PROJECT NAME:

项目名称

Implementation and Upkeep: e-SUS Primary Care (AB) Electronic Medical Report  实施和维护：e-SUS初级保健（AB）电子医疗报告

EXECUTING DEPARTMENT: 执行部门

Municipal Secretariat of Health (SMS) 市卫生局秘书处（SMS）

INVOLVED DEPARTMENTS:参与部门

Municipal Information Technology Company (IPLANRIO) 市信息技术公司（IPLANRIO）

Hospital 医院

The project of implementation of hospital management software is justified by the absence of an information system  in the hospital units of the Municipal Secretariat of Rio de Janeiro that has integrated modules that allow the agility and quality in the citizen's care.  由于里约热内卢市政秘书处的医院单元缺乏信息系统，医院管理软件的实施项目是合理的，该系统集成了模块，可以提高公民护理的灵活性和质量。

PC Primary Care PC初级保健

The municipality of Rio de Janeiro has, in the recent years, used four different Electronic Medical Records systems, selected by Healthcare Social Organizations - OSS. These systems have difficulties to meet the needs of the municipality's professionals and managers, with consequent interference regarding the demands of the Ministry of Health. 近年来，里约热内卢市政府使用了四种不同的电子医疗记录系统，这些系统由医疗保健社会组织 - OSS选择。 由于卫生部的要求，这些系统难以满足市政专业人员和管理人员的需求。

The records do not offer a uniform directory of information, since each one presents a different layout and paths within the system, both for registration and for accessing the data. The lack of uniformity in data entry is a problem and constitutes a challenge to solve questions related to data reliability.记录不提供统一的信息目录，因为每个记录在系统内呈现不同的布局和路径，用于注册和访问数据。 数据输入缺乏统一性是解决与数据可靠性相关的问题的一个问题和挑战。

The present project is required because we believe that the advances made by the investments of the Ministry of Health in information technology qualification policy and the restructuring of health information systems - SIS, with the consequent integration of these systems and interoperability among them, allows the Municipal Health Department to guarantee uniformity in data entry, a good health record, with a user-friendly interface for recording, and reliability of the data for decision making for health surveillance, and for the management, without cost, with consequent economics for municipal public management.由于我们认为卫生部在信息技 卫生部门保证数据录入的一致性，良好的健康记录，用户友好的记录界面，健康监测决策日期的可靠性，以及无需成本的管理，以及随之而来的市政公共管理经济, 因此需要目前这个项目。

Hospital 医院

In recent years, hospitals have undergone an important process of qualification of the services provided, where it becomes necessary that Information Technology is an important tool for hospital management, as well as the management of this information produced in this environment. This information is processed by different levels in the organization and will be fundamental for the hospital management, since it will be known all the indicators and results obtained, as well as storing all the data referring to the hospital care of the patients.近年来，医院经历了对所提供服务进行资格认证的重要过程，其中信息技术是医院管理的重要工具，以及在此环境中产生的这些信息的管理。 该信息由组织中的不同级别处理，并且将是医院管理的基础，因为将知道所获得的所有指标和结果，以及存储涉及患者的医院护理的所有数据。

Based on information available in the Health Portal of the Ministry of Health, e-SUS is one of the strategies of the Ministry of Health to develop, restructure and guarantee the integration of the systems, in order to allow a record of the individualized health situation through the National Health Card.根据卫生部卫生门户网站提供的信息，e-SUS是卫生部制定，重组和保证系统整合的战略之一，以便记录个体化的健康状况 通过国民健康卡。

The e-SUS refers to an electronic SUS, whose objective is to facilitate and contribute to the work organization of health professionals, a decisive element for the quality of health care provided to the population. In addition, E-SUS Hospital has integration with the National Health Card System and has interoperability between information systems.e-SUS指的是电子SUS，其目的是方便和促进卫生专业人员的工作组织，这是提供给人们的卫生保健质量的决定性因素。 此外，E-SUS医院还与国家健康卡系统集成，并具有信息系统之间的互操作性。

E-SUS Hospital is focused on the HIS (Hospital Information System) and PEP (Electronic Patient Record), and provides reporting tool, metadata-based dynamic forms, management indicator panel, laboratory system and ERP. E-SUS医院专注于HIS（医院信息系统）和PEP（电子病历），并提供报告工具，基于元数据的动态表格，管理指标面板，实验室系统和ERP。

The purpose of this system is to meet the demands of Public Hospitals in the Federal, State and Municipal spheres, as well as the Project S.O.S. Emergencies, Urgent and Emergency Services (Prompt Service Unit) all demands within the Ministry of Health.该系统的目的是满足联邦，州和市政领域公立医院的需求，以及S.O.S.项目。 紧急和紧急服务（即时服务单位）卫生部内的所有要求。

