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Overlooking healthcare is a mistake

5 febrero, 2021 • By

This is my first blog entry of 2021 and although the majority of us were hoping that the year would have started better, the truth is that this pandemic is making life difficult for us. As the president of Valencia’s College of Physicians quite rightly described, this is not a wave, this is a vertical wall.

And I’d like to add: it is impossible to face a challenge like that of this pandemic without order or planning or correct management from our authorities which, in addition, still do not count on physicians to make decisions. It seems that some public debates carry more weight than the deaths of hundreds of people every day, a terrible statistic that we have experienced for the last few weeks.

Almost a year since the start of this unprescedented health, social and economic crisis, our leaders still do not believe in the importance of uniting and combining forces and strengthening the coordination between public and private resources. Once again, it seems that they prefer to put beds in hospital halls, chapels or the corridors in the Emergency department rather than sitting down with all the healthcare workers and jointly planning the best way of treating Covid patients, as well as non-Covid patients that cannot or should not wait any longer. It is important to remember that, after a year of the pandemic, the waiting lists are unbearable in many hospitals. We are talking about people’s health.

I sometimes have the feeling that putting a patient in a private hospital bed is valued less than putting them in the cafeteria of a public hospital. And I find it outrageous that someone may even question what is better for that patient.

These types of situations are those that, in my opinion, we have to reflect on in terms of what we’re not doing well, both within the sector and in society in general, especially if we allow these things that shouldn’t happen to indeed happen. They shouldn’t even occur. You can’t close your eyes when faced with situations that have no justification. Not to mention the hospital tents that have been set up in the Valencian Community and I’m not going to go into the criticisms. All you need to do is hear what the poor patients who were admitted there have said. But the bottom line is that, unfortunately, our leaders have spent the last year making bad decisions and making them too late, investing in botched jobs that don’t improve the healthcare of the citizens or the work of the professionals and wasting and disregarding resources that the private sector has made available to them since the beginning.

And that bias regarding private healthcare and its professionals brings me to another disdainful gesture shown to this group, a group as professional and vocational as that of the public centres. I’m referring to the vaccination process. You don’t need to be an expert in the subject  or manage a health group to realise that neither the organisation nor the logistics of the vaccination process have been good on the part of the relevant authorities. And a lot of things surprise me: from the lack of foresight to the disastrous planning and distribution of the vaccine, in some locations a dose wasted due to a lack of adequate needles and countless other things. But it surprises me again that private healthcare professionals are marginalised when it comes to the vaccination process, as if they don’t treat Covid patients (and non-Covid, who could catch  it when they come to a consultation without knowing it). At least, there have been medical associations that have gone to the courts to demand the vaccination of these professionals and, after having it granted, the governments have taken it as an obligation…but putting them almost at the bottom of the list. It’s outrageous. All health professionals, regardless of where they carry out their work, are equally valuable. Today and always. But especially in the context of this virus. Marginalisation in healthcare during a pandemic is a very serious mistake.  

And I want to stress a fundamental idea. We have to focus all of our efforts on two objectives: to guarantee appropriate healthcare for all Covid and non-Covid patients; and to give a definitive boost to vaccinating. There are success stories and examples of unified efforts, resources, staff and infrastructures that have resulted in a very high percentage of vaccinations among the public, for example, Israel.

We have time to re-direct 2021 and turn some predictions around that, at present, are not optimistic. But I want to say loudly…together, we will achieve it!


English

Open letter to Torrevieja Health Department employees

21 octubre, 2020 • By

Dear colleagues,

As you all know, yesterday the Health councillor, Ana Barceló, unfortunately confirmed the Generalitat Valenciana’s unilateral decision to not extend Torrevieja Health Department’s contract with Ribera Salud.

I firmly believe this is the wrong decision for the professionals and citizens in this area, and worst of all is that I am certain that there are voices within the Government that believe so too, as well as within civil society.

