Q COSTA RICA — Through a technology platform called UNIDOS, Costa Rica’s Colegio de Médicos y Cirujanos (College of Physicians and Surgeons of Costa Rica, also known as the Medical Association) aims to have 15,000 private doctors handle the waiting lists of the Caja Costarricense del Seguro Social (CCSS, also known as the Caja).
Currently, there are 391,000 patients awaiting outpatient consultations and 211,000 waiting for surgery, making it urgent to take action to resolve the problem. The goal is to handle outpatient appointments—including those for specialized care—more efficiently.
The UNIDOS platform will randomly connect users with general practitioners or specialists based on geographic proximity and schedule availability, thereby streamlining the process and ultimately allowing users to rate the care they receive, according to the Medical Association.
For example, under this plan, a person living in Pérez Zeledón waiting for a cardiology appointment could be scheduled with and treated by a specialist outside the CCSS system. To achieve this, the doctor’s schedule will be coordinated with the system to identify available time slots and assign appointments.
“The EDUS system is designed to make this interoperability feasible. The technology is already available to ensure that information from every consultation is recorded in the CCSS system, guaranteeing proper follow-up on diagnoses and treatments without incurring additional costs,” noted Elliott Garita Jiménez, President of the College of Physicians and Surgeons of Costa Rica.
The Expediente Digital Único en Salud (EDUS)—Unified Digital Health Record—is the official digital health platform created by the CCSS to manage patient medical information.
Under this proposal, physicians would handle the surplus of appointments scheduled daily within the CCSS, thereby facilitating patient care. The number of excess appointments to be allocated each day would be determined by the institution at all times.
The proposal was submitted to the CCSS last June, and to date, there has been no response.
“It is an alternative proposal in which consultations will be provided just as they are at the CCSS, utilizing electronic medical records, prior test results, and everything necessary to deliver quality care. Integrating physicians into the UNIDOS system is a decisive step toward addressing one of the main challenges facing the Costa Rican healthcare system,” concluded Dr. Garita Jiménez.
If the Caja accepts and implements the proposal to allow private doctors to treat patients on public waiting lists, it will cover the full cost. Patients on the waiting list will not be required to pay any portion of the fee for a private doctor.
The proposal is distinct from the Caja’s Medicina Mixta program, which lets insured patients see a private doctor for an outpatient consultation while still receiving their prescriptions and lab tests for free through the CCSS network.