Jara Project: the interoperability in the healthcare enterprise.

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Jara Project the interoperability in the
healthcare enterprise.
Juan P. Alejo González Subdirector Sistemas de
Información - CIO Servicio Extremeño de Salud
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The Extremadura Healthcare System Project
Servicio Extremeño de Salud The Client

• SES is the institution, belonging to the
  ExtremaduraRegional Government, responsible for
  providinghealthcare 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.

• Population 1.050.000 citizens
• 8 Health Areas
• 104 Primary Care Centers
• 400 other Primary Care units
• 11 Hospitals
• 13.000 employees
• Budget 1.000 M (approx.)

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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

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Situation at SES before 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

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Situation at SES before project Jara

• Users
• Low efficiency in delivering care
• Bureaucracy
• Integration motor paper flow

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Situation at SES before project Jara

• The healthcare organization
• Doesnt know what is happening
• Doesnt know why it is happening
• Cannot properly manage the support
• processes

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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

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How?
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How?

• Coordinated care process
• Unique workflow
• Standardization

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

• Standards facilitate interoperability between
  systems

The capacity of two or more systems or
components to exchange information and to use the
information that has been exchanged
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Standardization

• 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)

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Project Jara components
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Project Jara

• 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

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Project Jara

• System for patient management and administration
• 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

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Project Jara

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

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Project Jara

• System for patient management and administration
• Unique health history for each patient
• Integration of systems
• System for economic and financial management
• Budgeting, accounting, third parties, treasury,
  costs

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Project Jara

• System for patient management and administration
• Unique health history for each patient
• Integration of systems
• System for economic and financial management
• 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

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Project Jara

• System for patient management and administration
• Unique health history for each patient
• Integration of systems
• System for economic and financial management
• System for purchasing and supply management
• Human Resources system
• Organizational structures, positions report,
  planning and management of shifts, personnel
  administration, selection, training

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Project Jara

• System for patient management and administration
• Unique health history for each patient
• Integration of systems
• System for economic and financial management
• System for purchasing and supply management
• Human Resources system
• Information Storage and Warehouse System
• Transactional information (operative)
• Management information for analysis and
  decision-making

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Project Jara
Management System Economic resources
Management System Human Resources
Healthcare Information System
Technology architecture
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Implementation plan
Projects
2004
2008
2005
2007
2006
HEALTH CARE
Primary care
23 months
Hospital based care
33 months
Go-live January 2006
ECONOMIC-FINANCIAL AND LOGISTICS
15 months
Go-live January 2006
HUMAN RESOURCES
15 months
SYSTEMS INTEGRATION


SYST. ARCHITECTURE
PROJECT MANAGEMNT
CHANGE MANAGEMNT
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Logical Map - Status
Project Jara
User workflow - Administrative Applications
Emergencies
Emergency
Admissions
Other services
Admissions
Other services
MR Archive
Outpatient Clinics
Work incapacity
Management

HC file
Waiting list
External consultations
Waiting lists
Applications
Service Requests
of appointments and agendas
Management
Management

schedules
Management

users
User Management
Electronic clinical history
Electronic clinical history
Management of clinical reports
Infirmary care


Nursing care
Departmental clinical
Departmental diagnostic
Health programs
Health programs
Vaccinations
Pharmacy /
Unidosis
Vaccinations
Pharmacy /
Unidosis
subsystems


subsystems
Departmental clinical
Departmental diagnostic
Operating rooms
Prescription


Other subsystems
Other subsystems
Drug Prescription
subsystems
subsystems
Clinical management
Phase 3
Phase 1 - Live
Prescription


Phase 2
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Design criteria

• User-friendly environments/interfaces (SESLinEx,
  SES portal)