Also, the Valencian Government has the data corresponding to the previous reversion to direct public administration of the Health Department of La Ribera, whose waiting list has grown threefold in two years, whose professionals are up in arms and which costs the Valencian people upward of 80 million euros a year. Furthermore, in the case of Torrevieja, this decision is even more serious and incomprehensible because of the terrible social and healthcare crisis and financial recession that we are living through. We are in the middle of a global pandemic and our leaders are going to allow their political needs to take time away from what is really important: ensuring citizens have access to the best healthcare.

The councillor’s unimaginable announcement yesterday cannot be justified in terms of quality or efficiency, even less so in terms of health results. Because this department is the best in the Valencian Community thanks to the excellent work, commitment and efforts of all the people that make its day-to-day operation possible. And we are not the ones saying it. The official reports and audits of the Generalitat Valenciana itself say so: patient satisfaction is higher, waiting times are shorter and the best healthcare is provided, thanks to the proven real commitment to healthcare plans, investments, technology and human and material resources. And this has been ratified by independent organisms that certify the quality of the healthcare provided to citizens in the Torrevieja area, such as The Joint Commission International.

But I am not writing to you to butter you up, because no one knows better than you the magnificent work you have done and continue to do during these 14 years in such a special region, with a multinational population for whom, in many cases, without a doubt, the quality of healthcare received is a reason for their residence here. And there is no question that what the Valencian Government want to do to this department will reach Europe and the authorities of the 138 nationalities that live here, with facts and figures.

Our intention, as you know, was and is to extend this commitment with the region for five more years. This is why we presented an investment plan with clear, real proposals agreed upon with the local councils, valued at 40 million euros. For this reason, we also recently signed a new collective bargaining agreement, with conditions regarding reconciliation, equality, training, professional career and internal promotion that no other public hospital in the Valencian Community has.

If your attitude and commitment in the last 14 years has been outstanding, your response during the hardest months of this pandemic that you continue to deliver today confirms that you are Ribera Salud’s main asset. And I take this opportunity to reaffirm my gratitude and admiration. Despite what some try to extend, this crisis has proven that public-private collaboration is essential, and that the only way we will get through this complex situation is together.

I will not deceive you. After yesterday’s announcement, this is the beginning of a period of uncertainty where we all have many questions and the Health Council has very few answers. This is the truth.

But in this letter, I want to convey trust, hope and perseverance. We will continue to prove that we are a great team and that we will not give up looking after the health of our citizens with the best professionals, the latest technology and the highest safety guarantees for you while you do your job.

Remember that the future is not set in stone. Who would have thought that 8 months ago we would be living in lockdown for months because of a virus and that still today we would be living a global pandemic. No one knows where or how we will be in a year.

I am committed to continue working with a positive attitude, seeking joint forces and resources, public and private, to ensure that citizens have the Healthcare they deserve and that you as professionals continue to do your job with all the necessary means, the highest guarantees and the certainty that, as we have seen in Alzira, others cannot give you. I refuse to believe that the message of unity and call to public-private collaboration by the president of the Generalitat Valenciana, Ximo Puig, last October 9, are hollow just five days later.

We all hoped this day would never come, but it has. I ask for your patience and trust and encourage you to continue to highlight the importance of the work, commitment, and vocation of the public service that Ribera Salud has always displayed.

We are all in this together.

Dear colleagues,

As you all know, yesterday the Health councillor, Ana Barceló, unfortunately confirmed the Generalitat Valenciana’s unilateral decision to not extend Torrevieja Health Department’s contract with Ribera Salud.

I firmly believe this is the wrong decision for the professionals and citizens in this area, and worst of all is that I am certain that there are voices within the Government that believe so too, as well as within civil society.

Also, the Valencian Government has the data corresponding to the previous reversion to direct public administration of the Health Department of La Ribera, whose waiting list has grown threefold in two years, whose professionals are up in arms and which costs the Valencian people upward of 80 million euros a year. Furthermore, in the case of Torrevieja, this decision is even more serious and incomprehensible because of the terrible social and healthcare crisis and financial recession that we are living through. We are in the middle of a global pandemic and our leaders are going to allow their political needs to take time away from what is really important: ensuring citizens have access to the best healthcare.

