Interoperability is Understood such as the ability of different systems and organizations to work together, leading to a simplified exchange of data and information. In health, one of the greatest challenges today is the decentralization of clinical data, dispersed in different systems, which has several consequences that contribute to system inefficiency.
Causes and Consequences of Data Decentralization
It is understood that part of decentralization stems from the difficulty of enumerating existing systems. In 2021, at Paper From Arthur Chioro and Giliate Coelho Neto's Public Health Notebooks, he collected 54 information systems fed with data from all Brazilian municipalities. A Fiocruz indicated that about one third of the municipalities use e-SUS electronic medical records, while the others have their own systems and the last third uses paper forms that are digitized by the health departments at a later time.
This lack of system integration can lead to duplication of data, difficulty in accessing different systems, and also has a direct impact on the clinical sphere. As a consequence of the decentralization of data, the patient does not have a clinical history concentrated in a single location, which hinders a more comprehensive medical assessment for the causes of a given condition. This lack of interoperability contributes to less accurate diagnoses and an excess of exam requests, leading to waste and a less efficient system.
An overview of the current interoperability scenario
In this sense, there is an understanding that interoperability in health is an important issue, but the way in which these systems and data must be integrated still poses challenges. There is an expectation about the government and, currently, manufacturers of information technology systems work with working groups from the ANS and the Ministry of Health. In addition, there are also initiatives from operators, hospitals, and technology developers.
Regarding the most recent milestones, in May 2020 the federal government created the National Health Data Network (RNDS) with the purpose of integrating Primary Care data by the year 2028. Due to the pandemic of Covid-19, the network focused, a priori, on the registration of tests and vaccines against the disease, which became available on Conecte SUS.
At the end of 2020, the Digital Health Action Plan 2020-2028, which points to the understanding of this need for operational integration in both supplementary and private health. However, there are challenges, such as involving the participation of different Players in this process. There are many interests at stake, involving health operators, health professionals, hospitals, and patients.
Within these proposals that arise, a point considered fundamental so that there is no complete dependence on the public sphere concerns the standardization of data, which would facilitate the exchange of information. That is, in addition to the issue of technological integration, the construction of questionnaires with a common auxiliary base to interoperate the data.
Participation of healthtechs and the concept of Open Health
In this scenario, there is an increase in initiatives of Healthtechs. In 2022, for example, there was a milestone in the announcement of the first Brazilian experience of interoperability between a Healthtech health care provider and a hospital: Sami and BP (Portuguese Benedicence of São Paulo). The partnership with Healthtechs it is important for establishing a relationship of trust, and it should be noted that the integration of data between operators and hospitals involves challenges ranging from technology to disbelief between the parties involved in the process.
Still, many Healthtechs have focused on this issue and on building solutions around Open Health, a model in which patient data is shared, given their authorization, for an improvement of health care. That way, the patient's history would be available regardless of a health professional change. In this sense, according to District Healthtech Report 2022, Open Health would be a trend for health, since healthtechs were fundamental in this process in other countries, offering tools for the development of policies in the public sphere.
It is worth noting that the Open Health proposal in Brazil is inspired by Open Banking, a model launched for the financial market in 2021. This model leads to some expectations of changes for the sector, including: increased competitiveness, since it would help reduce costs in the private sector; an improvement in the provision of services; more agile care through the sharing of patient health information; and, even, greater autonomy of patients in relation to their own health, bringing more independence over their choices.
