The Ministry of Health in Portugal is developing a new strategy focused on citizen-centred communications. The initiative is transforming the way information about health services and resources are shared with citizens, promoting knowledge of healthcare indicators and access to services through websites and mobile apps.

The new SNS Portal (Portal da Saúde) forms the core of several projects developed by Portugal’s national health service, the Serviço Nacional de Saúde (SNS). Launched in 2016, the portal integrates information about public healthcare services with real-time data, and includes projects focused on doctors, nurses and other health professionals, as well as citizens.

The project is supported by the Simplex program, implemented by the Administrative Modernization Ministry. The SNS Portal is a key element in the government’s strategy to modernise and simplify public administration, integrated into the “Administração aberta + Simples + Próxima” initiative.

Among other things, the portal allows users to schedule an appointment with a doctor, renew a prescription, and work out whether they are entitled to exemption from healthcare fees. One of the most-used areas shows waiting times for emergency appointments in nearby hospitals and healthcare units.
The portal provides information on doctors’ appointments and surgeries in several SNS hospitals, including indicators such as expenditure on medicines, calls answered by the Health Line 24 service, and how many vaccinations a particular health centre has carried out.

Policy context

Transforming the national health service is one of the Portuguese government’s biggest projects, covering processes that include modernising services and setting up new platforms to communicate with citizens. Access to healthcare is a significant problem in Portugal, dividing the population between those who can pay for private hospitals and those who can only use the public system. People in the latter group may face long waiting times for surgical procedures and consultants’ appointments.
The SNS Portal provides services that already existed through other websites, but adds new ways to manage citizens’ interactions with the national healthcare services. Some of these are among the best practices used in private health systems, changing the current model of Portuguese healthcare and allowing everyone to access best-in-class services. Digital platforms are now being used as an alternative to telephone and in-person booking, saving time and resources. There is also a transparency objective, allowing every citizen to check information online through the Transparency area.
The portal is supported by a significant transformation of the information systems used in hospitals and healthcare units. This covers hardware, software, and also processes: digital documents, for instance, are replacing paper for prescriptions and vaccination records, saving a great deal of office time.
 

Description of target users and groups

 

The SNS Portal was designed by professionals to give citizens a number of new features accessed through online tools that are simpler, clearer and more user-friendly than those previously available. Every person with access to the Portuguese healthcare system (which means everyone living in Portugal) can register with the website. This gives them a personal area through which they can monitor their healthcare information and communicate with medical professionals conveniently, safely and securely.
The service evolved from a previous system known as the Patient Portal (Portal do Utente), which was launched in 2013. In particular, the SNS Portal adds extra functionality in the Citizen’s Area; it also allows the sharing of information between users, health professionals and health service providers.
The number of registrations with the SNS Portal has been growing fast. Its 1,350,000 users represent approximately 13% of the Portuguese population, and about 25% of active health service users. Every day, citizens use the portal to book more than 15,000 appointments with their general practitioners.
In the personal area of the portal citizens can check their complete personal health records, provide emergency contacts, and register medication and allergies. They can also view timelines of medical episodes, and a medical summary that has been validated by a doctor.

 

 

Description of the way to implement the initiative

The SNS Portal aims to transform the SNS through a digital approach that is more connected to citizens, giving them the ability to check their information and save time managing appointments, while allowing greater transparency in SNS data. This requires a huge investment in technology and new or modified processes.
Supporting the visible face of the SNS Portal are several technological platforms, managed by Serviços Partilhados do Ministério da Saúde (SPMS) and covering software, hardware and apps. These are integrated so as to give users and practitioners the best experience, and allow the hundreds of healthcare centres to function in a more efficient way.
In such a complex environment, interoperability is key. SPMS has developed middleware known as LIGHt – Local Interoperability Gateway for Healthcare – to mediate the exchange of information between SPMS products and external clients. LIGHt provides internal systems with an integration engine responsible for managing interfaces in a configurable, standardised, reliable and secure way, preventing direct or unauthorised access to databases and allowing access audits. LIGHt is oriented towards local integration – that is, within the institutions themselves – with communication based on HL7 v2.5 messages.
This solution goes beyond integration; it is an open source platform for interoperability that addresses the four layers – legal, organisational, semantic and technical – that were originally designed and developed for DREAM and Hospital SClínico, other projects developed by SPMS.
With the implementation of LIGHt, SPMS intends to promote the adoption of standards in messages exchanged at the local level of institutions. This will unify local systems at the national level so that everyone speaks the same language and in a standardised way.

Main results, benefits and impacts

Figures for the numbers of registrations and the use of the portal are a good measure of the project’s success. Considering that one of the targets of the SNS Portal is a group of the population with below-average resources and familiarity with digital tools, having 13% of the Portuguese population registered represents good progress. However, the project managers want to move forward and continue to add services to attract more users.
Services delivered by the SNS Portal to doctors, nurses, health centres, hospitals and other healthcare providers are also a very important part of the project. These services clear the way for the whole system to work smoothly and to be useful, providing all the services and information needed by citizens and other healthcare agents.
The SNS Portal is a very visible part of Portugal’s digital transformation. It embodies the open data initiative of the Ministry of Health, providing wide access to datasets related to the operations and transactions of the several entities that make up the national health system.
One of the integrated projects is the Transparency Portal that represents a paradigm shift in how health information is shared with citizens. With its innovative and integrated approach, this portal brings together up-to-date, relevant and cross-cutting data from the different health entities. Following the principles of Open Data, it is intended to reinforce commitment to ensuring the rigour and transparency of information, and to disseminate data on access, quality and efficiency within the health service. Users will be able to take advantage of this openness simply and quickly.
Data held by the system is classified into four areas: access, efficiency, quality, and health in Portugal. Performance is summarised in the form of key indicators that are constantly updated. Examples are “operations performed in hospitals in 2016”, “current drug costs” , “prescriptions electronically prescribed in 2016”, and “mammograms performed in 2016”.
There are more than 50 datasets available in the data catalog of the Transparency Portal, aggregating data from different SNS entities across several domains. Searching, sorting and filtering tools allow users to query datasets based on theme, keyword, entity, view type, or modification date.

 

Start date:

2016

Operational date:

23 August 2017