torrevieja hospital overview · healthcare system driving health care management torrevieja...

5/14/2009 10:42 AM

Healthcare Executive Forum© 2006 Microsoft Corporation. All rights reserved.This presentation is for informational purposes only. Microsoft makes no warranties, express or implied, in this summary. 1

Providing healthcare services within a per capita healthcare system

Driving Health Care ManagementDriving Health Care ManagementDriving Health Care ManagementDriving Health Care Management

Torrevieja Hospital overviewWe are a medium size hospital located in Spain east costWe are a medium size hospital located in Spain east cost

The hospital was opened in October’ 06The hospital was opened in October’ 06


Our mission is to provide full health care assistance to a Our mission is to provide full health care assistance to a department in our regiondepartment in our region

We have a special management formula that allows a We have a special management formula that allows a private company to manage a public service in order to private company to manage a public service in order to provide better service level at lower cost. provide better service level at lower cost.

Torrevieja Hospital overview


RIBERA SALUD; 45%

Asisa; 35%

Ortiz e Hijos; 5%

Acciona; 10% C. Benidorm; 10%

Our Owners… Our Owners… Torrevieja Hospital overview


Our Management Model


Necessity to introduce competitors and technology in the public systemNecessity to introduce competitors and technology in the public system

Savings in current expenses for more efficiencySavings in current expenses for more efficiency

Comfort for Government, it controls what is responsibility of othersComfort for Government, it controls what is responsibility of others

Management ModelWhy a Why a PPP modelPPP model… …

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• The construction of a hospital costs over than 80 M€, to run the wholeproject 120 M€ per year are needed.

To avoid payments on health charges.

• The concession takes all the risks.• Higher efficiency is achieved (flexible management and money saving

for Valencian Health Board) and incentives for employees.

To achieve success in health caremanagement.

Management ModelWhy Why a PPP model… a PPP model…


Difference between financing and service allowance: FINANCIAL: Valencia’s Government. SERVICE ALLOWANCE: Company (Torrevieja Salud UTE)

Contract: Administrative concession for the construction of the hospital and following management

Term: 15 years with the possibility of another 5 more years

Management ModelLegal TermsLegal Terms


Coverage: Hospital and Primary Care centers (23 centers)

The Company provides healthcare services with PublicHealth System. Universal and free healthcareservices.

The management enjoys the advantages of a private company, regarding financial resources and equipment as well as human resources

Management Model Legal TermsLegal Terms


Payment per person: The money follows the citizen. Capitated payment (600 € per person/year). Increase based on sanitary budget.

Transfer of solution for moving patients, profitable for Valencia Government: The company pays 100% of healthcare services costs for its coveredpopulation in other health areas,; Valencia Government pays 85 % of health services given to any other health area patients.

7,5% of profitability limited by law

Transfer of risk: Expenses become fixed for Valencia Government.

Management Model Financial PolicyFinancial Policy


Covered population: It´s determined by the Information System of Population (Health Care Card).

Public Control: Valencia Government control, within the Hospital (Comisionado Unit)

No waiting lists: surgical waiting lists are fixed by contract

Competition with public sanitary system. Doctor and Hospital free choice for every patient .

Management Model Sanitary DesignSanitary Design


Global healthcare services: Primary care and Hospital attention.

Differences with public sanitary system: single rooms, quickerservice,, IT solutions, variable payment, etc.

Several competitors for latest concessions, which brings up the levelof effort put into it. (e.g. Manises and Elx-Crevillent)

Management Model Sanitary DesignSanitary Design

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Public and free healthcare services Controlled Project

Property refund to Valencia Government Capitated payment

Management Model


Hospital de Manises

Hospital de Denia

Hospital de Elx-Crevillent

Hospital de La Ribera

Hospital de Torrevieja

Management Model


Our incomes… Our incomes…

7070--75% of the avegare income in Comunidad Valenciana.75% of the avegare income in Comunidad Valenciana.



