. For example, interconnected and interoperable health systems can reduce healthcare costs associated with redundant diagnostic testing, unnecessary hospitalizations, and preventable readmissions. Digital health tools can be used to effectively monitor the burden of disease and the health status of a country, providing valuable data to guide cost-effective policy interventions and improvement initiatives. Digital health tools can support improvements to the quality of care by providing decision-support tools that support the application and monitoring of standardized clinical protocols. Interoperable health information systems enable the continuity of care across levels of care, and can also strengthen patient safety, for example by flagging potential drug interactions. Digital health solutions also provide access to the data and tools that support population health management approaches for the prevention and effective management of chronic conditions such as diabetes, heart disease, and mental health conditions. Digital health can also increase access to essential healthcare services, and potentially reduce barriers to access that contribute to health inequities. Telehealth can connect patients in remote regions to healthcare specialists, without the need to travel. Patient portals and mobile applications empower patients with information and tools to better manage their health. However, to realize these potential benefits of the digital transformation of the health sector, Suriname needs to have a coordinated approach, informed by evidence and guided by best practices and principles. Therefore, the Agenda for the Digital Transformation of the Health Sector has been developed in alignment with the national eGovernment strategy to help achieve the Ministry of Health’s key policy priorities.
3What is Digital Health and Digital Transformation?
The World Health Organization defines digital health as the field of knowledge and practice related to the use of digital technologies to deliver health care and services and to improve health. Digital health expands the concept of eHealth to include digital consumers, with a wider range of smart devices and connected equipment. It also covers other uses of digital health technologies such as the Internet of Things, artificial intelligence, big data, and robotics.[1] Digital health tools, for example, include information systems such as electronic health records, telehealth and virtual health care solutions, and mobile health apps, as well as information systems that facilitate the exchange of health information between health information systems. [1] Global strategy on digital health 2020-2025. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO.
4What is IS4H? and what is the purpose of it?
IS4H stands for “Information Systems for Health,” which is a term used to refer to the use of technology in healthcare. The purpose of IS4H is to improve the quality, efficiency, and effectiveness of healthcare services through the use of information and communication technologies (ICTs). The ultimate goal of IS4H is to enable better health outcomes for patients by providing healthcare professionals with the tools they need to deliver high-quality care.
5When will the transformation to Digital Health be implemented?
The transformation to digital health is a multifaceted process involving several crucial steps. The initial groundwork with stakeholders began in late 2022, and progress is steadily being made since then. The first sub-component, which involves digitizing death certificates, is projected to be implemented by the end of 2023.

The major transformations are set to occur during 2024. Starting from January 2024, the private general practitioners are expected to commence the transition to a certified digital Electronic Health Records (EHR) system. This process is anticipated to last for a year, which indicates that full implementation for private practitioners will be completed around January 2025.

Meanwhile, two main components - regional health services and medical mission with an EHR - will begin their implementation processes in the second half of 2024. Given that these are significant and complex parts of the digital health infrastructure, it can be expected that the implementation will take some time, perhaps extending into 2025

It's important to note that these are projected timelines and can be subject to change based on a variety of factors, such as technological advancements, regulatory changes, stakeholder cooperation, and unforeseen circumstances. However, based on the current timeline, we can anticipate significant strides towards a comprehensive digital health system by the end of 2025.
6To whom is the transformation to digital Health applicable?
The transformation to digital health applies to a wide range of individuals and groups within the healthcare industry. Patients can use digital health tools to better manage their health conditions, access healthcare services remotely, and receive personalized care. Healthcare providers can use digital health technologies to streamline their workflows, improve patient outcomes, and increase efficiency. Healthcare organizations can use digital health technologies to improve patient satisfaction, reduce healthcare costs, and enhance the overall quality of care.
7Do I need a doctor’s card to visit the doctor?
If you don’t have a doctor’s card, you may still be able to visit a doctor depending on the circumstances. Firstly, if you have a medical emergency, most doctors and healthcare facilities will provide immediate care regardless of whether you have a doctor’s card or not. However, in non-emergency situations, having a doctor’s card is important to ensure you receive appropriate and timely medical care. If you don’t have a doctor’s card, you may still be able to visit a doctor by paying out-of-pocket for the consultation. This option is usually more expensive, but it allows you to see a doctor without having to wait for a card to be issued.
8Who can view my medical records and why?
The patient is the primary individual who has the right to access their medical records. Medical records are a highly sensitive and personal collection of data that contain information about an individual’s health status, medical history, and treatments received. As such, the privacy and confidentiality of medical records will be highly protected by law. Generally, medical records can only be viewed by authorized individuals who have a legitimate reason to access them. These individuals include the patient and healthcare providers involved in the patient’s care.

