19. 07. 2021.

It is time to start using IT in healthcare to create new values

Interview with Siniša Košćina for Entrepreneur magazine. 

Faced with the inevitable change of established patterns of business and processes catalyzed by the pandemic, last year digitalization and digital transformation experienced their accelerated growth and implementation in all spheres of business. The leader of the transformation is the IT sector, so domestic experts rolled up their sleeves and showed what we already know - that the IT sector is a generator of growth and development in Croatia. One sector in particular has come under public eye, under greater pressure than ever, the health sector is experiencing its true test of resilience. Can IT generate growth and development here as well, and can a system that is so extensive and complex be reformed with IT solutions? What IT solutions already make our healthcare processes easier? 

We talked about these and other topics with Siniša Košćina, Director of Business Development of the Health and Public Sector of IN2, the company recognized as a leading provider of IT services in the private and public sector. IN2 Group has been operating in our market for almost 30 years, the group operates in five countries in the region, and in addition to Croatia, they are also present in Bosnia and Herzegovina, Serbia, Slovenia and Macedonia. As of 2018, they are part of Constellation Software Inc. which operates in over 100 countries around the world, has 125,000 customers and operates in more than 80 different verticals in the public and private sectors. 

The pandemic is a major challenge for society and the economy, and the health sector in particular has come under pressure. What changes have you noticed in doing business with healthcare entities? Has the health sector also rapidly begun to accept the benefits of digital transformation?

Of course, like all sectors, the first changes were related to the direct challenges of the pandemic. Specifically, it was reconfiguring the healthcare business to Covid services, and at a later stage, monitoring the use of Covid resources (ward occupancy, monitoring of patient movements, their symptoms, and engaged therapy) to support vaccination. I am pleased to see that with the reduction of these direct challenges, the health sector has continued to transform, that is, that the pandemic has been used as a catalyst for the digital transformation that continues. 

What does the digital transformation bring to healthcare institutions and healthcare professionals, and what to patients?

Institutions using IT technologies work faster and better every day, although sometimes it is not directly visible to patients, indirectly the patients themselves benefit from a shorter time to receive the service, but also better and faster services. What patients can see directly are prescriptions, referrals and appointments in their e-Citizen box, while their findings are automatically sent back to the family doctor. In large and complex systems such as healthcare, it takes years of work and dedication to perfect the processes, methods of application and adaptation, listening to the needs of end users and a combination of knowledge and experience of system development experts. I would add that the agility and modularity of the system are also very important, which has been shown precisely through the rapid adaptation of our solutions to the new circumstances. We continue with the processes of informatization of existing systems, but also discover some new areas, which is actually what we as experts in the development of IT solutions are most looking forward to, to see the real application of our solution in the lives of our citizens. 

The main platform of the IN2 Group primarily intended for hospital informatization is the Integrated Hospital Information System - IBIS and its component Hospital Information System BIS. The platform covers a range of health IT spectrum, from primary, secondary and tertiary health care, through diagnostic systems, to complex national e-health solutions in Croatia and Slovenia. In how many institutions in the Republic of Croatia has BIS been implemented and what are the results?

I would like to point out the introduction of BIS in the hospital health system as one of the major investments in health care, which has been carried out by a group of Croatian IT companies for the last 20 years, among which IN2 BIS stands out in the field of hospital health systems. health system. In terms of the number of institutions with a presence in 46 hospitals, IN2 BIS supports over 80 percent of the total capacity of hospital services and we are proud that our customers are our long-term partners, some of them from the very beginning of the 1990s. If we take into account that in this segment we have almost 30,000 named end users who today use the advantages of computers in their daily work, then you know that we have done a good job. Further improvements are going towards interoperability, where all this data of health care institutions will gain additional value through the exchange, but also the secondary use of data. With BIS, we have a constant opportunity to upgrade additional services because healthcare is developing very quickly, personalized medicine is the future, and such advanced technologies are practically impossible without IT support. 


You have also achieved BIS implementations in foreign markets such as Vietnam, Azerbaijan and Saudi Arabia. What challenges did you face during the implementation and what are the points of contact, and what adjustments did you have to make in relation to the system in the Republic of Croatia?

Export is a brand new game. Experiences from the domestic field are a necessary precondition for us to think about exports at all. When we landed in Baku five years ago, we never dreamed of what level of services we would have to provide in the demanding foreign market. I was personally involved in the first project and it is an experience for what no one can prepare you in advance, there is no preparation but just step in and work. That successful reference opened the door for us and calls started coming in from other overseas markets, like Saudi Arabia, and then you become aware that you have succeeded.

