ASUR - Single Regional Health Registry Information System for LAZIOcrea
The Regional Health Information System (SISR) consists of several applications and procedures which are based on local archives. The absence of uniform and integrated management of information flows and data, has led over time to the fragmentation of the registry files of the ASL and hospital companies, distributed throughout the region. This does not allow to have an updated and comprehensive regional picture of the data of patients, health workers and public and private health structures.
The reference regulatory context in the field of health, the needs for greater efficiency and effectiveness of the National Health Service and compliance with the guidelines of the National Health Plan plan determine, at regional level, the emergence of needs such as:
- rationalize health information systems by unifying the registries of all regional health companies to provide better service to citizens;
- make the individual registry position certified in the regional system, for all users;
- provide a unified service of consultation, verification and feeding of centralized registries to all regional companies;
- align regional and business systems with the national system of control of pharmaceutical and specialist expenditure managed by the Ministry of Economy and Finance;
- align the basic codes and the codes of the regional health structures on the information systems to allow a uniform exchange of information.
CODIN in partnership with Telecom Italia S.p.A., was awarded the tender for the creation of the single regional health registry system (ASUR) for LAZIOcrea. As part of the project, CODIN was responsible for the design, implementation and installation of the ASUR application system.
The ASUR system responds to the needs described, going on to build a patient registry system, which takes care of the management and centralization of the regional patient data and whose data are kept up to date and shared with local and company registries. The ASUR Master Data is made available to all interested parties at a regional level through Web Services, through which it is possible to obtain updates on the registry positions. This allows for a coordinated and univocal management of data, arriving at a regional image of the health service users' basin for a better governance of the regional health service. The system today manages the data of 7,000,000 patients and 120,000 Healthcare Workers.
The solution implements the following features:
- management, in a centralized database, of the registry of the assisted people of the Region and of the certified information received from the Municipalities of the Region and the Ministry of Economy and Finance;
- complete management of the registry of public and private health facilities that provide national or regional health services and operate on the territory of the Region;
- distribution of certified information to all interested parties;
- consultation and verification of data relating to basic and product codes (eg institutional codes or ISTAT codes, ICD9-CM codes, etc.);
- management of authorizations and registrations of application users;
- production of analytical or summary statistics;
- system monitoring that detects application errors;
- integration with third parties for the processing of HL7 v3 services;
- integration with the application integration bus for the provision of system functions on the Enterprise Application Integration platform.
The proposed technological platform complies with the principles of the "Three Tiers" architectural model in a Web Oriented environment, typical of Java J2EE Technology, and allows access to services through interfaces based on recognized technological standards. The system components have been created through the use of the following products and protocols: Apache struts framework; Oracle RDBMS; OpenSSL; TIBCO platform (ESB); unique communication protocol HL7 v.3 and SOAP protocol.
The multi-year project involved CODIN staff in the following services:
- carrying out the analysis of the project in all its phases;
- development of application functions and Application Cooperation services;
- analysis of the functional and managerial flows related to the organization of the project in the region;
- solution installation, configuration and start-up services;
- operator assistance and training services.
The project intervention led to the achievement of the following benefits:
- increase in efficiency in the provision of services to patients;
- more efficient management of compensation thanks to the elimination of compensation not due to general practitioners and the recovery of those paid in excess, thanks to the updating of information on deaths or transfers of patients;
- greater control over regional healthcare expenditure thanks to the alignment of regional and business systems with that of pharmaceutical and specialist expenditure managed by the Ministry of Economy and Finance;
- realization of the preliminary steps for the introduction of the patient's single health record.