The councillor’s unimaginable announcement yesterday cannot be justified in terms of quality or efficiency, even less so in terms of health results. Because this department is the best in the Valencian Community thanks to the excellent work, commitment and efforts of all the people that make its day-to-day operation possible. And we are not the ones saying it. The official reports and audits of the Generalitat Valenciana itself say so: patient satisfaction is higher, waiting times are shorter and the best healthcare is provided, thanks to the proven real commitment to healthcare plans, investments, technology and human and material resources. And this has been ratified by independent organisms that certify the quality of the healthcare provided to citizens in the Torrevieja area, such as The Joint Commission International.

But I am not writing to you to butter you up, because no one knows better than you the magnificent work you have done and continue to do during these 14 years in such a special region, with a multinational population for whom, in many cases, without a doubt, the quality of healthcare received is a reason for their residence here. And there is no question that what the Valencian Government want to do to this department will reach Europe and the authorities of the 138 nationalities that live here, with facts and figures.

Our intention, as you know, was and is to extend this commitment with the region for five more years. This is why we presented an investment plan with clear, real proposals agreed upon with the local councils, valued at 40 million euros. For this reason, we also recently signed a new collective bargaining agreement, with conditions regarding reconciliation, equality, training, professional career and internal promotion that no other public hospital in the Valencian Community has.

If your attitude and commitment in the last 14 years has been outstanding, your response during the hardest months of this pandemic that you continue to deliver today confirms that you are Ribera Salud’s main asset. And I take this opportunity to reaffirm my gratitude and admiration. Despite what some try to extend, this crisis has proven that public-private collaboration is essential, and that the only way we will get through this complex situation is together.

I will not deceive you. After yesterday’s announcement, this is the beginning of a period of uncertainty where we all have many questions and the Health Council has very few answers. This is the truth.

But in this letter, I want to convey trust, hope and perseverance. We will continue to prove that we are a great team and that we will not give up looking after the health of our citizens with the best professionals, the latest technology and the highest safety guarantees for you while you do your job.

Remember that the future is not set in stone. Who would have thought that 8 months ago we would be living in lockdown for months because of a virus and that still today we would be living a global pandemic. No one knows where or how we will be in a year.

I am committed to continue working with a positive attitude, seeking joint forces and resources, public and private, to ensure that citizens have the Healthcare they deserve and that you as professionals continue to do your job with all the necessary means, the highest guarantees and the certainty that, as we have seen in Alzira, others cannot give you. I refuse to believe that the message of unity and call to public-private collaboration by the president of the Generalitat Valenciana, Ximo Puig, last October 9, are hollow just five days later.

We all hoped this day would never come, but it has. I ask for your patience and trust and encourage you to continue to highlight the importance of the work, commitment, and vocation of the public service that Ribera Salud has always displayed.

We are all in this together.

All the best,


English

The Challenge of digital transformation

22 septiembre, 2020 • By

Based on my intervention during the 1st Public Health Observatory Symposium, organised by the newspaper El Español on September 10, I would like to share some of the thoughts I was able to contribute to that interesting forum, specifically during the discussion panel dedicated to digital transformation.

When we talk about digital transformation, of the healthcare system and the challenges we face, we must make a diagnosis beyond this crisis that’s been triggered by COVID-19.

The macrotrends within the Health sector are there. We have an increasingly ageing society, and we speak about disease chronicity precisely as a result of this ageing population. There are also three other components or factors that we must know how to redirect or lead in the right direction, to ensure the sustainability and quality of our healthcare system. I’m referring to the introduction of new healthcare and information technologies, the shortage of healthcare professionals and the unsuitable training and experience of current healthcare professionals for the demands of today’s society.

Let’s start at the beginning, along the path that should guide the present and future of our Public Health. Digital transformation must become the system’s springboard.

Likewise, when we talk about our ageing population, we must tackle how we’re going to organise the social-healthcare space that has been (and still is) under so much stress during this pandemic. But we mustn’t resign ourselves to this. We must seek solutions.

