Vietnam: Complete regulations to eliminate the paper Medical Examination Book and replace it with an integrated Electronic Health Record on VNeID

Vietnam: Complete regulations to eliminate the paper Medical Examination Book and replace it with an integrated Electronic Health Record on VNeID​ (Image from the internet)

Complete regulations to eliminate the paper Medical Examination Book and replace it with an integrated Electronic Health Record on VNeID

The content is discussed in Official Dispatch 5906/BYT-VPB1 of 2024 in response to the voters of Dong Nai province after the 7th Session of the 15th National Assembly issued by the Ministry of Health.

Voters reported that each time they go for medical examination and treatment at hospitals of various levels, they are required to purchase a new medical examination book, which is wasteful. Meanwhile, during the examination, doctors do not record in the medical examination book but rather print prescriptions and directives from a computer. Voters petition the Ministry of Health to eliminate this procedure as hospitals have now technologized, printing via computer.

The Ministry of Health of Vietnam issued Decision 1332/QD-BYT dated May 21, 2024, on the issuance of the Electronic Health Record for integration on the VNeID application; Decision 2733/QD-BYT dated September 17, 2024, providing guidance for pilot implementation of the Electronic Health Record for integration on the VNeID application, and other relevant documents to direct, guide entities to deploy the integrated Electronic Health Record on the VNeID application.

The Ministry of Health has cooperated with the Ministry of Public Security, Vietnam Social Security, the People's Committee of Hanoi, and other related units to conduct pilot implementation of the Electronic Health Record serving integration on the VNeID application in Hanoi; currently, the Ministry of Health is deploying it in 8 provinces and centrally-run cities; it is anticipated to organize a national deployment conference for the Electronic Health Record for integration on the VNeID application in October. Based on that, the Ministry of Health will complete the regulations to abolish the Medical Examination Book and replace it with the Integrated Electronic Health Record on the VNeID application.

Thus, in the future, the Ministry of Health will complete the regulations to abolish the Medical Examination Book and replace it with the Integrated Electronic Health Record on VNeID.

Response to inquiry regarding health insurance referral procedures in Vietnam

According to Official Dispatch 5906/BYT-VPB1 of 2024, voters state that currently, according to regulations, patients seeking examinations or treatments at higher-level healthcare facilities must undergo referral procedures which are cumbersome, especially for patients who have stabilized treatment at higher levels and need regular follow-up examinations. Such patients still have to obtain referral documents from the district health centers to the provincial general hospitals and further to central hospital levels, which is complicated, especially for patients in remote areas. Voters suggest that the Ministry of Health should consider simplifying the referral procedures for medical examination and treatment.

The referral system for medical examination and treatment is currently structured to ensure patients receive examination and treatment appropriate for their condition and at facilities with the necessary expertise at each level. Higher-level facilities handle more severe and complex conditions. When a patient's condition exceeds the lower-level facility's capacity, the healthcare facility will perform the referral procedure to a higher-level facility for continued treatment. Conversely, when a patient has stabilized from treatment at a higher level and requires regular monitoring, they can be transferred back to a lower-level facility for continued treatment and care.

Currently, referral procedures follow the Circular 14/2014/TT-BYT of the Ministry of Health. As per regulations, from January 1, 2016, health insurance participants have been allowed inter-district referrals within the province, and from January 1, 2021, inter-province referrals for inpatient treatment nationwide without referral documents. This facilitates easier access for the public to medical treatment at district and provincial level facilities.

Regulations regarding referral documents play a crucial role in reducing overload at central hospitals, ensuring quality treatment, and maintaining balance in managing the Health Insurance Fund. Central hospitals are designated as final referral entities, focusing on severe cases, advanced techniques, scientific research, and education, rather than ordinary conditions and primary care. Overload risks errors, complications, reduces treatment quality and efficiency, affecting patients. Hence, the Ministry of Health urges voter understanding and support for referral document regulations to mitigate hospital overload, enhancing operation efficiency and treatment quality across hospitals.

To reform procedures and facilitate patient convenience, the draft Law amending and supplementing certain articles of the Health Insurance Law includes measures such as allowing patients with certain rare, severe diseases requiring advanced techniques to access treatment at higher-level facilities without referral procedures. For certain chronic diseases, patients would be managed, monitored, and dispensed specialized medications at levels higher than usual, enabling convenient treatment without needing referrals but still enjoying benefits. Concurrently, the Ministry of Health is gradually implementing electronic referral documents and electronic follow-up appointment slips for patient convenience and timely care.

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