It is a complete hospital management system, previously under the responsibility of the Department of Informatics of SUS (Universal Health System) - DATASUS and that passes through strategic realignment in the Ministry of Health, so that it has the license of use available for use in the municipal sphere. This system replaced the HOSPUB system that is still used by some of our municipal hospitals.它是一个完整的医院管理系统，以前由SUS（通用卫生系统）信息部--DATASUS负责，并通过卫生部的战略调整，因此它具有可用于的使用许可证 市政领域。 该系统取代了我们的一些市政医院仍在使用的HOSPUB系统。

From this realignment, the software will be made available free of charge, with the Ministry of Health responsible for the evolutionary, corrective and adaptive development of the System, as well as version control. The infrastructure of logic, hardware, printers and peripherals for implantation of e-SUS Hospitalar is the counterpart of the Municipal Health Secretariat of Rio de Janeiro. 从这次调整中，该软件将免费提供，卫生部负责系统的演进，纠正和适应性开发，以及版本控制。用于植入e-SUS Hospitalar的逻辑，硬件，打印机和外围设备的基础设施是里约热内卢市卫生秘书处的对应物。

It is expected that the software, after adjustments, will meet the needs of patient data records and other needs at all organizational levels, ranging from the patient's entrance, all care, electronic medical records, to administrative, with solutions for data integration, with all unified information. This will bring the integrity and uniformity of data and information to all processes developed in the hospital environment in an integrated way. 预计该软件经过调整后，将满足患者数据记录和所有组织层面的其他需求，包括患者入口，所有护理，电子病历，行政管理，数据集成解决方案，以及所有 统一信息。这将以统一的方式为医院环境中开发的所有流程带来数据和信息的完整性和一致性。

The software of the Ministry of Health allows the observation of waiting time for care and risk classification. Marking exams, prescribing medicines and scheduling appointments is also facilitated. It is a software that by its integration, will make possible the computerized control of all the processes of the hospital environment. The tool has ten support modules (scheduling, outpatient clinic, surgical center, surgical suite, hospitalization, prescription, electronic patient record, employee registration, patient registration, user safety), nine support modules (warehouse, pharmacy, billing, hygiene, laboratory, nutrition, clothing and SAC), six management modules (purchasing, dynamic forms, risk classification, stock control, commitment control, financial) and strategic management (dashboard).卫生部的软件允许观察护理和风险分类的等待时间。 还有助于标记考试，开药和安排预约。 它是一种软件，通过它的集成，可以对医院环境的所有过程进行计算机控制。 该工具有十个支持模块（日程安排，门诊，手术室，住院，处方，电子病历，病人登记，病人登记，用户安全），九个支持模块（仓库，药房， 营养，服装和SAC），六个管理模块（采购，动态形式，风险分类，库存控制，承诺控制，财务）和战略管理（仪表板）。

One of the points of great relevance is the security of information, given the volume of information generated in a hospital unit. This requires the realization of a contingency plan to manage these risks. In this sense, IPLANRIO and the Management of Engineering and Architecture of SMS Rio de Janeiro are involved in the development of the project aiming at the construction of the current diagnosis of the infrastructure of hospitals defined by the Under-Secretariat for Hospital, Emergency and Emergency Care, with the aim of developing planning adequate to meet the needs and ensure the implantation of medical records in conditions suitable for the use of professionals and data volume.鉴于医院单位产生的信息量，信息的安全性是其中一个重要点。 这需要实现应急计划来管理这些风险。 从这个意义上说，IPLANRIO和SMS里约热内卢的工程和建筑管理部门参与了该项目的开发，旨在建立由医院，紧急和紧急情况秘书处确定的医院基础设施的当前诊断。 护理，目的是制定足以满足需求的计划，并确保在适合专业人员和数据量使用的条件下植入医疗记录。

PC Primary Care PC初级保健

The e-SUS Primary Care Electronic Medical Record (e-SUS AB) is a strategy of the Department of Primary Care-DAB/Ministry of Health, to restructure the information of Primary Care at the national level. This action is in line with the more general proposal for the restructuring of Health Information Systems of the Ministry of Health, understanding that the qualification of information management is fundamental to increase the quality of healthcare services for the population. The e-SUS AB strategy refers to the qualified electronic process of the SUS (Universal Healthcare System - the Brazilian Public Healthcare Service) in search of an electronic SUS. e-SUS初级保健电子病历（e-SUS AB）是初级保健部 - DAB /卫生部的一项战略，旨在重建国家一级初级保健的信息。 这一行动符合卫生部卫生信息系统重组的更一般性建议，理解信息管理的资格是提高人口医疗服务质量的基础。 e-SUS AB策略是指SUS（通用医疗保健系统 - 巴西公共医疗保健服务）的合格电子流程，用于寻找电子SUS。

