It will also interface with national programs run by Brazil’s Department of Health. Each of the Federal District’s 2.5 million residents will be issued a “Citizen’s Health Card” that grants instant, secure access to all of their personal medical files.
Rapid return on investment
José Roberto Arruda, Federal District Governor, thinks the project will bring the public healthcare system out of what he refers to as the “Stone Age”, but acknowledges that it comes at a price. “For this to work, a large job needed to be done first. We invested R$6 million in systems alone, and that much again in equipment and training,” he says. Fortunately, thanks to TrakCare’s modular architecture, the district government is already seeing significant cost savings and improved quality of care from the portions of the project that have been completed.
One prime example of this is the Test Portal, which allows patients and their doctors to access the results of laboratory tests over the Internet. So far, the Test Portal has been rolled out at the Base Hospital, several regional hospitals, and the Central Laboratory itself. Together, these hospitals account for 5.5 million of the over 8 million laboratory tests performed each year in the Federal District. According to José Geraldo Maciel, the Federal District’s Secretary of Health, with the old paper-based system, 20% of test results were lost before they could be reviewed by a doctor. And when doctors ordered repeat tests, the results were lost 30% of the time. “The 8.4 million tests that we perform each year cost the system about R$60 million. This waste represents a minimum annual loss of R$18 million,” Maciel explains. The portal will cut waste to zero by allowing users and/or healthcare professionals to access, at any moment and in real time, the complete patient record, including all laboratory test results. Results are available faster, too, often ready in less than 24 hours. With the old paper-based system, patients typically used to have to wait 15 to 30 days to get test results.
Significant savings are also being realised through managing the purchase of medicine, which costs the Federal District about R$220 million annually. According to Maciel, “About 20% of these resources are lost, and with them, another R$40 million.” By implementing TrakCare in the healthcare centres, it will be possible to halt the distribution of medicine without a doctor’s prescription, or the distribution of the same medicine more than once to the same patient in different healthcare centres.
Bed management is another area that is yielding cost reductions. Currently, all of the 257 intensive care beds in Brasilia (in 17 hospitals, of which 10 are public and 7 are private) are being regulated by the new government project in real time. The system has already brought savings on the order of R$1 million with the management of ICU beds contracted in the private hospitals. “Brasilia has around 4 thousand beds in all of the hospitals of the system and the occupation per bed is 2.3 patients per month. We can set as a goal for the end of the governor’s term, to double the occupation of each bed from 2.3 to 4.6 patients per month, effectively building 4,000 more beds in Brasilia without laying a single brick,” states Maciel.
The Federal District Subsecretary of Health, João Luiz Arantes de Freitas, predicts that in three years, when the Integrated GDF Healthcare System is completely operational, the total savings will reach R$100 million per year.
A model for the nation
One of the most highly anticipated stages of the Health Integration project is the deployment of the Citizen Health Card system. A pilot project at the Gama Regional Hospital has issued health cards to approximately 100,000 inhabitants of the region. This program will gradually be rolled out to all of Brasilia’s 2.5 million residents, giving them instant, secure access to their personal electronic medical record.
And it doesn’t stop there. Officials on the federal level view Brasilia’s health integration project as a model to be adopted by the national Single Healthcare System. Says José Carvalho Noronha, Federal Aide of Health Assistance and Attention, “Here we are designing the structure that will guarantee every Brazilian citizen opportunities related to the care of their health. And, I am foreseeing, it is a short hop from here to implementing and having a user identification card, the national health card – starting with the Federal District.”
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