Türkiye

By Federica Andreoni
10 min

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 country's growth and internationalisation, which is 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

Screenshot 2024-08-13 at 15.26.05.png
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:

Screenshot 2024-08-13 at 15.40.34.png
Usage for children under 15 years ago is measured by parental usage (Birinci, 2023)

Screenshots

My Medical History Screen (home page)
The Smart Assistant Screen can be accessed from the homepage menu. On this page, patients can view their disease history and personal information such as blood type, weight, height, age, body mass index, and smoking status. The diseases they have had are marked on a human body diagram, and the diagnoses are shown in the fields indicated by dots.
My Health Facility Visits Screen: for each visit, patients can see details and contents of the prescription, diagnosis, report, tests performed, and radiological images taken.
My Visits / Hospital Visits Details Screen
My Visits / Share Health Records Screen: patients can share selected health information for a temporary period to be set by them. They will be sent a verification code.
My Visits / Hospital Visit Evaluation Screen: patients can evaluate the health facility in terms of service quality.
My Prescriptions Screen
My Prescriptions / Prescription Details Screen
My Reports Screen: here, patients can see all the reports written by their physicians.
My Diseases Screen (diagnoses)
My Tests Screen: patients can see all tests they have had, their results, and their reference values by the date and description, and they can access the details by clicking on the test. They can filter by date range and procedure name.
My Tests / Test Results Chart Display Screen.
My Radiology Images Screen.

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, their respective diagnoses, and treatments.

My Blood Donation Screen: patients can view the address and date information of blood donation teams and track their blood donation history.
Voluntary Bone Marrow Donation Screen: here, patients can submit their request to become a voluntary bone marrow donor.
Covid-19 Vaccine Information Screen.
My Allergies Screen: patients can view and add new ones. However, patients cannot add Diagnosed allergies and Skin Prick tests.
Patient Information Screen. Patients can access the latest status information regarding intensive care hospitalization information about themselves and their consenting relatives, as well as view the physician notes.
My Insurance Activities Screen: patients can generate an insurance code to allow insurance companies access to their health records. Insurance companies can only view health data submitted to the e-Nabız System using this code. On the "My Insurance Activities" page, patients can enter details of the insurance companies with which the code will be shared. A separate insurance code can be created for each insurance provider, or a single code can be shared with multiple companies.
My Emergency Notes Screen: patients can add to this page so that notes are available for healthcare professionals in case of emergency.
On the ‘My Documents’ page, patients can upload photos related to their health that they want their physician to see, such as rashes, etc. Once uploaded, the patient is also free to edit or delete the documents.
Vaccine Calendar: patients can view their childhood vaccines through the Vaccine Calendar. This feature shows the vaccines included in the childhood immunisation schedule of the Ministry of Health of the Republic of Türkiye, along with their current status. For those needing a document, the Electronic Vaccine Card can be downloaded as a PDF. The Vaccines section also provides a detailed list of all administered vaccines. Patients can access percentile charts for head circumference, height, and weight in the Percentile section.
My Medications Screen: patients can see the list of all medications prescribed and details such as dose, period, number of boxes, box picture, package insert, amount of medication contribution due, medication contribution due difference by the substitute medication, amount of examination, and prescription contribution dues.
Access log details screen: patients can see who accessed their record, when, and from which institution.
Organ donation choices screen: patients can choose to donate their organs after their death. On this page, they can select which organs to donate.
Appointment Activities Screen: patients can book new ones and see those that are already scheduled.
Sharing / My Children Screen: patients can share any part or the entire record. If they have children under 18, they can view their health records in the “My Children” section with the consent of the other parent. In the "Permanently Shared by Me" tab, patients can give any person with permanent access to view their records. Patients can also send messages from the My Messages section. Patients can manage their time-limited permissions with the "Temporarily Shared by Me" tab. From the "Shared with Me" tab, they can access those who have shared their health details with them. They can edit the content of the health details they have shared and revoke the permission. They can accept/reject connection requests.

Bibliography

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