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A Paperless Hospital Information System for less than $1 Million? What we can learn from Spain

Earlier this week I was in Barcelona, Spain, presenting at a Microsoft customer event called the Health Industry Leaders Innovation Forum. Healthcare executives from across the EMEA region came together to share information on how they are using information technology in healthcare and to exchange ideas on how to drive even greater innovation in the industry. We listened to presentations on progress being made in the provision of e-health services at the National Health Service in the UK including some exciting portal work in Wales. Members from our UK team discussed progress to date on the NHS Common-User-Interface initiative. A physician leader from Spain talked about healthcare industry trends and opportunities for venture-funded projects in his country, and IT executives from Egypt shared ideas on clinical transformation opportunities there. A complete review of the Forum proceedings is beyond the scope of my Blog, but I did want to share information on one of the presentations that particularly caught my attention. It caught my attention because it illustrates so well something I've been writing about on this Blog and elsewhere; how commodity software is being used to build very robust healthcare industry solutions quickly and inexpensively.

The customer in this case is a new hospital in the Valencia region of Spain. Torrevieja Salud is a 250 bed, privately managed, public facility that recently began serving patients. It has 11 operating theaters, 22 surgical beds and a full service ER with a 50 bed observation unit. From the very beginning, project designers planned for a facility that would be completely paperless when it opened its doors. The commodity building blocks they used included SQL Server 2005, Exchange, Terminal Server, Windows Server, MS Dynamics NAV, BizTalk 2006-HL7 Adapter, SharePoint, and the .Net Framework. Over a 2-year period, a development team of just 22 people built a fully functional healthcare information solution they call Florence. It handles all clinical and administrative functions for the entire facility. It even provides a rich balanced scorecard view of key performance indicators. Partners included Microsoft, HP, Drager Medical, Palex, B Braun, and Servicom 2000. I asked how much money they thought they had spent developing their HIS? The answer was approximately €600,000 (around $800,000). Compare that to the tens, or hundreds of millions of dollars being spent for equivalent functionality in an American hospital of equal size and you're left scratching your head. In fact, even in those American hospitals spending that kind of money I've rarely seen a true "paperless" environment.

To be honest, I didn't have an opportunity to visit Torrevieja Salud and see it with my own eyes. But even if their HIS built on commodity software did half of what is being claimed or cost 10 times as much, it would still be a bargain. I'm sure the folks at Torrevieja would be delighted to show off their new facility to anyone who might be interested. American Hospitals take note. I think there is a lesson here!

Bill Crounse, MD   Healthcare Industry Director     Microsoft


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