“Our Mission is Patients’ Health, and the Goal is Profit, as we Would not Otherwise be Able to do Business Well”

AmCham Focus: Slovenian Healthcare – on the one hand, problems, on the other hand, success.
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“Everything has to be focused on the quality of work for the patient’s well-being,” said Silvana Šonc, director of the Hospital Sežana at the AmCham Focus, regarding the status of healthcare in Slovenia. Robert Cugelj, general director of the University Rehabilitation Institute Soča (URI Soča), added that with the optimization of processes, they have improved the environment for employees and for patients.

At this AmCham Focus – entitled “Slovenian Healthcare – on the one hand, problems, on the other hand, success” – we talked about the advantages and disadvantages of Slovenian healthcare. The conversation led by Jadranka Jezeršek Turnes, Kontekst Consulting and Member of the AmCham Commission for Healthcare and quality of being, also included mag. Silvana Šonc, director of Sežana hospital, who presented lean management for the benefit of patients and healthcare professionals, and mag. Robert Cugelj, the general director of the University Rehabilitation Institute Soča, who talked about process optimization, international integration, market orientation and patient-oriented activities.

Ajša Vodnik, CEO of AmCham Slovenia, said in the introduction that in AmCham Slovenia, when talking about healthcare, we are talking about opportunities and we are talking about people, because we want to place a person at the center. “Without a good healthcare system, there is no good society, and we, as commercial associations, can also help to improve our healthcare. We do not want to interfere, but we want to help and be a platform for dialogue,” said Vodnik, adding that Slovenia’s healthcare in particular has some exceptional reference cases that can be a good example for many others.

Both Šonc and Cugelj agreed at the beginning of the discussion that there is no need to deny that healthcare is a commercial activity, since it is necessary to provide a certain service that has to be paid, with the money we have. “Healthcare is not a charity activity,” said Šonc, while Cugelj presented the situation in Slovenian healthcare with concrete figures.” In 2016, 600.000 patients more were treated in Slovenian hospitals than in 2009. The number of patients is growing every year; between 2012 and 2014, there was a huge decline in both revenues and incomes in hospitals. At that time, hospitals had to do many things to manage the business and treat people,” said Cugelj, and continued: “From 2009 to the present, hospitals have had a total of 580 million unpaid services. If we did not do any programs for which we were not paid, it would be a disaster. Also, the costs arising from the negotiations between doctors and the government between 2013 and 2016 total 119 million euros, and will never be reimbursed.” “Healthcare must remain in operation. This is sometimes a problem because the political body is not aware of the consequences,” said Cugelj, adding: “Healthcare is in a severe crisis”.

Process optimization for better business
Both co-speakers then presented how they themselves took on the improvement of work processes in their institutions. Šonc presented the processes on the basis of which she repositioned the hospital in Sežana. “When I took over the hospital 20 years ago, it was facing closure and totally run-down, so we started from the bottom. When after a few years we started operating on a positive zero, we found out that the work processes were poorly set up and that the work organization was not set up optimally. We reformed the processes and established new working conditions, which lasted almost four years,” said Šonc, adding that this is a never-ending process and that it requires a lot of knowledge and patience. “We set up strict limits, everything became more transparent, and since we are a small hospital, no bill is paid until I personally approve it,” she said.

Cugelj had a similar experience, explaining that the process rework began in 2008 when there was enough money in the healthcare system. “But we needed changes, because we found that our work processes were not optimal and we had thousands of unstructured documents. We started a 3P program, a renovation of business processes, and it changed everything,” said Cugelj, explaining that at the beginning there was a lot of resistance and difficulties in convincing people that this would be good for them. “We knew that we would restructure jobs, that new knowledge would be needed, but we promised people that there would be no redundancies,” said Cugelj, adding that the new way turned out to be excellent after six months, and that nobody would do it differently today. “In the first year alone we saved 15 percent on material costs, because people knew that we were controlling them, so the system became transparent,” said Cugelj, adding that Soča was operating with profits all throughout the crisis.

Digitalization as a welcome help
Later in the conversation, they talked about the digitalization and introduction of new technologies in business operations of hospitals. “Digitalization is coming openly and widely, but processes need to be sorted out first,” said Cugelj, adding that the whole patient path is being digitalized in Soča, and an e-healthcare card is being introduced. “Digitalization is also coming in the field of equipment. We strive to carry out as many processes as possible without people. We are currently in the project phase of introducing robots and using virtual space, but for that we need time and money,” said the general director of URI Soča. Šonc also added that clear working processes are a prerequisite for digitization and that they have good conditions for them. “In optimizing processes, we tried to remove anything that does not give us added value. In our hospital, for example, we have connected everything with tube mail, we have a room service management in the hospital room, e-charts are available to patients next to their sick beds. We also achieve traceability of medicines and medical consumables,” explained the co-speaker, adding that she is working hard to introduce robotic distribution of medicine in the pharmacy section. The co-speakers agreed that it is necessary to improve or simplify the system of public tenders in order to be able to get cheaper medical aids, to simplify the whole process, and thus encourage a number of providers, including foreign ones, to submit tenders.

Practical examples
Practical examples were at this AmCham Focus presented by Peter Pustatačnik from Telekom Slovenije, who spoke about the innovative remote service of care for the elderly as a result of cooperation between the company and a healthcare institution, and Krištof Zevnik, dr. dent. med. from Ordinacija Zevnik, who presented Medikont, an online medical community for joint orders of medical products directly from the manufacturer.

You can see the photos of the event on our Facebook page.