Digital Transformation of Slovenian Long-Term Care: Data, Coordination and Accountability

An older person should not have to explain the same circumstances repeatedly simply because different parts of the care system use different records. A long-term care coordinator should not need to reconstruct essential information from disconnected systems before changing a personal plan. National decision-makers should be able to understand whether new long-term care entitlements are reaching people without requiring providers to reproduce the same data through multiple reporting processes.

These are operational questions, but increasingly they are also digital ones. Slovenia is building its new long-term care system while simultaneously developing the information infrastructure needed to administer it. The challenge is examined here as part of the Slovenia Ageing, Long-Term Care & Community Support Knowledge Hub.

The reform is more ambitious than replacing paper with electronic records. Long-term care now involves formal entry points at Centres for Social Work, structured assessment, entitlement decisions, registered providers, personal plans, long-term care coordinators, compulsory insurance financing and national administrative and analytical functions. Each generates information. Unless those information flows connect, fragmentation can survive even when every organisation becomes individually digital.

Slovenia has recognised this through investment in the digitalisation of long-term care and social welfare, including the DIGIDO programme. The strategic opportunity is substantial: digital infrastructure can reduce duplicate administration, support coordination and make implementation more visible. Yet it also raises questions about interoperability, data quality, privacy, workforce capability and accountability. The test of digital transformation will therefore not be how many systems are introduced, but whether information follows the person reliably enough to improve decisions and outcomes.

Digital transformation is part of implementing the new care system

Slovenia’s Long-Term Care Act, ZDOsk-1, created a new social insurance-based framework rather than merely adding another service to the existing social welfare system. The right to a family caregiver began in 2024, long-term care at home and associated rights expanded from July 2025, and institutional long-term care and the cash benefit followed from December 2025.

By 2026, digital infrastructure therefore has to support a live national system rather than prepare for a distant reform.

The information journey can begin at a long-term care entry point within a Centre for Social Work. Information is required to establish an application, assess need and determine eligibility. Once a service-based right is selected, a registered provider and its long-term care coordinator become important to implementation through the personal plan. The Health Insurance Institute of Slovenia, ZZZS, has administrative and financing responsibilities within compulsory long-term care insurance. The National Institute of Public Health, NIJZ, maintains the Register of Long-Term Care Providers, RIDO. National authorities need information to oversee implementation, financing, access and system development.

Digitalisation therefore sits across the architecture rather than inside one organisation.

This makes interoperability and system integration particularly important. A digital entry-point system that cannot exchange relevant information with provider systems may improve administration inside the Centre for Social Work while leaving the overall pathway fragmented. The same is true of a sophisticated provider record that cannot support required exchanges with national systems.

The objective is not necessarily one application used by everyone. It is an information environment in which different systems can perform their legitimate functions while agreed information moves securely between them.

DIGIDO addresses a problem that predates the new entitlements

Slovenia’s DIGIDO programme — digitalisation of the recording, storage and use of data in long-term care and social welfare — is designed to provide substantive support for this transition.

The starting point is important. Providers of long-term care and social welfare have historically used different information systems that have not been sufficiently connected or harmonised. The reform therefore cannot assume that a common digital infrastructure already exists.

DIGIDO runs from 2024 to 2028 and is intended to support the development of information solutions required for ZDOsk-1. Its work includes support for the information system used by long-term care entry points, assessment of provider digital maturity, foundations and guidance for a more unified information environment, support for provider-system upgrades, prototype development and a data and analytical system for long-term care.

The programme also recognises that software without implementation capability is insufficient. Training forms part of the investment, including support for staff using entry-point information systems.

This combination matters. Large care reforms often treat technology as a final implementation task: policy is designed first and software is expected to reproduce it. Slovenia’s approach acknowledges that digital architecture is part of the operating model itself.

Organisations examining similar transformations can use the Digital Transformation Readiness Assessment to examine strategy, digital capability, governance and resilience. It is not an assessment of compliance with Slovenian requirements, but it illustrates an important principle: digital readiness depends on organisational capability as much as technical procurement.

The first critical data journey runs from application to personal plan

For a person seeking long-term care, information has to cross several operational stages before support becomes real.

