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Ehtel Conference Economics in e-Health Brugge, November 2002

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. Contents. Introduction Slovenian HIC Programme - Outline Cost Analysis

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Ehtel Conference Economics in e-Health Brugge, November 2002

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  1. Ehtel ConferenceEconomics 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

  2. Contents • Introduction • Slovenian HIC Programme - Outline • Cost Analysis • Direct Benefit Analysis • Development Benefits • Conclusions Ehtel Conference - Economics in e-HealthBrugge, November 2002 Marjan Sušelj, HIIS 2

  3. Slovenian HC and HI- In the Macroeconomic Perspective Ehtel Conference - Economics in e-HealthBrugge, November 2002 Marjan Sušelj, HIIS 3

  4. 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-HealthBrugge, November 2002 Marjan Sušelj, HIIS 4

  5. HIC Project - Goals • 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 Ehtel Conference - Economics in e-HealthBrugge, November 2002 Marjan Sušelj, HIIS 5

  6. HIC System - Outline Ehtel Conference - Economics in e-HealthBrugge, November 2002 Marjan Sušelj, HIIS 6

  7. HIC System - Dimensions • Component / Item Total • Implementation: • Health insurance cards 1.950.000 • Health professional cards 16.700 • Card readers 6.640 • HC service providers 1.036 • SW houses participating 43 • Self-service terminals 290 • SST locations 270 • Operation: • SST transactions / month 450.000 • HIC renewed / year 47.087 • SST information sessions / month 256.000 Ehtel Conference - Economics in e-HealthBrugge, November 2002 Marjan Sušelj, HIIS 7

  8. 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-HealthBrugge, November 2002 Marjan Sušelj, HIIS 8

  9. 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-HealthBrugge, November 2002 Marjan Sušelj, HIIS 9

  10. HIC System - CBA Payback Period Ehtel Conference - Economics in e-HealthBrugge, November 2002 Marjan Sušelj, HIIS 10

  11. in 1000 EUR VHI CHI HIC System - Actual vs. Predicted Investment Costs Ehtel Conference - Economics in e-HealthBrugge, November 2002 Marjan Sušelj, HIIS 11

  12. HIC System - Maintenance Costs Average monthly costs: 150 kEUR Ehtel Conference - Economics in e-HealthBrugge, November 2002 Marjan Sušelj, HIIS 12

  13. HIC Project - Evident Benefits 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 andpremium payment - increased discipline Ehtel Conference - Economics in e-HealthBrugge, November 2002 Marjan Sušelj, HIIS 13

  14. HIC Project - Development Benefits • 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 Ehtel Conference - Economics in e-HealthBrugge, November 2002 Marjan Sušelj, HIIS 14

  15. Concluding Remarks • 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 Ehtel Conference - Economics in e-HealthBrugge, November 2002 Marjan Sušelj, HIIS 15

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