Adjustments were necessary because there are a lot of geographically specific processes. For example, in Azerbaijan you pay for a health service in advance or the simple fact that there is no national list of medicines opens up additional work for you and the like. Our international team is composed of the best people developed and learned on the Croatian market and with the right approach, opening a new export market becomes a difficult but extremely interesting job. 




Can the Croatian health sector learn some lessons from foreign markets? Which country would you cite as a positive example of digitalization of healthcare?

It absolutely can and does do it on multiple levels. As a company that deals with hospital information systems, coming into contact with very interesting new processes and ways of organization and business, we are transferring this to the Croatian space and we have already implemented some ideas. As far as the whole country is concerned, our role models are certainly in Western Europe and there I can hardly single out one country, because different roads are conditioned by different local circumstances, but looking at the Nordic countries as a model we cannot go wrong. Of course, with an understanding of our current needs. Long-term market presence, knowledge of business processes and opportunities for adaptation and even innovation in the healthcare IT market are the greatest strength of IN2. 

When we talk about digital services and products in healthcare, apart from BIS, what other products are your implemented and in use? Are these solutions used in their full capacity or is there room for even greater usability?

After BIS, I would like to point out the internationally awarded solution in the segment of eHealth - eOrdering, and the sequentially developed eInstrument that we exported to Slovenia. Thus, we have covered two EU markets with important parts of the eHealth platform.

I would like to point out the product that we think has the greatest export potential, it is a laboratory information system (BioNET LIS), which, except in Croatia and the region, successfully operates in all three previously mentioned export markets. It is in the area of ​​this very affordable module, and on the other hand an extremely demanding environment where today in laboratories you have a large number of devices with various testing options using a large database, which you can not cover with human labor, is an exceptional advantage of computerization. 

In partnership with the Srebrnjak Children's Hospital, you presented the P4 Platform project for the introduction and monitoring of a personalized balanced nutrition in kindergartens. Where did the idea for the concept come from and what is the expected result of it?

This is a very interesting collaboration because it is a continuation of the parental initiative to take care of the nutrition and health of their children. The field of healthy eating today is almost equal in the prevention and treatment of chronic diseases. During the development of the concept, we were surprised at how much attention we pay to nutrition as parents while children are under our supervision, but during kindergarten and school age we lose that control. This is exactly what this project is trying to address and provide insight into the nutrition of children in kindergartens, and if a problem develops from that nutrition, such as allergies and food intolerances, that we have locating the causes and monitoring treatment at a whole new level. The concept will be accompanied by an information system that will enable the collection and exchange of data between the Srebrnjak Children's Hospital and kindergartens. Two years of work on this project will result in the introduction of the concept of personalized balanced nutrition in targeted kindergartens in three Croatian counties in order to preserve health and prevent chronic diseases, with special emphasis on providing adequate care, ie nutrition to children with food allergies and other conditions that require special nutritional conditions. 


How long have you been developing IT solutions for the healthcare sector? Is there a change in the importance of the IT sector in terms of generators of growth and development in the beginnings of your career and today?

The field of IT in healthcare is extremely demanding in terms of knowing how healthcare processes work and that is why it is not uncommon to have IT professionals who have been dedicated to healthcare all their lives. In my guest lectures, I try to bring FER fifth-year students closer and motivate them for this area. And I am proud that every year a couple of students decide to join us and develop and learn with us for a longer period of time. We have a positive example of a student who joined us so six years ago to be in the position of product line manager today. This path is open to anyone who wants to develop their career in this specific but prosperous area.

In the beginning of my career, I worked on various large IT projects, and the area I work in today was discovered 12 years ago. I learned a lot from the experts who have been there since the very beginning of the computerization of hospitals, and I would like to take this opportunity to thank my colleagues Zorislav Nola and Valter Raponja. I would also like to mention KBC Zagreb, where I baked my craft as a project manager for the implementation of BIS, and discovered healthy eating as an interesting area.

As far as IT as a generator of growth is concerned, it has already become a generally accepted fact. Today, this no longer needs to be defended or proven, that is, today, if you do not have IT with you, you practically do not exist. 

How do you predict the continuation of the digital transformation of healthcare in our market?

We have mainly digitized business processes, although there are still challenges, for example in the already mentioned interoperability. Strategically, now is the time to start using IT in healthcare for more than just the acceleration and quality of the process, but to generate new knowledge, to better manage the system, but also to further open the entire system to citizens. At one point we turned to cloud systems, data exchange, synergy, and now is the time to move parts of the process towards each individual stakeholder and create a new area for further strides. Mobile technology is already there and waiting for our ideas and projects. IN2 has recognized this and is going that route.

Source: Entrepreneur, Author: Vladimir Mihajlović
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