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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
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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
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Slovenian HC and HI - In the Macroeconomic Perspective Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS3
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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
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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
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HIC System - Outline Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS6
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HIC System - Dimensions Component / ItemTotal Implementation: Health insurance cards1.950.000 Health professional cards16.700 Card readers6.640 HC service providers1.036 SW houses participating 43 Self-service terminals290 SST locations270 Operation: SST transactions / month450.000 HIC renewed / year47.087 SST information sessions / month256.000 Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS7
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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
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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
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HIC System - CBA Payback Period Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS10
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HIC System - Actual vs. Predicted Investment Costs Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS11 VHI CHI in 1000 EUR
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Ehtel Conference - Economics in e-Health Brugge, November 2002Marjan Sušelj, HIIS12 Average monthly costs: 150 kEUR HIC System - Maintenance Costs
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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
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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
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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
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