Working towards a single electronic health record for every citizen
The engineer Mariano Soratti is the head of the Sistema Integrado de Información Sanitaria Argentino (Argentinian Integrated Healthcare Information System, SISA) being developed by the National Health Ministry, Argentina. We interviewed him to find out how such an ambitious project is put together, bearing in mind that Argentina is a federal country in which each province has an autonomous government and its own regulations regarding healthcare.
EHealth Reporter Latin America: What must a developer take into account when planning a new clinical system so that, once implemented, it can interact with SISA?
Mariano Soratti: To interact with the site? You’ve asked an interesting question. Firstly, if it is a new project, they need to assess whether it can be developed on web platforms, which would facilitate interoperability with SISA greatly as the system works on a web platform. The second point is related to the data: the potential extent of it and whether the system interacts with those of the authorities of the establishment and jurisdiction because SISA publishes data dictionaries for different records. So it’s useful to keep in mind different data dictionaries, the nominal SISA records, and adapt to them as far as possible, making an effort right from the start to record the same or more information as that being implemented in SISA. And another relevant piece of advice would be to ensure that the coding is compatible.
EHRLA: How does one ensure that the coding is compatible?
MS: The world of coding is pretty disorganized. In general everyone codes according to their own choices and capabilities. As SISA also makes its coding public, it is also a good idea for developers and projects under development to use either the same codes or ones that they have been using but that have a mapping mechanism for these codes. If the local system uses the codes of its own area, it needs a mechanism that allows its code to interact with the code of the local INDEC area, which is the one used by SISA. This is basic technical advice that will help to adapt systems to facilitate inter-system dialogue.
EHRLA: Do you think that this will one day lead to a healthcare system that connects the whole country?
MS: That’s the idea but we know that there’s a long way to go. The other piece of advice, I don’t know if it’s advice or just a thought, is to keep in mind that this process takes time, many months and years of work and a lot of records. Everything will come together in time to create the citizen’s record and ensure the regular functioning of all the nominal records. But the process needs to be shepherded. Not everything is written yet, it’s not as though you can just sit down and program for a couple of weeks and get everything done. It is a process that involves many aspects that we still can’t really envisage, you have to take notes with each development, progress, liaise with the authorities, and plan many different things here at the Ministry. It’s a progressive development process.
EHRLA: Is it accompanied by the necessary legislation?