Abstract
Background: SIGA as an IT platform supported by clinical referrals monitors National Health Service (NHS) waiting and response times, and optimises patient access to healthcare, serving as the foundation for GOOD INTEGRATED CARE DELIVERY.
Approach: The Portuguese (NHS) has a main priority: To create adequate responses to citizens' needs, by reducing patient inequalities, improving access to healthcare and clinical information, and colaboration between the health sectors and key stakeholders.
To meet these needs, the Integrated Access Management System (SIGA) is being developed in several phases. It is an innovative measurement for national coverage and contributes to accessible interaction with the NHS.
SIGA is supported by clinical referrals, that will grant information to determine and monitor patients' NHS actions. This information will be provided regardless of whether it is a single clinical event or multiple ones for the same pathology; independently of the type of care involved (primary care, secondary care, tertiary care). It allows for an active monitoring of performance and degree of compliance with “Maximum Guaranteed Response Times” by care typology (general, oncology, cardiology and chronic viral disease) and by priority. Patients can also track their own referrals and care activity.
SIGA is the key stone for integrated monitoring of patient waiting times and delivery of care, to decrease inefficiency and for faster identification of healthcare “bottlenecks”. By producing a timely response and creating an assertive resolution, SIGA guarantees the fulfillment of the NHS.
The design of SIGA involved close collaboration with the SNS Executive Directorate, SPMS (Shared Services of the Ministry of Health), and the institutions, as pilot units in an initial phase.
Results: SIGA has already completed three phases of the project, providing significant advances in the management of access and continuity of care in the SNS. Through SIGA’s dematerialized referrals, we obtain a range of indicators: number of patients on waiting lists, patient order of priority, median and average waiting time, the clinical referral diagnoses, the percentage of clinical events attended to within a timely manner, among others.
The system also allows for early intervention in suspected cases of oncological pathologies, chronic viral diseases and heart disease (based on the 129889 referrals made with this attribute).
Implications: SIGA has proved essential for crisis management, as it assured the continuity of care, through dematerialized referrals that reduced the need for face-to-face appointments and increased the use of teleconsultations.
This approach showed the value of an integrated and flexible system for tackling public health challenges.
The next stages are the development of the remaining phases of the SIGA, and the implementation of the transversal SIGA, which will support, the effective monitoring of the integrated care.
In its future complete form, it will emphasise the following:
- Adjusted health policies;
- Patient empowerment;
- Integrating the monitoring, control and management of access to the NHS.
- A global and transversal vision of patient access and will be possible to understand whether or not a patient with a particular pathology has received the appropriate care.