The NHS Health Information System is a vital element in our response to the
challenges arising from the new organisational situation within the NHS and from the
increasing demands that citizens, patients, professionals and the health administrations
themselves are making of the public health services, for more and better information.
The NHS Health Information System must be based on unquestionable technical
credibility and neutrality within the NHS, as it will earn the recognition of those who
use its services only through a high degree of participation by the generators and
users of the information and through a permanent effort towards transparency. To
develop it, a policy of continuous improvement and innovation will be applied and the
process towards its consolidation will be based on the following:
• Using explicit methodologies that are technically rigorous.
• Producing an annual report on its development, to be presented to the Interterritorial
Council.
• Collaborating permanently with NHS agents.
• Disseminating reliable, appropriate, up-to-date information suited to the needs of
the different users.
Review of 2006-2008
The three years that the Quality Plan has been in effect have been characterised, as
regards the Health Information System, by a high degree of participation by the
autonomous communities in the construction of a common information system. Under
the co-ordination of the Ministry of Health and Social Policy, the Key Indicators of the
NHS have been selected and defined, and actions aimed at creating an NHS data bank have also been carried out. Similarly, improvements have been made to the existing
subsystems of information related to the large health areas (state of health, health care
system, citizen satisfaction).
• Key Indicators of the NHS. These indicators are a prioritised set of information covering aspects considered relevant to health and the Spanish health system. Once they have been established and presented to the Interterritorial Council and the Board of Ministers, they will be made known to the public. For this purpose, a Statistics Portal is currently in development. The Portal, along with the Key Indicators, will provide different types of statistical information regarding health and the health system in a speedy and innovative manner. This tool will be at the service of health care authorities, managers, health professionals, researchers and the general public.
• NHS Data Bank. There is now public access, free of charge, to anonymised microdata and time series metadata from the statistical and information systems of the Health Information Institute, about: health (Spain’s National Health Survey, series 1987 - 2006), health care centres (Catalogue of Primary Care Centres, series 2007 and National Catalogue of Hospitals, series 1995 - 2007), activity (Statistical Study on Inpatient Medical Facilities, series 1996-2005) and citizen opinion (Health Barometer, series 1996 - 2007). Also, the National Register of Deaths database has been set up to allow for consultation by researchers.
• Furthermore, applications have been developed and can be used through the website to obtain data from the Minimum Basic Data Set-Hospital Discharge (MBDS-HD).
-Which includes the Register of NHS Hospital Admissions, mortality, the National Health Survey and population figures.
• Among the improved information subsystems, the following advances must be mentioned:
-The revised version of the National Health Survey, which was presented in May
of 2008 and has brought about significant improvement in the detection and
measurement of health inequalities (especially in relation to gender and social
class, mental health and the health determinants related to the physical and
social environment).
- The newly-created Primary Care Information System (PCIS), which serves to fill a
transcendental information gap that existed in the NHS.
-The General Register of Health Centres, Services and Facilities, which gathers and
updates the list of health care providers authorised by the autonomous communities
(in development phase).
-The new plan for the use of indicators from the Statistical Study on Inpatient
Medical Facilities, which contains the main data concerning the structure, activity
and expenditure of Spain’s hospitals.
-The innovation project regarding the model of analysis of the MBDS-HD, the main
source of information about morbidity attended and the care process in hospitals,
which enables in-depth analyses to be made on the characteristics of hospital care
given to patients in the NHS.
-Extending the MBDS-HD to the field of hospitalisation without overnight stay (Major
Outpatient Surgery and Day Hospital).
-Enabling access, for research purposes, to the National Register of Deaths, through
the Ministry’s website.
Finally, actions have been undertaken to increase the transmission and
transparency of information. Such actions include reducing the lag time between
the production and the dissemination of data, through both the improvement
of production processes and the publication of provisional information in the
form of “previews”. Similarly, the development of contents related to the Health
Information System that are available on the Ministry of Health and Social Policy’s
website, as well as the holding of Annual Forums on the NHS Health Information
System, have also contributed to increased transparency.
Activities planned 2009-2010
To maintain the rate of progress attained in the NHS Health Information System, consolidating the achievements of previous years and taking further steps in improvement
and innovation, the following actions are to be undertaken.
