An event on ‘Our National Health Informatics System’ was held at Üsküdar University Faculty of Medicine as part of the University Culture course. In the online event, Deputy Minister of Health Dr. Şuayıp Birinci, with his presentation, evaluated the current state of health services influenced by digitalization over the last 20 years. Birinci also offered recommendations for the improvement of our health system, stating, “Currently, the 30-year costs to the state for obesity patients in Turkey, including direct and indirect expenses, amount to approximately 7 trillion TL. If everyone exceeds 5,000 steps a day, the system saves nearly 12,000 TL annually. Therefore, the most important thing that can be done in this country right now is to take action.”
The event, moderated by Lecturer Dr. Cengiz Gül from Üsküdar University Faculty of Medicine, was attended by Üsküdar University Faculty of Medicine Dean Prof. Dr. Haydar Sur, faculty members, and medical students. The online event, themed 'Our National Health Informatics System', took place with the participation of Deputy Minister of Health Dr. Şuayıp Birinci.
Turkey has the highest number of intensive care beds
Deputy Minister of Health Dr. Şuayıp Birinci began his speech by addressing the scarcity of hospitals and the age of existing ones, stating, “Our hospital count increased by 35 percent, and the average age of hospitals decreased from 49 to 13. Nearly 120,000 beds were added in the last 15 years. We increased public intensive care units by 28 times. Turkey has the highest number of intensive care beds per capita in the world. This is why no one was left without a bed during the pandemic.”
Technology is our greatest tool to strengthen the system
Dr. Birinci stated that Turkey has the highest satisfaction in the world relative to the money spent in the health sector, saying, “This data reveals how effectively health expenditures are utilized.”
Birinci added that the system needs continuous renewal due to the constantly changing elements of health services. “Expectations are also shifting, but one thing remains constant: the rates of aging and chronic diseases are increasing. Technology is our greatest tool to strengthen the system.” he said.
The drug tracking system is also one of the most valuable applications in the world
Dr. Şuayıp Birinci stated that 20 years ago, there was a 13-fold difference in the number of physicians between Ağrı and Ankara relative to their populations, and today that difference has narrowed to 2-fold. He added that such data can only be generated through digitalization. Birinci reminded that the 'Turkey Health Information System Action Plan' was created in 2004, saying, “Although this initiative might seem simple today, it can be considered a document that met the needs of that time. Subsequently, the national health dictionary created was also one of the most important building blocks. A system like E-Nabız and the Central Physician Appointment System (MHRS) were established. MHRS was chosen as the best project in London, and there is still no project of this magnitude. The drug tracking system is also one of the most valuable applications in the world. It is the only tracking system that can be used nationwide and integrated with health systems. There are 10,000 registered drug types, 19 billion registered box counts. The daily transaction count is 79 million, and approximately 27,000 pharmacies use this system.”
“Everyone collects health data; we collect both health and administrative information”
Deputy Minister of Health Dr. Şuayıp Birinci noted that the purpose of the e-nabız system, initially launched among Istanbul hospitals and later made available throughout Turkey, is to direct individuals to the appropriate hospitals. He stated, “Over 500,000 patient relatives were on the roads in Istanbul every day. We fought for everyone to be able to access relevant specialties wherever they are, without the need to come to a central location. We established an electronic health record system so that everyone, from patients to health managers, can access their own data. Our difference from the rest of the world emerges at this point. Everyone collects health data; we collect both health and administrative information because we record the entire process that the data goes through.”
“The E-nabız project was showcased as an example to the world”
Birinci shared the information that the E-nabız system currently has 72 million users, has seen 4.9 billion logins, and 14.5 million organ donations have been made through the system. He said, “Different systems work together. When we explain this to a foreigner, we are asked how we achieved it. There is no such example in the world. Data from all health institutions can be accessed.”
Birinci also stated that the e-nabız system can be used to inform patient relatives, adding, “You struggle to explain this to a Westerner. A group of people who access health data through family members has emerged. The E-nabız project was showcased as an example to the world.”
