Ombudsman Velislava Delcheva has asked health minister Katya Ivkova to say how far the merging of a child's electronic health records has got after a full adoption, her office said. The records cover medical care and vaccinations in the National Health Information System (NHIS).

The case began with a complaint from a woman in Sofia. She could not get full information on the vaccinations of her adopted child, who had to start nursery on 1 October. The nursery needs complete and accessible vaccine data, including from before the adoption. The ombudsman sent her recommendation on 2 October.

The complaint calls for a clear procedure to merge health data from before and after the adoption into one electronic file. It should not create needless red tape for adoptive parents or block children's access to services.

The Ministry of Health has already acted on the case. The mother was told that an inter-agency working group has been set up. It will look at the legal and practical options for merging the child's records from before and after the adoption. The group must draw up a procedure for a single electronic health file after full adoption and prepare changes to Ordinance No. N-6 of 2022 on the NHIS.

Delcheva asks whether the group has finished its work, whether the changes to the ordinance are ready, and when the system will start to work in practice. She also wants to know when and where the final rules, written guidance and application forms will be published. She further asks what instructions the regional health inspectorates will get, how soon they will be in place, and what will happen if problems arise in the user interface of the electronic health file.

The ombudsman also expects clear guidance on what parents and adoptive parents must do to have all of the child's health data entered in the NHIS.

A week ago, Delcheva recommended to Ivkova and to the head of the National Health Insurance Fund, Assoc. Prof. Dr Vladimir Daskalov, that children's vaccinations be entered automatically in their electronic health files. She asked them to look closely at the problem and to consider having the health fund enter missing NHIS data itself, or at parents' request. The aim is to end cases where children and parents have to prove facts that the system already holds.

The ombudsman's office says both cases raise the question of how reliable and complete the electronic health files are, and whether the institutions share information well. Adoption adds one more requirement: the records must be merged correctly, in line with the rules and with protection of personal data. In the ombudsman's view, technical and administrative problems should not stop children and families from using health and education services.