The Public Private Collabroation model, eZdorovya, and the transformation of the healthcare system in Ukraine

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17 million of people joined the eHealth in less than 6 months, which is every third Ukrainian. Such growth determined by the Public Power Corporation model of organizational process of the eHealth implementation in Ukraine. It was developed by the state-owned enterprise eZdorovya in cooperation with the government, business, IT and civil society. It enables to create a national highly secure eHealth system fast, effectively and transparently. Today, the eHealth in Ukraine is one of the key anti-corruption initiatives.

Innovation Summary

Innovation Overview

Until 2016 the medical system in Ukraine was stuck in the 80s - old, poor infrastructure, enormous amount of paperwork, endless queues, the Ministry of Health lacked data to make strategic decision. More than a half of payments were done out of pocket in to the health system. In 2016 Ukrainian government started the financial reform of the healthcare system aiming to substitute the outdated one with the result-based model. The eHealth system was determined as the main tool to make these changes happen. State-owned enterprise eZdorovya was defined as the main institution that would lead the process of the eHealth implementation.

Firstly, eZdorovya team together with the Ministry of Health, business and international consultants analyzed the strengths and weaknesses of Ukrainian economy in general, and the healthcare system in particular. In terms of weaknesses, there were three main challenges:
- The whole Ukrainian healthcare system worked on paper.
- Government had not enough human and financial resources to develop all the necessary software.
- The question of time was very critical due to the electoral cycle.

One of the main strength is the IT sector. IT industry in Ukraine is among the top three industries with the largest share of GDP in the country. IT products make more than 3% of the state's GDP. The total income of the industry in 2017 amounted to $ 3.6 billion. So, the working team decided that the growing IT will help to digitalize the healthcare system using best IT solutions, that is the reason the Public-Private Collaboration model was developed.

In April 2018 the Public-Private Collaboration model was introduced and there have been already remarkable results. Almost every third Ukrainian joined eHealth system in 6 months. The model made the process of transformation effective, transparent and fast. This model of organisational process of eHealth implementation in Ukraine was developed by government, business IT, civil society, and the eZdorovya team.

The cornerstones of the Public-Private Collaboration model for eHealth implementation are:

1) Open source and open code. All repositories should be publicly available. This minimizes the risk of vendor lock-in (binding to a particular developer), and gives the possibility of developing the system by other teams, including volunteers and small and medium enterprises. Such open data approach demonstrates the highest level of transparency and allows a wide community to contribute to the National eHealth project.

2) Developing the eHealth together with business. The state didn’t have enough resources, so the Ministry of Health and other state bodies decided to share the responsibility of the PPC model development with business. Moreover, business in Ukraine is more experienced in using new technologies, providing customer support and dealing with sales, on this wise the eHealth system can only benefit from it.

3) Two-component system. The government saves the necessary data and provides the business with the tools to cooperate with the Ministry of Health and the National Health Service in Ukraine.

Business enables the medical institutions to interact with the Ministry of Health and the National Health Service providing the IT platforms for them. Respectively, the new markets emerge, respectively. The free competition within these markets encourages businesses to improve the quality of service in such manner this is the end-users (patients) win.

4) Autonomy of the system. The involvement of business keeps the system stable regardless of the political situation in the country. Government determines the policy and strategy and works as a partner with business in order to digitalize the healthcare system in Ukraine.

5) Minimizing the burden for taxpayers. Everyone pays for what he chooses depending on which Medical Information System (developed by various certified business enterprises) the medical institution working with. Business creates the user-interfaces so that state spends less budget money for the development of the eHealth.

Three main components are crucial to the model. The newly created National Health Service in Ukraine is responsible for all the purchase, cost-analysis, and fraud prevention. The Ministry of Health is responsible for eHealth strategy and policy in the health sector. SOE eZdorovya is responsible for digital transformation of the health sector.

In 6 months more than 17 million Ukrainians joined the eHealth system. The newly created National Health Service has received its first funding (8.6$ million) and has already financed the medical institutions around Ukraine. The medical facilities are starting to get more money from the National Health Service.

eZdorovya helps Ukraine to take a huge step to European integration. eZdorovya is being financed by international organizations and governments donors to implement the public private collaboration model.

Innovation Description

Innovation Development

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Year: 2018
Level of government: National/Federal government


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