Portuguese state of the art
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Portuguese eHealth Interoperability strategy
Licinio Kustra ManoAntilope Iberic Summit
Valladolid, Spain / 2014-09-24
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Portuguese eHealth
Interoperability strategy
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Agenda
1. Background and scoping
2. Vision and approach
3. PT in action
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EHEALTH INTEROPERABILITY
How did we get here?
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• SPMS stands for
–Ministry of Health Shared Services
SPMS – Who we are
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• A public enterprise created in 2010
• Functioning under the guardianship of the Ministries of Health and Finance
• We aim to provide shared services:
– purchasing and logistics, financial management, human resources
– information and communications systems
SPMS – Who we are
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Cooperation with the health services in innovation and change management;
Promoting knowledge sharing for strengthening the reform of the health sector;
Provision of shared services, keeping in mind the needs and responsibilities of the services of the NHS network;
Functioning as a purchasing agency, obtaining economic gains through economies of scale and trading in competitive dialogue with suppliers;
Contributing as an Operating Unit of the Ministry of Health for the promotion of modernisation and innovation, through the proper integration of information and communications technologies, in perfect coordination with national and regional policies.
SPMS – Our mission
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Contributing as an Operating Unit of the Ministry of Health for the promotion of modernisation and innovation, through the proper integration of information and communications technologies, in perfect coordination with national and regional policies.
SPMS – Our mission
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• ~ 10 million citizen
• ~ 50 Public Hospitals
• ~ 400 Primary Care Centres
• ~ 90% running our ICT solutions (ADT and EHR)
• ~ 60 ICT Solutions (SPMS portfolio)
SPMS – Our realm
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Healthcare Environments are.. Complex Adaptive Systems
Hospitals Primary Care
Centres
Patient’s homes Neighborhoods & Communities
And each one has their own little ecosystems’
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Interoperability is “good will”
Interoperability: ‘the ability of two or more systems or components to exchange information and to use the information that has been exchanged’
Barriers:
– Different languages
– Different health systems
– Different infrastructures
– Different technologies
– Different procedures
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Building Blocks? Standards, Profiles, Guidelines, Terminologies and Architectural Specifications Even so, HOW TO: - Provide appropriate treatment? - Provide access to comprehensible and meaningful medical information?
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Can we measure interoperability?
Interoperability measures how accurately, effectively and consistently health entities exchange clinical information as Electronic Health Records by Health Information Systems
Better interoperability may lead to:
Better achieve health sector’s goals
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• Equitable
• Safe
• Effective
• Patient-Centered
• Timely
• Efficient
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VISION AND APPROACH
Can we see and move beyond?
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eHealth European Interoperability Framework Vision on eHealth EIF
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What can we do towards interoperability?
Learn and prepare
Promote and “spread
the word”
Lead by example
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Learn and prepare
• Participation in International Projects:
– EXPAND, epSOS, eSENS, Trilium Bridge, (+4 EU projects in 2015)
• Create internal skills and organizational culture about interoperability
– Internal Technical Interoperability team/efforts
– Internal Semantic Interoperability expert and national orchestration
– HL7 & IHE Training, Certification and Testing (e.g. Connectathons)
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Learn and prepare
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Promote and “Spread the word”
• Organize events with industry to engage and learn needs and readiness
• Coordinate reference international projects
http://www.expandproject.eu/
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Lead by Example
• Evolving our ICT solutions with a Standard Interoperability Layer
• Inclusion of interoperability requirements and recommendations for IT investment on contracts with the NHS
• Link with other national wide efforts in ICT interoperability (eg. AMA: Stork 2, eID Nation Strategy)
• Promote the establishment of “PT” IHE, HL7… other Chapters or subgroups
• Representing Portugal on International Initiatives
• Foster national and international adoption of eHealth standards
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Lead by Example
• PDS – Use of Technical Interoperability standards
• Links to more than 10 different applications using same technical specs;
• API development for Patient portal – to link to mobile/other applications;
• Creation of a interoperability layer (HL7 based) between SONHO (main hospital ADT solution – more than 50 hospitals)
• Work towards decoupling application layers – in legacy applications (SONHO vs SAM/Sclinico)
• Developing Semantic Catalogues (CPARA V3, CPAL, SNOMED CT release
center – Pathology-Oncology RefSet)
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PT IN ACTION
Changing the world one API at a time
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• DB Links
• Low standard adoption and awareness
• Low flexibility and reusability
Current situation
Cenário actual de interoperabilidade
Sonho/Sinus
SAM SAPE
RIS
LIS
Outros sistemas Departamentais
Outros PCE’s
Estatística e análise de dados
Gestão de filas de espera
...
Sistemas de prescrição externa
comerciais
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• System Overload
• Diminished ability to manage and regulate
• Evolution (replacement)
constraints
• High maintenance costs
Current situation - IMPACTS
Cenário actual de interoperabilidade
Sonho/Sinus
SAM SAPE
RIS
LIS
Outros sistemas Departamentais
Outros PCE’s
Estatística e análise de dados
Gestão de filas de espera
...
Sistemas de prescrição externa
comerciais
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Workflow inter-institucional
Interoperabilidade (HL7 / SOA / IHE / …)
Aplicativos
internos
Portal do
Utente
Utente Comunicação
Inter-ministerial
eGravida
eVacinas
eDiabético
(…)
NACIONAL
CIT
(…)
SICO
SIM@SNS
SIARS
(…)
SICA
Monitorização Sistema de Saúde
(…)
MOTIS
BAS
Registos / Aplicações Nacionais
RNU
RNE
RNP
RNSS
(…)
SIGLIC
CCC CTH RCU
eCriança
LOCAL / REGIONAL
PEM
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LOCAL / REGIONAL
… SONHO/SINUS SCLINICO …
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…
LOCAL / REGIONAL
SCLINICO SONHO/SINUS …
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Treat patient, “the tree and the forest”.
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Let’s…. build it together.
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Sharing is key!