An application is made through the appropriate entry point. Eligibility is assessed using the national assessment framework, which examines the person’s functioning across defined areas and places eligible people into a long-term care category. A decision establishes entitlement. Where a person chooses a service-based right, the provider’s long-term care coordinator works with the person to develop the personal plan that translates entitlement into actual support.

Each stage depends on the previous one, but each also has a different purpose.

Assessment information is not identical to a care plan. A legal decision is not an operational schedule. A provider record is not a national entitlement register. Digital design should preserve those distinctions while avoiding unnecessary re-entry of information that has already been established.

This is where digital care planning can provide value beyond electronic documentation. The personal plan should become a usable operational record connecting recognised need, agreed services, individual preferences, review and change.

The danger is that digitalisation reproduces a paper process screen by screen. Staff may then spend more time satisfying mandatory fields without gaining better information for practice.

Good design asks which information needs to follow the person, which data should remain with a particular professional or administrative function, who is authorised to change it and which changes should trigger action elsewhere in the system.

A change in dependency tests whether information really follows the person

Consider a 78-year-old man receiving long-term care at home after assessment through his regional Centre for Social Work. His personal plan reflects moderate assistance with daily activities, while his daughter provides additional informal support.

Several months later he experiences a significant deterioration in mobility. Home-based workers begin providing more assistance than anticipated and repeatedly record that transfers are becoming difficult. His daughter separately contacts healthcare services because she is concerned about recurrent weakness.

In a fragmented information environment, each organisation may possess a valid piece of the picture without anybody seeing the whole pattern quickly. The original assessment remains in one system, daily care records in another and health information elsewhere. The daughter becomes the person connecting the information manually.

Slovenia’s developing long-term care arrangements increasingly recognise the need for responsiveness when health or functional circumstances change. In September 2026, temporary implementation measures strengthened routes through which significant changes identified by a provider can lead to priority reassessment by the entry point.

Digital infrastructure can make that process stronger if it supports a clear signal rather than merely accumulating notes. The provider needs a way to identify a material change, communicate the relevant information and know that it has reached the responsible entry point. The entry point needs enough evidence to decide how reassessment should proceed without unnecessarily reconstructing information already available.

The scenario demonstrates the difference between electronic records and digital coordination. Every record could already be digital while the pathway remained disconnected. Transformation occurs when information supports the next legitimate decision.

Data quality becomes a care-quality issue

As long-term care becomes more data-dependent, poor information can have direct operational consequences.

An incorrect provider identifier can disrupt administration. An outdated contact can delay communication. Inconsistent recording of service activity can distort payment or national analysis. A personal plan that no longer reflects the person’s functioning can create a mismatch between formal entitlement and everyday support.

Data quality therefore cannot be delegated entirely to an information-technology team.

Frontline workers create much of the information on which the system depends. Coordinators interpret and update it. Managers need to recognise unusual patterns. National institutions need consistent definitions if they are to compare activity meaningfully.

The wider data quality and performance metrics challenge is particularly important during reform implementation because apparent variation may reflect either genuine differences in access and delivery or inconsistent recording.

Slovenia will increasingly need to distinguish between the two.

For example, if one area appears to complete personal plans more slowly than another, national oversight needs confidence that the measure is defined consistently before treating the difference as a performance problem. If home-based service utilisation differs significantly between regions, the explanation might involve population need, provider capacity, local availability, recording practice or some combination of these.

Better data does not remove the need for interpretation. It creates a more reliable basis for asking the right questions.

Financing creates another major digital interface

Slovenia’s long-term care reform introduced compulsory long-term care insurance, with contributions collected from July 2025 and the new financing architecture supporting the progressive introduction of rights. ZZZS plays a central role in administering compulsory long-term care insurance and the financing of services.

This makes service information financially significant.

The system needs to know who is entitled, which right is being used, which registered provider is delivering relevant services and what activity is eligible for payment. Providers need sufficient certainty to operate, while the financing system needs safeguards against inaccurate or duplicate claims.

