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Electronic apology notes for students - the most important questions and answers

On the eve of the new school year, the Ministry of e-Government, together with the Ministry of Health and the Ministry of Education and Science, announced the introduction of the new electronic note to excuse student absences.

The long-awaited innovation was met with broad public support, and in the discussions following the announcement, some important points of clarification emerged.

We publish the most frequently asked questions and the answers that the three ministries provide. We remind you that from October 1, only the e-note will be valid.

Is the new e-note payable?
As before, medical notes do not fall under the main package of activities that are covered by the NHIF budget. Every general practitioner is obliged to have a price list in a prominent place in his office and he himself determines the fee for services that are not covered by the health fund. Therefore, some may not charge, others may ask for 1 BGN, and others 2 or 3 BGN. A receipt should be issued for each service that is paid for.

Can the e-note be issued retroactively?
The note is issued with the date on which the examination of the child was carried out, but the deadline for the excuse of absences can be recorded retroactively. For example, if the child falls ill on Friday the 15th and the parent takes them for a check-up on Monday the 18th, the note will be dated the 18th but will excuse any absences made during the period of illness, e.g. for the dates 15 - 22 of the respective month.

Can the doctor refuse to issue an e-note if there is no internet, for example?
The doctor cannot refuse to issue an e-note. If it is prevented due to technical reasons, the note can be issued later when the review is registered. It should be taken into account that the National Health Information System (NHIS) is also adapted to work in offline mode and all doctors are obliged to work in the NHIS.

Can dentists issue an e-note?
Yes. Dental software is also integrated into NHIS and this allows dentists to issue e-notes for excused absences.

Can other doctors, for example in the emergency room, issue e-notes?
E-notes can be issued by outpatient medical care specialists, for example after consultation with a cardiologist, allergist, etc. at the discretion of the relevant specialist. The doctors of the emergency medical care centers (EMSC), as before, are not engaged in medical treatment and will not issue medical notes to excuse absences.

Are other medical records that are required for school also electronic?
The digitization of the students' personal preventive card, which is required at the beginning of the school year, is about to take place.

Are absences automatically excused when the doctor submits the e-note to the MES system?
At the time of issuing the electronic medical note, its data are entered into the National Electronic Information System for preschool and school education, from where they are automatically transmitted to the electronic diaries for excused absences of the respective student. Electronic medical notes also become immediately visible to the parent in the electronic diary. The class teacher, school principal and parent do not need to take any further action. All electronic diaries used in the school education system allow for automatic excuses for already reflected absences, as well as respecting absences at the time of entering them in the diary if a medical note is already available in the diary.

How does the e-note get from the doctor's office to the school?
After filling out the outpatient list for the performed examination, the doctor creates the e-note (in the NHIS) using the software he uses. In order to prevent possible errors, the doctor is given the right to cancel the note within 2 hours after registering the note. Only after this period the entered data: (NRN) of the examination, information about the child, period of absence, etc. are automatically submitted to the Ministry of Education and Culture system, from where they reach the electronic diary. All processes are automatic and do not require anyone's intervention.

What will be written on the e-note itself about the illness for which the student is absent?
The student's medical diagnosis is part of the information contained in the e-note. In order to protect the children's sensitive health data, it does not reach the MES system. The information that reaches the school diary is the period during which the student will be absent from school.

Who can access the health data in the e-note?
Only those individuals who have access to the child's health record will be able to see the diagnosis given to the child at the examination. Teachers will not have access to the diagnosis, so sensitive child data will also be preserved.

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