Torrevieja Hospital in Spain is a high performing public hospital that uses keyhole surgery and other modern techniques. The current funding regime in Alicante province requires the hospital to achieve high operational efficiency and employee productivity. Moreover, foreign nationals visiting the region expect world-class services. From the very beginning, the hospital put Microsoft® technologies at the heart of its healthcare services and built an integrated infrastructure. As a result, the end-to-end paperless environment helps staff access patients’ records anytime anywhere, make timely decisions, and serve more patients. High efficiency has led to 50 per cent lower patient waiting times than the average in Spanish hospitals. Moreover, the hospital spends only €571 (U.S.$717) per patient per year—compared to €898 spent on average by most other public hospitals.
The Spanish national government decentralised its healthcare system in 2002 and provided autonomy to the 17 regional governments. Although it has resulted in greater and equal access for citizens, avoiding concentration of health services in urban areas, decentralisation also has its flaws. One prime example is the Alicante province in the south Valencia region where challenges for public healthcare have escalated in the recent years.
In this fifth most populous province of Spain, more than 19 per cent of residents are foreign nationals—one of the highest ratios in the country—and most of them are north European retired citizens. The demand for top-class health services is high but many hospitals are closing down due to the scarcity of trained doctors and funds from government authorities, as well as inefficient technology to support administration.
However, one hospital in the city of Torrevieja in Alicante recognised the need for a more efficient healthcare system and set up new standards of quality in Spanish medical services. Hospital de Torrevieja is a public hospital under private management. It opened in October 2006, and, in just two years, has delivered results that make it one of the best hospitals in the country—conducting 400 surgical procedures a week with additional capacity for another 100. The hospital uses keyhole surgery and other modern techniques to improve standards of healthcare.
By the end of 2007, the surgeons and staff at Torrevieja Hospital had carried out 15,000 operations—up to four times more output than most other Spanish healthcare centres. It has the most advanced technology for medical procedures in the country, such as laser surgery. As a result, 56 per cent of patients do not need to stay in hospital after operations and follow up care is provided on an out-patient basis.
Luis Barcia, Chief Executive Officer of Torrevieja Hospital, says: “The key factor that differentiates us from other hospitals and ensures excellent services is our use of technology in all functional areas. By setting up a high-performance infrastructure based on the latest Microsoft technologies, we could transform the existing primary and secondary care centres into highly efficient centres—consistently improving service quality through automated processes and efficiently managing the hospital with a complete view of all operations.”
From the very start, the hospital’s management defined a clear goal of creating a “paperless hospital.” Miguel Ortiz, Chief Information Officer at Torrevieja Hospital, and his team planned an infrastructure that could integrate systems used in all departments—from digital X-rays to electronic medical records, from business management to the supply chain.
After detailed research on the technologies available in the market, Ortiz decided to deploy Microsoft® technologies to fulfil all requirements. Currently, the hospital uses the Windows Server® 2008 Enterprise operating system for production servers because it best supports its data load, and the 2007 Microsoft Office suites supported by Microsoft Exchange Server 2007 to manage internal communications.
To select the most suitable business management solution, the hospital commissioned an economic and financial study from an external consultancy firm. Based on the results, it chose Microsoft Dynamics® NAV and Microsoft SQL Server® 2008 data management software. Ortiz says: “At first, we considered a made-to-measure solution. But on analysing the technologies we required, we found that the Microsoft .NET Framework with SQL Server 2008 could give us maximum return on investment. They work with Microsoft Dynamics NAV, plus we could easily build additional tools to manage our administrative records.”
The accessibility of Microsoft expertise was another key reason for selecting Microsoft products for end-to-end IT infrastructure requirements. “Firstly, it was easy to find Microsoft technology experts in the market—even in our region—which was important for our team to manage the new systems. Moreover, worldwide teams from Microsoft showed keen interest in our project right from the start and provided extensive support and guidance on how to approach it,” says Ortiz.
Ortiz and his team went live with the service oriented architecture within 12 months of starting development. The main processing engine and management tool, called Florence, covers all services provided within the hospital. All line-of-business applications are integrated with each other through Microsoft BizTalk® Server 2006 R2, and draw information from the same database. Doctors’ reports, appointment schedules, medical test results, clinical documentation, data on apparatus used for patients in the Intensive Care Unit—is all digital. Specialists, general practitioners, and administrative staff all access comprehensive information through customised dashboards on their computers.
Florence also provides a unique feature to schedule and manage appointments. It alerts patients about upcoming appointments by sending text messages to their mobile phones. Barcia adds: “Patients can also send texts to the hospital to find out the average waiting time. Florence automatically calculates the time, recognises the right mobile phone number from a database of 130,000 patient records, and answers the text messages.”