Nursing homes must work more closely with the healthcare system, allowing professionals to follow up on residents, especially Primary Care professionals. There’s no need for nursing homes to turn into hospitals, but the Healthcare System must create mechanisms that will allow us to comprehensively follow up on the health of our elderly, the most fragile members of our society, and anticipate risks.

When approaching the chronicity of many diseases, largely due to this ageing population and also because of the advances in treatments, it’s essential to discuss including all the different healthcare levels: from primary care to hospital care, including social-healthcare and home care. As part of the system, we must all share a common vision and outline common strategies for action.

Because there’s no question that we’re heading towards a more predictive and preventive model. It’s important to be one step ahead of circumstances, to anticipate citizens’ health issues, to foresee the progression of their disease… In this sense, primary care must play a fundamental role within the system. Because we’re heading towards a system that, as well as healing, must also take care of and be by people’s side throughout all stages of life.

Which is the role of healthcare professionals within this new model? Through these digital transformation processes that all organisations within the sector are working on, we must disentangle the healthcare professional from more bureaucratic tasks and allow them to focus on what provides citizens with the most value, which is better care, which also entails greater satisfaction and recognition. Therefore, we must leave behind the traditional hospital concept to come home, working hand in hand with primary care, and thus see Public Health in a new light, with a more holistic approach.

To face these issues and enable new solutions, digital transformation is a fundamental platform and an ally to changing the health model, beyond COVID-19.

And these changes and the sector’s necessary evolution have a single objective: the citizens. Because people are going to play a leading role in this transformation. If someone had told us on March 1 that we’d be under lockdown, not just us but our businesses and the entire world, and that we’d be capable of adapting our organisations to working from home in less than 15 days, we wouldn’t have believed it. But we were able to do this and much more, both organisations and people. And this must give us hope, because citizens must take on the leading role in this transformation.

Some say that the population lacks digital culture… We may not know the inner workings of a mobile phone or computer, but we all know that if we want to reach a destination, know the weather forecast or stay in touch with our loved ones, our mobile phone, in short, technology, is indispensable. And that’s also digital culture. Without it, we wouldn’t have survived.

I also firmly believe that this digital transformation will empower citizens, giving them a larger role in managing their health, and making ours a more democratic, open and efficient system.

Technology also makes us more transparent, which involves trust. And digitalisation is key within the British concept of accountability, because transparency makes us more responsible.

In short, we must be capable of doing more and better things.

We can’t forget that digital transformation helps the Health system’s long-term strategies, as well as the 2030 Agenda and the Sustainable Development Goals, where goal 3 is good Health and Wellbeing. I believe that these are concepts that we, the agents that work within the system, must all strive for. In addition, goal 17 is partnerships between institutions. I’d add between public and private institutions. Because the goal is to end poverty and provide our citizens with wellbeing, and we shouldn’t place before these main goals nuances, political positions or personal whims that may become an obstacle to reaching these worldwide goals.

These days are highlighting that innovation is linked to public-private collaboration, where we find the pharmaceutical industry, big companies within the healthcare sector that participate in this symposium, and institutions. We all need to work towards common goals, discuss new relationship models between the payer, whether public (such as the State or the Autonomous Communities) or private (such as insurance companies), and suppliers of all kinds (industrial, pharmaceutical, hospital and professional) and, also, reconsider the funder’s relationship with citizens. A new relationship must arise. We must bring to the table the need to share strategies and plans, and change the relationship by moving towards shared risk models, so that we understand everyone’s mission.

Let me finish with some thoughts on this healthcare crisis brought on by COVID-19, which has already been with us for six months, and will most likely stay for some time. It has shown us that, when faced with such a crisis, we should have worked together even more, with a greater joint effort than up until now… I hope that we’ve learnt our lesson and that we’re all aware that, without bringing something to the table, without coming to an understanding, we’re going to struggle to overcome this situation, not only in the field of healthcare, but also in the social and business world. This is the greatest lesson the pandemic has taught us.