General Practitioners

1Can the current system used by GPs also be connected to the HIEP?
Yes, a current Electronic Health Records (EHR) system used by General Practitioners can potentially be connected to the Health Information Exchange Platform. However, it's important to note that all EHR systems must undergo a rigorous certification process.

This certification process evaluates whether the EHR system meets all the requirements outlined in the EHR Due Diligence and Data Requirements document. Specifically, the system must contain the necessary data parameters for interoperability purposes in accordance with the defined core data set.

In addition, the EHR system must adhere to all relevant regulations and legislation, particularly those related to privacy and security concerns. This is crucial in ensuring the safety and privacy of patient data when it is shared across various health systems through the Health Information Exchange Platform.

Therefore, while it's possible for a current system to be connected, it will require going through this certification process to ensure that it is suitable and ready for this level of integration. Once certified, these systems will not only enhance the delivery of healthcare services but also ensure that patient information is securely and efficiently shared across different healthcare providers.
2How will the transformation from card indexes to digital health records in a EHR take place?
The transformation from card indexes to Electronic Health Records (EHR) entails a careful planning process and the selection of a suitable EHR system. It involves integrating information from the card indexes into the new EHR system, which may require digitizing and migrating data. Physical card indexes could also be scanned for reference purposes to ensure continuity of records during and after the transition.
3How will the transformation from card indexes to IS4H take place?
The first step in this transformation is the digitization of patient records. This involves converting patient information from paper-based records to electronic health records (EHRs), which can be stored and accessed in a central database. The digitization process involves scanning paper records and entering the data into the EHR system. Once the digitization process is complete, the next step is to integrate the EHR system with other healthcare systems, such as laboratory information systems, radiology information systems, and pharmacy systems.
4Can a patient go to several laboratories or pharmacies with the same request?
After a patient has taken a lab test at one laboratory, they will not be able to take the same test at a different lab since the system will indicate that the test has already been completed. This applies to pharmaceutical receipts as well.
5What happens if there’s a power or internet outage?
In the event of a power or internet outage, continuity of care is ensured by the EHR system's ability to work offline. This feature, allows healthcare services to continue unhindered. Additionally, power outages can be managed through the use of generators, ensuring that the EHR system and other vital healthcare operations remain functional even during such disruptions.

Patient privacy & Consent

1Can the patient modify his/her own health records?
Only the general practitioner can modify patient data. However, the patient is allowed to discuss with the general practitioner if information needs to be amended.
2 Is there legislation on the security of patient data?
Yes, there is legislation concerning the security and privacy of patient data. As of now, specific laws pertaining to digital health records are being formulated, with some now on the dock at the National Assembly. The IS4H (Information Systems for Health) project team advises the National Assembly on the draft privacy legislation and is preparing a separate health law that includes provisions for privacy and security. Until these specific laws are enacted, patient data privacy and security is governed by legislation derived from the constitution. Moreover, as Suriname has committed to the Inter-American Convention on Human Rights and the Convention on Civil Rights, elements from these conventions also guide the legislative framework for patient data security in the country.
3Do other doctors also have access to patient data? And how will this be handled?
For continuity of care, General Practitioners with a permit from the Ministry of Health, as well as emergency rooms, can access patient data. However, this access is limited to instances when they are involved in treating the patient. Any access to health records beyond the patient's primary physician is communicated to the patient’s primary physician, who is responsible for monitoring and controlling this access to ensure patient privacy and data security.
4Does the IS4H team, ministry of health or any other organisation have access to the stored patient data?
Stored patient data is not accessible to the IS4H team, the Ministry of Health, or any other organization. Access is granted exclusively to licensed physicians actively involved in patient care. Stringent security measures are in place to safeguard patient information, ensuring privacy and confidentiality. While these entities contribute significantly to the digital health ecosystem, they only receive anonymized data necessary for formulating health policies, without any identifiable patient information.