“Technology touches our lives”
Dr. Birinci noted that artificial intelligence technologies are being used in healthcare, stating, “Thanks to artificial intelligence, we have increased the early diagnosis rate to over 50 percent. Previously, 20 percent of women diagnosed with breast cancer were diagnosed at stage 4 or 5. Now, only 1 in 200 women are diagnosed at stage 4 or 5. We catch all of them much earlier. I am saying this to show how technology touches our lives.”
Birinci added that with the ‘My Prescription system’, corruption has been eradicated, with the ‘white code application’, violence in healthcare can be instantly monitored, and with the ‘Emergency health automation system’, the entire process from a patient's admission to discharge can be tracked. He continued, “SİNA, the decision support system where data collected through digital systems is processed and accessible to everyone within their own authority, is the largest decision support system in the world with the most users, generating different reports for each individual. SİNA knows, on average, how many people will die tomorrow. It also knew this during the pandemic, and it knew the intensive care admission rates. It sees the risks of diseases and can provide data on what percentage of patients in risky groups will be hospitalized and what percentage will enter intensive care. Thanks to this data, we can take precautions in hospitals.”
“In Turkey, people are born digitally and die digitally”
Birinci also touched upon the Death Notification System, saying, “In the past, when someone died, there were issues like inheritance procedures, death reports, and removal from life records. In Turkey, people are now born digitally and die digitally. In fact, the baby is registered from the first pregnancy test. If the baby's name has been decided after birth, a report is written electronically, and the Turkish ID number is sent to the family's mobile phone within 5 minutes.”
“Chronic diseases account for 75 percent of SGK expenditures in terms of unit cost”
Birinci stated that the disease management platform is a system that alerts physicians about which tests should be performed for which disease, saying, “It is necessary to somewhat alleviate the pressure on Turkey's total disease burden by managing chronic diseases. Because, as in the rest of the world, chronic diseases account for 75 percent of SGK (Social Security Institution) expenditures in Turkey in terms of unit cost. One out of every two people over the age of 65 must live dependent on someone else. We can see how much pressure the healthcare system will be under in the future and how much our own future is threatened. Therefore, what needs to be done is to take care of our own health. We were able to design technological systems that will strengthen us in this way. Of course, much better ones will be developed, and these platforms will reach a much better point. Through the disease management platform, we have so far monitored 60 million people. I dream of increasing the system's capacity to 1100 diseases; if we do that, robots will be able to diagnose and monitor many patients. We will significantly reduce the burden on physicians.”
If everyone exceeds 5,000 steps a day, the system saves 12,000 TL annually
Dr. Birinci pointed out that currently, the 30-year costs to the state for obesity patients in Turkey, including indirect expenses, amount to approximately 7 trillion TL. He said, “If everyone exceeds 5,000 steps a day, the system saves nearly 12,000 TL annually. Therefore, the most important thing that can be done in this country right now is to take action. The only way for this country to manage its health economy is for everyone to take ownership of their own health.”
6 out of every 100 people apply to a branch they shouldn’t actually go to
Deputy Minister of Health Dr. Şuayıp Birinci provided information about applications such as the HES Code application and the contact tracing system, which were rapidly put into use during the pandemic, noting that these systems were used quickly and successfully.
Birinci concluded his words by mentioning the ‘Neyim Var’ (What Do I Have?) project, stating, “This is one of our most valued and important projects.”
He elaborated: “This system asks you questions like a doctor and tells you which doctor you should see. It offers 5 suggestions for what your illness might be. 6 out of every 100 people apply to a branch they shouldn’t actually go to. We estimate this could be an average of 120-130 thousand patients. We are talking about a model that can diagnose 85 percent of those who apply to the healthcare system. It guides patients with warnings such as 'Call an ambulance immediately,' 'Go to a family doctor,' 'Go to this specialty,' or 'Consult an emergency neurologist.' Now, we are integrating this with laboratories and turning it into an auxiliary tool for doctors, preventing unnecessary or family doctor-resolvable applications from going to hospitals, and by including issues such as which emergency area to go to, we are transforming it into a project that will contribute to managing the process from the moment people leave their homes. We are talking about a model that can provide services from Turkey to many countries around the world. What boosts our courage here is that in 2020, one out of every two people searched for health-related questions online. That is, one out of two people are browsing the internet regarding health.”
The event concluded with a Q&A session.