Torrevieja Hospital is today a pioneer in the healthcare industry in its region, providing one the most responsive and accessible services to its patients. The key to its success is the innovative ways in which it is using technologies to empower medical professionals, effectively administer operations, and consistently reduce patient waiting and hospital stay times.
Patient Waiting Time 50 Per Cent Lower Than Most Spanish Hospitals
With text message alerts, patients do not need to wait unnecessarily for their turn to consult the doctor. They can also check their appointment status using the automatic appointment machines located at the hospital entrance.
“It’s amazing how technology can improve the ability to fulfil customer requirements,” says Barcia. “Our automated text alerts and appointment scheduling system helps patients contribute to the management of supply and demand for healthcare services. As a result, the average waiting time in emergencies at Torrevieja Hospital is 60 minutes—compared to 120 minutes in most other Spanish hospitals.”
Paperless Environment Empowers Healthcare Professionals
The paperless solution offers numerous benefits to healthcare professionals. Doctors can access patient records from any computer at the centre, view X-ray results, and request additional tests. The casualty department staff can work on patients’ medical records—view or amend data, add remarks, and upload test results—using a Tablet PC mobile computer. “Hospital employees’ services are not limited to treating patients face-to-face. They are responsible for their health at all times. Easily accessible, digitalised information helps staff monitor a patient’s health round the clock and make the right decisions,” says Barcia.
One of Lowest Patient Stay Times in the Country
The tools and technologies available to doctors are also an advantage for patients. Doctors can access medical tests—that are stored in the database in digital formats—within minutes. They can provide precise diagnoses more quickly, saving the patient’s time. “In addition, if a doctor gets scan results by Friday afternoon, he gains two days to prepare in advance for a surgery on Monday,” says Barcia.
These factors have led to high employee productivity at Torrevieja Hospital, resulting in an average time of 4.3 days for a patient’s stay at the hospital—compared to 6 days in most other hospitals in Spain.
Right Technologies Save €327 Per Patient Annually
||We do not receive funds from the government like other public healthcare centres and that’s why we have to be extremely efficient and productive—Microsoft technologies have helped us achieve this.
Chief Executive Officer
For the executives at Torrevieja Hospital, a prime benefit from Microsoft products is excellent value for money. “As a privately run hospital, we do not receive funds from the government like other public healthcare centres and that’s why we have to be extremely efficient and productive—Microsoft technologies have helped us achieve this. A simple illustration is cost per patient being much below the average in Spain due to effective administration and high employee productivity,” says Barcia.
The hospital spends €571 (U.S.$717) per patient per year. Jose Miguel Calderon, Account Manager at Microsoft, Spain, says: “A public hospital of similar size spends about €898 per patient every year. But Torrevieja Hospital can manage with €327 less per patient year-on-year because of the innovative ways in which it uses latest technologies to deliver results such as low waiting times, effective decision making, and high productivity.”
Employees Receive 40 Per Cent Higher Salaries Than the Regional Average
The hospital’s directors have weekly meetings to review internal operations against a suite of key performance indicators. They can access business intelligence reports on their laptops during the meeting and get up-to-the-minute data including employees’ performance, number of surgical procedures and patients treated, as well as complete financial records. Complete visibility of business data helps them make the right decisions and reward employees according to performance.
Barcia says: “Our employees receive bonuses depending on their monthly performance. This system is feasible in our environment because the tools and technologies help doctors work more effectively. As a result, they can earn up to 40 per cent more at Torrevieja Hospital than other hospitals in Valencia—a key reason we retain world-class doctors for a longer time.”
Scalable, Robust IT Environment Helps Meet Changing Business Needs
Because the hospital heavily relies on IT to deliver services, patients’ lives, in turn, are also highly dependent on the technology. The management at Torrevieja Hospital was, therefore, keen on having a reliable IT environment. “Using Microsoft-based solutions we could establish a robust environment,” says Barcia. “Since the hospital opened 18 months ago, we haven’t had a single stoppage.”
Barcia also stresses the importance of the flexibility of the infrastructure: “It’s tremendously pliable when it comes to adapting to changing business requirements—this is vital for us to consistently achieve higher levels of healthcare quality.”
In August 2008, to keep patients’ relatives informed of their health status, the hospital set up Florence touch screens in the accident and emergency departments. When a patient is admitted and registered on the system, relatives receive a personal identification code. They can enter it into Florence and quickly get access to the patient’s latest reports. Barcia says: “The time we save by not having to personally communicate information to a patient’s family can now be devoted to attending other patients—further shortening waiting times and encouraging more efficient service.”
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For more information about Hospital de Torrevieja products and services, call (+34) 965 721 2000 or visit the Web site at: www.torrevieja-salud.com
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