Tema 21 - Administrativos - SAS - Servicio Andaluz de Salud - Volumen 1

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Administrative Relations in Health Services

Overview of Topic 21

• Focuses on the relationship between health administration and citizens within the Andalusian Health Service.

• Discusses administrative information, suggestions, complaints, and document management processes.

Challenges in Public Health Systems

Demand for Healthcare Services

• Highlights the growing demand for healthcare services as a significant issue faced by public health systems globally.

• Factors influencing this demand include population aging and increased citizen interest in quality of life.

Impact of Information Technology on Health Services

Technological Advancements

• Citizens' access to information about their rights is increasing, leading to greater demands for recognition through social participation.

• The role of information technology (IT) is crucial in addressing new healthcare service needs.

Guidelines for IT Use in Public Administration

Code of Conduct Implementation

• A resolution from October 22, 2020, establishes a code of conduct regarding IT use by public professionals in Andalusia.

• Key principles include service proximity to citizens, responsibility, data protection security, efficiency in resource use, and accessibility.

Cybersecurity Measures in Health Administration

Security Protocol Development

• The STIC unit specializes in cybersecurity measures to protect facilities and stored information within the Andalusian Health Service.

Enhancing Access to Healthcare Data

Improving Patient Care

• New models aim to provide healthcare professionals with relevant clinical data access for better patient care.

Digital Strategies for Healthcare Transformation

Telehealth Initiatives

CGS: Evolution and Services of the Andalusian Health Service

Introduction to CGS

• The beginning of CGS marked a significant moment in the evolution of information systems and technologies within the Andalusian Health Service, facilitating support for end-users of corporate applications.

• CGS provides various access channels to its services, ensuring continuous support 24/7 throughout the year.

Focus on Integration and Management

• The primary focus of CGS is on integrating and managing all IT services, aimed at supporting professionals within the organization and enhancing both assistive and non-assistive activities reliant on information systems.

• Services are directed towards two main groups: IT management professionals (sub-directorate of IT, TIC professionals in SASS centers, suppliers) and users from administrative, management, and healthcare sectors.

Catalog of Services Offered by CGS

• Key services include user support, incident diagnosis/resolution related to IT systems, access management (user onboarding/offboarding), password resets, complaint handling regarding information systems, and functional queries about corporate applications.

• Comprehensive monitoring and management of service levels provided by information systems to users; proactive notification about anomalies in SAS's information systems.

Problem Management & Inventory Control

• Proactive problem management aims to reduce recurring incidents while maintaining centralized inventory control over elements comprising information systems.

• Specialized support for administration and operation includes user workstation configuration and antivirus application access setup.

Access Channels for Users

• "Mis Centros Servicios" serves as a primary channel for users to register requests or report issues directly related to daily IT usage without delays.

• Accessing "Mis Centros Servicios" requires DMS AES credentials via a specific URL link provided for ease of use.

Corporate Portal Features

• The corporate portal offers direct access to essential applications, downloadable user manuals/procedures/forms for requests/access data along with security bulletins regarding system interventions.

• Users can subscribe to news updates through RSS feeds; forms/documentation are readily available for various applications.

Mobile Application Accessibility

• The mobile app "UP Móvil" allows users to manage requests conveniently using DMS AES credentials; it is designed for intuitive use across devices.

Digital Health Services in Andalucía

Application Features and User Management

• The application allows users to update their team location, which must be kept current. Users can also modify their DMS AES password and will receive notifications as the expiration date approaches.

• Currently being implemented across hospital centers in Andalucía, the application will soon be available on primary care devices. Access requires DMS AES credentials.

Support Channels

• The traditional telephone channel is available for contacting TIC support, offering similar solutions as other channels but may experience delays during high demand periods.

• Contact numbers include 317.000 (Corporate) and 9-5-05-01-70-0. Email support is available at emailsau.qs.espaarrobajuntadeandalucía.es. A new WhatsApp channel has been introduced for 24/7 contact with CEEES.

Evisan Telemedicine Program

• The Evisan program was awarded by the European Commission for promoting online public services across Europe, facilitating vital emergency support and teleconsultations with specialists.

Electronic Health Record System: Diraya

Overview of Diraya

• Diraya serves as the electronic health record system within the Andalusian health service, managing comprehensive patient information regardless of the healthcare professional or setting involved.

Integration and Accessibility

• Diraya integrates all user information into a single health record accessible when needed, enhancing coordination among various healthcare levels including primary care, specialized care, emergencies, and hospitalization.

Structure and Modules

• Information in Diraya is structured using common tables and codes developed through professional consensus; it consists of interconnected modules that share data effectively.

Key Modules of Diraya

Main Components

• Three main modules include:

• User Database (BDEU): Contains all health-related administrative information about citizens.

• Centralized Access Module (Maco): Identifies professionals allowing them access to authorized functions across different modules.

• Service Structure Module: Details resources and services offered by the healthcare system.

Continuous Updates

• Diraya undergoes constant updates to incorporate new services or enhance existing ones; some applications are integrated while others synchronize data with it.

