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The SIGLIC system for improving the access to surgery in Portugal.

This paper describes the design and first results of an information system (SIGLIC) that supports the new integrated management program (SIGA) to improve the access to surgery in Portugal. SIGIC, the Ministry of Health’s agency responsible for access to surgery management, started re-thinking the system in 2005 by redefining key processes and workflows. The designed information system SIGLIC integrates all hospitals with surgery with every other hospital, where it picks the data to allow the search for optimal solutions for each patient. In the context of SIGIC (Waiting List for Surgery’s Integrated Management System) “access” means to assure the treatment by services in terms of quality, standards, equity, process and transparency. The existence of a significant number of patients waiting for treatment that exceed the clinical acceptable times has ominous consequences not only for the individuals (increasing suffering, reduce treatment success, more complex treatments) but also for the society (more expensive use of resources, higher absenteeism, etc), which made the government to create SIGIC program. SIGIC’s goals are to reduce waiting time for surgery, to apply identical standards to all patients, to profit from good use of resources and, to create a national structure of homogeneous information based in a system of data collection. The methodology followed was to: a) “survey of information systems and technology in Demand/Supply/Resources” b) “institutionalization and monitoring of procedural standards for management of the Waiting List for Surgery (WLS)”, c) provide “evaluation by results” and, d) “Correction of deviations to the standard”. To fulfill SIGIC’s objectives it was created a management model (SIGA) and SIGLIC to support it. By now 57 public hospitals and 96 private clinics and hospitals (with convention in SIGIC) had joined the SIGIC network. The Information model include the following items: information on patients and events to allow “Process management”, “clinical information” for “Disease Management” and “financial data” to allow management between the health units, from which data is gathered to improve access management. The information is recorded by hospitals in accordance with a set of standards and integrated into the central database of SIGIC. The quality of integrated information from the hospitals is guaranteed by a set of tools to validate its consistency, rejecting non-compliant data. The information is recorded in hospitals throughout the process of managing the patient on WLS and integrated daily in the central database. The results since 2005 show the importance of an integrated information system to overcome the bureaucracy: There was a 36% improvement in number of scheduled surgical episodes and 60% reduction in days on waiting time.

The SIGLIC system for improving the access to surgery in Portugal.

This paper describes the design and first results of an information system (SIGLIC) that supports the new integrated management program (SIGA) to improve the access to surgery in Portugal. SIGIC, the Ministry of Health’s agency responsible for access to surgery management, started re-thinking the system in 2005 by redefining key processes and workflows. The designed information system SIGLIC integrates all hospitals with surgery with every other hospital, where it picks the data to allow the search for optimal solutions for each patient. In the context of SIGIC (Waiting List for Surgery’s Integrated Management System) “access” means to assure the treatment by services in terms of quality, standards, equity, process and transparency. The existence of a significant number of patients waiting for treatment that exceed the clinical acceptable times has ominous consequences not only for the individuals (increasing suffering, reduce treatment success, more complex treatments) but also for the society (more expensive use of resources, higher absenteeism, etc), which made the government to create SIGIC program. SIGIC’s goals are to reduce waiting time for surgery, to apply identical standards to all patients, to profit from good use of resources and, to create a national structure of homogeneous information based in a system of data collection. The methodology followed was to: a) “survey of information systems and technology in Demand/Supply/Resources” b) “institutionalization and monitoring of procedural standards for management of the Waiting List for Surgery (WLS)”, c) provide “evaluation by results” and, d) “Correction of deviations to the standard”. To fulfill SIGIC’s objectives it was created a management model (SIGA) and SIGLIC to support it. By now 57 public hospitals and 96 private clinics and hospitals (with convention in SIGIC) had joined the SIGIC network. The Information model include the following items: information on patients and events to allow “Process management”, “clinical information” for “Disease Management” and “financial data” to allow management between the health units, from which data is gathered to improve access management. The information is recorded by hospitals in accordance with a set of standards and integrated into the central database of SIGIC. The quality of integrated information from the hospitals is guaranteed by a set of tools to validate its consistency, rejecting non-compliant data. The information is recorded in hospitals throughout the process of managing the patient on WLS and integrated daily in the central database. The results since 2005 show the importance of an integrated information system to overcome the bureaucracy: There was a 36% improvement in number of scheduled surgical episodes and 60% reduction in days on waiting time.