Project Details

Medical e-consultations

Short Description and Goal

New E-consultation for Zagreb’s patients thanks to Andalusia’s experience.

Detailed Description

Health Center Zagreb and the Regional Ministry of Health of Andalusia took part in a twinning as part of the 2016 ScaleAHA twinnings. The aim of the twinning was for Zagreb to learn about the Diraya system and implement elements of it in the region. Zagreb wished to twin with advanced regions in order to find digital solutions related to Active and Healthy Aging that could be implemented in the region, and to learn from experiences of Reference Sites that have successful eHealth strategies in place. Andalusia’s more than 20 years of experience in eHealth systems development and its elaborate operating system Diraya made the Andalusian Reference Site the excellent candidate for twinning. Zagreb and Andalusia submitted a twinning application for knowledge transfer focusing on the Diraya system.

Diraya is a comprehensive system that supports the Andalusian electronic medical record system. The conceptual model and the technological architecture of Diraya have raised enormous interest in other health administrations thanks, among other things, to its cutting-edge services such as the electronic prescription or the centralized appointment system.

Following the twinning, Health Center Zagreb organised a series of co-development workshops with primary care physicians and ICT service providers in order to find the best ways to implement the desired elements in the Croatian healthcare ecosystem. As a result of these sessions, a set of modules which were added to the existing service were created and carefully implemented by conducting a series of pilot-projects. This proved to be a highly successful approach, resulting in opening up new communication channels between citizens, health care providers and health care workers. Healthcare services for complex patients have been improved based on examples from Andalusia health services with the expected significant impact on the quality of health service delivery.

One of the most challenging, yet rewarding results was the development of the E-consultation module informed by the Diraya system and the experience of Andalusia. E-consultation is a cross-specialty communication tool built on an existing inter-professional communication model PRO used in GP practices. This digital service fosters collaboration between cure and care sectors and provides multidimensional approach to managing patients. Patients can receive hospital specialist recommendation for managing a specific health issue based on GP-hospital specialist multidisciplinary interaction. This recommendation then transforms to time and financial savings for the patient and the healthcare system, optimised care patterns, and could help improve quality of care and health outcomes.

“The twinning with Diraya informed the development of a number of modules which have since been added to the existing Zagreb service portfolio. Most notably, an e-consultation module was developed based on the twinning results” – Antonija Balenović, Director of Health Center Zagreb

With the current level of scale-up and through the increasing public demand, the transferred services could reach up to 350 000 patients and there are indications that some solutions could soon be implemented on national level, potentially impacting millions. We believe that the key to more adaptive policy on digital health solutions is to showcase the benefits of the solutions in small-scale pilots and communicate well on different levels to both create the public demand for the solution and facilitate the adoption of enabling policy.


Project Website(s)

Project Topics

Health Care, Public Services & Administration, Science

Level / Project Complexity /


Participating Cities

  • Andalucia
  • Zagreb

Sizes of Participating Cities

• 500.000 - 1,5 Mio

Participating Countries

  • Spain
  • Croatia

Project Region(s)

• Europe

Media Credits