Procurement Innovation Challenge Winner Case Story by: Mauro Labello, National Resources Fund, Uruguay

1. MSP
(Ministry of
Health)
FNR
(National Fund of
Resources)
SNIS (NHS)
Primary Health Providers (private and pulbic)
Patients
Brief Scheme about Health Provision in Uruguay

2. Some other data in relation to Fondo Nacional de Recursos
and Uruguay
• FNR is a marked fund to financially assist people in the treatment of
certain events and pathologies. Examples of this treatments are care
and procedures associated to cardiac, kidney, liver, marrow and lung
transplants.
•In 2005, the provision of high cost meds was also consolidated under a
national policy. FNR took on ultimate responsibility for financing
treatments for diseases such as certain cancers, rheumatoid arthritis
and certain other immunological and chronic conditions.
•Medical treatment under FNR supervision and funding is supplied
equally and universally on a national basis.
•Uruguayan populations is about three million and a half and the Net
National Income per Capita adds up to 15.850 usd dollars annually.

3. Challenge
FNR assumed its new responsibility pursuing an overall goal for funding strictly cost-
effective therapies prescribed under specifically designed guidelines. The importance of a
second medical opinion in addition to a primary indication.
•Logistically the challenge consisted on developing a system that, without dropping
centralizing procurement power and authoritative medical supervision, make it possible to
sustain other important key objectives:
•Any new system should increase vendors access to the procurement
process, specifically easing up the distribution function. It also imply optimizing
trade and marketing opportunities to new vendors.
•It should also foster the use of generic medicines (those no longer patented and
less expensive) by compiling data about their availability and clinical
effectiveness.
•It was required to prevent duplication of resources by taking advantage of
existing pharmacies networks and hospital facilities.
•By making data and resources readily available to physicians and healthcare
managers the system ought to contribute to overall management capability.

4. Our modeled objective
Our objective system result in a web-based “social network” allowing cross-cutting
collaboration between FNR, healthcare providers, medical suppliers (including some clinical
laboratories) and patients themselves.
Supervision and
management
abilities, audita
bility to every
actor (“social
network”)
Authorizaton
Process and
dosage
calculations
(centralized)
Direct health
treatment
(decentralized)
Pharmacies and
med delivery
(decentralized)
Negotiation
with suppliers
(centralized)

5. Tools
• Web based technologies (web and more web)
•Explicitly handling of all inherent responsibilities through properly written
agreements among the different stakeholders across the system. Examples of
these responsibilities involve concepts like:
• Web management duties and rights acceptance from the different
agents
•Patient and people “habeas data” rights and privacy concerns
•It security issues from the different users perspective
•Institutional responsibility for third party property in the case of direct
health providers
•Standard usage in the “handling” of clinical data whenever it is possible
(HL7, CDA or others in acceptance)

10. Results
• Wider treatment options
•Better cooperation from suppliers
•Valuable data for cost evaluation and treatment monitoring
Lessons Learned
Cultural issues matter
Invest in team building
Try to discover trade opportunities to promote it solutions not necessarily direct
funding (what public sector should learn from private entrepreneurship)
Be patient very patient