In early 2012 the Colombian healthcare system was the subject of several important statements by different political leaders about the need to build solid and reliable information technology systems being an essential factor in the proper functioning of the sector. The Minister for Healthcare and Social Protection, Beatriz Londoño Soto, in an interview with the El Tiempo newspaper on the 5th of February, mentioned the need to have good information technology systems in the Ministry itself, the Healthcare Superintendent’s Office and generally in every area of the sector. The General Auditor of the Republic, Sandra Morelli Rico, also spoke categorically about resources being diverted from the system and the need to have reliable systems that would prevent these abuses. For his part, Carlos Alberto Botero, President of the National Federation of Governors, called upon the Ministry of Health and Social Protection to create an information technology system that would include all Colombians and thus make it possible to create healthcare policies for system users and affiliates.
These statements address an essential problem in any economic sector in the 21st Century, information, from different angles. They are statements that build upon what can be heard at every meeting in the sector, in every company, hospital or university linked directly or indirectly to healthcare.
The healthcare sector in the 21st Century is characterized by a surprising paradox: clinical care is highly technological but carried out in an environment of discontinuity and disconnections whose information support is mainly based on paper. 21st Century technology coexists with 19th Century procedures.
Bureaucratic healthcare has signs and symptoms which make it very easy to diagnose: a large number of procedures in which the different people involved are not interconnected, manual procedures supported on paper; slowness and inefficiency. In an environment like this, it is natural for there to be a high probability of errors, both clinical and administrative, leaving one’s ‘veins open’ as the Auditor General said, for unscrupulous people to divert public funds.
However, the outlook is not all bad. In recent years information technology has begun to appear in the sector in force and there are already successful examples which have made access to healthcare services easier, moving towards more computerized, participative and integrated models.
The current crisis represents an opportunity to systematize, generalize and democratize these kind of solutions so that they can reach everyone in the sector. The challenge is to address the sustainability of the system, to provide quality services to patients in an environment of limited resources, innovating with forms of administration (integrated networks) and making use of the advantages of Information Technology.
Colombia requires and needs a great wave of deployment of information technologies in the sector. It needs to change the paradigm to move as soon as possible towards an e-Health bureaucratic model for healthcare. This wave should include strategic initiatives such as clinical primary care and treatment, but should also perfect basic administrative systems such as registration systems, systems supporting billing between the EPS and the IPS (electronic billing), centralized purchasing systems and other initiatives in which technologies play a central role.
However, a critical and essential factor for the success of this ‘wave’ is strategic planning as initiatives of this size and importance cannot be improvised. Right now, technological advances seems to pass us by and there is a strong tendency towards reaction, we follow ‘fashions’, and much tactical activity is expended as part of the ‘pilot project’ syndrome; on projects which are never expanded or generalized or don’t achieve the promised results. Furthermore, there are data storage centers which, because they are fragmented and dispersed, are not converted into useful information. In summary, many technological projects fail due to poor planning. No individual project or initiative, a good as it may be, will solve the sector’s problems. It requires a strategic vision of information systems and a well laid out and coherent plan to give order and meaning to these investments.
Finally, Colombia needs leaders at all levels of the healthcare sector (the Ministry, the Superintendent’s Office, regional bodies, the Auditor, EPS, IPS, etc.) to be coherent and to align the public discourse on major healthcare policies with the reality of investment into information technology systems. Information Technology must not be seen as an expense but an investment, one that will pay dividends in the short, medium and long terms.
Current difficulties must be transformed into an opportunity for the healthcare sector in Colombia: a moment of change when the necessary transformations become possible, increasing their value in public policies, recovering and increasing citizens’ confidence in healthcare institutions.
