Jara Project: the interoperability in the healthcare enterprise. Juan P. Alejo González Subdirector Sistemas de Información - CIO Servicio Extremeño de Salud

Project Jara The Extremadura Healthcare System Project Servicio Extremeño de Salud – The Client Population: citizens 8 Health Areas 104 Primary Care Centers 400 other Primary Care units 11 Hospitals employees Budget €1.000 M (approx.) SES is the institution, belonging to the Extremadura Regional Government, responsible for providing healthcare services to more than one million people in the region, including defining health policies, public healthcare surveillance, clinical assistance (primary and acute care), mental health, etc.

Project Jara Situation at SES before project Jara  Clinical practice  data, information and knowledge  A typical organization based on knowledge  Information on paper  Information in multiple IT applications

Project Jara Professionals in the health sector:  Difficult to access the necessary information  Vital information for a patient might be missing  There is redundant information  Bureaucracy Situation at SES before project Jara

Project Jara Users:  Low efficiency in delivering care  Bureaucracy  Integration motor: paper flow Situation at SES before project Jara

Project Jara The healthcare organization:  Doesn’t know “what is happening”  Doesn’t know “why it is happening”  Cannot properly manage the support processes Situation at SES before project Jara

Project Jara  Program for Transformation of IT Systems at SES  Integrated IT System  Option to create links with other organizations  Provide suitable communication channels with citizens Project Jara

How? ¿?

Project Jara  Coordinated care process  Unique workflow  Standardization How?

Project Jara Unique workflow Healthcare Information System Management Information System Economic Data Flow Logistics Data Flow Hum.Res. Data Flow

Project Jara        Standardization

Project Jara        Standardization

Project Jara       I'm requesting a radiography Request accepted Standardization

Project Jara Standards facilitate interoperability between systems Standardization “The capacity of two or more systems or components to exchange information and to use the information that has been exchanged”

Project Jara Standards:  Patient identification: CIP  Communications (message format: HL7, XML…)  Representation of clinical data (ICD, LOINC, SNOMED…)  Confidentiality, data security, and authentication  Technologies: open operating systems (LinEx - Linux for Extremadura) Standardization

Project Jara: components

Project Jara 1. System for patient management and administration Identification, appointment, agendas, referrals, consultations, service requests … Unique for all SES professionals Unique identification of citizen Integrated for all levels of service Project Jara

1. System for patient management and administration 2. Unique health history for each patient Accesible by all SES professionals regardless of the level of care and the organizational unit in which they are providing service Available according to the criteria for consultation and visualization that are established for each of the user profiles Project Jara

1. System for patient management and administration 2. Unique health history for each patient 3. Integration of systems Population database system of Extremadura (CIVITAS) Departmental systems (laboratories, radiology, pathology, pharmacy, dietetics...) Standardization Project Jara

1. System for patient management and administration 2. Unique health history for each patient 3. Integration of systems 4. System for economic and financial management Budgeting, accounting, third parties, treasury, costs… Project Jara

1. System for patient management and administration 2. Unique health history for each patient 3. Integration of systems 4. System for economic and financial management 5. System for purchasing and supply management Complete cycle from planning to order, as well as management of contracts, up to accounting Integrated with economic and financial management system to record the corresponding economic and accounting facts Project Jara

1. System for patient management and administration 2. Unique health history for each patient 3. Integration of systems 4. System for economic and financial management 5. System for purchasing and supply management 6. Human Resources system Organizational structures, positions report, planning and management of shifts, personnel administration, selection, training… Project Jara

1. System for patient management and administration 2. Unique health history for each patient 3. Integration of systems 4. System for economic and financial management 5. System for purchasing and supply management 6. Human Resources system 7. Information Storage and Warehouse System Transactional information (operative) Management information for analysis and decision-making Project Jara

Management System Economic resources Management System Human Resources Healthcare Information System Technology architecture

Project Jara Implementation plan Primary care Hospital based care Projects months months HEALTH CARE ECONOMIC-FINANCIAL AND LOGISTICS 15 months Go-live: January 2006 HUMAN RESOURCES 15 months CHANGE MANAGEMNT PROJECT MANAGEMNT SYST. ARCHITECTURE SYSTEMS INTEGRATION Go-live: January 2006

Project Jara Logical Map - Status Electronic clinical history Prescription Other subsystems Health programs Vaccinations Pharmacy /Unidosis Departmental clinical subsystems Departmental clinical subsystems Infirmary care Electronic clinical history Other subsystems Health programs Vaccinations Pharmacy /Unidosis Departmental diagnostic subsystems Departmental diagnostic subsystems Management of clinical reports Nursing care Clinical management Drug Prescription Operating rooms Management users Management schedules Applications Management HC file Waiting list External consultations Emergencies AdmissionsOther services of appointments and agendas Service Requests Waiting lists Outpatient Clinics Emergency AdmissionsOther services Work incapacity MR Archive User workflow - Administrative Applications User Management Management Project Jara Phase 1 - Live Prescription Phase 2 Phase 3

Project Jara Design criteria User-friendly environments/interfaces (SESLinEx, SES portal)