During the implementation phase, Slovenia has used transitional financing arrangements while the final service model and supporting processes become established. Temporary measures adopted in September 2026 extend the transitional method of financing long-term care services through the end of 2027, providing additional time to evaluate the planned service model and the conditions required for safe transition.

That is also a digital implementation issue. A payment architecture should not be introduced simply because software can calculate it. The underlying activity definitions, provider workflows and data need to be sufficiently mature for the information to represent what is actually happening.

Over-complex digital reimbursement can generate perverse administrative behaviour. If frontline workers have to record excessive detail primarily to support payment, documentation can compete with care. Conversely, an overly aggregated model can provide too little visibility to identify unusual activity or understand outcomes.

The stronger opportunity lies in designing financial data so that necessary accountability is achieved with the least avoidable duplication.

Institutional long-term care exposes the complexity of connected records

Imagine a woman living in an institution under Slovenia’s long-term care entitlement. Her long-term care needs are funded through the long-term care system, while healthcare and rehabilitation remain connected to compulsory health insurance arrangements. She also takes multiple medicines and periodically receives external specialist healthcare.

From her perspective, these are not separate lives. She is one person living in one place.

Digitally, however, different information has different legal and operational purposes. Her long-term care record needs to describe assistance, functioning, personal outcomes and relevant daily support. Clinical records need to contain appropriate healthcare information. Financing data needs to support the correct insurance mechanism. The institution needs enough information for staff to act safely without creating uncontrolled access to every record held elsewhere.

A transfer to hospital makes these boundaries particularly visible. Relevant information about medicines, communication, mobility, cognition and current support may need to accompany her. On return, changed clinical instructions or functional needs may need to reach the long-term care team promptly.

This is a practical example of why digital records and information governance are inseparable. More sharing is not automatically better. The objective is appropriate information, available to the appropriate actor, for an appropriate purpose.

If the same demographic and core functional information is repeatedly transcribed between systems, error risk increases. If systems become so interconnected that access boundaries disappear, privacy risk increases instead. Digital maturity lies between those extremes.

Health and long-term care digitalisation cannot develop in isolation

Slovenia is modernising health information infrastructure at the same time as long-term care digitalisation develops. The Digitalisation of Health Act entered into force in late 2025, creating a framework for reform of health-data collection, processing and protection and for more centralised digital infrastructure.

The national health strategy for 2026–2036 also places digital solutions, data and artificial intelligence within the future direction of healthcare, while recognising rehabilitation, social welfare and long-term care as part of support following healthcare treatment.

This does not mean that Slovenia has created one merged health and long-term care information system. Nor should integration be interpreted as unrestricted exchange of all information.

The operational requirement is more precise. Where a legitimate care pathway crosses sectors, essential information should not disappear at the boundary.

Hospital discharge is an obvious example. A person may leave hospital with changed mobility, medication, continence or cognitive support needs. Their existing long-term care arrangement may no longer be sufficient. If discharge information does not reach the people responsible for everyday support, the existence of sophisticated systems on both sides provides little practical protection.

This links digitalisation directly to hospital and home-care interfaces. The digital objective should be continuity rather than data accumulation.

The same principle applies to primary and community healthcare. Long-term care workers should not be expected to interpret clinical information outside their competence, but relevant changes in health may affect the care they provide. Healthcare professionals likewise benefit from knowing enough about functional support and living circumstances to make realistic decisions.

Digital architecture can make these interfaces easier, but governance still has to define what should be shared and who remains responsible for acting on it.

Interoperability needs common meaning, not merely technical connection

Two information systems can exchange data successfully while their users interpret the information differently.

This is why interoperability has both a technical and semantic dimension.

If one system records a service interruption as a missed visit, another as non-delivery and another as a user absence, national analysis cannot simply combine the fields and assume they mean the same thing. If functional status is described differently across healthcare, social welfare and long-term care, technical exchange may still require professional interpretation.

A mature information architecture therefore needs common definitions for the data that genuinely needs to travel across organisational boundaries.

Useful design questions include:

• which information has an agreed national definition;
• which system is the authoritative source for each core data item;
• who may create, view and amend information;
• how corrections are propagated where information has already been shared;
• which events should generate a notification or workflow rather than simply update a record;
• how access and changes can be traced where accountability requires it.