In this sense, the e-SUS AB system was developed to attend the work processes of Primary Care (AB) for the management of health care, and can be used by professionals of all AB teams, by the teams of the Family Health Support Centers (Nasf), the Clinic on the Street (CnR), Prison Health Care and Home Care (AD), as well as professionals who carry out actions in programs such as Health at School (PSE) and the Health Academy/Gym.从这个意义上说，e-SUS AB系统的开发是为了参加初级保健（AB）的医疗保健管理工作流程，并且可以由所有AB团队的专业人员，家庭健康支持中心的团队使用 （Nasf），街头诊所（CnR），监狱医疗保健和家庭护理（AD），以及在健康学校（PSE）和健康学院/健身房等项目中开展行动的专业人士。

In addition to the benefit of a single medical record that allows data entry of citizen health care in an adequate and uniform way, there is a need for investment in infrastructure with the acquisition of a Datacenter that also allows the storage of clinical data of the population served in municipal units, and in the licensing of ORACLE, enabling the citizen's record in our network to be available for consultation. 除了允许以适当和统一的方式输入公民医疗保健数据的单一医疗记录的好处之外，还需要通过收购数据中心对基础设施进行投资，该数据中心还允许存储人口的临床数据 在市政单位服务，并在ORACLE的许可证中，使公民在我们网络中的记录可供咨询。

The study of this infrastructure was carried out by IPLANRIO, the Municipal Information Technology Company, based on the demands we made for the ideal scenario of the application of e-SUS Primary Care in the city of Rio de Janeiro. In this study we designed a scenario for the provision of financial resources necessary for the infrastructure of the e-SUS Primary Care system, in the period 2018/2020 with a specific cost and risk.该基础设施的研究由市政信息技术公司IPLANRIO根据对里约热内卢市e-SUS初级保健应用的理想情况提出的要求进行。 在本研究中，我们设计了一个场景，用于提供e-SUS初级保健系统基础设施所需的财务资源，在2018/2020期间具有特定的成本和风险。

Hospital 医院

To implant the e-SUS Hospitalar, free software, available from the Ministry of Health, for use in twenty hospitals of the Municipal Secretariat of Health of Rio de Janeiro.植入e-SUS医院，免费软件，可从卫生部获得，用于里约热内卢市卫生部秘书处的20家医院。

Qualify records of patient care data.确定患者护理数据的记录。

Qualify the process of using the system, aiming at improving the performance of professionals working in the municipal hospital units of the city of Rio de Janeiro. 确保使用该系统的过程，旨在提高在里约热内卢市市政医院工作的专业人员的表现。

The hospital electronic medical record will be implanted in twenty hospitals between 2018 and 2021, distributed as follows: 医疗记录医院将于2018年至2021年间在二十家医院植入，分布如下：

2018 - Implantation of Electronic Hospital Record in 02 Hospitals 2018年 - 在02家医院植入电子医院记录

2019 - Implantation of the Electronic Hospital Record in 08 Hospitals.2019年 - 在08家医院植入电子医院记录。

2020 - Implantation of Electronic Hospital Record in 08 Hospitals.2020年 - 在08家医院植入电子医院记录。

2021 - Implantation of Electronic Hospital Record in 02 Hospitals 2021年 - 在02家医院植入电子医院记录

PC Primary Care PC初级保健

To implement the e-SUS Primary Care Electronic Medical Record Free Software, made available by the Ministry of Health, in all Primary Care units, distributed in the 10 Planning Areas (APs) of the city of Rio de Janeiro; 实施卫生部提供的所有初级保健单位的e-SUS初级保健电子病历免费软件，分发在里约热内卢市的10个规划区（AP）;

To qualify the process of using the e-SUS AB Electronic Medical Record system, aiming at improving the performance of professionals working in the APs of the city of Rio de Janeiro; 使用e-SUS AB电子病历系统的过程符合资格，旨在提高在里约热内卢市的AP工作的专业人员的表现;

To qualify the records management by healthcare professionals, positively impacting on health programming, care management, and decision making at various levels of management; 使医疗保健专业人员对记录管理进行资格审查，对各级管理层的健康计划，护理管理和决策会产生积极影响;

