Spain has a universal healthcare system where anyone that pays social security contributions is eligible for healthcare. In the digitalization sense, Spain does not have a national institution to coordinate digital health projects. Instead, each of the 17 Spanish regions has authorities with their own budgets.

Spain attributes roughly 9.5% of the GDP to healthcare. From the digitalization perspective, one of the most advanced regions in Spain is Catalonia.

Progressive Catalonia

As JMIR Public Health and Surveillance writes, the region has a long tradition of health information exchange in the public health care sector and is currently implementing an ambitious digital health strategy. With roughly 7.5 million inhabitants, Catalonia (Northeast Spain) has been considered a forerunner of eHealth adoption in Europe. Since 2009, a robust information exchange deployment has allowed health care providers within the public health system to share clinical information. Currently, the region is implementing a comprehensive digital strategy—it is just one of the few ambitious initiatives that is transforming health information systems in Europe.

As explained by Cesar Morcillo Serra, Internal Medicine specialist from Barcelona, the public healthcare system in Spain is very good but is struggling with waiting times for procedures and doctor’s visits. This is why many people decide to buy private health insurance which costs around 50 to 100 euros monthly. With that, they get instant access to healthcare.

Health insurance company Sanitas, for example, offers immediate video consultations. “We offer video consultation with the same doctors that you can visit face to face.We can manage to do that because we have more than 3000 doctors working for Sanitas in Spain. We developed an algorithm that looks for a free slot in the agenda of the specialist. We are building something like a ‘physical doctor on call’, with many specialities as well,” says Cesar Morcillo Serra.

Driving digital health innovation in hospitals

Sanitas is the leading Spanish health insurance and service provider and have been devoted exclusively to health care for more than 60 years. The Sanitas’ Cima hospital in Barcelona is an exemplar in digital innovation adoption.

Even before COVID, an innovation platform was established which seeks to promote entrepreneurship among employees. Another platform is in place, that aims to attract startup talent in areas such as prevention and genomics, liquid hospital, artificial intelligence, blockchain, data & analytics, and robotics.

The hospital recently adopted a new concept of remote measurement of vital signs and that is by facial imaging - people can measure their heart rate, heart rate variability, breathing frequency, blood pressure.

This is just one of the components of a liquid hospital - a new hospital concept that includes elements of e-Health, Social networks, Thematic portals, and virtual spaces. “ In a liquid hospital there are no barriers between the customers and Sanitas. We are always connected with the patients through our mobile applications. We can get in contact either through calls, chat, or video consultations. We did this to offer them an unforgettable experience. This is not just about technology, it is about connecting people and patients with the healthcare team,” says Cesar Morcillo Serra.

Tune in for the full discussion.

Some questions addressed:

• Let’s start with a little bit more about you. In 2019 you received the  Doctoralia Award for the best rated Internal Medicine doctor in Spain and the Best in Class (BIC) 2019 award for the best Internal Medicine service in Spain. What are you doing differently compared to your colleagues according to your opinion, what is your approach to medicine? 

• Let’s talk about the environment you work in - the Spanish healthcare system. Healthcare is decentralized, run on regional levels. There are 17 regions in Spain. How does in your view access to healthcare, waiting times, quality, development differ among regions? 

• In terms of digital health, Spain does not have a national institution to coordinate digital health projects. How does digitalization differ from other regions in healthcare and what is the state of interoperability among regions - if for example, someone from Barcelona moves to Madrid, what does it mean for his healthcare record? 

• You are participating in the eHealth section at the College of Physicians of Barcelona. This is a meeting place for doctors interested in eHealth and the doctor-patient relationship linked to the use of information and communication technologies applied to the healthcare sector. How “popular” is this section - in your assessment, what is the rough estimate of the percentage of doctors that are taking part? What I am wondering is, how many doctors are tech enthusiast, since, in general, many have enough on their mind with their clinical specialty.

• You lead several digitalization projects inside the hospital you work in - that is the CIMA Hospital. Can you tell me more about the digital health initiatives inside the hospital? How much innovation has come out of them? How exactly are employees encouraged and engaged? 

• The hospital recently adopted a new concept of remote measurement of vital signs and that is by facial imaging - people can measure their Heart rate, Heart rate variability, Breathing frequency, Blood pressure. That’s very impressive. Can you tell me more- how was this validated, tested, approved, etc. ? https://seguros.sanitas.es/dlandings/cambiate/display/pr/bluau 

• You are driving forward the concept of a liquid hospital - a new hospital concept made possible by technology and new ways of working towards a collaborative model among professionals, patients, and society. It includes elements e-Health, Social networks, Thematic portals and Virtual spaces. eHealth and thematic portals are quite self-explanatory, what about social networks and virtual spaces?