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Conversation with Pablo Rivero, General Director of the Quality Agency at the Spanish Government’s Ministry of Health

Pablo RiveroWhich are the foundations of the eHealth strategy and how was the implementation in Spain?

In Spain, the eHealth strategy was the result of the effort, the cooperation and the consensus of all the players necessary for any kind of strategy, whether from the public or the private sectors.   Also, it is important to receive the support from health professionals and the society and, for that reason, our program is supported by over thirty professional and patient associations.

Right now, Spain reports the following data regarding the eHealth strategy:

•    More than 70% of hospital and specialty centers use connections of 6 Mbps or higher and 91% of the health centers are connected to their corporation networks using bandwidths of 1 Mbps or higher.
•    Ninety seven percent of consultations at health centers use an information technology solution to facilitate the clinical-healthcare management of family doctors and pediatricians (clinical history and/or prescriptions).
•    Twenty percent of specialist consultations have electronic clinical history applications.
•    Thirty percent of public hospitals have started to computerize inpatient clinical histories.
•    Eighty five percent of hospitals have radiology management systems and 60% have digital image storage systems (PACS).
•    Ten Healthcare Services have an integrated system of Clinical History (one single record per patient) that is fed by different healthcare units (currently, from places with computerized clinical histories and other clinical documents –primary healthcare, laboratories, diagnostic test reports, imaging– with the gradual incorporation of other services such as specialist consultations, emergencies or hospitalization, as long as they become computerized).
•    Three Autonomous Communities have a system of electronic prescription (electronic prescription in the consultation and electronic delivery at the pharmacy; 5 Autonomous Communities are in the implementation phase and the rest has started pilot programs.
•    Fifteen Autonomous Communities and the INGESA (Ceuta and Melilla) are operating with the Individual Healthcare Card (IHC) common system and 2 Autonomous Communities are performing preliminary tests previous to implementation.

Underline three relevant projects you are presently working at regarding eHealth

Some of the main projects of the program are:

•    Individual Healthcare Card (IHC): with the creation of a healthcare card database which enables the unmistakable identification of each individual in the entire Spanish public healthcare system by means of a lifelong unique identification code generated by a common database in the National Healthcare System (NHS), in the Spanish Ministry of Health and Social Policy.
•    Digital Clinical History: Individuals are assured that healthcare professionals will have access to the clinical data they need from any facility of the NHS at any time. It guarantees security, privacy and control of individuals over information access.  Besides, individuals have access to their own clinical reports.
•    Electronic prescription: medical orders issued by physicians are stored in a data repository that can be accessed from any pharmacy in the country for delivery to the patient.  The electronic prescription has been implemented in 3 Autonomous Communities (Extremadura, Andalucía and Baleares) and the rest are developing several different projects.  

Which are the forthcoming challenges of the Spanish government regarding eHealth?

The forthcoming challenges within the framework of the second phase of the Online Healthcare Program (2009-2012) pursues a dual objective: to boost the interoperability of the electronic clinical history and the electronic prescription in the NHS and to continue supporting the strategies of the Autonomous Communities in order to expand their electronic clinical history and electronic prescription systems so that every Autonomous Community can attain a similar level of development and availability of the service.


eHealth Program
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