Expected results: To have the e-SUS AB Electronic Medical Record working in all Primary Care units, distributed in the 10 Planning Areas of the city of Rio de Janeiro; To have internal flows established within the Basic Healthcare Units (Primary Care Units), aiming at improving the work process and Healthcare of the citizen; To obtain quality in the records healthcare professionals produce, positively impacting health programming, care management, and decision making at various management levels.预期成果：在所有初级保健单位工作的e-SUS AB电子病历，分布在里约热内卢市的10个规划区域; 在基本医疗保健单位内部建立内部流程，旨在改善公民的工作流程和医疗保健; 为了获得医疗保健专业人员产生的记录质量，对各种管理层面的健康计划，护理管理和决策产生积极影响。

We plan the implementation so that by the end of 2020 all Primary Care units will be using the e-SUS AB Electronic Medical Record Free Software, within the scenario designed with the acquisition of a DATACENTER and licensing ORACLE from 2018 onwards. In 2017, the implementation of this project in the "type B" units is designed with the use of local servers with direct data transmission to the Ministry of Health. 我们计划实施，以便到2020年底，所有初级保健单位将使用e-SUS AB电子医疗记录免费软件，在2018年以后通过收购DATACENTER和授权ORACLE设计的方案中。 2017年，在“B型”单元中实施该项目的目的是使用本地服务器直接向卫生部传输数据。

2017 - Implementation of the e-SUS AB Electronic Medical Record in basic units Type B. (20\\\%)

2017年 - 以B类基本单位实施e-SUS AB电子病历（20％）

2018 - Implementation of the e-SUS AB Electronic Medical Record in 40\\\% of the basic units.

2018年 - 在40％的基本单位中实施e-SUS AB电子病历。

2019 - Implementation of the e-SUS AB Electronic Medical Record in 70\\\% of basic units.

2019年 - 在70％的基本单位中实施e-SUS AB电子病历。

2020 - Implementation of the e-SUS AB Electronic Medical Record in 100\\\% of basic units.

2020年 - 以100％的基本单位实施e-SUS AB电子病历。

Hospital 医院

Opportunities 机会

The software is part of the Ministry of Health's E-SUS Strategy, which is moving towards the unification of applications towards the Individual Minimum Data Set. In addition, it has integration with the National Health Card, CNES and SIGTAP and interoperability with other health systems.

该软件是卫生部E-SUS战略的一部分，该战略正朝着将个人最低数据集的应用统一起来。 此外，它还与国家卫生卡，CNES和SIGTAP集成，并与其他卫生系统互操作。

Threats 威胁

There is a need for investment in Datacenter infrastructure, Oracle License and PCRJ link (this last item adds value to information security) to ensure the appropriate scenario, enabling health services and actions performed are available for consultation in the citizen's history, in any of the hospital units where it is attended.

需要投资Datacenter基础设施，Oracle许可证和PCRJ链接（这最后一项增加了信息安全的价值），以确保适当的方案，使公民在任何 出席的医院单位的病历，用于健康服务和采取的措施的咨询。

Long-term investment planning - As the deployment will be gradual over 4 years, the investment should also follow this logic. A monthly assessment will enable you to review the sizing with greater accuracy after deployment. 长期投资计划 - 由于逐步部署将超过4年，投资也应遵循这一逻辑。 通过月度评估，您可以在部署后更准确地查看大小调整。

Continuity of investment - It is important to mention the need for continuity of investment in infrastructure due to the growth of the database and the validity of the equipment and licenses.投资的连续性 - 由于数据库的增长以及设备和许可证的有效性，有必要考虑到基础设施投资的连续性需求。

 Support in the area of Information Technology - It is fundamental that there is a professional IPLANRIO business analyst dedicated exclusively to the monitoring and evaluation of network infrastructure, connectivity and infrastructure architecture in the Datacenter. 信息技术领域的支持 - 最重要的是，有一位专业的IPLANRIO业务分析师专门负责监控和评估数据中心的网络基础设施，连接和基础架构。

Opportunities 机遇

The Municipal Health Secretariat starts using a single medical record in Basic Care, the e-SUS AB Electronic Medical Record, software made available by the Ministry of Health at no cost to the city of Rio de Janeiro, in all Primary Care units. 市卫生秘书处开始使用基本护理中的单一医疗记录，e-SUS AB电子病历，由卫生部免费提供给所有初级保健单位的软件，不用花里约热内卢市的钱。

