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Türkiye

Türkiye

Owned by Federica Andreoni
Last updated: Jan 23, 2025
10 min read

Turkish Airlines flies to the largest number of countries (Wikipedia, 2025). “Turkish hairlines” is the name of the hair transplant industry of Türkiye. A million people came in 2022 and spent approximately $2 billion (TRT World, 2023). This is part of the growth and internationalisation of the country, powered by a dynamic private sector.

Country’s healthcare system in a nutshell

Türkiye provides universal public health insurance through the Social Security Institution (SSI), allowing all registered residents access to free healthcare.

However, equitable access remains a challenge, partly due to a nationwide shortage of doctors. As a result, many people opt for additional private insurance to cover treatments in private hospitals.

The Republic of Türkiye, Ministry of Health is responsible for setting health policy and owns more than half of the country's hospitals. The SSI handles collecting and pooling social security premiums, contracts with healthcare providers, and sets tariffs for services. Other government agencies manage workforce planning and the regulation of drugs and medical devices.

Funding for social insurance premiums comes from both employer and employee contributions, with exemptions for those on low incomes. The Ministry of Health contracts with family physicians for preventative and primary care, paying according to the number of patients under care. Patients are required to make co-payments at varying levels for primary, secondary, and tertiary care services (World Health Organization, 2024).

According to the most recent data from 2011, health insurance covered 86% of the population in Türkiye. This coverage encompasses both those who are members of health insurance schemes and those who have 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

In 2008, the Republic of Türkiye, Ministry of Health, began to centralise and process personal health records, along with administrative and financial data, from all healthcare providers.

This started with the National Health Data Dictionary (NHDD), which has since served as a reference for information systems used by all healthcare facilities, significantly contributing to terminology standardisation. Subsequent steps toward digitalisation were built upon this common terminology and system architecture outlined in the NHDD. The NHDD laid the foundations for the Sağlık (“health”) system, introduced in 2009; upgraded to version 2 in 2011; and most recently, the e-Nabız system.

e-Nabız (“e-pulse”), the Türk Personal Health Record, launched in 2015. e-Nabız was developed to enable citizens to access their health data, collected from multiple healthcare institutions, in one place. Through the platform, patients can also authorise their healthcare professionals to access their records.

The Ministry of Health developed e-Nabiz and used private contractors for professional services for maintenance and technical support of the system (PKB interviews, 2024). Tiga Healthcare Technologies is one of the Ministry’s main contractors for this project (Tiga Healthcare Technologies, 2023). The health tech company also holds contracts with the Ministry for the Pharmaceutical Track & Trace System and E-prescription (as shown in the image below).

 

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Features

The Türk PHR system, e-Nabiz, has 38 features for treatment, prevention, health promotion, and health-related and interrelated areas. Data sources include both public and private healthcare providers.

  • The appointment section, shows future scheduled hospital appointments and information on past ones. The patient can book new ones. Past visit details include:

    • prescriptions, 

    • diagnosis, 

    • written reports, 

    • tests performed, 

    • radiological images.

  • The notifications section shows recent activities, such as the latest login and hospital visits.

  • Patients have multiple options when it comes to sharing:

    • "No physician can see my information"

    • “Family physicians can see my information"

    • "The physician who performed the examination can see my information"

    • " Every physician in the health facility where I had my examination can see my health information"

    • "All physicians can see my information".

  • Patients can also share a piece of selected health information with persons of their choice, for a period of their choice (they can also share permanently), after entering their email address and phone number to confirm.

Patients can also see:

  • Disease history, and personal information such as blood type, age, and smoking status

  • Measurements, such as weight, height and body mass index

  • Allergies

  • Intensive care hospitalisation information

  • Vaccine calendar

  • Access log to check who has accessed their record

  • Covid-19 vaccine information and appointments, get the vaccine certification

They can also:

  • Evaluate a health facility visit in terms of service quality and comment on the visit

  • Track and manage their blood and bone marrow donation choices

  • Make organ donation choices

  • Let their insurance companies access the data

  • Add ‘emergency notes’ to a section so that healthcare professionals can read them in case of emergency

  • Upload files

  • Add measurements

e-Nabiz also retrieves data from iOS HealthKit or Google Fit if the patient gives access from their smartphone (Birinci, 2023).

Challenges and areas for improvement

The system lacks a symptom-tracking feature.

Published outcomes - statistics

The research paper titled ‘A Digital Opportunity for Patients to Manage Their Health: Türkiye National Personal Health Record System (The e-Nabız)’, (Birinci, 2023) provides statistics about its usage and impact:

  • Rapid User Growth: In 2018, e-Nabız had 11 million users. By 2022, this number had grown to 68 million active users, representing 80% of Türkiye’s population.

  • Integrations: The platform collects data from 28,608 system-integrated health facilities and 39 other public institutions, including ministries.

  • Cost Savings: Since its launch in 2015, e-Nabız has stored radiological images within the system, eliminating the need for patients to request duplicate copies. This innovation has resulted in a 27.5% reduction in costs, saving 750 million Türk Lira (approximately USD 21.87 million) in radiological imaging expenses from the platform's inception until 2023.

Table 5 from the paper presents e-Nabız usage rates among Türk citizens in 2021, as shown below:

Screenshots

On the Pathology Information page, patients can download the report of the pathology procedure that they have undergone in health institutions for the diagnosis of all diseases, treatment options and determination of diseases associated with genetic syndromes.

On the ‘My Epicrisis Information’ page, patients can download epicrisis reports containing information about each of their conditions, the respective diagnosis and treatment.

Bibliography

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