Ehtel Conference Economics in e-Health Brugge, November 2002 Slovenian HIC Programme - Exercise and Lessons Marjan Sušelj Assistant to Director General, HIC System Health Insurance Institute of Slovenia Ehtel Conference Economics in e-Health Brugge, November 2002 Slovenian HIC Programme - Exercise and Lessons Marjan Sušelj Assistant to Director General, HIC System Health Insurance Institute of Slovenia

 Introduction  Slovenian HIC Programme - Outline  Cost Analysis  Direct Benefit Analysis  Development Benefits  Conclusions Contents Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS2

Slovenian HC and HI - In the Macroeconomic Perspective Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS3

Introduction - HIC System Background and Rationale  HIIS position in the HC  statutory provider of compulsory health insurance  custodian, manager and administrator of HI funds  mission: efficient economics of HC, friendly and efficient services  HIIS investments in IT in HC:  virtually all HC work posts computerized  EDI  HI databases  IT literacy  Comprehensive local IT support, bottlenecks in communications and data transmission Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS4

 Cost containment;  Transparent operation (income and expenditure side);  Accurate and up-to-date data for management and policy makers;  Data security;  Streamlined communications;  Advancing of services (elimination of non-essential procedures);  Financial and national economy benefits at reasonable financial investment;  Infrastructure for integration of different IT systems in HC and HI - paving the way to the e-environment HIC Project - Goals Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS5

HIC System - Outline Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS6

HIC System - Dimensions Component / ItemTotal Implementation:  Health insurance cards  Health professional cards  Card readers6.640  HC service providers1.036  SW houses participating 43  Self-service terminals290  SST locations270 Operation:  SST transactions / month  HIC renewed / year  SST information sessions / month Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS7

HIC System - Analysis of Costs CBA (1997):  Investment (purchased goods and services):  Equipment (cards, terminals, readers, …)  New/upgraded software  Development services (outsorced)  Card personalisation and mailing  Implementation:  In-house work costs for HIIS  Communications, overhead  Training for HC workers  Migration costs  Routine operation costs:  Card renewal  Maintenance of technology  Equipment depreciation  On-going costs (leases, energy,…)  HIIS service overhead Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS8

HIC System - Analysis of Benefits CBA (1997):  Time savings:  Insurance validity updating (insured persons, employers, insurance clerks)  Patient reception at the doctor’s (administrator)  Quality data for reporting and accounting purposes Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS9

HIC System - CBA Payback Period Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS10

HIC System - Actual vs. Predicted Investment Costs Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS11 VHI CHI in 1000 EUR

Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS12 Average monthly costs: 150 kEUR HIC System - Maintenance Costs

Two years of routine operation:  Decreased volume of administrative chores; elimination of non-essential procedures;  Faster and easier access to HC services;  Uniform technology and interfaces for all insurance providers - operation simplified for HC workers and patients;  Strict monitoring of contribution and premium payment - increased discipline HIC Project - Evident Benefits Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS13

 Hands-on use - stimulus for new ideas, needs and demands;  User proficiency - building the foundations for e-health;  Infrastructure for medical data;  Enabling infrastructure for internet communications;  Identification of patient and HC worker - availability of evidence, data for analyses and studies of new HC service payment models HIC Project - Development Benefits Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS14

 Progress: small steps, far-reaching effects;  Technology in the service of citizen;  Paramount importance of consensus;  Sharing of investments and benefits;  Tenacity and pioneering vision;  Mix of tangible (financial) and non-measurable benefits  In the service of the patient  Quality of life and health Concluding Remarks Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS15