Developing a Strategic Program for Chilean Health Information Technology

Abstract

As part of an effort to assist Chile in developing a strategic program to foster the development of the health information technology (health IT) sector over the next five to ten years, this study assesses the current state of health IT adoption and implementation in Chile, as well as the challenges and opportunities facing the sector over the coming years. The authors conducted an environmental scan and ten key informant interviews and found that there are a number of successful health IT projects and strategies for further development currently underway in Chile, but that the successful projects are generally localized within specific health care providers and lack integration. These and other challenges suggest significant potential for the Ministry of Economy and other stakeholders to take specific actions designed to encourage further development of the health IT sector in Chile over the coming years. The next phase of this effort will use the results from this study to develop a roadmap for the Ministry of Economy to encourage health IT development in Chile over the short, medium, and long terms.

To foster development in a variety of economic sectors, the Chilean government created “Strategic Programs for Smart Specialization” (referred to in this study as “Strategic Programs”). One of these programs is in the area of “health and technology.” The Ministry of Economy has tasked RAND with exploring the current state of health information technology (health IT) in Chile and developing a roadmap for its further development over the short (one to two years), medium (four to six years), and long (ten years) terms.

This study presents the results of the first phase of this work, an environmental scan and key informant interviews designed to gather information on the current state of health IT investment in Chile and the challenges and opportunities associated with further development of health IT in the coming years. We reviewed documents from a number of publication databases, including PubMed, Scopus, LILACS, and SCIELO, as well as the grey literature. We also conducted ten key informant interviews with two types of stakeholders: (1) key stakeholders in health policy in Chile, including those from government and academia, and (2) directors of projects associated with health IT that have received funding from the Ministry of Economy. While ten is a small number of interviews, which limits our ability to generalize the results to the entire health care system, we were able to capture some key themes and important recommendations as part of this process.

Our findings indicate that a number of health IT projects have been or are currently underway in Chile. The Ministry of Health (MINSAL) has developed a “Digital Health Strategy,” which is working to implement four phases of health IT adoption and implementation in the public health care system in Chile. In addition, universities, private businesses, and regional and international players have been working to develop health IT projects in areas including telemedicine, electronic health records (EHRs), referral and appointment systems, and resource management tools. All of these projects are designed to help reduce challenges faced by the health care system, which include inequitable access to care, significant wait times, and a low proportion of providers.

The interviews identified challenges and opportunities associated with the implementation of health IT in Chile. We found three closely related key challenges. The first is the lack of interoperability standards and requirements for new health IT projects. The second key challenge is the fact that most health IT projects in Chile have been implemented only on an individual clinic level—for example, in only one or a few hospitals or one region. A third important challenge is the lack of coordination among different stakeholders seeking to implement new health IT projects.

Respondents did indicate that there are a number of opportunities for the Ministry of Economy to foster development in health IT, for example, via the creation of a new center to encourage standardization (which is currently underway). The Ministry of Economy could also help to reduce the barriers to entry in health IT by funding additional smaller projects and helping to encourage adoption and implementation of health IT products via a certification process designed to demonstrate the value of these projects.

The results of this work will be used in the next phase of this project, which will develop the roadmap of activities that can be undertaken in the short, medium, and long terms in order to foster the further successful development and implementation of health IT in Chile.