Assistive Applications Linked to Diraya

Included Applications

• Various assistive applications linked with Diraya include:

• Primary Care Dapa,

• Clinical Station DA-H-C,

• Urgency SAP,

• Prescription management systems like Receta 21.

Initiatives for Pediatric Patients

Mundo de Estrellas Initiative

• This initiative aims to provide tools improving quality of life for children with serious illnesses in hospitals through virtual interactions with peers and healthcare professionals.

Salud Responde Information Center

Overview of Services

Apschita Médica: Enhancing Healthcare Access in Andalucía

Overview of Apschita Médica

• Apschita Médica provides a mobile application for users in Andalucía, offering access to qualified professionals and the latest communication technologies. Users can receive personalized information or services from home, available 24/7.

Services Offered by Salud Responde

• The platform is continuously evolving and includes a wide range of services such as:

• Appointments with family doctors and pediatricians.

• Specialist consultations and nurse appointments.

• Health advice and follow-up for high-risk patients during weekends.

Communication and Support Features

• Salud Responde manages health campaigns via SMS, offers translation services, and provides information on various health topics including tobacco cessation. It also supports families with periodic reminders for child-rearing from birth to age 14.

Patient Rights and Information Access

• Users have the freedom to choose their hospital, access advance directives, request second medical opinions, and receive updates on response times in healthcare processes. This ensures comprehensive support for patients at home after emergency assistance.

Technological Integration in Healthcare

• After ten years of operation, Salud Responde has improved public healthcare access in Andalucía by optimizing resources, reducing wait times, and minimizing unnecessary travel for users. Future enhancements will continue to expand service management capabilities within the public healthcare system.

European Health Initiatives: Expanding Access

EU Health Portal Contributions

• The European Union's General Directorate of Health provides a portal (salud UE) that offers extensive information on health-related issues at both European and international levels, facilitating easy access to community programs for citizens across member states.

Public Health Objectives Supported by EU Initiatives

• These initiatives contribute positively to individual behaviors regarding health while promoting continuous improvement in public health across all EU member states through accessible information sharing.

National Health System Quality Plan: Online Healthcare

Goals of the National Quality Plan

• The National Quality Plan aims to leverage information technology to enhance citizen care through:

• Clear identification systems for every citizen within the National Health System.

• Regular clinical data exchange among professionals across different regions.

Advancements in Prescription Management

• The plan promotes electronic prescriptions throughout the National Health System while ensuring accessibility at all points within the system along with proper data utilization practices. This includes improving telemedicine capabilities to reduce patient travel needs effectively.

Administrative Information Regulations

Administrative Suggestions & Complaints Framework

La Información Administrativa

General Administrative Information

• The General Administrative Information serves to guide citizens interacting with the Administration of Andalucía, facilitating their right to access public services.

• It encompasses the functions, competencies, and operations of various administrative bodies, detailing aspects such as organization, public services offered, management procedures, required documentation, and responsible units.

Specific Administrative Information

• Particular Administrative Information enables citizens to exercise specific rights and interests by addressing legal or technical requirements for initiatives proposed to the Administration.

• Citizens can inquire about the status of procedures they are interested in and identify authorities responsible for processing these procedures according to current laws and regulations.

Characteristics of Administrative Information

• Article 4 outlines that provided information must be clear and comprehensible. It is illustrative only and does not create rights or expectations nor harm any party's rights or interests.

Provision of General Administrative Information

• Articles 5 and 6 detail who provides different types of administrative information. General information should be provided without delay or restrictions on response time or communication methods chosen by the requester.

Provision of Specific Administrative Information

• The responsibility for providing specific administrative information lies with section heads or equivalent bodies as per established regulations.

• The administration must ensure appropriate means for each type of inquiry while allowing personal communication when necessary due to confidentiality or complexity.

Citizen Rights in Procedure Tracking

• If a requester wishes to know the status of their procedures or obtain document copies, they must first prove their legitimacy in doing so.

Libro de Sugerencias y Reclamaciones

Establishment and Purpose

• Article 3 from Decree 262 establishes a suggestion and complaint book (LESR), allowing individuals who feel neglected by health services to report issues or make suggestions for improvement.

Regulation Overview

• The suggestion book is regulated under Decree 262 concerning service operation within the Junta de Andalucía.

Accessing Suggestion Book Information

• Decree 294 outlines organizational measures for direct citizen attention services. A new model for accessing this information electronically was approved on September 6, 2021.

Availability

Overview of Complaint and Suggestion Procedures

Structure of Complaints and Suggestions

• The first copy of the complaint is designated for the interested office, the second for service inspection, and the third for the individual concerned.

• Under the cancellation provision from September 6, 2021, suggestion and complaint books established under a previous order remain valid as long as they are available.

• Key identification data in complaints includes:

• Identification of the complainant

• Identification of the department involved

• Text of the complaint

• Date, place, and signature.

Processing Complaints and Suggestions

• Upon formalizing complaints or suggestions, registration units must complete administrative sections, stamp all pages with a registration seal, and provide a copy to the complainant immediately.