Summer Population

600.000

Residents 213.000

Ensured Population

173.000

Our population … Our population …

Capitative population

Pay per act


Summer Population

600.000

Residents 213.000

Ensured Population

173.000

Our population …

Another public hospitals

100% billing rates

85% billing rates



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Company overview

27 % > 65 years old

60 % foreigner people

Our population …

Multi-pathologies

High health care demand

Multi-language

High Administrative complexity


GLOBAL INVESTMENT Building 48.748.456€

Equipment 19.520.110 €

Total 68.268.566 €

“The company has the responsibility in

the technological evolution”

“Government saves the investment

amount”

Minimum investment in 15 years by

contract80.000.000 €

Investment FORECAST

100.000.000 €



BUILDING SITE: 66.OOO M2 BUILDING SITE: 66.OOO M2 BUILDING SITE: 66.OOO M2 BUILDING SITE: 66.OOO M2

BUILT AREA: 38.397 M2BUILT AREA: 38.397 M2BUILT AREA: 38.397 M2BUILT AREA: 38.397 M2

NUMBER OF BEDS/ROOMS: 250NUMBER OF BEDS/ROOMS: 250NUMBER OF BEDS/ROOMS: 250NUMBER OF BEDS/ROOMS: 250

SURGERY ROOMS: 11SURGERY ROOMS: 11SURGERY ROOMS: 11SURGERY ROOMS: 11

OUTPATIENTS FACILITIES: 60OUTPATIENTS FACILITIES: 60OUTPATIENTS FACILITIES: 60OUTPATIENTS FACILITIES: 60

PARKING: 100.000 M2PARKING: 100.000 M2PARKING: 100.000 M2PARKING: 100.000 M2

EMERGENCY BOXES: 36EMERGENCY BOXES: 36EMERGENCY BOXES: 36EMERGENCY BOXES: 36

DELIVERY ROOMS: 2DELIVERY ROOMS: 2DELIVERY ROOMS: 2DELIVERY ROOMS: 2

ICU: 14 BEDSICU: 14 BEDSICU: 14 BEDSICU: 14 BEDS

EMERGENCY MONITORING BEDS: 53EMERGENCY MONITORING BEDS: 53EMERGENCY MONITORING BEDS: 53EMERGENCY MONITORING BEDS: 53

EMERGENCY AREA: 3000 M2EMERGENCY AREA: 3000 M2EMERGENCY AREA: 3000 M2EMERGENCY AREA: 3000 M2

DAY HOSPITAL : 77 PLACESDAY HOSPITAL : 77 PLACESDAY HOSPITAL : 77 PLACESDAY HOSPITAL : 77 PLACES

DYALISISDYALISIS: 17: 17DYALISISDYALISIS: 17: 17

Our features … Our features …



EfficientEfficient ResourcesResources ManagementManagement

MotivatedMotivated professionalsprofessionals

Variable Variable incomeincome systemsystem

Professional Professional careercareer

LowLow averageaverage staystay

PromotingPromoting outout--patientpatient surgerysurgery

AtAt-- home home hospitalizationhospitalization

Flexible Flexible scheduleschedule

No No waitingwaiting listslists

Our features … Our features … Torrevieja Hospital overview


UnifyUnifyPrimaryPrimary CareCare--SpecialisedSpecialised CareCare

HealthHealth PromotionPromotion

IllnessIllness PreventionPrevention

In In companycompany learninglearning

QualityQualitylevelslevels evaluationevaluation

PeoplePeople satisfactionsatisfaction

LatestLatest TechnologyTechnology

OnlyOnly oneone EmergencyEmergency entranceentrance



Paperless HospitalPaperless Hospital

Electronic Medical RecordElectronic Medical Record

Radiological System Radiological System -- PACSPACS

Integration with the health centersIntegration with the health centers

Doctor to PatientDoctor to Patient´́s home scenarios home scenario

Remote Diagnosis (Clinical + PACS)Remote Diagnosis (Clinical + PACS)

Integrated Systems MonitoringIntegrated Systems Monitoring

Automatic prescription systemAutomatic prescription system


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Our results


HOSPITALIZATION

InpatientsInpatients 15.644

StaysStays 68.674

AverageAverage staystay 4,3

OUTPATIENTS

Nº Nº outpatientsoutpatients 367.450

FirstFirst OutpatientsOutpatients 149.941

AppointmentsAppointments 538.735

EMERGENCY

Hospital Hospital EmergenciesEmergencies 70.994

AllAll TorreviejaTorrevieja deptdeptEmergenciesEmergencies 245.130

ResolutionResolution TimeTime 4,3 h.

AverageAverage WaitingWaiting timetime 58 min.

