eHealth Procurement: eHealth for Sustainable Healthcare Delivery. Ruscitti G. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

1. eHealth for Sustainable
Healthcare Delivery
eHealth Procurement
Parallel Session PS 31
Thursday 18 March, 2010,
9:30 – 10:45

2. Giancarlo Ruscitti MD
Secretary General for Health & Social Services
Veneto Region

3. Background
• The process of innovation of the Italian Public Administration
system and the need for cost containment are key to
aggregated purchasing in the health care system at the central
level (for Veneto, at the regional level);
• 2 pre-requisites are: achieving high quality standards of
technical characteristics of the goods, and a market policy for
goods purchasing;
• The centralized purchaser at the regional level can be more
cost-effective in a competitive health market

4. The Veneto Region health care system:
Health Care Providers and Professionals
• 21 Local Health Authorities
• 2 Hospital Trusts PUBLIC ACCREDITED INSTITUTIONS 64
•1 Veneto Oncology hospital
IRCSS (SPECIALIST RESEARCH
1
INSTITUTES)
Public health authority (Az. Osp.) 2
Hospital in the Provincial capital 6
Network hospital / strong integration 33
Integrating hospital of the network 8
Polyfunctional health centres 10
Management experimentation 4
PRIVATE ACCREDITED INSTITUTES 14
Care homes/ hospital 19
Classified hospital 4
• 41.806 Medical & Nursing staff IRCSS (SPECIALIST RESEARCH INSTITUTES) 1
• 11.702 Laboratory Technician
• 6.704 Administrative staff
• 117 Other Professionals
4 (* Veneto Regional Statistics Office data, 2009)

5. Veneto Region: Health expenditure
according to expense item (2009)
FINANCIAL BURDENS Total.Budget
0% 9.1 Billion Euro a year
AMORTIZATIONS AND OTHER COSTS
DEVALUATIONS HC GOODS
EXTRAORD.BURDENS 3% 9%
2%
0%
NON HC RELATED GOODS
1%
REGIONAL HC SERVICES
12%
PERSONNEL COSTS EXTRA REGIONAL HC
32% SERVICES
2%
PURCHASES OF NON HC
RELATED SERVICES PRIVATE SECTOR
7% SERVICES
31%
PUBLIC SECTOR
SERVICES
1%

6. From a traditional procurement strategy in
Veneto in each of the 21 LHAs…
• Innovation in P.A. sets out to
simplify and modernize
purchasing processes;
• Centralized Purchasing
encourages the use of ICT
which establishes a common
language of codes and standards
among purchasing platforms
The “old” way

7. The Veneto Region is divided into
23 Purchasing Offices dedicated to
Health Care & Social Affairs

8. …to an innovative purchasing
strategy for the Veneto
 A networked system of
e-Procurement at the Regional level
• minimize costs and maximize
outcomes among LHAs;
Good Networking • spread examples of best practice and
competence among central and
regional Health Authorities;
• bring about economic savings,
organizational benefits, and increase
competition and transparency for
suppliers.
The new way

9. Centralized Purchasing at the
Regional Level
• The aggregation of demand leads to a
potential increase in the negotiating
power between public purchasing
departments and suppliers;
• Centralized Purchasing substitutes a
host of often uncoordinated,
decentralized administrations;
• The potential benefit is an
improvement in the price-quality
relationship through a higher level of
competition among suppliers.

10. e-Procurement in the 5 new Areas
From 23 to 5 Centralized
Purchasing Centre
5 Areas responsible for:
• Purchasing procedures
• Contracting for the Provinces
• Accounting
• Goods Storage
The Veneto Health System • Distribution of goods across the 7
is divided into Provinces
21 Local Health Authorities • Payments to suppliers
and 2 Teaching hospitals

11. The Veneto Experience in Centralized
e-Procurement
• 50 calls for tenders between
2007 – 2009
• Items (Centralized PC = Venice):
• Pharmaceuticals
• Vaccines
• medical devices
• 350M euro (Cost reduction of 26%
achieved by the Centralized
Purchasing Centre on the original
starting price of €478M)

12. The new strategy
 Purchasing at the Regional level
eg. pharmaceuticals, vaccines, syringes, disposables, gloves,
disinfectants, etc
 Purchasing at the Area level
i.e. specific equipment serving hospitals in each of the
 5 Areas
 Purchasing at the single LHA level
i.e. all purchases that are not covered by the previous levels
(because not considered cost-effective)

13. Purchasing using the procurement platform
at the Regional Level in the Year 2009
• Pharmaceuticals to the value
of 230 M euro
• Drips to the value of 16 M euro
• Surgical needles and syringes
to the value of 9 M euro

14. Purchasing using the procurement platform
at the Regional Level in the Year 2010
• Generic Drugs
• Drips and Syringes
• Vaccines
• Devices for urinary incontinence
• Estimated Value: 200 M euro

15. Conclusions
 Centralized Purchasing at the Regional level has proven
to be effective for making consistent economic savings;
 A reduction in purchasing tenders has been beneficial
for the organization of the Health Care System
administration;
 The positive results of greater competition and
transparency has made it possible to convince local
health administrators of the importance of centralizing
purchasing and eProcurement

16. Thanking you for your kind attention!
Dr. Giancarlo Ruscitti
Regional Secretary for Health & Social Services
Department of Health & Social Services
Veneto Region, Venice ITALY
giancarlo.ruscitti@regione.veneto.it