DIGIDO’s emphasis on guidance for connecting provider systems to a more unified information environment is therefore significant. Slovenia does not need every provider to abandon every existing system simultaneously. It does need sufficient common architecture to prevent incompatible local systems from becoming a permanent barrier to national reform.

Organisations exploring similar architecture can use the Governance Maturity Assessment to examine whether accountability, escalation and assurance remain clear as information crosses organisational boundaries. Digital integration is sustainable only when responsibility travels with the data.

Digitalisation should reduce administrative burden rather than relocate it

Long-term care is labour-intensive. Every unnecessary administrative task competes with scarce professional and care-worker time.

Digital transformation can help by pre-populating information already held legitimately, automating routine validation, reducing duplicate reporting and making relevant records available without repeated requests.

It can also do the opposite.

Poorly designed systems may require workers to enter the same information into several applications, navigate multiple logins or complete fields that have little value to the person receiving support. Temporary workarounds can become permanent parallel processes. A new national reporting requirement can be added without removing the spreadsheet it was intended to replace.

This matters particularly while Slovenia’s long-term care system is stabilising. Policy, financing and operational arrangements have developed rapidly, and temporary implementation measures have been required to reduce administrative burdens and provide greater flexibility.

Digital workflows should therefore be reviewed from the perspective of the worker performing them, not only the institution receiving the resulting data.

The automation and workflow design principle is useful here: automate a coherent process rather than using technology to accelerate unnecessary steps.

Removing one duplicated form across thousands of assessments can release more capacity than introducing an advanced digital feature that only a small proportion of staff use.

A coordinator should see the person before the system

Consider a long-term care coordinator developing a personal plan with a woman who has significant physical disability. The digital record contains her eligibility category, assessed needs and administrative information. Several service options are available within her entitlement.

A poorly designed workflow could encourage the coordinator to proceed through mandatory screens until every required field is complete. The resulting record might be technically comprehensive while saying relatively little about what the woman wants to achieve.

A stronger system uses structure without allowing structure to dominate the conversation.

The woman explains that her priority is not simply assistance with personal care. She wants enough support in the morning to continue working from home and needs help that fits around her employment rather than determining it. That outcome should shape the personal plan.

Digital design can help by connecting assessed needs, agreed services, timing, preferences and review. It should also allow meaningful changes to be recorded without requiring the entire person to be reassessed every time an operational detail changes.

The scenario demonstrates why digital transformation must remain connected to outcomes-focused support. Structured data is valuable because it enables consistency and analysis, but narrative information remains important where it explains what matters to the individual.

The strongest records combine both: enough standardisation to support coordination and accountability, and enough personal meaning to guide real care.

Workforce digital capability is now part of implementation capacity

Slovenia’s digital long-term care strategy explicitly includes training because the success of a national information architecture depends on the people who use it.

Different roles require different digital capabilities. Entry-point staff need to use assessment and administrative systems accurately. Long-term care coordinators need to translate digital information into personal planning. Frontline workers need records that are practical during service delivery. Managers need to interpret operational and quality data. National analysts need to understand the limitations of the information they aggregate.

Training therefore cannot consist only of demonstrating where to click.

Workers need to understand why information is collected, how data quality affects other parts of the pathway, what information can be shared and how to identify digital errors. Managers need confidence to challenge systems that create excessive administrative work rather than assuming that a digital process is automatically efficient.

This makes digital skills and workforce adoption part of workforce strategy rather than a separate IT concern.

It also affects recruitment and retention. A cumbersome information environment can add cognitive and administrative load to already demanding care roles. Well-designed technology can reduce it. The workforce impact of digitalisation should therefore be measured, not assumed.

Cyber resilience becomes service resilience

The more essential digital systems become to long-term care, the greater the consequences when they are unavailable.

A cyber incident affecting a national administrative system may delay decisions. A provider-system outage may restrict access to care records or schedules. A connectivity failure may interrupt real-time communication. Where digital technology supports e-care or other safety-related functions, the consequences can become more immediate.

