@SinisaVarga Health Information and eHealth Landscapes: Bridging the Gap Sinisa Varga, Vice-President Health and Social Policy Committee, Croatian Parliament Better public health through strategic purchasing as a catalyst for eHealth design and development
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Health Information and eHealth Landscapes: Bridging the Gap … · @SinisaVarga Health Information and eHealth Landscapes: Bridging the Gap Sinisa Varga, Vice-President Health and
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@SinisaVarga
Health Information and eHealth Landscapes: Bridging the Gap
Sinisa Varga, Vice-President Health and Social Policy Committee, Croatian Parliament
Better public health through strategic purchasing as a catalyst for eHealth design and development
@SinisaVarga Implementation of Croatia's e-health plan 2002-2013
• ePrescriptions – fully implemented and operative since beginning of 2011
• eReferrals – biochemistry labs, specialists from 2011 onwards
• eWaiting Lists and eScheduling – fully implemented and operative since beginning of 2013; eHealth Records – ready for piloting in mid-2014
• By the end of 2017, all patient-related communication will be paperless available to all stakeholders within the health system (eScheduling, eReferrals, eFindings, eDischargeLetters) and result in improved efficiency and increased savings
• The introduction of “A5 referral pads” for consultations without patient presence should result in less primary care referrals to specialists and hospitals
• All hospital financial applications will be interconnected for permanent access in real time to financial, procurement, and payroll data
Key objective: Paperless care and cross-linking of stakeholders
The 2010 World Health Report on financing for universal coverage noted that: “Raising sufficient money for health is imperative, but just having the money will not ensure universal coverage. Nor will removing financial barriers to access through prepayment and pooling. The final requirement is to ensure resources are used efficiently.”
@SinisaVarga Strategic purchasing requires the purchaser to engage actively in 3 main relationships between stakeholders
“Passive purchasing implies following a predetermined budget or simply paying bills when presented. Strategic purchasing involves a continuous search for the best ways to maximize health system performance by deciding which interventions should be purchased, how, and from whom.”
• Payors through pooling of funds become bulk purchasers of goods (medicines, orthopedic and other appliances, sometimes capital equipment, etc) and services (medical and other out) in multi-million/billion dollar amounts
• Investments in software and other eHealth tools that increase efficiency and efficacy of the purchased goods and services have an extremely short return on investment (ROI).
• National screening programs (early detection of breast, cervical and colon cancer) have dedicated SW for recruiting patients, data collection and data analysis
• Data from primary care is automatically collected and transferred to the Croatian Public Health Institute
• Data from hospitals and other providers collected through billing by the Croatian Health Insurance Fund is transferred to the Croatian Public Health Institute
@SinisaVarga BD4BO - Data is gold of the 21st century: Systematic approach to healthcare outcomes us necessary in order to increase health services efficiency, efficacy and sustainability.
Better outcome
Less variation
Lower overhead costs
Healthcare system
improvement (outcomes/choices/rewards)
... result in system sustainability
Clinical records / registries Cl. studies /HTA/RWE/ comorbidity IT/software/telephon …
From services towards outcomes Big data for better outcomes / more possibilities! Creating value in every faze of the process
Big Data – possibilities of healthcare improvement...
Information
feedback
and
earning
Transparent treatment outcomes data
(big and deep data sources) Variation
analysis
Identification
"best practices"
Behaviour
change Better
outcomes
identifify, gather, connect and analyze
Value = outcome/cost
Better outcome
Less variation
Lower overhead costs
Healthcare system
improvement (outcomes/choices/rewards)
... result in system sustainability
Clinical records / registries Cl. studies /HTA/RWE/ comorbidity IT/software/telephone …
From services towards outcomes Big data for better outcomes / more possibilities! Creating value in every faze of the process
Health data is a key enabler of health system efficiency
• Transparent outcomes data increases provider competition on meaningful metrics, generating incentives for high quality care
• This is likely to lead to increasing specialisation, given the positive impact of caseload on provider performance
• Tracking patients over time reveals how follow-on complications can be avoided
• Patients at risk can be identified and intervention organised, reducing costly complications
• Root-cause analysis of outcomes variation can identify ineffective practices • Stopping ineffective practices eliminates spending that is not delivering
WHY: We believe that every citizen of the world has an equal opportunity for achieving health, happiness and well-being
HOW: By protecting the health of individuals, families, communities and the nation as a whole, in order to better the productivity of the workforce which results in a higher GDP, thus increasing living standards (better roads, houses, schools, hospitals, police, government, etc)
WHAT: To improve the health system by bettering the system of data collection, to use and analyze this data for public health interventions, better efficacy and efficiency of providers and financial sustainability of payors without reducing access to healthcare.