Jara Project: the

interoperability in the

healthcare enterprise.

Juan P. Alejo GonzálezSubdirector Sistemas de Información - CIO

Servicio Extremeño de Salud

Project Jara

The Extremadura Healthcare System Project Servicio Extremeño de Salud – The Client

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.)

•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.

Project Jara

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

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

Situation at SES before project Jara

Project Jara

Users:

Low efficiency in delivering care

Bureaucracy

Integration motor: paper flow

Situation at SES before project Jara

Project Jara

The healthcare organization:

Doesn’t know “what is happening”

Doesn’t know “why it is happening”

Cannot properly manage the support

processes

Situation at SES before project Jara

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

Project Jara

Project Jara

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Project Jara

Coordinated care process

Unique workflow

Standardization

How?

Project Jara

Unique workflow

Healthcare Information System

Management Information System

Economic

Data Flow

Logistics

Data Flow

Hum.Res.

Data Flow

Project Jara

Standardization

Project Jara

Standardization

Project Jara

I'm requesting a radiography

Requestaccepted

Standardization

Project Jara

Standards facilitate interoperability between systems

Standardization

“The capacity of two or more systems or

components to exchange information

and to use the information that has

been exchanged”

“The capacity of two or more systems or

components to exchange information

and to use the information that has

been exchanged”

Project Jara

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)

Standardization

Project Jara: components

Project Jara

1. 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

Project Jara

Project Jara

1. System for patient management and administration

2. 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

Project Jara

Project Jara

1. System for patient management and administration

2. Unique health history for each patient

3. Integration of systems

• Population database system of Extremadura (CIVITAS)

• Departmental systems (laboratories, radiology, pathology, pharmacy, dietetics...)

• Standardization

Project Jara

Project Jara

1. System for patient management and administration

2. Unique health history for each patient

3. Integration of systems

4. System for economic and financial management

• Budgeting, accounting, third parties, treasury, costs…

Project Jara

Project Jara

1. System for patient management and administration

2. Unique health history for each patient

3. Integration of systems

4. System for economic and financial management

5. 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

Project Jara

Project Jara

1. System for patient management and administration

2. Unique health history for each patient

3. Integration of systems

4. System for economic and financial management

5. System for purchasing and supply management

6. Human Resources system

• Organizational structures, positions report, planning and management of shifts, personnel administration, selection, training…

Project Jara

Project Jara

1. System for patient management and administration

2. Unique health history for each patient

3. Integration of systems

4. System for economic and financial management

5. System for purchasing and supply management

6. Human Resources system

7. Information Storage and Warehouse System

• Transactional information (operative)

• Management information for analysis and decision-making

Project Jara

Project Jara

Project Jara

Management SystemEconomic resources

Management SystemHuman Resources

HealthcareInformation

System

Technology architecture

Project Jara

Implementation plan

Primary care

Hospital based care

Projects 2004 20082005 2007

33 months

2006

23 months

HEALTH CARE

ECONOMIC-FINANCIAL AND LOGISTICS 15 months

Go-live: January 2006

HUMAN RESOURCES 15 months

CHANGE MANAGEMNT

PROJECT MANAGEMNT

SYST. ARCHITECTURE

SYSTEMS INTEGRATION

Go-live: January 2006

Project Jara

Logical Map - Status

Electronic clinical history

Prescription Other subsystems

Health programs Vaccinations Pharmacy / UnidosisDepartmental clinical

subsystems

Departmental clinicalsubsystems

Infirmary care

Electronic clinical history

Other subsystems

Health programs Vaccinations Pharmacy / UnidosisDepartmental diagnostic

subsystems

Departmental diagnosticsubsystems

Management of clinical reports

Nursing care

Clinical management

Drug Prescription Operating rooms

Management users

Management schedules

Applications

Management HC file Waiting list External consultations

Emergencies AdmissionsOther services

of appointments and agendas

Service Requests

Waiting lists Outpatient Clinics

Emergency AdmissionsOther services

Work incapacity MR Archive

User workflow - Administrative Applications

User Management

Management

Project Jara

Phase 1 - Live Prescription Phase 2 Phase 3

Project Jara

Design criteria

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