• If filed at an affected office's suggestion book, originals are sent to responsible departments while copies go to provincial inspectors or general inspections depending on central services involvement.

Response Timeline and Control Measures

• Affected departments must respond within 15 days after receiving complaints; this includes necessary clarifications from complainants before informing relevant authorities about actions taken.

• If clarifications are requested by departments, response time starts upon receipt of these clarifications.

Monitoring Complaints

• The General Inspection of Services oversees all complaints; those affecting peripheral offices are managed at provincial levels with monthly reports submitted by provincial inspectors regarding received complaints.

• Each complaint initiates an investigation file that documents all actions taken concerning it along with reports from affected bodies.

Nature of Complaints

• Complaints do not qualify as administrative resources nor do they halt existing legal deadlines for filing such resources according to Decree 262/1988.

• Complainants can still pursue other claims or appeals outlined in administrative procedure regulations regardless of their initial complaint submission.

Document Submission Regulations

• Documents refer to any written expression from individuals or official communications directed towards public administration entities. This includes both paper-based documents and electronic submissions ensuring authenticity and compliance with specific regulations.

Electronic Registries in Public Administration

Overview of Electronic Registries

• The electronic registry will document official documents directed to other bodies or individuals, allowing public organisms linked to each administration to maintain their own interoperable electronic registries connected to the general registry.

• Each administration's general electronic registry will serve as a portal for accessing the electronic records of various organisms, ensuring compliance with data protection legislation.

Creation and Management of Registries

• Regulations for creating electronic registries will be published in the official journal, with full texts available for consultation on the electronic access site. These regulations will specify responsible units and relevant dates.

• The access site for each registry will list current procedures that can be initiated. Document entries must respect chronological order and indicate the date of receipt.

Documentation Process

• Each entry in an electronic registry must include essential details such as a unique number, nature of the document, submission date, identification of interested parties, and references to content when applicable.

• An automatic receipt will be issued upon registration completion, providing an authenticated copy of the submitted document along with its presentation date and entry number.

Submission Methods

• Interested parties may submit documents through various channels: directly at the relevant administrative office's electronic registry or via postal services as regulated.

• All administrative registries must ensure full interoperability to guarantee compatibility and seamless transmission of registered entries across different systems.

Digitalization and Accessibility

• Documents presented physically must be digitized by assistance offices before being incorporated into electronic administrative files while returning originals to interested parties.

• Certain regulations may require specific documents to be submitted electronically based on economic or technical capabilities of individuals involved.

Financial Transactions and Updates

• Payments related to document submissions can be made via bank transfer directed at public offices; alternative payment methods are also permitted.

General Records and Electronic Registries in the Junta de Andalucía

Overview of General Records

• The general records of municipalities will serve as entry points for documents directed to the administration of the Junta de Andalucía.

• Telecommunication networks will facilitate electronic document submission 24/7, allowing for seamless entry and exit of documents.

Regulation and Security Measures

• The operation of telematic registries will be regulated, ensuring that electronic documents are stored securely with measures for integrity, protection, and user identification.

Citizen Rights in Document Submission

• Citizens have the right to submit documents at Junta de Andalucía's registries and receive confirmation of their submissions.

• Errors in receiving requests by administrative bodies must be promptly redirected to the appropriate authority while informing interested parties.

Electronic Registry Framework under Decree 622/2019

Establishment of a Unique Electronic Registry

• A unique electronic registry is established for all entities within the Junta de Andalucía, documenting all incoming and outgoing documents.

• The competent public administration department manages this registry, which is accessible through official digital platforms.

Functionality and Interoperability

• The unique electronic registry will automatically acknowledge receipt of documents and send confirmations to users via their provided email addresses.

• Discrepancies regarding document reception will be handled by the relevant authority responsible for processing those documents.

Document Submission Procedures

Standardized Forms and Digitalization Requirements

• Standard forms must list required documentation according to regulatory procedures when submitting requests electronically.

• Documents submitted in person must be digitized on-site before being incorporated into electronic administrative files.

Rejection Criteria for Submissions

• Any submission lacking essential information such as name, signature, or identification number may be rejected.

Regulations on Electronic Document Submission

Rights and Limitations in Document Submission

• When a document submission is rejected for specified reasons, the interested party has the right to request a receipt as proof of their attempt to submit and the reasons for its inadmissibility.

• There may be limitations on size or other aspects of electronic documents to ensure compatibility with existing technical applications used for electronic management of services and procedures.

Security Measures for Electronic Documents

• Electronic documents containing malicious code or devices that could compromise system integrity or security may be rejected. The submitting party will be informed in such cases.

Operation of the Unique Electronic Registry

• The unique electronic registry will operate continuously for receiving requests, documents, and communications. Interruptions are only permitted for justified technical or operational maintenance, lasting only as long as necessary.

Extension of Deadlines Due to Technical Issues

• In case of interruptions due to technical issues, the competent authority can extend any unexpired deadlines. This extension must be published alongside information about the incident using the same channels through which the original deadline was established.

Internal Electronic Communications within Administration