Alberto de Rosa, English

A new opportunity

1 julio, 2020 • By

We have been talking about this for many years. The post-COVID-19 reality means that it is now more necessary than ever to undergo reformations in the Health sector that will allow the system to be more flexible and provide it with the tools necessary to face health care crisis such as that we have just experienced. However, most researchers agree upon the fact that COVID-19 has been the first pandemic of the 21st century, but it will not be the last. First of all, we need to be prepared to coexist with this virus, at least until a vaccine is available on the market.

The great axes around which an urgent restructuring of the healthy system must pivot are, in my opinion: an increased Health budget, with total transparency; the introduction of reformations in the management of human resources and implementation of new organisational models, where digitalisation plays an essential role; the overcoming of barriers between levels of care, with greater integration in the social space; and the necessary involvement and collaboration of all resources in the system, both public and private.

Any type of reformation necessarily involves flexibilisation of the health system, the rigidity of which has been causing a lack of efficiency and loss of quality with regards to citizen care for decades. At a time when it is more important than ever to contribute, innovate and position ourselves one step ahead of any health care crisis that may threaten the population, the institutions must be brave and make effective decisions.

I have spoken about the necessary increase for the Health budget, of course, always from absolute transparency, prioritising resources and specifying items. But perhaps the most urgent challenge for a health system such as the Spanish one is the necessary reformation of the management of human resources, where, in my opinion, it would be advisable to redefine the legal framework in order to permit a more modern management of human resources and to introduce variable remuneration models and bonuses, in order to recognise the value provided by professionals at all times.

In the same way as the citizens have new needs with regards to the care for their well-being, I believe that it is essential to restructure the current medical specialties and to make decisions that permit an increase in the number of certain disciplines in order to adapt the offer to the demand for care. Spain is currently generating a large number of specialists that, as a consequence of the technological advances or the demographic profile of the citizens, are no longer necessary in these quantities. Even so, there is a lack of specialists in modalities where jobs for Resident Medical Interns (RMI) are not anticipated. This situation generates imbalances, rigidity in the system, low performance and, most importantly, a decrease in quality and care for citizens. Because if there is a lack of specialists, the waiting lists grow longer.

This COVID-19 crisis will imply an acceleration in the digital transformation process. It is fundamental to implement new organisational models to consolidate the general focus on digitalisation both for health care (with predictive models and online and offline care, useful healthcare websites, direct communication between the patient and their physician, promotion of home care and remote medicine, etc.) and for managing medicines (integrate complements for pharmacists in the care circuit, guarantee online prescriptions and a medicine cooperative, among others).

Another aspect to be learned from this health care crisis is that we must progress the citizen’s perspective as the protagonist of our system and overcome all barriers between the levels of care: primary care, hospital, nursing homes and specialised services. It is essential that we strengthen primary care, guarantee human resources and materials in order to offer personalised, approachable and quality care for our citizens.

It is urgent, after the devastating effect that COVID-19 has had on nursing homes, to reconsider the creation of a single socio-healthcare space in order to break the duality between Health and Social Well-being. Nursing homes must be added to the work areas that are currently integrated to the health departments.

Throughout this transformation, we must avail of all of the agents in the system, both public and private, because if there is something else that we’ve learned from this pandemic it’s that without working together and collaborating, it would have been much more difficult to provide an effective and quality response to our citizens.

I would like to dedicate this article to all of those who have lost their lives as a result of this pandemic.

(This article was published in New Medical Economics on 1sth July 2020)


Alberto de Rosa, English

Digitalisation and reindustrialisation, more lessons from this crisis

23 abril, 2020 • By

Last Friday I was interviewed on Cadena Ser by Amadeo Salvador and Arturo Blay, with whom I talked about the importance of global strategies when facing healthcare crises like COVID-19, how this worldwide emergency has proven that we need digital technology and the importance of undertaking an urgent reindustrialisation in Spain. As I have said in this interview and in similar statements that I made in the Levante-EMV newspaper and several blogposts, this worldwide pandemic has allowed us to prove that we can do many things very well without being physically present. Also, not having the resources to produce all the necessary supplies in Spain, at a time like this, has been detrimental. We should not leave two areas such as industrialisation and research completely in the hands of other countries, so that we can always have our own resources, when necessary.

