martes, 2 de diciembre de 2008

Healthcare: an image from Spain.

There are a lot of trends in Spanish Health IT market...

I would like this writing act as an introduction to Spanish IT healthcare sector, because in next posts I will talk about Spanish local facts, and I think it's important to know it before.

Model

First of all, is a public owned system, as a dominant way to give healthcare, with a mixed payer model in social and long-term care.

Despite of that, also exists a strong private caregiver sector, too.

Every autonomic region has its own public health service, and, in all (except Catalonia), they are owner of all public caregivers.

In Catalonia there is a mixed model between public and private caregivers with some degree of agreement in some health products, like diagnostic tests, or acute and long term care / social care.

There are centres with a 100% of activity under CatSalut agreements, and there are centre with a lower percentage of activity under the same agreement.

Recently, CatSalut started investments in infrastructure, that is, buildings, equipment, IT, and so on.

Before 2003, CatSalut acted only as a private payer.

The rest of Spanish autonomic governments held a strong control about Health IT, deciding in every thing what they buys, when and where they deploys, and who have access on it.

In Catalonia, last decision lays on hospital's owner.

Vendors

There are a lot of different vendors and products:

  • SAP i.s.h. / i.s.h.med (with partners like T-Systems, for instance)
  • Siemens (Selene)
  • HP-HIS
  • Stacks
  • Savac
  • iSoft
  • Picis
  • Costaisa
  • OrionHealth
  • Trakhealth
  • and others

No presence (or very few) from American health IT giants like Cerner or McKesson.

Cerner has an office in Barcelona (perhaps in Madrid, too), they haven't got yet a good reference here.

There is only one Spanish PHR, Keyose, but, as a model, government bet on Unique Electronic Record, to integrate EHRs in a unique tool, pursuing universal access across healthcare system.

Recently, Catalan Department of Health announces "Canal Salut", a public-powered PHR... So unfortunately, I haven't much more information about it.

Every autonomic region has started or will start their upper level EHR, so there is a project, lead by Spanish Ministry of Health to get a highest level EHR, sum of the autonomic EHRs.

There are some electronic prescribing projects and some (and interesting) telemedicine experiences.

It's possible that I forget things or vendors, but doesn't mean they haven't presence or relevance, I only write about I know.

Final words

This intends to be a high level view of Spanish caregivers and IT involved in it.

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