Slovenian Healthcare: It is Hard to Change a Car’s Tire While it is Driving

AmCham Focus on effective solutions in healthcare systems
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In the light of the ongoing public debate on the current Slovenian healthcare reform, the AmCham Focus that took place on Thursday, March 16, 2017, opened a debate on effective solutions in healthcare systems and the use of treatments that have been proven to work.

AmCham Slovenia and the AmCham Health and Wellbeing Committee that consists of experts from more than 45 companies are inspiring positive change and endeavor to bring good practice from the economy into other spheres of life. We believe the foundation of the quality of life to be in sustainable, effective, and people-focused healthcare – focused on patients as well as on doctors and medical personnel. Healthcare should be discussed as an important economic industry that contributes to GDP growth in the long-term. We thus advocate the solutions related to hospital digitalization that put the patient in the focus and ensure the patient coordinated and integrated care based on up–to–date and consistent clinical data. Since the healthcare system is incredibly complex, its good organization is of key importance.

The main guest of the AmCham Focus was Hon. Prof. Dr. Bernhard Rupp, MBA, an expert in the field of health economics and the healthcare system in Austria. He explained in the debate moderated by Vida Dolenc Pogačnik, AmCham Slovenia, that the Slovenian healthcare system is very good but that the question of providing a long-term service must be addressed. Triage, telephone business and applications are the future; he introduced Israel as an example of good practice in the field of hospital digitalization. He then warned that one should remain careful since reliance only on technology can be dangerous.

He emphasized that waiting queues are a big problem and proposed employing more specialist doctors as one of the possible solutions. "We must study the system and find the way to shorten these queues. One problem could be incorrect funds relocation in the system, but also corruption," said Professor Rupp and stressed that there is always more than one solution. The solution for system survival could be in hospital specialization, which also represents a good economic option because it can benefit the economy.

With regard to healthcare system financing, he proposed numerous options but stressed that we should not rely only on contributions. He pointed out that the patient has the right to choose and that the healthcare system should promote hospitals as the last resort for patients. "Hospitals are dangerous; you can only go there when really necessary," said Mr. Rupp and acknowledged that people in Austria and Slovenia rely too much on the hospitals’ comfort.

SEVEN TREATMENTS THAT WORK
In the second part of the AmCham Focus, moderated by Jadranka Jezeršek Turnes, Kontekst Consulting, we introduced seven treatments in the field of healthcare processes optimization, organizational and systemic solutions that could and already do function in Slovenian healthcare.

Janez Uplaznik (Mikropis Holding) introduced the 24alife program on 12 habits of healthy people. This is a program developed together with the Mayo Clinic that does not encompass only exercise and a healthy diet but focuses on the individual’s entire lifestyle. Their vision is to create a happy individual, happy society, and a happy world. "It is very important to be healthy. We all wish for a long and healthy life," said Uplaznik and added that Slovenian healthcare has been opened for his program and that they now exchange experience.

Adriatic Slovenica is one of the three insurance companies that offer supplementary health insurance covering additional costs that are not covered by the compulsory health insurance. Its Executive Director, Ivan Gracar, said that the relevant risk-management studies show that 3–6 % of all insurance procedures are linked to fraud. We can curb fraud by having better programs, more available data, and by more responsible behavior of the operators because the number of cases of negligence and errors is rising. He explained that they have developed a system that could not only be used with fraud but also in other business areas.

Associate Professor Matija Tomšič, MD, PhD, Clinical Department of Rheumatology of the University Medical Centre Ljubljana, introduced their way of tackling the long queues in Slovenia. He said that Slovenia is second-to-last in Europe in the number of doctors per 1,000 people. We also have 40 % less rheumatologists than the average. But since the clinic introduced an early intervention clinic, patients don’t have to wait for urgent examinations, they are examined the next day. All those with urgent referrals are treated immediately, half of them are referred for additional examinations. "We are offering first-rate services and success in healthcare despite a catastrophically low number of doctors," added Doctor Tomšič.

Samo Drnovšek, Marand, introduced one of the good examples of digitalization in Slovenia – the Think!EHR platform. It offers them four million medical documents with which they try to improve and to ease patient processing. "The healthcare system is changing and for it to improve, greater integration of healthcare, medical care, digital technology and data is urgent, as is enabling digital accessibility to patients," said Drnovšek.

Paul Johnson, The Qubix Group, introduced the digital transformation of public healthcare finances in Great Britain. He reported that the British healthcare system processes one million patients every 36 hours and that in 2016, 40 % more operations were carried out than in 2006 due to the optimization of work and financing. "First, we ask ourselves how to provide services with minimal funding, we then gather the data on activities and on financing and see the progress," he said.

Alexander Timmerman (Cisco) introduced telemedicine technology as well as the case in which they established a connection for a 12-year-old boy to be able to follow the class in his school while being hospitalized. It was a learning experience for all participants. The boy was able to learn and his peers became more attentive and emphatic. As one of the challenges of telemedicine, he pointed out the fact that doctors must not presume that patient treatment is the same in person as is via video camera.

Matija Klasinc, Healthcare ICT consultant at Parsek, introduced the Vitaly portal that encompasses the entire documentation of an individual patient from different doctors and healthcare institutions. The problem today is that some patients with numerous diseases at the same time have too much documentation to be handled by them or their caretakers. They thus have to be unified and combined in order to be user friendly.