Long-term care organisations therefore need contingency arrangements that distinguish between functions that can safely wait and those that cannot.

Imagine a home-based long-term care provider experiencing a prolonged system outage. Workers cannot access normal electronic schedules or the latest care information through their usual devices. The provider still has people expecting essential assistance with eating, personal care and mobility.

A resilient service needs a controlled fallback rather than improvisation. Essential schedules and minimum information must be recoverable through an appropriate contingency route. Changes made during the outage need to be reconciled when systems return. Staff should know how urgent changes are communicated and which decisions require escalation.

After recovery, governance should examine more than the technical cause. Did anyone miss essential support? Were workers able to identify high-risk visits? Did outdated information circulate? How long did reconciliation take?

This is where cybersecurity and digital resilience become directly connected to continuity of care.

Digital transformation increases capability, but it also changes dependency. Resilience planning has to evolve with it.

National data can turn implementation into a learning system

One of the most significant elements of DIGIDO is the planned data and analytical capability for long-term care. This creates the possibility of moving beyond administration towards system intelligence.

As the reform matures, national information could help answer questions that individual provider records cannot.

Are particular eligibility categories growing faster than expected? Does access to home-based long-term care vary geographically? How quickly do people move from entitlement decisions into active support? Where do provider-capacity constraints appear? How often does significant change trigger reassessment? How does the balance between home, family-caregiver, cash and institutional rights develop over time?

Such information can support policy, workforce planning and financing. It can also reveal where formal national equality is not translating into equivalent practical access.

But national dashboards need context. A low utilisation rate may indicate insufficient supply, lower need, different user choices or incomplete data. A rise in reassessment may indicate deterioration, improved responsiveness or inconsistent initial assessment. Indicators should initiate inquiry rather than automatically determine judgement.

Organisations building similar oversight can use the Quality Dashboard Builder to structure relationships between activity, capacity, quality, experience and outcomes. The principle is particularly relevant to Slovenia: national visibility becomes more useful when indicators are interpreted together rather than as isolated performance numbers.

People need confidence about how their information is used

Long-term care data can be exceptionally sensitive. It may describe cognition, continence, mobility, family relationships, home circumstances and the intimate assistance a person needs every day.

Digital transformation therefore depends partly on trust.

People should be able to understand why relevant information is collected and how it supports their care. Digital integration should not become an assumption that every organisation involved in a broad pathway needs unrestricted access to every detail.

Information-sharing arrangements need proportionality. A frontline worker may need specific information to deliver safe support without needing access to the person’s complete administrative history. A national analyst may require aggregated or appropriately protected data rather than identifiable narrative records. A family member may contribute important information without automatically having unrestricted access to everything the person has disclosed.

These distinctions are part of safe information sharing and confidentiality.

Transparency also matters when information is used for purposes beyond direct service delivery. System planning, evaluation and quality improvement can produce significant public benefit, but governance should make the purpose and safeguards clear.

The strongest digital care systems do not ask people to choose between privacy and coordination. They design access, permissions and information flows so that necessary coordination can occur without treating sensitive data as organisational property.

Artificial intelligence may follow, but Slovenia first needs dependable foundations

Slovenia’s health strategy now explicitly recognises artificial intelligence as part of future digital development, and AI will inevitably become relevant to long-term care as analytical capability expands.

Possible future applications include identifying unusual service patterns, forecasting demand, supporting workforce planning or helping professionals locate relevant information more efficiently. More advanced systems could eventually contribute to predictive analysis of deterioration or service instability.

These possibilities should not be confused with established national long-term care practice.

The immediate priority is more fundamental: reliable records, common definitions, interoperability, secure access and sufficient workforce capability. Artificial intelligence trained on inconsistent or incomplete data can make existing information weaknesses harder to see rather than correcting them.

The AI and automation in care agenda therefore depends on data maturity.

There is also an accountability question. If an analytical model eventually flags a person as being at elevated risk, somebody still needs to understand what the signal means and decide whether action is appropriate. Algorithms can prioritise information; they do not remove professional responsibility.

Slovenia’s phased digital development creates an opportunity to establish those foundations before predictive technology becomes deeply embedded. The future value of AI will depend substantially on the quality of the information architecture being built now.

