BSA is an integrated healthcare organisation with responsibility for Barcelonès Nord. Badalona is on the Spanish coast, 10 km north of Barcelona.  BSA manages the Hospital Municipal de Badalona, the Homecare Integrated service, the Socio-sanitary Centre El Carme, seven Primary Care Centres and the Centre for Sexual and Reproductive Health and provides care within the most populated suburban area of Barcelona.

The possibility of sharing electronic health records among the different health care levels allows access by patients to Secondary Care, while minimizing duplication. Specialists can see patients both at their home and in the Primary Care Centres.

I had the great pleasure of interviewing Jordi Piera, the CIIO of Badalona Serveis Assistencials (BSA) in Spain, who will be speaking about integrated care in Spain, at HIMSS Liège, March 28-29, 2017. Jordi has degrees in Computer Science Engineering and Enterprise Management and Direction, as well as a Masters in Telemedicine.

Denise: Jordi, please tell us about your responsibilities within the BSA.

JP: As the CIIO or Chief Information and Innovation Officer for the Badalona area, I wear several hats. Our organisation, Badalona Serveis Assistencials provides primary, acute, and intermediary care, as well as social services for 500 000 people and this figure is still growing. I work both on our daily operations and I am also in charge of research and innovation where we focus a lot on how ICT can help us to improve the quality of care we provide to our target population.

DS: I understand that BSA has been working with HIMSS for a number of years.

JP: Yes, our organisation began to collaborate with HIMSS in 2006, right at the very beginning of the operations of HIMSS in Europe. In fact, Badalona Municipal Hospital, with 120 beds, was one of the first hospitals in Europe to achieve HIMSS stage 6 and the first one in Spain all together with Denia Hospital. We are proud of that, and I have enjoyed being closely involved with the process. However, the EMRAM or Electronic Medical Record Adoption Model that enabled us to achieve that score, is primarily relevant for acute hospital care, and so it did not cover all of our needs which must include the full coverage of the continuity of care. Therefore, we were very interested in assessing our organisation within the HIMSS Continuity of Care Maturity Model (CCMM) when we learnt about it.

DS: You are presenting at HIMSS Liège on the Continuity of Care Maturity Model. Would you tell us about that?

JP: The CCMM helps us assess the full range of care settings that we operate in Badalona: primary care, acute care, intermediate care and homecare including social support. At HIMSS Liège, we will discuss how to achieve horizontal integration of services across these different settings. The CCMM enables us to foster a comprehensive approach to integrated care. In Spain, the health system is 100% public, the same as in Scotland for example but with the main difference that there, GPs still operate in private practices or trusts, which makes a great difference when trying to engage them into sharing information amongst care levels.

DS: Can you tell us about some of the integrated care successes in Badalona?

JP:  The first one that comes to mind is the early discharge program for elderly people. I believe we can truly say that this is a patient-centered programme. Let’s take the example of convalescence after a hip fracture. We have shortened the total convalescence period from 9 weeks to 6.1 weeks, thanks to integrated care. Patients go home from the hospital three days after their operation, because we are able to fully coordinate between the health and social care provision in order to provide a comprehensive set of homecare services fulfilling the specific needs of that particular patient.

Secondly, we provide prevention exercises for the elderly, so we get fewer falls and fractures. This is done through a strong collaboration between intermediate care (identifying possible candidates) and primary care (delivering the workshops for both elderly people and their caregivers).

Finally, I would like to mention our “physician nudging programme” in medication prescription. By “nudging,” we mean that we use ICT to gently encourage physicians to prescribe only when necessary while benchmarking them against their colleagues from other care settings. We do this by providing comparative data, ratios of a department or an organisation. Physicians see for themselves, that there are alternatives to their practice.

DS: So I guess we can say that people who live in the Badalona area are enjoying top level service in public health structures.

JP: Yes, for sure. I entered the world of IT in the year 2000 when I was still a student, and I’m really fortunate to have grown up along with the system. I had the opportunity to be part of different implementations of the Electronic Health Record, the integration with the social services, all the new eHealth strategy etc. Happy, but not finished yet. We have a lot more to do and I’m looking forward to bringing back some new ideas from HIMSS Liège!

The next HIMSS event in Europe is HIMSS Liège, taking place in Belgium on March 28-29. Bringing together key European stakeholders and organised in partnership with HIMSS Europe, the Liège University Hospital, and the University of Liège, HIMSS Liège is “the” Health IT event for the Benelux and Northern France. Speakers represent both Europe and the US. A special visit of the Liège Hospital will complete the programme, whose sessions will be held in English, Dutch, and French.

Denise Silber