Implementing an Integrated Large-Scale Clinical Information System for ISSSTE\u2019s Hospital Network in Mexico

Isaac Castañeda Alcántara,Sophie Domenge Treuille,Arturo Cervantes Trejo

doi:10.1007/s42399-020-00713-2

Isaac Castañeda Alcántara, Sophie Domenge Treuille + Show 1 more

Open Access

https://doi.org/10.1007/s42399-020-00713-2

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Abstract

The Institute for Security and Social Services for State Workers (ISSSTE) is a large public provider of health care services that serve around 13.2 million Mexican government workers and their families. To attain process efficiencies, cost reductions, and improvement of the quality of diagnostic and imaging services, ISSSTE was set out in 2019 to create a digital filmless medical image and report management system. A large-scale clinical information system (CIS), including radiology information system (RIS), picture archiving and communication system (PACS), and clinical data warehouse (CDW) components, was implemented at ISSSTE’s network of forty secondary- and tertiary-level public hospitals, applying global HL-7 and Digital Imaging and Communications in Medicine (DICOM) standards. In just 5 months, 40 hospitals had their endoscopy, radiology, and pathology services functionally interconnected within a national CIS and RIS/PACS on secure private local area networks (LANs) and a secure national wide area network (WAN). More than 2 million yearly studies and reports are now in digital form in a CDW, securely stored and always available. Benefits include increased productivity, reduced turnaround times, reduced need for duplicate exams, and reduced costs. Functional IT solutions allow ISSSTE hospitals to leave behind the use of radiographic film and printed medical reports with important cost reductions, as well as social and environmental impacts, leading to direct improvement in the quality of health care services rendered.

Highlights

This article is part of the Topical Collection on ImagingThe integration of technology and information systems to improve hospital and clinical performance has widely been practiced around the globe evolving rapidly since the 1960s [1,2,3]
In 5 months, 40 hospitals of ISSSTE had their endoscopy, radiology, and pathology services functionally interconnected, with operational clinical information system (CIS), radiology information system (RIS)/picture archiving and communication system (PACS), and clinical data warehouse (CDW) systems running on secure private local area networks (LANs) and a secure national wide area network (WAN)
A total of 3596 individual units of additional equipment were installed such as label printers, scanners, bar code readers, electronic signature equipment, CD/DVD recording robots, dictation software, microphones, interpretation workstations, microscope image capture equipment, highresolution monitors, and Digital Imaging and Communications in Medicine (DICOM) interface for analog equipment [14]

Summary

Introduction

This article is part of the Topical Collection on ImagingThe integration of technology and information systems to improve hospital and clinical performance has widely been practiced around the globe evolving rapidly since the 1960s [1,2,3]. Many health care systems around the world have reported the challenges and benefits of health informatics, including the implementation of hospital information systems (HISs), electronic medical records (EMRs), radiology information systems (RISs), picture archiving and communication systems (PACSs), clinical data warehouse (CDW), and clinical information systems (CISs) [2, 5,6,7,8]. These have since become the norm for successful and efficient medical care, public health services, and clinical practice in the twenty-first century [1, 4].

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