The Chilean Experience: Leading a Nation Towards a Shared Health Record HIMSS Latin America Workshop Rodrigo Castro CIIO Ministry of Health
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1 The Chilean Experience: Leading a Nation Towards a Shared Health Record HIMSS Latin America Workshop Rodrigo Castro CIIO Ministry of Health
2 Conflict of Interest Rodrigo Castro Apablaza, Eng., M.A., M.Sc. Has no real or apparent conflicts of interest to report.
3 Public Healthcare Network History The National Health Service NHS was established 1948 in UK The National Health Service SNS was established 1952 in Chile We have a culture of collaboration between different healthcare providers What is our cooperation challenge in the 21 century? To transform to digital health and establish an e-health roadmap to connected health!
4 Public Healthcare Network in Chile 7 Macro healthcare regions 29 Healthcare districts 96 Ambulatory hospitals 195 Hospitals 941 Urban Primary Care Center Rural Primary Care Center Healhtcare providers are connected by a public intranet: V o i c e - V i d e o - D a t a
5 Master Patient Index & Terminology Services Users Administration and Security Chilean e-health conceptual roadmap Services & Contactability Citizens Participation, Remote Assistance, Health Campaigns Medical Commission for Leave & Disability Medical leave, Public and Private Health Insurance, Disability and Impairment SIAS Longitudinal Health Record RIS/PACS, LIS Electronic Health Record MoH Management Systems SIRAPS, GRD, SIS-Q, LE & Others Decision Making Support System National Health DW Dashboards SIDRA Clinical Care Processes Management Sanitary Authorisation and Control, Public Health Surveillance and alerts, Health Promotion and Prevention Personal Computers Servers MoH Communications Network ICT Infrastructure Telemedicine Technology Contact Centre Technology Architecture
6 What is SIDRA? SIDRA (Information Systems for the Public Healthcare Network) aims to digitize all clinic and administrative processes within a healthcare center, be it primary healthcare or hospital. Its objective is to be THE source of clinical information for healthcare centers, healthcare districts, the Ministry of Health and other health related Government agencies. It is the vertebral column of Chile s e-health strategy, providing data for Public Health Surveillance and alerts, population health management and dashboards.
7 EMR adoption in Primary Care % 100% 80% 22% 46% 30% 60% 40% 78% 70% 54% 20% 0% Ambulatory care unit Emergency unit Medicine dispensing unit Progress Gap
8 EMR adoption in Hospitals % 100% 80% 45% 50% 25% 14% 25% 29% 60% 40% 75% 86% 75% 71% 20% 55% 50% 0% Ambulatory care Emergency Ambulatory care Emergency Ambulatory care Emergency High complexity Medium complexity Low complexity Progress Gap
9 Lessons learned SIDRA 1.0 Implementation by modules Lack of clinical processes definition Lack of standards definition Absence of dashboards Difficulties to extract/request data No Health sector Architecture Partial coverage of HIS solution SIDRA 2.0 Implementation by clinical/administrative processes Definition of clinical processes map Definition of standards to exchange clinical doc. Information systems with dashboards Unrestricted access to the data Definition of a Health architecture and integration to a national health data repository Full HIS and national coverage
10 QUALITY o o Usability o Integration o Standards Longitudinal Health Record o Analytics SIDRA SIDRA SCOPE
11 Investment SIDRA 2.0 EHR Clinical & administrative processes for all Hospitals and Primary Care Deadline public bidding April ID LR15
12 Electronic Health Record Terminoloy Services as a public good Snomed CT National Health Data Repository National MPI as a public good Architecture and standards (HL7 FHIR, IHE)
13 Health economic model and IT innovation
14 Cancer will be the next epidemic desease in Chile Top 5 Breast Colorectal Lung Prostate Stomach Tele-oncology Radiologist Virtual Clinical Meeting Hospital A Pathologist Hospital B
15 Chronic diseases another epidemic disease The top 5 Diabetes 1 y 2 Hypertension Cholesterol Cardiac problems Varicose veins Home care
16 RIS/PACS by macro regions Hybrid Model Central Repository Regional Repository
17 PUBLIC HEALTH SURVEILLANCE NETWORK Healtcare Centers Laboratory Network Healthcare Districts Public Health Ministry of Health SIDRA PUBLIC HEALTH SURVEILLANCE HEALTHCARE PROCESSES ALERTS MANAGEMENT RESEARCH INTERVENTION - PRIMARY HEALTH CARE - MEDICAL SPECIALITIES - EMERGENCY CARE EPIDEMIOLOGY ALERTS POPULATION SURVEYS P EPIDEMIOLOGY ALERTS MONITORING AND CONTROL
18 Cardiovascular Program Monitoring
19 Uruguay Costa Rica Perú Colombia Chile
20 Thank you! Rodrigo Castro Apablaza CIIO Minister of Health Chile Cabinet of the Minister Linkedin
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