It’s quite a challenge to provide health care for a city with 12 million inhabitants. For instance, how do you set up a system for patient information management that expedites care, makes good use of the resources available and at the same time, is easy to use?
To address this challenge, the Municipal Department of Health of the city of Sao Paulo launched an integrated health management system called SIGA Saúde in 2004. The system consists of four main components: electronic health records, patient flow monitoring and organization, health care unit management and connectivity with the national health care system.
When a patient goes to a health post or clinic, the person’s personal information is entered into a terminal. If the patient is not yet registered in the health care system, the computer instantly issues a patient identification card that is used in the national health care system, known as SUS (Sistema Único de Saúde), for “Unified Health System.” With this card, all the patient data can be retrieved on treatments previously received, date and place of treatment, medications being taken, any allergies, diagnosis and course of treatment, and other information from the patient’s health records.
In addition to identifying the patient, the system helps monitor the flow and organization of services and refer the patient for testing or to specialists or the closest hospitals. Since it is a fully integrated system, based on Java technology, each health unit is identified and connected to the rest of the health care network. The unified database helps expedite care, reduce waiting times and assist health care workers, and consequently reduces costs.
The SIGA Saúde system was developed by the Atech Foundation and its startup Vidatis, a company that supplies software and automated computer systems for health care management.
The president of Vidatis, Lincoln de Assis Moura, Jr., presented the system during the Technology Fair held at the headquarters of the Inter-American Development Bank in Washington, D.C., on June 13 and 14, following a conference on the IDB’s new initiative, “Building Opportunity for the Majority.”
“Technology has to be used to improve people’s lives,” said Beatriz Leão, who designed the data model for the system and is a former president of the Brazilian Society for Information Technology in Health. The “open source” technology used makes training in its use easy, allows the system to be expanded and does not require a server in each health unit. “All you need is a terminal with an Internet connection,” explained Leão.
The system is designed to serve the entire population that uses the public health system. As of May 2006, 11 million identification cards had been issued through the system. Four hundred primary care units and 4,000 computers located throughout the city are now part of the network.
With more efficient organization of the health care system, thanks to the compilation of data on previous visits and integration of requests for testing, there has been an increase in the number of patients seen in all areas of the city and a dramatic decrease in duplicate testing and fraud.
The system database and servers are located in Prodam, the municipality’s data processing company. The SIGA Saúde system is managed entirely by the Sao Paulo Municipal Department of Health, which determines what professional staff should have access to patient data, in order to avoid any breach of confidentiality issues.
The system belongs to the Sao Paulo municipality and the Brazilian ministry of health. The municipality is interested in distributing the system in order to create communities of cities, states and governments that use it, so that the cost of new developments can be shared.
Vidatis believes that the system can be adapted to different socioeconomic realities and implemented in other countries in Latin America and the Caribbean.
In addition to the SIGA Saúde system, Vidatis is developing a “virtual health pet” embedded in a patient’s cell phone that notifies the patient when it is time for the person to take his or her medicine and monitors the patient’s well being. The patient’s health information is stored in the cell phone, along with the schedule and dosage for each prescription. If no one answers the telephone, the “pet” automatically sends a text message (or “Short Message Service”) through the cell phone to a family member or health care professional.