Eng.º Carlos Segundo

Information Systems Director

The impact of computer technology on health care

HPA Magazine 15

The lack of I.T. technology or, more broadly, of information systems, in any area of today's society is unthinkable, in some sectors this technology is  mandatory, such as in the health sector.

With a view to providing better and safer health care to our patients, the HPA Health Group has always considered that the unification of patient information would be a crucial factor in defining the options to be implemented in its information systems. Therefore, all information systems that have been implemented in the Group have the patient as the central information factor.
The main challenge was the geographical distance between our various units across the Algarve, Alentejo and Madeira, so implementing a private data and communications network would have to be supported by fibre optic circuits, using common Datacentres, connecting all units of the Group. This system was initially implemented when we began building the second unit of the Group. The idea was to implement such a system that would permit future expansion in any location in the country, or even the world.
The second criterion was the implementation of the patient's single file, with access from any one of our units. It was intended to ensure easy access to the patient’s medical history by health professionals within the HPA Group, regardless of where and which Unit the patient had been treated previously. This option was a differentiating factor and unique in the country. 
The implementation of a clinical management integrated system was achieved, with a concern based on transversality and access to information, but above all on the possibility of reaching a timeous diagnostic decision. “Decision making” encompasses a wide range of information that includes clinical decisions, but also administrative, financial, human resources and management of the different health units.
The reason for adopting this technology was primarily intended to increase organizational resilience and operational efficiency and a contemporary access of the patient’s medical history, but above all also to guarantee and ensure total safety and follow-up by any professional that treating the patient, at any time, within our organization.
This model of solution unification has become the norm, facilitating all processes and ensuring a uniform operation, the same system was implemented in all our units, from the smallest clinic to the largest hospital. It permits us to implement pilot solutions in only one of the units and, once approved, can then be replicated in the remaining units.
The challenges facing information systems are ever increasing and must combine various requirements, the need to save information, to register information and above all to produce the information we require in return. In strategic terms, we are continuously ensuring that the system currently in use at the HPA Health Group is able to provide the user, with the information that matters most at all times. We reached this goal by upgrading the clinical process system, which now allows for more diversified use, while at the same time is unrelated to the hardware used. This facilitates work at a distance which became so necessary and urgent between the months of March and May 2020 and, which currently continues to be as important.
 

The future of the information systems currently in use at the HPA Health Group is being implemented with the view of bringing the patient in closer contact with our Units, at the same time simplifying the methods of communication and interaction with the patient, an example is the myHPA Saúde App which we will continue to improve by adding additional features.
For medical Professionals receiving timely information is crucial to timeously provide the medical care needed by the patient, “automated alarms” are already being implemented for healthcare professionals to receive alerts such as critical results, an adverse reaction or an adjustment of therapy on their personal devices, such as mobile phones. 
This evolution also involves the implementation of automatic aid for clinical decision making, through the guidelines of the best clinical practices worldwide, according to the patient’s clinical evolution. These steps are also being taken in administrative areas, in order to further automate the procedures involved.
As Director of Information Systems, I support the decisions of top Management and Clinical Directors, to guarantee the bases for a safer and more efficient provision of health care. To achieve this, past and future system implementations always require global integration to guarantee complementarity services and solutions.
The current reality is to create a system where patients can be permanently informed through digital channels to make, reschedule and cancel appointments, consult their past appointments, obtain detailed information on the consultations available and the health professionals as well as exam preparations, obtaining test results (reports and images), payment history and outstanding invoices. In other words, we continue to work on solutions that will allow us to be in permanent contact with our patients 24 hours a day, complying effectively and in a timely manner to patients’ requirements and expectations, wherever they may be. 
In retrospect, we will share some data provided by the information systems of the HPA Health Group in 2020:

• In-Patient Medical prescriptions: 78,111;
• Screenings: 66,565;
• Hospitalizations: 21,069;
• First Admissions: 89,392;
• Invoices Issued: 956,407;
• Medical Reports: 618,251;
• Administered Medication: 393,027;
• Out-Patient Medical Prescriptions: 391,034;
• Consultations: 566,036;
• Requisitions issued for Complementary and Diagnostic Exams: 480,622;
• Complementary & Diagnostic Exams Performed: 964,457;
• Therapeutic Validations by Pharmaceutical Services: 22,133;
• HL7 System Integration messages: 12,160,905.