Implementation of Electronic Health Record at all levels of care for Asociación Española

Asociación Española is the first mutual health organization established in the American continent, and has been providing healthcare services to their partners and the community for 166 years. In Uruguay, it provides healthcare coverage for more than 190,000 members, with a team of almost 8,000 medical and non-medical workers.

Requirements

The institution sought to implement the Online Clinical History in every level of care:

• Polyclinic
• Adult Emergency Room
• Gynecological Emergency
• Pediatric Emergency
• Emergency Room Entrances
• Medical house calls
• Emergencies
• Internment Conventional Adults
• Neonatal
• Pediatrics
• Intermediate
• ICU Adults

Solution

The online clinical history complies with all regulations defined by Salud.uy. One of the main highlights is the integration with the National Online Clinical History (HCEN for its acronym in Spanish), the use of technologies such as HL7, CDA and XDS, and the use of international classifications such as CIE-10, LOINC and SNOMED-CT.

In addition, it is interoperable with all support modules, which means that the physician can prescribe medications, procedures, and handovers through the use of HL7 messages to communicate with pharmacies (internal and social), laboratories, imagery, and schedule coordinations.

All results coming from laboratory and imagery analysis, in addition to consultations performed by several professionals, come together into a single XDS repository centered on the patient, which allows for medical professionals to have a complete overview of the patient’s clinical history.

It also complies with the current regulations issued by regulatory authorities and upholds several patient and physician-oriented security criteria.

In addition to covering all service areas, the Online Clinical History is a fundamental tool for the management and definition of medical policies because it makes it possible to obtain real-time statistics regarding the status of each population group, epidemiological reports, and specific tests. The project also included a complete change of the Hospital Management System, with Virazón being the new management system. The system included the following features:

• Patient Admission
• Patient discharges
• Bed management
• Bed mapping
• Transfers
• Hygiene
• Visiting access
• Management of births
• Management of fatalities
• National Information System (SINADI for its acronym in Spanish)
• Reports and indicators

Technologies and tools

• Genexus Evo 2
• Genexus Evo 3
• Genexus 15
• Oracle
• Java 7
• K2BTools
• K2BAudit
• GXServer
• Tomcat 7
• JBoss 6.3 eap
• WildFly
• Apache
• HL7 2.5
• CDA
• XDS

Results

The Virazón Online Clinical History system for Asociación Española has been operational for a number of years in every level of medical care in the Institution, including non-medical areas which still participate in the patient’s Health-Illness process. In this way, all clinical information related to patients was centralized and made accessible within all levels of care, both within the Institution and in outpatient areas.