Spanish solutions for digital healthcare

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1 Spanish solutions for digital healthcare Information technology has revolutionized healthcare. Electronic access to prescriptions and medical records, along with the ability to send diagnostics imaging electronically, has made possible a more personalized and efficient healthcare system. In recent years, the Spanish Healthcare System has initiated major efforts to improve accessibility and the use of its services through information and communication technology (ICT). The Ministry of Health and Consumer Affairs online healthcare project, conducted in cooperation with the governments of Spain s autonomous regions, is serving to advance the application of information technologies and close the gap in the incorporation of ICT in healthcare among the regions. The implementation of healthcare information technology, however, is not limited to public and regional administrations. Major private healthcare organizations have also discovered the benefits of ICT in improving their management models. These projects have been undertaken in collaboration with some of the leading Spanish companies in healthcare technology, such as Iecisa, Telvent and Indra. Medical Records Spain leads among European countries in the digitization of its citizens medical records. According to the Ministry of Health s National Healthcare System Quality Agency, 97% of all Spanish doctors have access to digitized patient information. That percentage, according to the Minister of Health, is well above that of France and Germany.

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3 Spanish solutions for digital healthcare The most significant efforts in integrating information technologies into the Spanish healthcare system have been carried out by the country s autonomous regions. Andalusia, Extremadura, Castilla-La Mancha, Valencia, the Basque Country, the Balearic Islands, Navarra and Catalonia have fully implemented electronic medical records at local healthcare centers. The remaining autonomous regions are currently developing projects to implement integrated electronic medical records in their local healthcare systems. Andalusia, in the south of Spain, has the most extensive experience in computerizing the public healthcare system. In 1997, the Andalusian Healthcare Service (SAS in Spanish), in collaboration with Indra, designed and began implementing the Diraya system. This plan commenced with the creation of healthcare cards equipped with microchips that contain identifying information and was expanded to include centralized appointment planning, digital medical records, and, most recently, electronic prescriptions. Diraya, developed by Indra, consists of a set of modules that enables healthcare providers to manage the patient s clinical information. This information is organized hierarchically, with different configurations based on the type of user, enabling customization for professionals and patients. Our solution offers comprehensive coverage of all activities, says José Cubelos, Indra s public administrations and healthcare market manager. The digital medical record is part of a citizen healthcare information integration strategy, making it available anywhere, anytime to provide medical care.

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5 Spanish solutions for digital healthcare In addition to the SAS medical records project, Indra developed the Ianus system for the regional government of Galicia s Department of Health. Ianus is a computerized healthcare system that coordinates information for specialized and non-specialized care in hospitals, and health services offered at walk-in clinics. Explains Cubelos, Health information digitization and medical record computerization is required for integrating all information that documents the many points of contact between the citizen and the healthcare system. The computerization of the medical records provides greater security compared to the hardcopy version, as well as greater control over access to the clinical data entered. At the institutional level, Indra has also implemented healthcare projects in the Valencia region through Abucasis, a computerized medical record system that unifies all records throughout Valencia s healthcare centers, specialty centers and outpatient clinics. All together, Indra has digitized the medical records of nearly two-thirds of the Spanish population, says Cubelos. Another company with vast experience in healthcare information systems is Telvent. In the field of electronic medical records, we were one of the pioneer companies in Spain, says Jesús Saavedra, Telvent s global services R&D and innovation manager. He explains that this concept was first implemented in 1992, with electronic medical records for specialized care and intensive care units. By 1996, Telvent had completed the first comprehensive electronic medical record and healthcare management system, which has been since implemented in dozens of hospitals in Spain and Latin America. Continues Saavedra, The electronic medical record solution has gone through several technological versions, and it has been perfected and improved in contact with doctors and nurses, bringing it to the current web-based

6 version known as the TiCares suite. Iecisa, the information and communication technology company in the El Corte Inglés Group, has also developed a number of integrated medical record solutions in recent years for public healthcare administrations and private companies. Iecisa has carried out projects at hospitals in Catalonia and at healthcare services in Asturias, Extremadura, Madrid, the Canary Islands and the Balearic Islands. According to Miguel Ángel Montero, Iecisa s healthcare and social services strategy manager, the most recent project was developed for the Badalona Healthcare Services, an organization that includes an acute care hospital, a primary care area, and social healthcare centers.

