Technical and administration challenges in healthcare

E-health applications for the elderly

A report published by demographers of the European Union concerning social structure proves that we live in society that is rapidly getting older. According to all predictions, in 2050 people in the 65+ age group will represent one third of the population of Poland. Not surprisingly, discussions regarding healthcare law, spending on care for the elderly and control over medical facilities have arisen once again.

In the face of an aging society

According to data from the Central Statistical Office of Poland, in the last decade the group of people at retirement age in Poland increased by more than one 1 million. Everything seems to indicate that the process of aging in our society will proceed. According to estimates by demographers, the number of older people (65+) in 2050 will exceed 30% in rural areas and will come close to about 35% in cities. To minimize the inevitable problems of society, i.e. to keep as many people as possible professionally active and reduce the cost of their treatment, increased preventative efforts are required.

The necessary legal framework

The last amendment to the act on healthcare services financed from public funds was made on 27th August 2004. It imposed on local government units the obligation to implement health prevention programs resulting from the identified health needs and health status of residents in a given municipality. The lack of efficient ways of financing public health has greatly reduced the local government options in this matter. According to preliminary information, the new law on the public health system not only integrates various efforts for health prevention, but also effectively ensures their financing. It is estimated that in the first year of the law, in 2016, the implementation of preventive health programs will cost approx. 1.5 billion PLN. Funds will likely come from the budget of the National Health Fund (1%) and Public Health Fund, funded from the excise tax on alcohol (1%), tobacco (0.5%) and gambling (3%).

Growing administrative problems

Local government units, which have been implementing health programs so far, have grappled not only with the low budget allocated for the implementation of health programs, but also with a lack of basic tools to improve their work. Project implementers were required to submit paper, partial reports, which were then manually reviewed and merged by the staff of local government units.

Preparation of the summary report on the implementation of all the measures was time-consuming and costly. The biggest problem turned out to be calculating the number of people covered by the program. For this purpose, someone had to compare and merge the lists of people submitted by all implementers. Depending on the local government unit, the aggregated lists may exceed even hundreds of thousands of beneficiaries, and with the increase in spending on public health their number may further increase.

The necessary process of computerization

Another change is the ongoing digitalization of the Departments of Health initiated by some local authorities. The primary function of the e-health applications that are being implemented is to improve the monitoring of existing health programs. Local governments that have decided to digitalize their data are able to gather consistent data in the central database. This allows them to detect residents’ re-participation in the health program, access up-to-date information, automatic alerting of detected irregularities in the implementation of the timetable of a given health program and automatic final report generation.

A great example of successful digitalization is the monitoring process of flu vaccinations. A local government unit determines the conditions for participation in the program (e.g. a person over 65 years old), defines the available health care benefits (e.g. medical examination, vaccination against influenza) and enters the details of agreements concluded with the implementers into the system (e.g. contracted number of vaccinations, unit price of the vaccination). In order to vaccinate a resident, medical staff have to enter the national identification number of that person into the system, thus limiting the amount of required data to a minimum. The system automatically verifies whether he or she can take part in the program. If a person has already been vaccinated in another medical facility, and therefore does not meet the program criteria or an implementer has already run out of contracted vaccinations, the system displays a warning. As a result, local governments do not have to manually merge and verify large amounts of data to count the number of people covered by the program – it always has the proper data.

Prospects for development

 The success of selected local government units shows that digitalization in terms of improving health care can be quickly and efficiently carried out, in particular when the local authorities decide to implement a solution already operating in other municipalities. Buying a proven solution guarantees not only a successful implementation, but also a way to use the best practices developed by other local governments.

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Sebastian Data Engineer / COO