Croatia Health IT Shifts From Building to Running

Croatia has moved past the stage of building digital health systems and into the harder test of running them at scale, Black Book Research reported in its “State of Digital Healthcare IT Croatia 2026”. The vendor research firm said the national backbone, the CEZIH system, now carries more than 15 million electronic referrals a year and more than 61 million prescriptions through its ePrescription workflow. It processes upwards of 300,000 structured primary-care reports a day and runs more than 1.5 million insurance checks daily. “Croatia is no longer proving the case for digital health,” said Doug Brown, the firm’s founder.

From building to running

Brown framed the change as a move past the build-out. The market, he said, is “shifting from digitization to execution”, and the firms that win in Croatia will be the ones that cut friction and improve patient flow rather than the ones that simply connect. Black Book Research reported that the mere presence of digital tools no longer sets providers apart. What separates them now is how well they turn that plumbing into faster workflows, better joined-up care and cleaner links between diagnostics, scheduling and records.

The citizen-facing portal shows the same maturity. Portal zdravlja has passed 800,000 registered users with more than 20,000 active each day, Black Book Research reported, a level of use that marks digital health as a mainstream service rather than a pilot. For a country courting international patients, that depth of adoption is the part that is hard to fake, because it reflects habit rather than launch-day numbers.

The load the system carries

The volumes behind the software are large. In 2024 Croatia ran 21,795 inpatient beds, recorded 631,249 hospital admissions and handled 1,345,014 day-hospital and one-day-surgery visits, Black Book Research reported. Internal medicine alone accounted for 619,932 of those day cases, and specialist outpatient care logged 10,285,914 examinations. At that scale the performance of referrals, scheduling and record continuity stops being a convenience and becomes the thing that decides whether the system holds.

From 2026 the CEZIH data-exchange rules extend to private providers working outside HZZO contracts, including privately paid services from clinics already connected. Black Book Research said the change widens the digital setup beyond its public-sector base and raises the bar for health-IT vendors. For medical travel that matters, because international patients often route through private clinics, and a shared record between public and private care is what lets a foreign case be followed rather than lost.

Money, adoption and the gaps that remain

Croatia’s Digital Decade roadmap sets out 31 measures backed by EUR 634.73 million, Black Book Research reported, holding digital transformation as a national priority for the rest of the decade. Public sentiment tracks the spend, with 81 per cent of Croatians saying that going digital in public and private services makes their lives easier. That acceptance gives new services a running start many health systems lack.

The gaps sit in the data the system already holds. In 2024, 396,005 people were registered with diabetes, though true prevalence among adults was estimated above 500,000, Black Book Research reported. Of 52,769 adult submissions, only 35.56 per cent of recorded diabetes patients showed good glycaemic control. The firm read those figures as the clearest opening for analytics and structured follow-up, the parts of digital health that turn a record into managed care.

AI and the vendor field

Telemedicine now reaches most of Croatia’s health institutions, in fields from radiology and cardiology to psychiatry and dialysis, Black Book Research reported. Artificial intelligence is moving from talk to deployment in imaging, diagnostics, structured reporting and scheduling. The marker the firm pointed to is ZdrAVKO, a round-the-clock AI health assistant launched in 2026 and reached through WhatsApp, a sign that the public sector will put bounded AI tools in front of patients. That willingness, and its limits, is the live question running through the wider debate over AI in healthcare.

The vendor field is crowded and, the firm stressed, not winner-take-all. Black Book Research named Ericsson Nikola Tesla, IN2 Group, Philips, Siemens Healthineers, MCS Group, Veridian Healthstream and Oracle Health as the players that matter, with relevance set by how well a product fits, how well it links to other systems, and how far it lines up with CEZIH and HZZO rules. By 2030 it expects the market to turn on four questions: clinical and operational effectiveness, data quality, resilience and governance, and strategic alignment.

What to watch

The claims here come from a single vendor research report, so the figures are best read as Black Book Research’s own count rather than an audited national return. The test is whether the execution it describes reaches the patient. Croatia’s pitch as a medical-travel destination, alongside work such as the ZagrebMed clinic’s push with foreign patients, rests on whether a case opened in a private clinic can be followed through CEZIH from referral to follow-up. The dated items to watch are the 2026 private-provider integration and whether the 35.56 per cent glycaemic-control figure moves once the analytics arrive.