1. Workshop 07A18
Healthcare innovation: The key to
sustainability of regional healthcare systems
José L. Rocha
General Secretary for Quality and Modernization
Regional Health Ministry of Andalusia
Spain
Quick facts of Andalusia
Regional responsibility for health policy and healthcare provision since 1984
8,202,220 Inhabitants
1,500 Primary Care Centers
44 Public Hospitals (16,281 beds)
9,782 M € Healthcare Budget 2009

2. Workshop 07A18
Healthcare innovation: The key to
sustainability of regional healthcare systems
Chronic diseases Ageing population
Spain (National Health Survey):
- 18 million people report a Chronic disease
UK (data from Department of Health):
- 60% of adults report a Chronic health problem
- 80% of GP Consultations
- 60% of Hospital bed days

3. Workshop 07A18
Healthcare innovation: The key to
sustainability of regional healthcare systems
Health and social care costs
100%
Healthy, Community
independent living Clinic Traditional
Health IT
Chronic Disease Doctor's
Management Office focus
Assisted Living
Quality
of life Skilled Nursing Specialist
Facility Clinic
Community
Hospital
ICU
Graphic from NHS/BT Global Services
0%
HOME CARE RESIDENTIAL CARE CLINICAL CARE
€1 €10 € 100 € 1,000 € 10,000

4. Workshop 07A18
Healthcare innovation: The key to
sustainability of regional healthcare systems
Appointment-making procedure
Citizen identification Daily appointments:
near 100,000
Data
Check
Appointment
Diary

5. Workshop 07A18
Healthcare innovation: The key to
sustainability of regional healthcare systems
Transparency .
Tobeinformed is health HealthResponds
Education Web Telephone enquiries
Information TV/DTV Second medical opinion
entertainment Mobile Living wills
Health card
Waiting lists
Telephone appointment
Healthcare information
Health advice
Information on Quality in
Discharge telephone survey
Health Centers
AIDS, Tobacco, bird flu...
Expectations bank
SMS services
Healthcare Information
Health Advices
Collection of Expectations
to promote participation
e-Administration
Living wills
Smart card
24
health andalusia
hr
Individual assessment and
and information information on Health

6. Workshop 07A18
Healthcare innovation: The key to
sustainability of regional healthcare systems
All the healthcare information on each citizen: Integrated
Currently 7.1 M people with single eHR Available at any time or any place
Primary Care: Specialised Care:
> 72 M consultations > 95 M consultations
using eHR booked by diraya
eHR
3,500 Pharmacies on-line:
> 150 M of e-prescriptions
Continuity of care
Health Care Information and
Management Integrated System

7. Workshop 07A18
Healthcare innovation: The key to
sustainability of regional healthcare systems
GP consultations before and after
electronic prescription
70
62,763
60
48,753
50
40
30
-22.32%
20
(global 15%)
10
0
SEP-05 SEP-06

8. Workshop 07A18
Healthcare innovation: The key to
sustainability of regional healthcare systems
Benefits to Citizens
Patient safety – sharing of clinical data reduces risk of adverse
events, makes healthcare more effective and more timely
Efficiency gains – time savings and avoided travel costs
Fewer re-assessment procedures for patients frequently changing
their GPs
Fewer repeat questions
Facilitated (referral) bookings (satisfaction surveys)
Avoided visits by chronic patients with long-term ePrescriptions
(validity: up to one year)
Benefits to Doctors & nurses
Comfort for GPs
Benefit from pride, professionalism and satisfaction
Decisions are based on comprehensive & reliable information
Provision of more efficient healthcare

9. Workshop 07A18
Healthcare innovation: The key to
sustainability of regional healthcare systems
Benefits to the Andalusian health service
Reduction in exposure to risk due to better clinical governance
Assurance that medical information is recorded correctly and fully
Assurance that advice is based on better information
Time savings – redeployment of resources:
Fewer repeat questioning about medication and medical history
Avoided visits for re-assessment and for renewal of
prescriptions (reduced by ca. 15%)
Better allocation of resources through eBooking
Cost savings from generic prescribing
Cost avoidance through central server
Benefits to the regional MoH
Information from research feeds into evidence-based standards
Dissemination of guidelines through Decision Support (DS) tools
Support & integration of strategic initiatives (improved care
processes)

10. Workshop 07A18
Healthcare innovation: The key to
sustainability of regional healthcare systems
Diraya: Cumulative economic performance
900.000.000
800.000.000
700.000.000
600.000.000
500.000.000
EUR
400.000.000
300.000.000
200.000.000
100.000.000
0
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Present value of cumulative costs Present value of cumulative benefits