Patricia D Aste is the President of the Asociación Argentina de Auditoría y Gestión Sanitaria (Argentine Association of Healthcare Administration and Auditing, SADAM), the body that organized the third Healthcare Auditing Congress.
Speaking to E-Health Reporter Latin America, she shared her views on the implementation and development of technologies in Argentina, the future of the healthcare sector and the objectives of the congress, which took place on August 29, in Buenos Aires.
Is it now a necessity for the health sector to invest in technology?
Without a doubt, investing in technology is probably the most important emerging challenge facing the public and private health sector.
In the 90s and during the first decade of this millennium, there was a focus on investing in infrastructure and institutional image. Today, institutions are giving priority to new technologies: it is an emerging area that is going to be increasingly important in the sector whether we re talking about the Electronic Health Record (EHR), control panels, integral management frameworks, administration control models or integrating clinical information with administrative information. But our objective is not just to benefit healthcare institutions or professionals but mainly to provide benefit to our patients.
Healthcare companies are far more convinced that technology is not a trend or a way of looking good to investors: they now see it as an issue of competitiveness. There is a direct correlation between technological investment and improving patient care.
Currently in Argentina, patients EHRs are not shared between different care centers, how does this affect data fragmentation?
The clinical history of a patient isn t fragmented, there are several clinical histories for the same patient.
I don t think it s possible right now for the country to have a unified Electronic Health Record. Firstly, it s a question of design: the health record, from a technological and content point of view, must be homogenous or homogenizable.
Today, no-one asks the person next to them what they re designing, or what exportable formats they have that can be used for other systems: no-one s regulating that. Maybe the authorities should start to set common codes and work out how to establish different minimum bases and platforms through which, in the future, we might be able to build, via the exportation of data or some other mechanism, tools to take advantage of hard information from the institutional core.
In fact, the electronic health record belongs to the patient. What we need to rethink is how much of this information serves future information: maybe today there s a basic set of data that it might make sense to make available to public and private institutions, but not all of it would be useful.
When we were at Harvard University they told us that only 11% to 15% of doctors in the country use the EHR so the level of adoption is not as generalized as is often assumed. It s not that they don t keep information on their databases, but only some of the data is saved.
At what point did you come to believe that auditing isn t just limited to billing but also includes ICTs?
For a long time auditors were seen merely as financial adjustors focusing on billing. At our first congress in 2012, the first thing we proposed was to re-conceptualize the role of the auditor, because it was simplistic to see auditors as being only related to billing; it devalued the specialty.
Today, auditing does not just include what has been done to a patient but also the diagnostic correlation, clinical monitoring protocols, internal audits, risk management, and programs for monitoring chronic patients. There is also a field related to institutional quality and there we re not talking about billing but correction or adaption of processes.
Auditing is an interdisciplinary networking job that helps to achieve efficiency, better use of the available resources, a reduction in the error rate and lapses in attention and greater optimization of the technological resources available at institutions.
SADAM sees ICTs as an important factor. How long has it promoted that concept?
The first congress was called ICTs and TIPs , playing on the idea that informatics tools must be adopted as central part of a competitive strategy for a public or private company, but the adoption of these tools is not just a continuation of the old concept of healthcare businesses; it s the creation of a whole new generation.
An institution does not become more modern because you ve plugged in equipment using a certain kind of software, it needs human resources training to work with the tool and use it to its best advantage.
A good tool cuts work time, makes diagnoses appear more quickly and helps doctors to make better, more accurate decisions and all this benefits the patient.
But these changes aren t magic, they re part of a generational change in administration methods that depends on training human resources.
Are controls and evaluation aspects of medical administration?
Yes, because evaluation and controls improve medical practice and make it possible to evaluate the indicators that suggest certain treatments and to provide the parameters and protocols that accompany the treatment of a determined condition.
What are the objectives of the Third Health Auditing Congress?
The objective of this congress is to return the focus to everything that the new tools, not just ICTs, have placed on the table, all the innovations they have implemented in different fields.
The idea is to identify the technological needs of public and private healthcare institutions, and the needs that the health service can recognize in terms of innovation.
We will try to determine whether the innovations should appear within the institution for internal motives, whether innovations deserve to be financed, and what the criteria are for incorporating new technologies into the healthcare system.
What is your view of the development of ICTs in Healthcare in Argentina and Latin America?
The use of ICTs is a platform that is about to take off. In the future there will be a lot of new technologies in a context that is more mobile, more focused on patient access via portals, and with more customizable tools.
