"We were looking for a scalable and flexible solution that would allow us to follow the innovation path"

Jordi Piera Jimenez is the Director of the digital health strategy office at the Catalan Health Service (CatSalut) and one of the masterminds behind the new Catalan digital health strategy. We talked to him about the challenges of dispersed healthcare data, about the benefits openEHR can bring, and about the future plans for Catalonia.

What is the single biggest challenge when it comes to healthcare data in Catalonia, and how is Catalonia addressing this challenge?

The most significant challenge in Catalonia's healthcare data realm is the fragmentation of information across various systems and entities. This dispersed data hinders comprehensive patient care, decision-making, and resource optimisation. While we have a unified system for primary care called ECAP, the hospitals run almost 30 different EMR systems in our 69 hospitals here in Catalonia. Since 2006, we have been building a repository called the Shared Electronic Health Record of Catalonia, using interoperability standards, allowing us to exchange information across the public sector. Now after many years of going down that road, we have realised the exchange of summaries of information does not suffice to build longitudinal care pathways and to truly enable care continuity across healthcare levels and organisations. Because of this, we have decided to implement a unified, standardised data repository, for which we have selected openEHR as the common data standard. This repository will integrate data from diverse sources, enabling seamless information flow across the healthcare network and allowing healthcare professionals to gain holistic patient insights. This will also allow us to develop and implement new innovations once for the whole region, and not 30 times (one per EMR product as it is now). The region is currently in the midst of this transformation with very big projects on the table, such as the new medication management system for the whole region.

Why did Catalonia choose openEHR when building the digital health strategy of Catalonia?

Catalonia opted for openEHR due to its open-source nature and flexible architecture, enabling the long-term storage of health-related patient information. “Data for life” as a concept, enabling true longitudinal healthcare patient records fostering patient-centric care. Unlike proprietary systems, openEHR allows customisation and scalability, aligning with Catalonia's vision for an adaptable healthcare ecosystem. Its robust data modelling capabilities facilitate the integration of varied datasets, ensuring interoperability and future-proofing the digital infrastructure. Also, we are leveraging the community and the number of ready-made models and implementations from which we can learn and share these experiences. The key benefit, as mentioned previously, is also allowing us to develop and implement solutions only once for the whole region, minimising the costs compared to a single instance implementation for each and every hospital or care centre. It also significantly decreases integration costs as well as maintenance and support costs, as the solutions are pre-integrated one with another, and we would be maintaining only one solution for all the regions.

How will the integrated and interoperable electronic prescribing and medicines administration solution benefit Catalonia?

Drugs are a big part of Catalan healthcare costs, going over 3 billion per year, meaning that anything related to it that can save even a part of those costs means a lot in total numbers. Since 2003, Catalonia has had a unique system for ambulatory prescription of medicines, which is fully connected to community pharmacies and used by all medical doctors within the public sector. Conversely, the prescription of intra-hospital medication is directly handled by hospitals themselves, when these internal processes should eventually be the same. This is why we have opted for Catalonia's integrated electronic prescribing solution to centralise medication management, significantly drive down the costs of the overall solution on a regional level, and improve patient safety and medication management efficiency. Real-time access to prescription data enables timely and informed decision-making by healthcare providers. Interoperability ensures the smooth transfer of prescriptions across care settings and pharmacies, reducing errors and enhancing patient outcomes. We also know that the healthcare and pharma industries will evolve, so we were looking for a scalable and flexible solution that would allow us to further modernise and extend the technology and follow the innovation path and evolution of the Catalan healthcare system.

What are the Catalan plans for the next five years, and how will they expand the system even further?

In the next five years, Catalonia plans to bolster its healthcare system by enhancing interoperability even further. Adding more central solutions based on openEHR that will be rolled out across the whole region and for all care providers. Telehealth initiatives will be expanded to ensure comprehensive healthcare accessibility, especially in remote areas. The region is heavily investing in research and development, exploring the potential of AI and predictive analytics. These advancements aim to enhance diagnostic precision, optimise resource allocation, and provide tailored, patient-centric care. Catalonia's future roadmap envisions a healthcare landscape driven by innovation, where technology optimises patient outcomes and operational efficiency. By leveraging cutting-edge solutions and fostering collaborative partnerships, Catalonia aims to create a healthcare ecosystem that is seamless, responsive, and technologically advanced, ensuring the well-being of its citizens in the years to come.

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