– Journalist: What is the first thing that comes to mind when you realise that unfortunately in the Community of Valencia we have already had 1,000 deaths due to COVID-19?
We are facing the first pandemic of the 21st Century. And, unfortunately, I hope that we learn consequences from this new disease and the challenge we are facing for the future. But we are definitely living through a dramatic tragedy. 

– Does the fact that Germany invests three times more in healthcare than Spain have to do with their country being less affected than us?
Many conclusions must be drawn. First, it is affecting the northern hemisphere much more than the southern hemisphere. I am really worried about what is going to happen in less-developed countries when southern winter starts. This week, at Ribera Salud and in collaboration with the World Bank, we have had the opportunity to explain to 150 government, public and private institutions the experience we have had facing this situation. Because, from the point of view of solidarity and sharing knowledge, we realise that this is a global epidemic and we must respond globally and share experiences. Right now, Europe has become the epicentre of this pandemic. And, more or less, collective decisions have been made. Which I think is very important: creating this kind of collective strategies and organisations. 

Some countries have decided to perform massive testing from the beginning. Which means numbers do not add up, they have many cases but an exceptionally low mortality rate. In Spain, we may possibly have more cases than we officially recognise, precisely due to the lack of massive testing. Something that we are now trying to correct. 

– Have there been warnings in recent history? Where there precedents that could have made us suspect that this could happen?
There have been other cases of warnings by the World Health Organization with SARS, and other cases that were stopped. Because that virus did not have the same characteristics as this one. I would say that it is a virus that spreads easily. And that is something that was possibly unknown or could not have been foreseen at the beginning of the disease. Only China, the source of it, was able to contain it by isolating the entire region of Wuhan. 

But it has spread very quickly because it is easily transmitted. It also has a peculiar development, in that there are no standard parameters, or at least, to date, they are unknown. And it affects people who initially seem to have similar physical conditions very differently. Some are much more intensely affected than others. And we have cases of young people who are seriously compromised. And children are hardly affected. It has focused on adults. 

In our case, for example, we know that we are in four autonomous communities. We have seen the mortality rate of all the people that have died in our hospitals, 90% of them are over 70 years old. And, for example, 75% are men, which is also something that should be studied. 

“PUBLIC HEALTHCARE IS DEFENDED BY LISTENING TO TECHNICIANS AND EXPERTS. WITH FAST DECISIONS. NOT WITH POPULISM, SLOGANS OR IDIOMS” 

– Should national industry be strengthened so that we do not run out supplies?
In an article I wrote a few days ago, I was saying that one of the lessons we must learn from this situation is that we must strengthen global organisations. It is obvious that the virus does not distinguish between regions, borders or ideologies. If we want to provide an effective response, we must do so globally. And coordinating country strategies, especially among European countries, is essential. But we must also think about the future. For example, we must invest more in digital technology. Now we are trying out how organisations can be connected without being physically present. Investing in digital technology can be a good lesson. 

Regarding reindustrialisation, we have realised that not having solutions within the country, at a time like now, has left us at times defenceless to get essential supplies to ensure the safety of our professionals and citizens. Therefore, this service economy that we have developed has perhaps proven that, at this time, it should be reformulated in favour of reindustrialisation. 

And a third topic that I find really interesting: if we want to be a leading country, we must invest in research. And not depend on third parties, but have enough independence. These are the three lessons I think we should focus on moving forward. 

PUBLIC AND PRIVATE HEALTHCARE HAVE PROVEN THEY CAN WORK TOGETHER” 

– What do you think about the statements that have been made about public healthcare?
I feel like a manager of public healthcare and I think it must be taken seriously. I would like for the people who write headlines about public healthcare without really understanding how it works, to think more about experts and technicians for once. And less about slogans, populism, and idioms. We have a strong public healthcare in Spain because it has great professionals, who are the real heroes of this story. And within public healthcare, which we value so much now that we are in a crisis, what we can and must do is talk about how to make it more effective. I think we have proven that we must be very fast and search for very flexible formulas to be able to face a crisis. 

