On December 16th 2010, at the 8th ordinary meeting of the Brazilian Tripartite Commission (CTI), a draft Ministerial Order establishing the standards for interoperability to be adopted by health information systems of the various levels of the Brazilian National Health System (SUS) was submitted for agreement. CTI is the Brazilian collegiate body representing the Ministry of Health (MoH), the National Council of State Health Secretaries (CONASS) and the National Council of Municipal Health Secretaries (CONASEMS), i.e. 3 levels of government. The CTI is responsible for setting regulation and operational policies within the SUS. The interoperability framework consists of a set of basic assumptions, operational rules and technical specifications to regulate the exchange of information between public and private, municipal, state and federal health information systems, also establishing conditions of interaction with the other spheres of government and society in general. (Minutes of agreement meeting: http://portal.saude.gov.br/portal/arquivos/pdf/decisoes_cit2010.pdf)
The standards will be publicly available on the DATASUS (SUS’s IT department) website (draft statement: http://portal.saude.gov.br/portal/arquivos/pdf/2c_221210.pdf)
They will be updated on a regular basis and will contain a set of meta-data that follow the format already defined by the Brazilian E-government program. Version 1.0, attached to the above resolution, contains two sets of standards, one for web services and one for data structures and semantics, the latter only defined at the logical level (business) and non-physical archival database, so that legacy systems can communicate through nationally agreed XML Schemas. The standards choices are as follows:
- EHR information model: openEHR
- clinical reference terminology: SNOMED CT
- clinical documents: HL7 CDA
- record location: IHE PIX (Patient Identifier Cross-Referencing) and PDQ (Patients Demographics Query)
The draft was approved unanimously and agreed by the members of CTI for adoption on a national scale. The draft has been revised and, according to the Coordinator of Information Systems of DATASUS, Francisco José Marques, it is expected to be approved by the new Minister of Health in the near future.