Key Indicators of the NHS
• Disseminate the Key Indicators of the NHS and continually update the information
available.
• Complete the information covered by the indicators by progressively incorporating
additional data (pharmaceutical service, dietary health, environmental health and
other aspects of health and the health care system).
NHS Data Bank
• Consolidate and broaden the bank by incorporating new databases and updating the ones already present.
Improving and integrating existing information subsystems.
Standardisation:
• Improvements in coding
-Action plan for the transition to and implementation of ICD 10.
-Strengthening the existing Technical Coding Unit by adopting the International
Classification of Primary Care (ICPC-version II).
• Creation of a system for NHS recognition of the validity of health registers that already exist in professional and scientific spheres.
Developments in integration and improvement:
• Consolidation of the data concerning primary care activity and continuing the
project for the construction of the Clinical Primary Care Database.
• Continuation of work begun with the autonomous communities to revise the
Statistical Study on Inpatient Medical Facilities.
• Implementation of the model of indicators and analytical themes pertaining to
hospitalisation, based on the use of the MBDS-HD, and implementation of webbased
supporting tools with which to examine results, adjustment measures,
comparative analyses and time series analyses.
• Finalizing construction of the National Register of Health Centres, Services and
Facilities.
• Finishing construction of the Information System on NHS Waiting Lists for
specialist consultations and diagnostic tests.
• Improving information processing, integrating the data from different perspectives
(organisational, functional, territorial or any other that may be deemed relevant).
• Maintaining and developing the Ministry of Health and Social Policy’s statistical
planning and coordination activities, enhancing the dynamism of the Interministerial
Statistics Commission and the works undertaken in relation to the National Plan on
Statistics and its corresponding Annual Programmes.
Further develop the plan to improve data accessibility and the dissemination of information
• Improving the content structure of the website and increasing data accessibility
by using a variety of formats and including bilingual summaries of information
(Spanish-English) for the main statistics.
• Publishing and planning the dissemination of the items published by the
Information System of the NHS in the various formats (paper, CD and online
publications) included in the Ministry’s Publishing Programme.
• Broadening the variety of microdata and metadata that can be downloaded
directly from the Ministry’s website, with complete confidentiality guaranteed at
all times.
• Opening the Statistics Portal of the Ministry of Health and Social Policy to the
public and consolidating its access system and functioning. The Portal will allow
for interactive consultation and generation of reports based on the following
information systems:
-Basic data and statistics from the MBDS-HD.
-Statistical Study on Inpatient Medical Facilities.
-Mortality Statistics.
-The National Health Survey.
-The Health Barometer.
-Database of the Key Indicators of the NHS.
-Basic data from the Primary Care Information System (PCIS).
• Ensuring that a proper response is given to all requests for general information
received through the e-mail
informacionsanitaria@msc.es and also any to requests
made by citizens and more specialised users for the right to use data.
• Reinforcing the relationship of the Ministry of Health and Social Policy with
international organisations such as DG SANCO, Eurostat, WHO and OECD, through
active participation in the different forums and compliance with the commitments
made regarding the sending of data.
Greater transparency |
NHS Health Information System |
• Developed in collaboration with the autonomous communities. • Construction and approval by the Interterritorial Council of the NHS Key Indicators • NHS Data Bank available to the public. • Statistics Portal: interactive applications for queries regarding health and health determinants, hospitalisation and mortality, available to bodies and researchers. • Forthcoming dissemination of the NHS Key Indicators and implementation of permanent update procedure. • Consolidation and extension of the NHS Data Bank. • Continual improvement of the content structure and dissemination of information • Opening the Ministry of Health and Social Policy Statistics Portal to the public. |
Improving and integrating health statistics |
• Numerous interventions designed to improve and offer greater coverage of subject areas. • Clinical Primary Care Database under construction. • Strengthening the extension of the MBDS to the ambulatory and private levels and implementing and improving the model of indicators and analysis of the MBDS-HD. • The National Register of Health Centres, Services and Facilities under construction. • Need to improve the Health Information System on NHS Waiting Lists for specialist consultations and diagnostic tests. • Strengthening relationships with DG SANCO, Eurostat, OECD and WHO. |