Spanish SAP and i.s.h.med experience

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1 IBM Spanish SAP and i.s.h.med experience Matěj Adam IBM Healthcare EMEA 1

2 The general elements of the Spanish Healthcare System Decentralization in 17 Regions Distribution of the management responsibility and the service performance 3 key roles Regulating body Buyer of services Healthcare provider Seller of services Who is responsible (it can vary depending on the region) Ministry of Health Healthcare Councils (regional) Healthcare Councils (regional) Healthcare Services (regional) Healthcare Services (regional) Other public providers Private providers In all Spanish regions the Healthcare Services represent the predominant entity (in some cases even monopolistic) for the Sanitary Service. 2

Ministry of Health Healthcare Councils (regional) Healthcare Councils (regional) Healthcare Services (regional) Healthcare Services (regional) Other public

3 IBM Extremadura: Information Services Transformation 3

4 Servicio Extremeño de Salud SES is the institution responsible of the care activities offering in the Extremadura autonomous region. Population: citizens 8 Healthcare areas 104 Primary Care units 300+ additional centers 14 Hospitals employees Global budget: million Euros (approx.) 4

000 citizens 8 Healthcare areas 104 Primary Care units 300+ additional

5 SES Extremadura (Spain ) Scope: All key business processes: back-office (Finance and Accounting, Logistics, Human Resources) and clinical. Financial Recursos and Accounting Inf. Systems Presupuestaci Budgeting ó n Contab. PS Accounting Presup. Contabilidad Financial Econ. Accounting Patrimonial Controlling Control de Costes Accounts Payable Tesorer ía Emergency Urgencias Sistema Executive Tratamiento Information de la System Informaci 1. System for the patients management Sistema Sistema Clinical de de Información Información Information Asistencial System Asistencial Patient Flujologistics de Usuarios - ADT 2. Unique healthcare record by patient 3. Systems integration Otras Other prestaciones functionality Incap Sick Leave. Temp. Gesti Records ó n Archivo Archive HC Waiting Lista de Lists espera Consultas Outpatients Externas Peticiones Requests Gesti ó Agendas n de Agendas Patient GestiIdentification ó n Usuarios and Mgt. ó n Admisiones Admission 4. Economic and financial management system Selection Facturaci Billing ó n Historia Cl íehr nica Electr ó nica and Hiring 5. Purchases and procurement management Gesti Clinical ó n de Documentation Informes Cl í nicos Registro/Gesti Personnel ó n Expedientes Records Administration de Personal Contrataci Mgt. (RM) ó nsystem Cuidados Care de Plans Enfermer ía Desarrollo y For - Purchasing Compras Subsistemas Clinical Departa Training Programas Health Programs de Salud Vaccines Vacunas Pharmacy/ Farmacia/ Unidosis maci ó n Personal mentales Subsystems Cl í nicos 6. Human Resources system Inventory Almacenes Mgmt. Logistics Inf. System Prescription Prescripci Otros Other subsistemas Subsystems Clinical Processes Quir Surgery ó fanos 7. Information Treatment system Subsistemas Diagnostical Departa mentales Subsystems Diagn stico Gestión Human Recursos Resources Humanos Organizational Estructura OrgStructure á nica/rpt Gesti Time ó n de Management Tiempos Trade Relaciones unions Laborales Autoservicio Employee Self-service Empleado Prev Health and Safety NPayroll ó mina 5

Accounting Patrimonial Controlling Control de Costes Accounts Payable Tesorer ía Emergency Urgencias Sistema Executive Tratamiento Information de la System Informaci 1.

6 Integration between Care Levels Social-Sanitary Care Social-Sanitary Hospital, Old people s Homes, Home Care, Chronic Patients... Primary Care Acute Care Unique and integrated Health Records Shared resources and information User as unique client Emergency Ambulance Services 6

.. Primary Care Acute Care Unique and integrated Health Records

7 IBM ARGOS: Institut Català de la Salut Modernization Project 7

8 Catalonia Healthcare Catalonia statistics: Population: inhabitants Surface: km 2 Population density (pop/km 2 ): 190 Other CatSalut providers Hiring 8

9 Institut Català de la Salut (ICS) is the biggest public provider of Health Services in Catalonia More than professionals 50 millions of care interventions per year 8 Hospitals 460 Service Units of Primary Care Budget of million ICS represents the 80% of Primary Care and the 32% of Acute Care in Catalonia Purchase is about 700 million 9

000 professionals 50 millions of care interventions per year 8 Hospitals 460 Service

10 Modernize: what for? To improve the care quality Advanced technological equipments Care coordination Electronic Medical Records To achieve a greater efficiency Costs reduction Resources reassignment Shared services Purchases center For the public management to have the same level as private management For the citizen to get the best attention possible 10

Electronic Medical Records To achieve a greater efficiency Costs reduction Resources

11 Some Lessons learnt in Change Management A project success does not only mean that the system works, but also that the organization assimilates new ways of working (and this is not always easy for public organizations). For this kind of projects, the change management has to become a primary task. Some Lessons learnt in the system development No matter the time or the resources devoted to a development, incidences will always be generated. The number of incidences increases proportionally to the number of code lines. A good incidences management is fundamental for this type long-term projects with several roll-outs. The consultants adaptation processes to the healthcare modules is slower and more complicated than for the rest of modules. For instance, in six months a MM consultant with several years of experience can be replaced. But the same cannot be done with a consultant with two years od experience in IS-H. 11

Some Lessons learnt in the system development No matter the time or the resources devoted to a development, incidences will always be generated.

12 IBM Thank you! 12

EMR AND BIG DATA. September 2014 EMR

EMR AND BIG DATA. September 2014 EMR EMR AND BIG DATA EMR AND BIG DATA September 2014 EMR 1. Spain: Healthcare model The Spanish Health System is characterized by the fragmentation of both the public (17 autonomous communities) and the private