'Discovering new ways to improve value is the biggest influence on integrated IT strategies today'


(HealthTech Wire / Interview) – Understanding a hospital’s concept for innovation and translating it into the right solution is crucial for IT success. With this issue driving the agenda at the Carestream Advisory Board in June, we asked one leading IT strategist, Juan Lucas Retamar Gentil, Deputy Director of Information Technology and Communications at the Andalucia Ministry of Health, how necessity is driving the delivery of innovative solutions across his domain.

Can you give us an example of the challenges you face in enabling more value focused patient care?

I work in a large geographical area – almost eight million people. Every year we spend more money on chronic diseases and we have identified that there are now over 300,000 people with chronic conditions in the region. The cost of treating them in the hospitals grows higher each year. So we started with a set of initiatives to give primary care doctors a good set of targets. The next step is to monitor the patient at home – balancing targets with risks. Of course they will always need to come to the hospital in certain cases, but we need to develop the outside monitoring for the situation to be sustainable. Mobility is essential – we have a big team of nurses who work at home with the patients.

What kinds of integrated IT projects are emerging to enable this wider trend?

Some very different initiatives! For example, we are studying the possibility of collaborating with approximately 4,000 pharmacists in Andalucia ahead of a project, which will allow patients to be monitored – not diagnosed – at those pharmacy offices. All their clinical history will be integrated. We have 42 hospitals, all with the same HISS, and this will be a way to bring all the different points such as blood pressure and glucose to the same place. The key for us is to avoid the patient going to emergency or primary care when there is no need.’ 

How do these projects, which depend on shared data and collaboration, impact on your IT strategy?

In the last 15 years – the time I’ve worked in healthcare IT – I’ve seen a real change. It’s difficult if you’re of a certain age, but young people coming into the system have a different way of thinking. They are completely digital. And we are in the middle. We are building tools that one set of our ‘customers’ don’t feel comfortable using, while we have another set who are asking us for many things and we aren’t able to provide them!

How does this affect your vision of collaborative technologies such as enterprise imaging?

The big change for us is that patients belong to the system, not the doctors. Information is shared between our 42 hospitals, regardless. It does raise issues of ownership – for example, if a doctor has compiled a lot of data to make a study, they don’t want it to be available for someone else to take the profit. But the fact is, our patients can go to whichever hospital they want, so communication has to be open. In the beginning, we had a lot of resistance but now everybody is used to this model and it works.

What role can enterprise imaging play in your strategy for collaboration between the hospitals in your region?

Currently, radiology and nuclear medicine information is shared between all centres – hospitals and primary care centres – in the region of Andalusia. This has motivated enormous improvements in the collaborative work between professionals as well as in the organisation of the service, providing better patient care - which is our main objective. To extend this concept to the other medical imaging specialties will be one of the main axes of transformation in the next two years, allowing us to improve the attention between levels of care and addressing any specialist structural deficiencies in certain regions.

What are the most significant challenges this will bring in terms of agreeing on data ownership and how it is managed?

In the Andalusian Health Service, for many years the concept of property transcends the centre. In the first instance, the citizen is the owner of data, which is at the service of the entire organisation. The sharing across the organisation of information generated in one centre is something that the vast majority of professionals assume and welcome, on the basis that patients habitually move between centres and have a single history – or set of information – wherever they go.



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