And if we want to be strong enough within the healthcare world to face these situations and the challenges of the 21st Century, we must not forget ageing or chronicity. And learn to combine forces… Combine the resources of the Administration, the State, the Government as well as private resources. And we must not be afraid of realising that right now we are all together. Public healthcare managed by the Government, by companies like ours and private healthcare, all working hand in hand. It is a good example for the future. The fact that we can work together towards a goal, which is to provide citizens a better service. 

– Do you think that we have taken advantage of all the elements that private healthcare can offer?

It depends on the situation. For example, in Madrid and Catalonia, where the crisis has been greater, there has been a single authority, called “Plan 102”, where public, private, and public-private resources, which is what we are, had exactly the same value. Because there was an urgent need to do so. In the Catalan system, where historically the public and state-subsidised sectors often work collectively, no issues have arisen, and they have worked well together. In the Community of Valencia, we considered the need to work together. But fortunately, the system has not become overrun as many managers feared. And the intense collaboration with the private sector that was expected has not been necessary. 

I think this is positive because it has not been necessary. But we appreciate and recognise that all the private clinics have been at the disposal of the Healthcare Department. 

MASSIVE TESTING IS ESSENTIAL. WHEN WE ARE SITTING NEXT TO EACH OTHER, WE MUST KNOW WHO HAS HAD THE DISEASE AND WHO HAS NOT TO LEAD A NORMAL LIFE” 

– What do you think about the fact that many people have stopped going to PHC clinics, or self-medicate, or A&E Departments are quite empty…?
At all our centres in the Community of Valencia we are doing many virtual consultations with other specialities. Many have preferred to stay home to follow the recommendations, because they do not want to risk becoming infected and have preferred to not come to hospital. But that does not mean that the tools are not in place. This is why I insist on investing in digital technology. We have a health portal called “Yo Salud” [My Health]. We are amazed by how its use has increased among citizens to stay in touch with hospital and PHC professionals, with a 900% increase this month. 

“OUR VIRTUAL PORTAL “YO SALUD” [MY HEALTH] HAS INCREASED ITS ACTIVITY BY 900% IN ONE MONTH” 

Before we had 100 consultations, now they have been multiplied by 9. Therefore, one lesson is that, obviously, there are serious diseases where you definitely have to go to the A&E department. But for communication about chronic diseases, going to the physician is not indispensable, although being in touch with them is. And we must promote formulas such as digitalisation. 

– Spain has a lot of fibre optics, but digitalisation is more than that, right?
These are discussions that come up in recent years. Seeing how we can improve citizen-patient communication, not only with physical visits, which are essential. But also, in cases like high blood pressure, being able to send your physician a message saying “Hey, I don’t feel well but I’ve taken my blood pressure, here are the results” and for your physician to reply… We must promote that closeness in communication and being more in contact. 

This is another challenge that the crisis is bringing to the table. And now, when they were announcing the data, I remembered something essential: the necessary relationship between the hospital and healthcare sector in general and the social sector. We have been talking about social-healthcare space for years. And perhaps this crisis has made us realise that we have focused all our attention on the healthcare sector, especially on how to strengthen hospitals to respond to this crisis. And care in nursing homes has been overlooked. Unfortunately, we are seeing tragic data. But now is the time to think about that idea of social-healthcare space. 

– Could the system collapse when this current crisis is over because of everything that is not being treated?
We are starting to look into how to set ourselves in motion again. Because we have already overcome this critical phase where it was difficult to foresee what would happen the following week, we had to be ready for the worse outcome and we have been focused on getting by day-to-day. 

Now that we are not absolutely obsessed by this, we must start thinking about what happens after the crisis. And we are working with a concept that is very important: working with the maximum safety for our professionals and our patients. Because we must move forward. And that is something that I am also insisting on many times: on doing massive testing. Because, when we are sitting next to each other, we need to know who is asymptomatic and who has had the disease to try to lead as normal a life as possible. That is why we must insist time and again on doing massive testing. 

This is the link to the full interview on Cadena Ser, in case you find it interesting: https://cadenaser.com/emisora/2020/04/17/radio_valencia/1587126029_909395.html