Digital transformation should make local variation more visible

National entitlement does not guarantee identical operational conditions across Slovenia.

Provider capacity, workforce availability, geography and existing service infrastructure differ. Municipal social welfare services also continue alongside the new national long-term care rights. People in different places may therefore experience different combinations of formal entitlement and practical availability.

Digital data can make these differences easier to identify.

Consider two areas with similar age profiles but markedly different uptake of long-term care at home. Without reliable data, discussion may rely on anecdote. With connected information, analysts can explore whether differences begin at application, assessment, user choice, provider availability or service commencement.

The response then becomes more precise. An information problem requires better communication. A provider-capacity problem may require workforce or market development. A delay in assessment requires a different intervention from a shortage of available home-based hours.

Digital visibility therefore has an equity dimension. It can help distinguish variation that reflects legitimate local circumstances from variation that suggests people with similar needs are experiencing materially different access.

That aligns digital transformation with the wider objective of reducing inequalities and strengthening prevention. Data is not the solution to geographic inequality, but it can make persistent patterns harder to overlook.

Accountability should follow the information journey

As Slovenia’s digital architecture becomes more connected, responsibility can become more complicated.

A provider may enter information. A national system may store it. Another institution may use it to make a decision. An analytical platform may aggregate it. If the original information is wrong, several downstream processes may be affected.

This creates a need for clear information ownership without confusing ownership with exclusivity.

Operational governance should establish where authoritative data originates, who can correct it, how errors are communicated and how recurring problems become visible beyond individual cases.

The same applies to digital incidents. A failed interface that delays one record may appear minor. Repeated failures affecting hundreds of transfers represent a system issue. Governance mechanisms need enough visibility to identify the difference.

This is why decision-making and escalation remain important even in highly automated environments. Automation should make routine processes easier while making exceptions more visible, not burying them inside technical logs.

Digital accountability ultimately requires both technical and service perspectives. Information specialists can explain why an interface failed. Care leaders need to explain what that failure meant for people.

Slovenia’s digital reform offers a wider international lesson

Many countries are attempting to connect health, social care and long-term support while working with information systems developed at different times for different purposes. Slovenia’s institutional arrangements are specific to its social insurance, social welfare and healthcare structures, so its emerging digital architecture cannot simply be copied.

The transferable lesson lies in recognising digitalisation as part of system design.

A new entitlement creates information requirements. A new assessment creates data. A new funding mechanism creates transactions. A new provider network creates reporting relationships. If digital architecture is considered only after these structures have been established, administrative fragmentation can become embedded before integration begins.

Slovenia is attempting to develop the operating system while the wider long-term care reform itself is still bedding in. That creates implementation complexity, but also an opportunity to redesign information flows around the new model rather than permanently reproducing historic arrangements.

The most useful international principle is therefore not technological. It is organisational: decide what information needs to achieve before deciding how much technology to deploy.

Conclusion

Digital transformation is becoming part of the infrastructure of Slovenian long-term care rather than a separate modernisation programme. Assessment at Centres for Social Work, personal planning, registered providers, compulsory long-term care insurance, service delivery and national oversight all depend increasingly on information moving accurately between people and institutions.

DIGIDO provides an important foundation by addressing provider-system fragmentation, supporting entry-point systems, developing common information architecture and building analytical capability. Yet technology alone will not create a coordinated system. Slovenia still needs reliable definitions, interoperable workflows, proportionate information sharing, digitally capable workers and clear responsibility when data is incomplete, delayed or wrong.

The strongest direction is to judge digitalisation by what it removes as well as what it creates: fewer repeated explanations for people, less duplicate entry for workers, faster recognition of changing need and better visibility of where national entitlements are not translating into practical access.

As the long-term care system matures, richer data may support forecasting, prevention and eventually more advanced analytical technologies. Those possibilities will be valuable only if the foundations remain trustworthy.

Slovenia’s central digital challenge is therefore not to make long-term care more technological. It is to make a complex national care system more connected, understandable and accountable while keeping the individual — rather than the information system — at the centre of every decision.