Strategic Objectives of the Georgian Health System New Vision For Better Health MEDEA 2011 Ministry of Labor Health and Social Affairs

 New Infrastructure  New Opportunities for Professional Development  New Standards for Medical Activity and Case Management  New Model of Health Financing  E-Health - MHIS & EMR  New Regulations for Medical and Pharmaceutical Services  Strengthening MEDIATION services  New Public Communication Strategy

New Infrastructure  Hospital Sector Reform -More then 1 billion USD to be invested in new Infrustructure -Up to 150 new health facilities will be constructed/renovated and equiped -Public-Private Partnership in Service Delivery

Tbilisi 37 Samegrelo 8 Kvemo-Kartli 7 Kakheti 8 Svaneti 3 Abkhazia Ajara 9 Guria 3 Imereti 15 Mckheta- Mtianeti 5 Shida kartli 5 Samckhe- Javakheti 7 Racha- Lechkhumi 2 New Infrastructure

 Updating Public Health Infrastructure -USA-Georgia Partnership: DTRA project - 11 advanced new Public Health Laboratories, integrated surveillance system -Mental Health Facilities: MH departments integrated in General Hospitals, new facilities for long- term Care, Community based outpatient clinics -Infectious Diseases: New National TB, HIV/AIDS and Infectious Disease Centers

New Infrastructure Throughout the country  December 2011 – 90 new facilities  April 2012 – 7 new facilities  2013 – rest of the projects More than 8000 new bed capacity in total

 Short-term objectives – be prepared for Defining list of Priority Medical Specialties -Re-certification of Health Professionals -“Mini residency” programs New Opportunities for Professional Development

 Priority Medical Specialties for new medium and small size (<50 beds) general hospitals and PHC centers -Nurses- Anesthesiologists -Hospitalists- Pediatricians -Family Doctors- Ob/Gyn -Emergency Physicians- General Surgeons New Opportunities for Professional Development

 Re-certification of existing Medical Professionals -Introducing board certification procedures – establishing Boards of Priority Specialties -Inviting Georgian doctors and nurses from USA and Western Europe into the process of re-certification -Start Re-certification of doctors and nurses October 2011 New Opportunities for Professional Development

 “Mini Residency” programs and ToTs -USA-Georgia Partnership: USAID project on mini- residency program for Emergency Physicians – existing know-how -Training for trainers in priority specialties – creating pool of trainers -Spreading the knowledge – continuous on the job training New Opportunities for Professional Development

 Long-term objective -Establishment of advanced residency program in collaboration with international medical universities -Clinical base for residency program – linking with private multi-profile hospitals -Trilateral cooperation – Government, University, Hospital New Opportunities for Professional Development

New Standards  Updated standards for medical facilities -December 2010 – amendments in Georgian legislation on “Licensing” and “Healthcare” – introduction of new licensing requirements for hospitals, PHC facilities and diagnostic centers -All new health institutions are being created in accordance to the new regulations -All medical institutions will have to re-obtain licenses according to new regulations after December 31 st 2011

New Standards  Strengthening system of standardized care -MLHSA, World Bank and UK National Institute of Clinical Excellence (NICE) –manual for creation of national clinical guidelines and protocols -Special emphasis on implementation of existing national guidelines – quality control, costing -Translation and adaptation of international guidelines

Total Health Expenditure New Model of Health Financing Total Health Expenditure mln. GEL Total Health Expenditure as part of GDP

Structure of Total Health Expenditure New Model of Health Financing International aidPrivatePublic

Trends in Public Health Expenditure New Model of Health Financing Public Health Expenditure mln. GEL Public Health Expenditure as part of GDP

Administration of state vertical programs New Model of Health Financing Vertical programs prevention Vertical programs individual health State funded private insurance

Insurance System Development Progress Insurance Program for People Under Poverty Line (120,000 piloted in two regions) Annual premium $ 52 Insurance Program for People Under Poverty Line ( 750,000 countrywide) Annual premium $ 89 Insurance Program for People Under Poverty Line (950,000 countrywide). Voluntary (state subsidized) insurance (120,000 countrywide) Annual premium $ Budget in US$22,305,00053,988,00079,079,000100,669,000

E-Health - MHIS & EMR Data Repository Prescriptions Financial/ Billing EMR/ Clinical

E-Health - MHIS & EMR

 2010 – SIMS development  2011 January – electronic birth and death certificates  2011 March – new system of international classificators  2012 – direct electronic data exchange between providers and MLHSA

New regulations for Pharmaceutical industry  “Recognition” registration mechanism for OECD/EU/FDA approved products  Parallel import mechanism – only notice regime applied  Amendments in legislation – “conflict of interests”

Strengthening MEDIATOR services

– “Open door” strategy for population – regional branches of MLHSA, local government, service providers from October 2010 – Media campaign from December 1 st 2010 – Mediation between service providers and insurance companies from September 2010 Strengthening MEDIATOR services

New public communication strategy  MLHSA and WB joint project on public communication: -Introducing health reform -Promoting health insurance -Re-establishing links with Georgian health communities abroad  First time in state health programs – public communication costs for Safe Blood, Immunization and Onco-screening programs

Our proposals to US based Georgian health community:  Time to invest in health infrastructure  Time to invest in human capital development  We offer direct line to the minister and his deputies  Green light to your initiatives and projects  Joint efforts for better health in Georgia