Innovative Framework of Medical Services Management in Greece

Author:

Athanassios K. Papamichos OT, MSc

President and CEO, Health Units S.A.

During recent years, there has been a growing interest in reforming healthcare systems worldwide. Countries of all economic development levels are looking for creative ways to organise and finance healthcare in such a way as to promote equity, effectiveness and efficiency. The European Union is increasingly facing problems in this regard, as a result of globalisation, a lack of competitiveness and its ageing population. This state of affairs is a clear indication that the status quo is no longer an option.

The Lisbon European Council (23- 24 March 2000) identified problems arising in healthcare delivery due to increasing costs and expenditure as well as the less than optimal quality of medical services. Subsequently, they stressed the need for investment in human resources and the information society, calling for new models that will ensure the provision of high quality medical services.

Within this framework, the National Reform Programme of Greece – for the period 2005-2008 – is focusing on the development of models, which evolve from productive private entrepreneurial initiatives that can promote competitiveness and openness of the economy.

Health Units S.A.

The Greek Ministry of Health and Social Solidarity (MoH) responded to calls for healthcare delivery reform by designing models that are based on preventive and person-centred healthcare systems. The establishment of Health Units S.A. in 2004 – a state-owned company serving public interest – created an innovative operational tool for the provision of qualitative healthcare services to citizens, while complying with the rules of a competitive market economy.

The MoH provided the venture capital for this new legal entity and has the right to transfer up to 49% of its initial capital to other institutions of the public sector, such as the existing social insurance funds, in order to maintain the public character of the company.

The Greek government, through the Inter-ministerial Committee, supervises the operational and financial

Management of the company. The primary aim of Health Units S.A. is to operate and develop the Olympic Village Polyclinic and build on the experience and know-how in healthcare delivery that was acquired during the summer Olympic Games of Athens in 2004.

Along with the provision of primary care clinical services, the company offers specialised medical services (e.g. home care, rehabilitation), advanced treatment techniques for athletes, and preventive medicine consultation. Other objectives include the continuous education and training of healthcare professionals, and the promotion of occupational health and life sciences.

Innovations and Advantages

The legal scheme of Health Units S.A. offered the potential to develop a series of innovations. Firstly, the company constitutes the first Société Anonyme offered by the State, providing modern and competitive medical services to citizens with private insurance.

Additionally, it uses a new legal framework, which allows better management of material and human resources, thus allowing greater flexibility in decision-making, and, subsequently, faster and better responses to the demands for high quality healthcare services.

A new, flexible form of administration and management – freed from long bureaucratic procedures and unsuccessful methods used by public organisations and healthcare units – has been implemented. It offers the potential for developing and enhancing human resource effectiveness through evaluation and motivation criteria.

Health Units S.A. utilises Quality Assurance and Total Quality Control techniques according to international standards and protocols (Business Management and Administration – ISO 9001:2000, Data Integrity and Security – ISO 27001, Biological Laboratories – ISO 17025, Environmental Management – ISO14001, Hygiene and Security at Work – ELOT 1801, Clinical Protocols – Balanced Scorecard). Furthermore, it prioritises the integration and best practice of emerging technologies in healthcare. Finally, the company’s legal framework safeguards its public character while still offering the option of exploiting different funding sources.

Olympic Village Polyclinic

Until now Health Units S.A. has focused on the post-Olympic development and operation of the Olympic Village Polyclinic. The polyclinic became operational during the Olympic and Paralympic Games of Athens. It received much praise from the international community for its high quality medical services offered to more than 12 000 athletes, officials, delegates, and members of the Olympic family.

Inspired by the technical know-how acquired during the Games, the advanced infrastructure and the stateof- the-art biomedical equipment, the company decided to implement a project that would alter the operation and organisation of clinical services. This transformed the Polyclinic into a centre of excellence in the fields of primary care, physical therapy and rehabilitation.

Today, it is known for:

• providing high-level integrated primary care clinical services to citizens;

• providing qualitative medical services in physical therapy and rehabilitation; and

• developing specialised services in athlete support, home care, telemedicine, prevention and healthcare promotion.

Quality of diagnosis, therapy and continuous care is enhanced through the use of information and communication technologies in the form of a  Hospital Information System, a Laboratory Information System, a Radiology Information System, a Picture Archive and Communication System and an integrated, patient centred Electronic Medical Record. In addition, electronic clinical workflows are devised in a way that allows flawless transition from conventional procedures to a complete paperless/ filmless hospital environment. The development of a Management Information System, which monitors the business process, and management of healthcare delivery within the network of Health Units primary care centres will provide a new model for integrating the Healthcare Enterprise in Greece.

Strategic Planning

The company’s strategic plan concentrates on developing:

• a network of primary care centres with integrated operational and managerial standards, which can offer qualitative medical services to citizens;

• e-health services;

• educational and training activities for healthcare professionals;

• new, innovative medical services in primary care; and

• Public-Private Partnerships (PPPs).

Public-Private Partnerships will encourage the development of new projects, exchange of know-how, and standardisation in the organisation of healthcare delivery. During the last few years, several PPPs have been established throughout the European Union, including new member states from Eastern Europe and the Mediterranean. The basic advantages of such partnerships in healthcare include finding potential investments and funding for new projects, applying emerging technologies in medical services and ensuring that they are accessible at the point of need, and developing preventive and personcentred National Healthcare System models that can guarantee financial sustainability. As part of its broader strategic planning, the MoH aims to use Health Units S.A. as a tool for developing cooperation and partnerships with national and international public/private organisations, thus improving cost-effectiveness of medical services in Greece while maintaining their public character.

Conclusions

Strategies of healthcare integration aim to bring together input, organisation, and management, in order to make the delivery of particular services more efficient and accessible to citizens. The legal and operational

framework of Health Units S.A. offers the opportunity to modernise and enhance the effectiveness of medical services in Greece.