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.

Internal blogging or not, that's the decision...

In the organization for I work there are a rock-solid internal blog culture and one of its blogs is owned by our general manager.

In one of her posts (the last one, I think), she wrote about pit and pitfalls on public, internal corporate blogs.

She wrote "External (public) blog gives other possibilities as improve enterprise image but it becomes a limited content blog" (this is a free, non-exact translation from the Spanish original text).

So, I think I could say several things about this phrase.

If your corporate blog are public (for example, "Running a hospital" or "Life as a Healthcare CIO", you'll find it in my blog roll), I don't think you have limits to express yourself... the only one limit you have in public corporate blogs is to ensure that all of you write is fully aligned with corporate strategy.

There is another possibility, this is to become a anonym or pseudonym blog owner, not linked with your company, and you get writing all of you can think, knows and believe... and perhaps you would be not aligned... and, of course, this kind of blog isn't a corporate blog.

So, in a regulated healthcare sector, it's possible to get a wide access, public blog, but in a private enterprise is difficult to do it...

For our general manager, the right decision is to keep her internal blog as internal.

There are some competition executives with strange skills, like to read and guess about what are your weakness through public corporate blogs reading, as some people reads tea cup bottom... and sometimes they get right!

Heard in a train.

I'm a commuter.

I live 70 Km. from my office.

I spend about 3 hours daily to go to the office and come back to home.

Usually, I don't know people that are into the train. Sometimes, I meet some former colleagues, but not in a daily basis.

I have got a lot of time: I watch through the window (normally I see how the sun arises over the Mediterranean Sea), I read some free press, and some times, I sleep.

So, this isn't my wish, I heard people talk between them.

There are different themes of coverage:

Crisis, jobs (hired, fired, my boss, my colleague), holydays, and so on...

There are a specific group of women, they take same train as me, and talked a lot and loud: they capture my attention.

Why?

For the conversation theme, I guess they are nurses, and I think they are working in a radiotherapy department, perhaps they are related to stereotaxic surgery theatres.

Now, I'm working in a project for a comprehensive cancer centre, and certain words and terms are specific of.

And these women don’t work in the same centre where I'm doing this project.

They say a lot of things. And all are negative.

My boss this, or said, or didn't make, or... or not put in practice some security procedures.

This kind of talking, however, is grumpy for itself.

But, unfortunately, when she said "not put in practice some else", I have my doubts... Is there any health risk for workers or patients?

Well, this class of comments is harmful for the medical centre where they work, and makes public to be unsure about right security procedures.

And the answer to above question is "no". Procedures related to radiotherapy, radiology, or similar, are under continuous auditing by several government offices, and usually these kind of departments holds ISO approval.

I remember a business video I watched two years ago, Who Killed The Customer.

I think is the same thing, in health business.

For a casual listener, reputation of medical centre would be damaged, and if it is possible, we would choose another one than this.

Fortunately, they don't say where they work...

Sometimes is better to still quiet... and sleep!