SURGERY ACTS

SurgerySurgery ActsActs 20.368

OutpatientOutpatient SurgerySurgery ActsActs 7.300

% OSA% OSA 55,88%

DeliveriesDeliveries 1.654

Our resultsOur results


HOSPITAL GLOBAL SCOREDecember 2006 May 2007 December 2007 October 2008

Hospitalization 8,71 9,17 9,00 9,11

Outpatients Department 8,39 8,63 8,37 8,62

Emergencies 8,15 8,51 8,17 8,24

HOSPITAL RECOMMENDED TO OTHERSDecember 2006 May 2007 December 2007 October 2008



Emergencies 8,00 8,45 8,13 9,13

HOSPITAL FIDELITYDecember 2006 May 2007 December 2007 October 2008



Emergencies 8,53 8,57 8,30 9,41



EconómicosEconómicos

• Taking into account:• The increase of investment planned in the

beginning (100 M€ instead of 80 M€)• Higher financial cost as the reason of interest

rate increase

We are achieving the results forecasted inthe Business Plan presented to theshareholders in 2004

OurOur ResultsResults


Top 20 (Position 1) “General middle-sizehospitals” in 2007. First Hospital in the history

that gets this prize in the first year of life.

Top 20 in the management of pathologiesof nervous system.



How we reached the success

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How we reached the success


Some IT and comunication efficiency tools


• Florence is a complete electronic Medical Record Database, that integrates assistance records together with the clinical information, covering all hospital departments.

• Efficiency focused, Florence has been developed taking into account all the Clinic Records Keepers run in the region. Perfection focused, It counts with the support and know-how of professionals from different fields.

• It has been designed to bring you a user-friendly tool, patient focused and process-management creating guidelines tool for daily business operations.

• Ensure the principle of legality, it provides data protection for both the patient and doctor, in compliance with European Regulations in the field of personal data protection.

Our Solution

Florence e-learning

Florence Management

Florence EMR


Our Solution


• The Florence´s alert system allows acting in response as soon as the problem appears.

• It allows to establish metrics and immediate alarms on some variance or problems.

• Florence warns automatically (route SMS) to the different levels of supervision when certain metrics exceed themselves.

Solution : Possibilities to measure variance over forecast on-line


• Allowing the access to the clinical information " at any time and from any place “.

• Allowing on-line collaboration between professionals.

• Promoting individualized attention.

• The system warns route SMS of relevant changes in the clinical history.

• The doctor has full access to the clinical records from house, including visualization of patient.

Solution: Facilitating work at home

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• In order to facilitate professionals job we provide them with last innovations in mobility.

• Florence Promotes telemedicine and telecommuting.

• In order to satisfy all professionals needs, Florence evolves constantly.

• Use of Motion terminals helps to increase notably mobility of the physicians and nurses in the hospital.

Solution: Providing easy accesses to the work tools


• Improving doctors quality of life during on call duties.

• Shortening the process times.

• The system warns route SMS of relevant changes in the clinical history.

• The professional can establish alarms that will be sent via SMS

Solution: Doctors keeping informed in any places


• Florence contains the processes and act as guide for the doctors and patients.

• All the patients flows and all the waiting areas are managed by the system.

• Florence manages all the waiting lists of the department

Solution: Allowing to guide professionals and patients


• Florence gives us an immediate analysis of the demand and its variations, in order to be able to adjust quickly the resources.

• Florence has the possibility to “guide the citizens “in the use of the resources providing them with the information regarding where they will obtain better attention.

• In real time, patient obtains information related to the waiting time in each center with Emergency Care.

• Florence manages all the waiting lists of the department.

Solution: Allowing to influence over demand


• Using SMS or Web tools to provide informationabout waiting time in Emergency or to remindappointments.

• Obtaining information about the waiting lists andproviding advices of healthcare from the screenslocated in diverse centers.

• By means of tools assisting in self-service.

97% of common emergencies were attended97% of common emergencies were attendedin primary care centersin primary care centers

Solution: Transmitting information to the patients in simple way


Our vision of the future

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Application artificial intelligent technology

The computer data base developed by the Torrevieja Hospital, will allow tomake health forecast about the disease evolution of some kind of patients,using artificial intelligence technology.

With this advanced technology at the same time we can also follow evidencebased practice.

Our vision of the future


Summary


New Hospital

New processes

Unknown patient demand

Special population peculiarities

Clinical results(Best rates in Spain)

Patient satisfaction (9 points over 10)

No waiting list

Better economic results than expectedFlexible and powerful own

software solution based on Microsoft technology

Summary

Building design adapted to needs

Full optimization of work processes

New model of health care management: Variable

Retribution System; payment by act


Thanks for your attention

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