Hungarians' inventiveness may begin with their language. The language has a complex grammar style that trains cognitive agility. Due to migration then isolation, the language is unrelated to most surrounding European neighbours. The small nation’s speakers have to learn a different language structure to communicate with the rest of the world, further training cognitive agility. John von Neumann (creator of computing architecture), Charles Simonyi (creator of Microsoft Office) and Andrew Grove (co-founder of Intel) are all Hungarian-American technologists.

Country’s healthcare system in a nutshell

Hungary’s single health insurance covers nearly all residents. Its range of services is more limited compared to other European Union countries.

Since 2011, reforms have centralised the system, with the national government overseeing strategic direction, financing, regulations, and most specialist and inpatient care. The Ministry of Human Capacities manages the system through the National Healthcare Service Centre (ÁEEK), which coordinates care, plans hospitals, and oversees licensing. In 2012, the central government took control of local hospitals from county and municipal authorities, with ÁEEK managing these state-owned facilities.

The single health insurance fund is administered by the National Institute of Health Insurance Fund Management (NEAK), which is supervised by the Ministry of Human Capacities. Funding is derived from payroll contributions and government transfers.

Healthcare delivery is predominantly hospital-based, with the national government directly managing hospitals and providing most inpatient and outpatient services, though some local governments still operate polyclinics (World Health Organization, 2023).

Health insurance covered the entire population of Hungary, including both members of health insurance schemes and those with free access to state-provided healthcare services (Our World in Data, n.p.).

Public vs private

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Source: The World Bank.
The pink column refers to the public expenditure as a % of the country’s total healthcare expenditure. The blue dot is the country’s expenditure on health per capita, expressed in international dollars at purchasing power parity.

The national PHR

History

The National eHealth Infrastructure and its specialised modules were established under the Social Infrastructure Operating Programme. Funding was from the European Union and the Hungarian State. Total investment amounted to 4.87 billion Hungarian forints (approximately 13.15 million USD). Continuous development of the system is ensured through close cooperation between the Hungarian State and the European Union. For example, project no. 1.9.6 of the Human Resource Development Operating Programme focused on establishing the Electronic Health Service and Data Integration System (EESZT).

EESZT interconnects previously fragmented healthcare data systems across the country and. It collects all data into a central system. This enables treatment locations to access the necessary information seamlessly. Another key objective was to provide modern centralised services, such as electronic prescriptions, electronic referrals, and medical documents, as well as the eProfile. These promote the widespread adoption of modern healthcare practices.

EESZT usage has been mandatory since November 2017 for publicly funded healthcare providers and pharmacies. Non-publicly funded providers (including private practitioners) must provide data to the central implant and prosthesis registries, and for the National Ambulance Service, since November 2018. Since June 2020, private providers with valid operating licences, performing outpatient medical or dental activities, have also been required to report data to the EESZT (EESZT, n.d.-a; EESZT, n.d.-b).

Historical patient data has not yet been incorporated, so only data entered after joining the system is visible.

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Source:https://e-egeszsegugy.gov.hu/web/eeszt-information-portal/history-of-eeszt

Features

Most hospitals in Hungary integrated with EESZT (EESZT official website). This integration automatically uploads nationally data added locally in a hospital's electronic health record (EHR). Authorised health professionals—such as hospital staff, general practitioners, or pharmacists—can access from EESZT through their respective systems. Access is role-based; for example, pharmacists can only view prescription information.

Patients can access their medical data through the EESZT citizen portal and mobile app. Features include seeing:

• Prescriptions and dispensed medications, including medical aids.

• Referrals for specialist consultations.

• Health documents such as outpatient appointment reports and notes, admission, and discharge documents.

• COVID-related data, including vaccination certificates, test results, and health certificates. Patients can also book COVID vaccinations.

• Test results.

• eProfile, which includes critical health information such as allergies, pregnancy status, and implants. This profile contains health data rarely subject to change, uploaded by the GP, and could be life-saving if accessed during emergency care.

The Event Catalogue shows the patient a log of all healthcare service usage, whether in outpatient or inpatient facilities or at family doctor services.

Patients can also monitor who has accessed their data. They can customise settings to receive email notifications about specific EESZT events, controlling what data is displayed to physicians based on their permissions and preferences ( EESZT, n.d.).

Challenges and areas for improvement

Key areas for improvement include:

• Limited Patient Input Capabilities: The platform currently allows patients to input limited types of health measurements. They are unable to manually add other essential medical data, such as allergies, detailed medical histories, or additional health documents (e.g. files or reports).

• Lack of Direct Communication Between Patients and Professionals: EESZT does not allow direct communication between patients and healthcare professionals. So patients cannot use the platform to consult or follow up with doctors.

• No Device Integration: While patients can manually enter data measured by external health devices (e.g., wearable fitness trackers), there is no direct integration between these devices and the EESZT system.

