Interview with David Labajo


The Marketing and Business Development Manager at Telefonica España remarks a transformation of the health care model thanks to technology and telemedicine as the most efficient driver to ensure the sustainability of the health care system

 An interview by Beatriz Cortiles

Everyone in the health sector envisages two trends: the patient as epicentre of the system and healthy lifestyles. Are both equally relevant?

Both are crucial, and have much in common with the change of the health care model we need in Europe – and particularly in Spain. By one hand, we have a model focused on intervention since there is a health problem; however, we have barely focused on prevention, education and healthy lifestyles. In fact, Spain is the OECD country that spends less on prevention – according to the Bernat Soria Report of 2011. Nevertheless, it has been proven that among the factors affecting our life expectancy and our health, health care assistance has an impact of 10%, while our eating habits, physical exercise and lifestyles have an impact 5 times bigger.

We have to change our current model, and put more focus on pushing prevention, and achieving a change in the social behaviour in favour of healthy lifestyles as cornerstone. However, for that purpose citizens and health care professionals need new tools and mechanisms allow them to achieve this awareness, this behavioural change. We need also prevention policies with a total participation and involvement of the citizens. Still, people will get ill and the best and most efficient health care assistance will be required to solve successfully and quickly the health problems.

But we have to ask ourselves: How are the patients today? How are the diseases? What kind of support do they need? Because the current patient differs a lot from the patient we had 40 years ago. In general, the patient is an aged person, has multiple pathologies, and doesn’t have an acute problem, but needs a chronic monitoring.

However, the health care assistance is basically the same as 40 years ago, focusing on acute episodes rather than on the chronic ones, focused on solving occasional problems, and limited in time; and not on providing an ongoing monitoring of the patient’s health. Hospitals are still organized according to specialities, and not according to the sort assistance required or the kind of patient. Each service and each speciality tries to specialize in treating a particular disease, and we still find many cases where the patient acts as coordinator between specialists. But there’s nobody looking at the patient as a whole, with all diseases and health conditions the patient may have, his or her social and employment status, so the best decisions can be taken from all the available information.


Smart health (eHealth and mHealth) has been so far in the hands of manager like you, that is, telecom specialists; should better network infrastructures be developed?

We have to see telemedicine and technology applied to health as a tool to implement new, more efficient and more productive support models for the patients, from the point of view of medicine and economy. Technology is not an end in itself, but one more tool for health care. As such, it must be embraced by health professionals, and not only those tied to technology or information systems, as they are with a new treatment or a new surgical technique. Nowadays we have the necessary technology for a successful and guaranteed implementation of new clinical processes based on technology and telemedicine. We don’t need to develop new networks or infrastructures. But we need to change processes and roles in the organization, from a model based on a visit to the doctor every three months to an ongoing, smart monitoring model that alerts preventively in case of adverse evolution of the patient.


The meaning of new words is sometimes fuzzy. What does eHealth refers to?

Some new words add some confusion: telemedicine, telepractice, eHealth, mHealth… Ultimately, these are different terms that refer to the same concept: the term eHealth includes all solutions and services based on technologies and communications available for health professionals, patients and relatives, in order to achieve a better health for the people, along with a more efficient management of health care resources.


What can these solutions contribute to patients and health professionals?

As I said earlier, the key is on changing the health care assistance model by means of technologies, i.e. eHealth. A new assistance model based designed for a better control of the patients, to achieve an ongoing monitoring that allows preventing and anticipating adverse evolutions, thus achieving better health outcomes in patients and a higher quality of life. Health professionals, thanks to eHealth, have new tools that enable them to manage their patients better, with more control and reducing the number of non-necessary visits.


We all talk about smart solutions, smart health professionals and smart services. Are there smart patients?

Health care systems have taken so far a very patronizing relationship with patients, investing only a little in their education and little encouraging self-care and self-control. We need patients to take a leading role in their health care, through education and self-care. We need empowered patients actively committed in improving their health.


Prevention, education and promotion of healthy lifestyles. Could you put them in order and explain what should be done?

All of them are related with a new assistance model to be built. The promotion of healthy lifestyles and education are the main tools to achieve a better prevention.


Which are the major challenges for health care on the next ten years?

There’s no doubt that population aging is the biggest challenge we face today. Spain is the second oldest country in the world, and will be the oldest country before 2050. We must take into account that 80% of people older than 65 are chronic patients and this group precisely is the one consuming an 80% of health care resources. The population aging will increase the number of chronic patients, and consequently health care costs, putting in risk the system sustainability.


The speed of changes in this new world is breath-taking; but for health, everything seems to move so slowly… Do you agree?

The technology evolution we are experiencing involves many social changes, and revolutionises sectors like banking, retail or tourism. However, this transformation is not getting with the same speed to the health sector.


What’s the Telefonica’s role in this sector?

Telefonica’s vision is that the health care sector must transform, adapting itself to the new reality of patients of professionals. We must evolve from a reactive system that acts only when a problem arises, to a proactive, preventive system. We must evolve from a system designed to treat acute diseases to focus on chronic pathologies. From a system based on personal attention to a system that escorts the patient wherever he or she is, and not only between the walls of a hospital. The transformation of the health care system and the assistance model thanks of technology and telemedicine are without doubt the most efficient driver to ensure the sustainability of the health care system, as well as to improve the patient monitoring and health outcomes.


Which are the projects and services that endorse the presence of Telefonica in the health care sector?

From Telefonica we have been putting in operation experiences and projects for years than prove the benefits enabled by technology and telemedicine to the transformation of the sector.

  • Projects like iCOR for monitoring chronic patients of cardiac insufficiency thanks to telemedicine, at the Hospital del Mar in Barcelona, have proven the clinical and economic benefits, with significant cost reductions, as well as a 50% improvement of mortality rates.
  • Valcronic, one of the biggest experiences in Europe for monitoring and controlling chronic patients with multiple diseases, also with relevant improvements in terms of patient control, significantly reducing urgencies and hospitalizations.
  • Initiatives like United4Health with SERGAS, an European project participated by 12 EU countries.
  • Projects like Telemàc with the Catalan Health Institute; one of the most awarded projects due to its innovation and excellent outcomes.
  • Customers like Grupo Hospitalario Quirón and currently the IDC Salud group have trusted Telefonica for the overall management of all their technology systems, health workplace management and implementation of new management models of the clinical image within their group.
  • The Valdecilla Hospital in Santander, through with Ferrovial, has chosen Telefonica as reference technology partner with the goal of upgrading the technology of the hospital so it will be at the edge of innovation.
  • Innovating projects, like REMPARK, a European project within the 7th framework program, and one of the most valued for its treatment of the Parkinson disease.