Healthcare Online Programme

Web address of the case:

http://www.red.es

Country of the case:

Spain

Posting Date:

13 May 2009

Last Edited Date:

01 June 2009

Author:

Ines Hernando (red.es )

ehealth | spain | eHealth strategy

Type of initiative

Strategic initiative

Case Abstract

Healthcare Online, developed jointly by the central government and the regional Health Deparments, seeks to promote the adoption of ICT in the healthcare public sector and enable the exchange of healthcare information within the Spanish National Health System.

As a result of these two years of close collaboration, the Spanish Health System has made significant advances in the identification of patients, developing a national electronic directory, and has upgraded the infrastructure deployed in the healthcare centres and health data processing centres. At the same time, the regional healthcare authorities have intensified their efforts towards implementing electronic healthcare records e-precription services.

During this time, the Ministry of Health and Social Policy and the regional Health authorities have made a joint effort regarding the sets of clinical data to be shared through the National Health System central node and the data model that will enable the exchange of information.

Description of the case

Domain

eHealth

Topic

Sector

Healthcare

Start date - End date

May 2006 (Ongoing)

Target Users

Add Patients | Health authorities | Health professionals

Target Users Description

The Programme is being implemented throughout the Spanish National Health System. Activities are being carried out in public healthcare premises (primary out-patient healthcare centres and hospitals) as well as in the the National Health System Central central node infrastructure.

According to the data of the "ICT in the National Health System: The Online Healthcare Programme" report published on 2008, more than 278,000 healthcare professionals and 60,000 administrative staff work in the National Health System that provides health services to 45 million citizens through its 3.525 out-patient healthcare centres and 449 public hospitals and specialized care centres.

Scope

National | Regional (sub-national)

Status

Implementation

Language(s)

Spanish

Policy Context and Legal Framework

The Healthcare Online Programme is part of the Avanza Plan which is being implemented by the Spanish government since 2005 with an overall budget until 2010 of â‚¬5.700 million.

The Avanza Plan aims at accelerating Spain's integration in the Information Society and it's objectives are to increase productivity, strenthen the industrial ICT sector, encourage R&D and develop modern interoperable services, based on the uise of ICT. This Plan is based on the European i2010 strategy and was launched to achieve at national level the objectives set out by the European initiative.

The overall management of the Avanza Plan funds falls under the responsability of the Ministry of Industry, Tourism &Trade. Its implementation in the healthcare sector has been materialised through a Collaboration Framework Agreement between the Minsity of Health and Social Policy and the Mnistry of Industry, Tourism & Trade. Under the umbrella of this Framework Agreement, each autonomous region has signed bilateral agreements with the Ministry of Industry, Tourism & Trade.

Project Size and Implementation

Type of initiative

IT infrastructures and products

Overall Implementation approach

Public administration

Technology choice

Not applicable/not available

Funding source

Public funding EU | Public funding national | Public funding regional

Project size

Implementation: Larger than €10,000,000

Implementation and Management Approach

The implementation of the different actions comprised in this initiative is managed by Red.es (attached to the Ministry of Industry, Tourism and Trade), the regional Health Departments and the Ministry of Health and Social Policy.

The coordination of the activities developed in each region is carried out by a joint committee composed by both ministries and the regional Department of Health.

The Ministry of Industry, Tourism and Trade manages the following projects:

Deployment of infastructure and ICT equipment in healthcare centres
Upgrade of health data processing centers
Enlargement of the infrastructure installed in the National Health System's Central Node and certification under the ISO 270001:2005 standard
e-prescription and e-dispensing in 2 autonomous regions.

The regional Health Department's efforts are focused in four major lines of action:

Develop a reliable system for patient identification
Electronic health records
e-prescription and electronic dispensing
Online services such as online appointments with GPs.

The Ministry of Health and Social Policy has developed a unified database of personal health cards for all the country and is coordinating the implementation of a pilot project that will enable the exchange of clinical data between regions through the National Health System central node infrastucture. The Central Node is not a centralized EHR system and will not store data but rather facilitate access to datasets stored in each of the regional health nodes.

Impact, innovation and results

Impact

With a view to improve the provision of healthcare services, more than 60,000 PCs have been delivered and installed in over 5,600 health care centres. Around 232,000 healthcare professionals work in these centres where 28,3 million citizens receive medical attention.

The Healthcare Online Programme has also contributed to boost the implementation of the e-prescription and e-dispensing services. In 2006 only the Andalusian out-patients centres and pharmacies had this service up and running. Today the Balearic Islands regional Health Service is also offering these services in its territory and all the other regions have taken the necessary steps to implement the service in the medium term.

Another major achievement has been the enlargement and reinforcement of the National Health System central node infrastructure, which has now the appropriate security requirements to enable the exchange of clincal data between regional Health authorities.

Furthermore, the Programme has validated a new management model in the National Health System in which the Ministry of Industry, Tourism & Commerce through its public entity Red.es, plays the role of technological partner of the regional Departments of Health and the Ministry of Health and Social Policy.

Healthcare Online has also helped to raise awareness among all stakeholders regarding the key elements that need to be tackled to achieve the objectives set by the Spanish eHealth agenda.

Ultimately, the main beneficiaries will be the citizens whose health information will be more easily accesible by the healthcare professionals, enabling them to make more informed medical decisions.

Further details on the Programmes' results is available in the publication "ICT in the National Health System: the Healthcare Online programme" (attached).

Track record of sharing

The Programme is widely known at national level and has managed to trigger collaboration on eHealth matters between all the regional Departments of Health and the Health and Social Policy and Industry, Tourism and Trade ministries.Â

Moreover, a joint report has been published to convey the Healthcare Online activities. This report analyses the results achieved by the Programme in its halfway point and contains an accurate description of the different regional eHealth initiatives that are underway in Spain.

Lessons learnt

Align with regional eHealth strategies: in decentralized Health Systems, the design and implementation of eHealth initiatives must seek to strike the right balance between regional and national interests and priorities.
Achieving regional eHealth interoperability is the first step towards an interoperable national health system. Both goals must be pursued in a parallel and coordinated manner to avoid that regional health information develop into silos.
A flexible demand management process must be put in place to enable, on an ongoing basis, quick assement of the regional Health authorities IT needs, adopt funding decisions and guarantee timely procurement and deliver of the IT products and services.

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