The consultants OVUM recently published their annual report “Trends to Look Out For: Healthcare Technology,” for the year 2012, analyzing global trends in the healthcare technology market. As often happens in these cases, the report, which was of great interest to professionals in the sector, contains data and information gathered from around the world, with an emphasis on markets in the developed world such as the USA or Europe. This type of report rarely examines Latin America, which has its own specific characteristics, in great detail. This article explores the Healthcare Technology trends mentioned in the report from a Latin American perspective in the light of our experience working in several different countries in the continent.
Cost Reduction and Improving Patients’ Health are the Two Key Goals
The report begins by emphasizing the trend towards increased spending on healthcare as a proportion of countries’ GDP. Ageing populations, an increase in the incidence of chronic diseases and the lack integrated healthcare policies, in addition to other factors, has generated a worrying increase in costs throughout the globe. Latin America has also suffered from this trend, adding to its other concerns: the deficit of health infrastructure, the lack of health professionals in some areas (especially rural areas) and the persistence of preventable diseases.
The epidemiological transition in the region thus sets two challenges: to continue improving basic access to healthcare and also tackling the appearance of phenomena similar to those in more developed countries: chronic diseases, unhealthy habits, etc. In this context, it is very important to change the current model of healthcare in which healthcare systems are closely focused on acute disease, so that more attention is paid to factors such as prevention, active patient participation, improvements in administrative processes and the adoption of information technology.
Many Latin American countries are now investing in establishing and expanding the Primary Care model which forms the backbone of their health strategy. An example of this focus, adopted as a national policy, can be found in Colombia whose new Healthcare Law (1438/2011) declares that the adoption of a Primary Care model throughout the country is its primary objective.
These Primary Care strategies place prevention programs center stage. Insurance companies and healthcare providers in the region agree that although prevention programs are expensive, they will lead to considerable savings in the long term. In Latin America, however, there is still not enough being spent on prevention programs, although the situation is changing with several countries placing a serious emphasis on prevention. For example, in Chile, a major portion of the healthcare budget for 2012 is dedicated to a “Prevention Expansion” program which includes specific initiatives for determined sections of the population, such as adolescents.
Adoption of Information Technology – the Electronic Health Record as a key component
The priority technological initiative for 2012 in the sector will be the implementation of Electronic Health Record (EHR) systems, also known in our region as Folders, or Clinical Files. EHRs are an essential part of the system on which the whole value pyramid offered by an e-Health strategy must be sustained. Without EHRs it would be difficult to advance and improve the safety of the patient, reduce costs by eliminating unnecessary diagnostic tests, properly determine the efficiency of clinical protocols or efficiently obtain quality healthcare statistics.
In Latin America, EHR systems are basic initiatives in many countries: Mexico, Brazil, Chile, Peru, Colombia and Argentina, to name a few, have made and continue to make a significant effort to standardize their use, although we are still far from achieving high adoption rates, especially within public systems.
Although there is general awareness in Latin America of the need to use EHR systems, public incentive programs have not yet been implemented very widely, with the public programs that do exist being fragmented and insufficient. In general, governments in our countries do not have well-structured e-Health agendas like those in Europe, the USA and some Asian countries.
Mexico provides an example of a national program and policy designed to encourage the use of EHR systems. Regulation 024, declared by the Federal Government’s Director General of Healthcare Information Technology is a unique effort in the region which will undoubtedly encourage the use of Electronic Records in that country. The Regulatory framework is accompanied by financial efforts in which the Mexican government incentivizes the implementation of EHR solutions which meet NOM 024 guidelines in hospitals and clinics in their states. It thus appears to be one of the most coherent and structured initiatives in the region.
Interoperability
Interoperability is without doubt a major pending challenge in the sector throughout the world, including Latin America. It is thus also a priority but not as pressing as the implementation of electronic health records and, generally, clinical systems (digital imaging, pharmacy systems, emergencies, etc.) This is a logical situation as it is difficult to exchange clinical and administrative information if we don’t first computerize basic processes.
Efforts in Latin America are tentative, but they have begun. Countries such as Mexico, Brazil or Chile, to cite a few examples, are taking interesting steps in the search for alternative viable ways to exchange clinical information which could contribute real value to patient care.
It is important to bear in mind that the healthcare sector, in terms of information technology, has typically been characterized by poor levels of process integration between different players: healthcare authorities, insurers and healthcare providers. Each body has made progress in terms of its information technology needs but in an isolated manner and with a limited outlook, losing sight of the whole sector. For this reason interoperability cannot be seen in merely technological terms. The key goal is to achieve an integrated vision of processes throughout the entire sector as a preliminary step towards exchanging quality information between different bodies.
In this regard, Chile has made real progress with the creation of working committees which include different bodies (FONASA, MIUNSAL, the Institute of Public Health, Cenabast, the Office of the Healthcare Superintendent) and the Healthcare Information Technology industry, to create an integrated policy on information technology projects.
Business Intelligence – Exploiting Existing Information
The report emphasizes the importance of prioritizing business intelligence (BI) projects for healthcare providers in 2012. The EHR implementation initiatives, once executed, represent an undeniable advance in terms of availability, quality and wealth of the clinical information to which healthcare professionals have access. Those institutions which have implemented EHR systems have begun to request analytical solutions which allow them to exploit the information available in their electronic records for clinical, administrative and research purposes on a massive scale.
Latin America presents contrasting situations. Whilst many healthcare providers lack EHR Solutions, leading one to think that investment in BI will still be a while coming, hospitals which have already established EHR solutions will invest in analytical solutions so that they can extract full value from the investment they have made.
