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ADRES impulsa su transformación digital con alianza estratégica con HIRA de Corea
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La Administradora de los Recursos del Sistema General de Seguridad Social en Salud (ADRES) firmó un convenio de cooperación con el Servicio de Revisión y Evaluación del Seguro de Salud de Corea (HIRA), en el marco de la cooperación bilateral entre Colombia y Corea, transformación digital para intercambiar buenas prácticas en auditoría automatizada, análisis de gasto e inteligencia de datos. Esta alianza consolida la posición de ADRES como “pagador inteligente” y fortalece su transformación digital con el respaldo de organismos multilaterales.
Alianza bilateral para la innovación en pago y auditoría
Este 20 de junio de 2025, ADRES y HIRA suscribieron un memorando de entendimiento en Bogotá, con la presencia de Jung-Gu Kang, presidente de HIRA; Félix León Martínez, director de ADRES; el embajador de Corea, Wang Keun Lee; y el viceministro de Protección Social, Luis Alberto Martínez. El acuerdo establece intercambios técnicos en:
- Pago de servicios a prestadores: optimización de flujos y reducción de errores
- Auditoría automatizada de cuentas médicas: detección temprana de inconsistencias
- Análisis del gasto en salud: modelos de inteligencia financiera
- Interoperabilidad de datos: compartición segura de información entre entidades
“Esta cooperación fortalece procesos críticos para garantizar la transparencia y eficiencia en el uso de los recursos públicos”, señaló León Martínez durante la firma.
Transformación digital de ADRES: del pago al ‘pagador inteligente’
En su intervención, el director de ADRES subrayó que, gracias al apoyo del Banco Mundial, el BID y ahora HIRA, la entidad avanza hacia un modelo de pagador inteligente. “Hemos modernizado nuestra operación bancaria e impulsado un grupo de analítica de la información,. Invitamos a quienes opinan sin conocimiento a que conozcan nuestro enorme desarrollo y transformación.”
La experiencia surcoreana en datos y auditoría
El presidente de HIRA, Jung-Gu Kang, explicó que Corea ha desarrollado un sistema de revisión de reclamaciones médicas basado en inteligencia artificial y reglas de negocio automatizadas.
“Queremos adaptar prácticas que permitan a ADRES optimizar la auditoría médica y el uso de tecnología en la atención clínica. Nuestro interés es identificar oportunidades de mejora en el contexto colombiano.”
Cooperación internacional como palanca de cambio
El viceministro Luis Alberto Martínez en la importancia de esta iniciativa “Corea es un país que tiene una experiencia recorrida en el manejo de los recursos; la ADRES tendrá la oportunidad de fortalecer sus capacidades, especialmente en la función de recaudo, en la mancomunación
de los recursos y en su asignación”.
Este acuerdo se une al firmado el pasado 6 de junio con el Fondo Nacional de Salud de Chile (Fonasa), lo que demuestra el interés de varias naciones en compartir modelos exitosos de gestión financiera en salud.
Tatiana Asprilla
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