(PKB interviews, 2024)

Published outcomes - statistics

The latest statistics are from the 19th of April 2021 and are available at https://web.archive.org/web/20210419151255/https://e-egeszsegugy.gov.hu/web/eeszt-information-portal/the-role-of-the-eeszt-in-hungarian-healthcare.

“Today, more than 26 thousand health professionals and 13 thousand pharmacy staff uses the system in Hungary. Starting from 2020, more than 22,000 institutions have access to the EESZT infrastructure, including private service providers.

This number breaks down as follows:

• There are more than 6000 active general medical practitioners, as well as:

  • more than 300 outpatient institutions

  • more than 100 inpatient institutions

  • more than 3000 pharmacies

  • more than 8800 private healthcare institutions

• The details of more than 600 million receipts have been entered into the EESZT.

• An average of 800,000 new electronic prescriptions (ePrescription) are ordered daily.

• By June 2020, there was a 90% increase in the monthly prescription of electronic prescriptions.

• Annually, 75 million medical documents (e.g. medical records, outpatient data sheets, discharge summaries) and approximately 180 million doctor-patient appointments are recorded online in the EESZT system in Hungary. This amounts to a daily average of 300,000 medical documents recorded in the Infrastructure.”
  (EESZT Information portal, 2021)

Screenshots

Login

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On the login page patients can select an option on how to identify themselves and log in. Options from top to bottom:

• UGYFELKAPU which is the Citizen Portal for Hungarians

• Electronic National ID

• Citizen Portal+

• via Phone

• Face-to-face

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This is the login page that appears after clicking on the third option of the menu of the above screenshot (Citizen Portal+). The fields required are user name and password.

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Home page after login. List of available features (the bar at the top is the same as the icons)

Carer functionality

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Here patients can give professionals permission to access their data.

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Log of all the patient’s delegation and the patient’s logging in and out.

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Here patients can see the notifications for the delegations

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On this page patients can create a new rule for handling their health-related information. The first radio button option is to give permission to someone to buy their prescriptions. The second radio button option is to give permission to someone to use their Citizen Portal and Health Portal mobile application. This way they can log into the patient's account and can use the functionalities of the mobile app in their name

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The list of carers and how they can act on the patient’s behalf, including the timeframe

Patient history: documents by private professionals, GPs, hospitals, etc.

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This is the list of documents from private and public healthcare providers, that are added to the record automatically after every encounter, such an admission, a discharge, a medical appointment etc. Sometimes there’s no document attached, but only the encounter details. On this page patients can find data only upon selecting a timeframe.

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Patient history/example when clicked on ‘Details’: here you can see, when you click on EHR documentation, the notes of the appointment

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Patient documents page e.g. appointment’s notes from the doctor; outpatient appointment report.

e-Referrals

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eReferrals. This shows the list of referrals that the doctors 'prescribed' the patient. The table shows: date, type of care, clinic name, status, valid until date, referral id, options (which is a drop down menu)

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Options: patient data, referral data, print referral

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Patient data

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Referral details

e-Profile

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Covid vaccine info

Prescriptions

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List of medicines the patient bought from their e-prescription. Patients cannot add a medication.

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This page shows a list of the pending dispensing (prescribed medications the patient still hasn’t bought).

eGYSE

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Prescriptions for “medical aid”

Codings

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These are all codes and abbreviations that a doctor might use. When patients see a code in their doctor's letter, instead of e.g. a diagnosis or a procedure, they can use this legend to see what the code stands for

Mobile application help page

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Covid-related pages

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Covid vaccination appointment request

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Covid vaccination document, covid test documents, recovery document

Telemedicine / Measurements:

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Here patients can add their own data, but only some (more details in the screenshots below)

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To add data to the measurements section: patients can select the device - but cannot connect it-, the type of data, and the file. Patients can extract data from their devices, and then upload the file (e.g. xml,PDF…) to the record.

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Filter on Device

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Translation for Device types

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Filter on datatype

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Translation for datatypes

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Filter on file extensions (xml, jpg,pdf,json,zip,txt)

Devices menu:

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This is the page to add a new device.

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Translation for data source types

Folders menu:

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Create a new folder to organize measuring devices and data

Bibliography

• EESZT., n.d. The Role of the EESZT in Hungarian Healthcare. Available at: https://e-egeszsegugy.gov.hu/web/eeszt-information-portal/the-role-of-the-eeszt-in-hungarian-healthcare(accessed 13 September 2023).

• EESZT., n.d. Citizen Portal - Main Page. Available at: https://www.eeszt.gov.hu/hu/nyito-oldal (accessed 13 September 2023).

• EESZT., n.d. EESZT Information Portal - The History of EESZT. Available at: https://e-egeszsegugy.gov.hu/web/eeszt-information-portal/history-of-eeszt (accessed 13 September 2023).

• World Health Organization, 2023. Hungary: Country Overview. (online) Available at: Hungary health system information (accessed 13 September 2023).

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