7 Spanish solutions for digital healthcare Digital Imagery Digital medical imagery has become an important complement to patients medical records. Doctors can view x-rays, ultrasound scans and other diagnostic tests immediately with just a click of the mouse, which offers organizational, economic, and environmental savings. In 2003, the Castilla-La Mancha Healthcare Service, in the central region of Spain, tasked Indra with the Ikonos project for a digital imagery diagnostics system. It was a pioneer experiment in Europe to advance electronic medical records, and it was to include the installation of the equipment to digitize, store, and view the image, as well as services such as monitoring, project maintenance and user training. The digital medical imagery system developed by Indra is currently operational at all hospitals in Castilla-La Mancha. The x-rays, ultrasound scans and other diagnostic tests are no longer provided to the patient in hardcopy format; they are now sent along with the corresponding report to an internal network in digital format, accessible from any other center in the region. The collaboration between the government of Castilla-La Mancha and Indra has resulted in the creation of the Center of Excellence in Digital Medical Imagery in Toledo, just a short distance from Madrid. The aim of this center is to become a research and development space for technology and management in healthcare. This will include new programs and innovation projects related to future digital medical imagery for use in healthcare centers. The new facilities, opened in September 2009, contain cutting-edge technology for the healthcare sector: computerized radiology, digitizers, diagnostics, and operating room stations.

8 The entire Ykonos program can be monitored from the Toledo-based Center of Excellence, connected to the Castilla-La Mancha Healthcare Service network.

9 Spanish solutions for digital healthcare But Indra is not the only company making a name for itself in digital medical imagery. Telvent is developing the digital medical imagery storage and processing system for all healthcare centers in the autonomous region of Andalusia. According to Saavedra, the project has already been partially executed and is beginning to bear fruit. He believes that the benefit of this system applied to public healthcare is clear, as, once completed, the corporate electronic medical record system can be used to access and consult patients radiological studies from anywhere in Andalusia, regardless of where they were conducted. The development of digital medical imagery is also making it possible for remote medicine to become a reality. Both telemedicine and remote healthcare are becoming increasingly important, particularly in rural areas, where the evolution of communications and the development of digital imagery have been crucial, says Montero. Iecisa is currently involved in a tele-dermatology project for the autonomous region of Castilla-Leon. Says Montero, The idea is to establish a consultation from the rural primary healthcare center, where the doctor and the patient are located, in videoconference with the dermatologist at the reference hospital, who will have received the images. These types of projects are generally based on providing infrastructure such as communications and video-conferencing technologies and on the development of software suited to the customer s requirements. An end to paper prescription Just as patients medical records have been turned into computer files, prescriptions are also becoming transformed into processing orders stored in a data repository. This represents a major advancement for both doctors and patients.

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11 Spanish solutions for digital healthcare The elimination of paper slips leads to convenience and efficiency: the doctor prescribes the medicine by computer and gives the patient instructions on taking the drug. The patient can pick up the drug at a pharmacy with the healthcare card or ID card. Telvent s Saavedra believes that the electronic prescriptions provide a triple advantage: For the administration, this means taking better advantage of resources and reducing time in the doctors offices and cost of the medicine. For the professionals, it means better control over the entire prescription-dispensing cycle and the ability to dedicate time to tasks with a greater added value for care. And for the patient, this represents an improvement in the perception of service quality, since it means that they no longer have to make an appointment just to have their regular medication prescribed. Spanish companies specializing in ICT for the healthcare sector have been pioneers in Europe in the implementation of electronic prescription systems. Today, the solutions designed by Spanish companies are operating around the country. Indra has concluded developments in Andalusia and maintains projects in Aragon, Madrid and Valencia. The company is also undertaking a pilot project in Cantabria, in the north of Spain. Telvent participated in the initial stages of implementing this model in Catalonia, developing a proprietary system. And the temporary business venture created by Iecisa and Isoft is conducting a pilot project in Navarra, in the northeast of Spain.

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13 Spanish solutions for digital healthcare International Presence The leading Spanish healthcare ICT companies work not only at the national level. Their experience creating solutions for the Spanish healthcare system has enabled these companies to expand into international markets as well. In Portugal, Indra has developed a digital healthcare information system for the Azores region, which manages healthcare and human, material and financial resources in the regional healthcare system. In Tunisia, Indra reviewed the country s public healthcare model and created a new strategic model for its medical and management information systems. The company also has projects at hospitals in Morocco and Mexico. Telvent is currently implementing the TiCares system in the Dominican Republic, which will make it possible to take the electronic medical record model to all citizens in the country, says Saavedra. Additionally, the company is involved in the initial stages of the electronic clinical file project for the University Hospital of Santiago de Chile and its related centers. This will allow the digital management of patients files throughout the Chilean healthcare network. Montero at Iecisa says the company is not currently involved in any projects abroad, but is in the definition phase for an electronic medical record project in Peru.

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