The hospital management in Tunisia is basing its information system on that used in Spain, whose development dates back to 1985. Tunisia does not have a unified patient information system, which has a detrimental effect on the efficiency of the services it provides, including lack of control over the patient conditions to patients being kept in hospital for longer than is required for their recovery. In Tunisia, each specialist keeps a separate medical record for each patient, meaning they are not informed of any other conditions she or he may suffer. This means that health spending is not controlled and that more money than necessary is invested in some services rather than others. However, there is a solution to this cause and effect scenario.

That is why Tunisia presented the European Commission (EC) with its situation so that, through a twinning project, a second country with experience in this field might support them in their efforts to tackle the problem. The FIIAPP was finally chosen to lead the project, funded by the EC with 1.3 million euros and the Castile-La Mancha Healthcare System (SESCAM) as the collaborating body responsible for training its Tunisian colleagues in the system. The twinning manager in Tunisia, Hassan Ben Salem and Director of Studies and Planning of the Ministry of Health talked about different aspects of the project and the satisfaction of the Tunisian portfolio.

Why did the Tunisian government decide to apply for this project?
We started reforming our health system in the nineties to give hospitals more self-management powers. Since that time we have been developing a hospital information management system, but it was deficient in that it did not include medical information. This meant that we were unable to measure patients’ hospital stays in an efficient, centralised manner. This project aims to make an economic and medical evaluation of every day spent in hospital. It will initially be deployed as a pilot scheme in six hospitals and, if successful, it will be extended to other hospitals in the country.

What is the main benefit of this twinning project?
It will enable us to calculate costs per hospital and per disease. A hospital without a medical information system cannot control cost recovery or provide its patients with suitable information. This system will make us more efficient.
Does this type of system mean lower hospital administration costs?
There’s no guarantee we will spend less, but we will be able to rationalise our finances and spend better. In other words, hospitals will be funded fairly and sustainably and we will spend effectively.

This project is based on hospital management in Spain. What is your opinion of this method?

It has been a great opportunity for us to be able to use the Spanish system as a model because Spain went through the same or a similar problem as ours approximately 30 years ago. We are fortunate that Spain has agreed to this twinning and that we can benefit from this experience. We are taking this project very seriously and are open to Spanish suggestions. We are also very pleased with the cooperation between the
FIIAPP and the SESCAM.

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