Volume 8 - Issue 1, 2008 - My Opinion

Interview with Dr. S. Ondategui-Parra


Dr. Silvia Ondategui-Parra

Associate Hospital Director

Teknon Medical Center

Barcelona, Spain

Adjunct Assistant Professor

Boston University

Boston, US

[email protected]

How did You Come to be Involved in Healthcare Economics and Medical Management?

My interest in management started during medical school. This is the reason I went through a pioneering four-year residency programme in hospital administration. I also achieved other advanced degrees in the field. I spent the last six months of my residency as a Fulbright Scholar in the US and felt attracted by the American style of healthcare management. So, I stayed working as a member of the executive team of the Brigham and Women’s Hospital and Dana Farber Cancer Centre (both affiliated to Harvard Medical School) for several years. Currently, I get to practice as healthcare manager in Europe and as faculty at Boston University Medical School, combining my passion for the European lifestyle and American academics.

Why is Healthcare Management a Growing Topic for Radiologists?

In the words of Dr Margaret Chan, Director-General of the World Health Organisation (WHO) in an address to the Directorate for Health and Social Affairs, Norway, “We face three main problems. For some diseases, we have no tools or only imperfect ones. In other cases, we have excellent tools, but high cost puts them beyond the reach of the poor who need them most. Third, we often have powerful interventions that are cheap or even free, but fail because we lack the systems and personnel for their delivery.”


Healthcare management matters are hot topics nowadays, not only because of a growing focus on cost-led medical departments and paymentby- results schemes, but also because of the growing globalisation of the world’s healthcare industry with the advent of telemedicine and the growth in outsourcing. Technology has truly transformed how doctors, consumers and insurance companies are interacting. New systems aim to reward efficiency, support patient safety and encourage waiting list reductions. Importantly, this changing healthcare model will ensure a more consistent basis for medical funding rather than being reliant on inherited and often antiquated budgets or the bartering skills of personnel in the management chain.

How have Growing Financial Pressures Added to this Growth?

Increasingly, money is linked to the amount of output achieved. Therefore efficiency is the key priority of every healthcare manager today. Strides in medical healthcare technology will inevitably never offset the growing burdens being met by struggling national healthcare systems across the world. However, by increasing the information available to hospital and department administrators we are ensuring that what resources are available, are being maximised in an informed and responsible manner that leads to the best outcome for patients and the continued growth of the individual healthcare unit.


Understanding the economics of healthcare for the individual stakeholder is the only way to make the system stable and self-sustaining. Since “money doesn’t grow on trees”, to be familiar with the revenue and cost cycles is the only possible way to achieve success in healthcare as in any other system.

Why is Healthcare Management Knowledge so Under-Disseminated in the Field of Medicine?

The main reason for this lack of dissemination is the traditional focus on the scientific and clinical aspects of healthcare fostered by medical education, rather than the cost and the affordability of healthcare, particularly for populations. I believe the increase in the number and quality of education programmes related to health management, such as MD & MBA programmes, is changing the traditional model.


What are the three most important management challenges that will face medical managers in the coming years?

The three most important challenges are resources, resources and resources! The aging population, advances in technology and the current economic environment force the health systems and organisations to work efficiently. Once all the stakeholders, including governments, insurance companies, providers and the industry, accept it, then it may be possible to roll out a more stable system.

How is the US Different to Europe in its Approach to Medical Management Education?

More than compulsory education, it is the system itself that fosters interest in medical management education. The US system’s competitiveness makes a savvy medical management a key element. In addition, the undergraduate degree programmes are more prevalent and better established in the US.

What Main Healthcare Economics/Management Courses Exist in Europe and the US that Might be Interesting for Department Leaders?

With respect to radiology management courses in the US, I’d recommend the Association of University Radiologists (AUR) course as well as the Radiological Society of North America (RSNA) programme. In Europe, the International Diagnostic Course in Davos organises every year an appealing “mini MBA” type of programme. The Management in Radiology (MIR) society also has a yearly meeting and course. Since the management of diagnostic imaging is a hot topic the demand for these programmes is increasing.

ECR 2008: Acting on Reliable information

Visitors at the European Congress of Radiology (Vienna, Austria 7-11 March, 2008) will have a chance to experience first-hand radiology information systems and reporting solutions that are powered by SpeechMagicTM – the award-winning speech recognition platform from Philips.


“In radiology reporting ‘powered by SpeechMagicTM’ has established itself as a seal of efficiency and accuracy. Third-party solutions that integrate SpeechMagic can therefore be seen throughout the congress – at more than 40 workstations”, said Anne Durand-Badel, regional marketing manager for Philips Speech Recognition Systems.


Durand-Badel said that together with its partners, Philips is advancing speech recognition to support patient safety by helping radiologists capture vital information in the RIS or EHR. This will help to provide clinicians with accurate and reliable information which they can then quickly act upon.


The lack of adequate information at the point of care is a common cause of medical errors. In Italy medical errors result in up to 90 deaths a day (Special Eurobarometer “Medical Errors”, January 2006, European Commission, DG Health and Consumer Protection). In Germany, 38,000 patients per year are believed to die because of bad teamwork and communications or poor IT support (www.klinik-heute.de), and 850,000 medical errors are reported from the UK each year (National Patient Safety Agency).


“Fast and accurate information capturing in RIS and EHR systems with the help of speech recognition contribute to avoid those errors,” underlined Anne Durand-Badel.


Philips has recently been honored by Frost & Sullivan with the 2007 Global Excellence Award for its demonstrated leadership in the field of speech recognition technologies for the healthcare market. According to Frost & Sullivan, Philips “has excelled in anticipating market demand for speech recognition solutions, leveraging both global and regional integration partnerships, improving its customer service offering and introducing innovative, industry-leading technologies.”


A list of Philips Speech Recognition Systems integration partners at ECR 2008 is available at www.philips.com/speechrecognition.

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IntervieweeDr. Silvia Ondategui-ParraAssociate Hospital DirectorTeknon Medical CenterBarcelona, SpainAdjunct Assistant ProfessorBoston UniversityBoston, US

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