Developing a new model of information systems and Electronic Health Records in Catalonia
Dr Josep Vidal-Alaball, Head of the Central Catalonia Primary Care Innovation and Research Unit, Institut Català de la Salut
Catalonia, located in the northeast Spain and with a population of 7.7 million habitants, has a health care system that provides publicly financed universal health coverage free at the point of access for everyone who lives in Catalonia. It is a mixed health care model funded with taxes that grants equal access to a wide range of benefits offered by a single publicly available network of health care resources, not all of which are publicly owned. The network also includes a range of health care organizations (eg, mutual societies, public and private foundations, health consortiums) that have historically provided health care services. More than one in four people in Catalonia have an additional private health insurance, which does not make them lose their right to public health care.
Catalonia is one of the most advanced regions of Europe in digital health adoption and has a long tradition of health information exchange in the public health sector. Catalonia is implementing a very ambitious Digital Health Strategy Plan (40 million annual budget) that is set to transform the actual ecosystem. The Plan proposes the development of a unique Electronic Health Record (EHR), a test and image repository, the improvement and renewal of clinical and care work environments, and the digital transformation of processes and care models through emerging technologies. The Plan will work to transform entirely the Catalan Health System with the main aim to consolidate a person-centred model of information systems that enables clinical and managerial decision-making across the health care cycle.
Currently there is a single EHR for primary care but 29 different EHR products in the intermediate care hospitals and at least 10 different systems for social care records. The new integrated longitudinal HER, that will include data from primary, community, mental, social and hospital care, is the main piece of the Plan and represents a functional and technical repository of all the information collected from citizens that must be registered and shared throughout the health system. It is not just, or mainly, a technological update, but a model for data management and an architecture of information systems that corresponds to and anticipates the changes that are taking place in the healthcare model.
The new EHR will be able to decouple data from applications, storing data in an open format. This will enable data to follow the patient and will foster better integration and collaboration, helping scaling-up innovations and promoting personalised medicine.
Bibliography:
- López Seguí F, Vidal-Alaball J, Sagarra Castro M, García Altés A, García Cuyàs F. General Practitioners’ Perceptions of Whether Teleconsultations Reduce the Number of Face-to-face Visits in the Catalan Public Primary Care System: Retrospective Cross-Sectional Study. J Med Internet Res. 2019;22(3):1–8.
- Pérez Sust P, Solans O, Fajardo JC, Medina Peralta M, Rodenas P, Gabaldà J, et al. Turning the Crisis Into an Opportunity: Digital Health Strategies Deployed During the COVID-19 Outbreak. JMIR Public Heal Surveill [Internet]. 2020;6(2):e19106.
- The Catalan Information Systems Master Plan. Building en digital health strategy for Catalonia together. Ministry of Health. Generalitat de Catalunya. 2017. https://salutweb.gencat.cat/web/.content/_ambits-actuacio/Linies-dactuacio/tic/pdsis/pdsis-en.pdf
15 of February 2022