Analysis of introducing e-services: a case study of Health Insurance Fund of Macedonia

Information systems play a significant role in the improving of health and healthcare, as well as in the planning and financing of health services. Fund’s Information System is an essential component of the information infrastructure that allows assessment of the impact of changes in health insurance and healthcare for the population. The purpose of this paper is to give a brief overview of the affection of e-services and electronic data exchange (between Fund’s information systems and other IT systems) at the quality of service for insured people and savings funds.

The authors opted for an exploratory study using the e-services implemented in Health Insurance Fund (HIF) of Macedonia and data which were complemented by documentary analysis, including brand documents and descriptions of internal processes. In this paper is presented an analysis of the financial aspects of some e-services in HIF of Macedonia by using computer-based information systems and calculating the financial implications on insured people, companies and healthcare providers.

The analysis conducted in this paper shows that the HIF’s e-services would have a positive impact for the insured people, healthcare providers and companies when fulfilling their administrative obligations and exercising their rights.

The analysis presented in this paper can serve as a valuable input for the healthcare authorities in making decisions related to introducing e-services in healthcare. These enhanced e-services will improve the quality service of the HIF.