The software is part of the Ministry of Health's e-SUS Strategy, which is moving towards the unification of applications towards the Individual Minimum Data Set. In addition, it has integration with the National Health Card, CNES and SIGTAP and interoperability with other health systems. 该软件是卫生部的e-SUS战略的一部分，该战略正朝着将个人最小数据集的应用统一起来。 此外，它还与国家卫生卡，CNES和SIGTAP集成，并与其他卫生系统互操作。

Threats 威胁

There is a need for investment in Datacenter infrastructure, Licensing Oracle and Rio de Janeiro City Hall (PCRJ) link (this last item adds value to information security) to ensure the appropriate scenario, guaranteeing health services and actions performed are available for consultation in the citizen's medical record, in any of the basic units where he/she is serviced. 需要投资数据中心基础设施，许可Oracle和里约热内卢市政厅（PCRJ）链接（最后一项增加信息安全的价值），以确保适当的方案，保证公民在他/她服务的任何基本单位的医疗记录，在提供的健康服务和行动可用于咨询 。

Volume estimate - The database volume was estimated based on information provided by the Ministry of Health. Average size of the databank with 12 months of use in a Healthcare unit with 3 family health teams. It has been, subsequently, revised with actual information about the size of the CMS Jose Paranhos Fontenelle databank , which that has 12 months of use, being both PostgreSQL databases. 数量估计 - 数据库数量是根据卫生部提供的信息估算的。 数据库的平均大小，在拥有3个家庭健康团队的医疗保健单位中使用12个月。 随后，它已根据CMS的Jose Paranhos Fontenelle数据库的大小实际信息进行了修订，该数据库有12个月的使用时间，都是PostgreSQL数据库。

Number of units planned - The number of units is not set at 234. This is the number of basic care units at the time of project realization, and variation may occur according to the expansion of Primary Care in the municipality. 计划的单位数量 - 单位数量未设置为234.这是项目实现时基本护理单位的数量，并且可能根据市政府初级保健的扩展而发生变化。

Number of concurrent users - The number of concurrent users surveyed was based on the types of profiles of the Basic Healthcare Units, not including the rooms with interleaved functions. 同时使用用户数 - 调查的同时使用用户数基于Basic Healthcare Units的配置文件类型，不包括具有交叉功能的房间。

Infrastructure Architecture Estimate - The Information Technology Management of IPLANRIO  requested the Ministry of Health (MS) this architecture. The Federal University of Santa Catarina, which in partnership with MS developed and maintains the e-SUS AB system, reported that currently no Municipality contains a scenario similar to that of the city of Rio de Janeiro, making it impossible to provide this information. The University also reported that the application does not contain in its coding the prediction of balancing. 基础设施架构估算 - IPLANRIO的信息技术管理要求卫生部（MS）采用这种架构。 圣卡塔琳娜联邦大学与MS合作开发并维护了e-SUS AB系统，报告说目前没有任何市政当局包含类似于里约热内卢市的情景，因此无法提供这方面信息。 该大学还报告说，该应用程序在其编码中不包含平衡预测。

Through the experience with the DESESC system (system supported by Jboss and Oracle used by the Municipal Department of Education) which has a configuration similar to e-SUS AB, it was possible to estimate the architecture for the application. 通过具有类似于e-SUS AB的配置的DESESC系统（由市政教育部使用的Jboss和Oracle支持的系统）的经验，可以估计应用程序的体系结构。

Long-term investment planning - As the deployment will be gradual over 3 years, the investment should also follow this logic. A monthly assessment will enable to review the sizing with greater accuracy after deployment. 长期投资计划 - 由于部署将在3年内逐步进行，投资也应遵循这一逻辑。 每月评估可以在部署后更准确地审查大小。

Continuity of investment - It is important to mention the need for continuity of investment in infrastructure due to the growth of the database and the expiration of the licenses and equipment deterioration. 投资的连续性 - 由于数据库的增长以及许可证和设备恶化的到期，有必要考虑基础设施投资的连续性需求。

Support in the area of Information Technology - It is fundamental that there is a professional IPLANRIO business analyst dedicated exclusively to the monitoring and evaluation of network infrastructure, connectivity and infrastructure architecture in the Datacenter. 信息技术领域的支持 - 最重要的是，有一位专业的IPLANRIO业务分析师专门负责监控和评估数据中心的网络基础设施，连接和基础架构。

Hospital 医院

Investiment 投资

TOTAL: R$ 51.511.112 / USD 15.826.686  总计：R $ 51.511.112 / USD 15.826.686

Primary Care 初级保健

Investment 投资

    TOTAL: R$ 35.238.986 / USD 10.827.107

TOTAL OF THE PROJECT:  USD 26,653,793 项目总数：26,653,793美元