SOCIETY | Sep 6, 2016

Health in an open data format: the case of Uruguay

In February of every year in Uruguay, the citizens can choose their own health care service provider; three years after the first choice has been made they have the possibility of changing this provider. Today, more than 1.6 million users are potentially involved in the new selection. To improve service management and to simplify the citizens’ choice, an integrated national platform ATuServicio was created. The platform is a project on public health data held by the Ministry of Health integrated with the data of the NHS Integrated Services (SNIS) service providers. The project was created, in fact, precisely through a collaboration between the government and civil society, without a binding legal framework, something that made cooperation sometimes difficult; both parties had equal access to designing and building the system, helping to improve the quality of public data and setting and choosing the various indicators. The application has been regarded as one of the best use and sharing cases of open data in the healthcare sector and awarded by various international companies such as Open Knowledge (UK), GovLab Sunlight Foundation and the University of New York (USA); it was also a finalist of the Open Data Institute Awards (UK) and won the first prize for the Open Government Awards.

Open data in Uruguay 

Uruguay is one of the most advanced countries in Latin America for open data; internationally it ranks at 7th place in the Global Open Data Index (our country is currently at 17th, Ed). The national government has in recent years implemented open data policies mainly through the National Agency for E- Government (ASEGIC). The national agency has promoted the opening and reuse of open data mainly through dialogue and debate with organizations and civil society, using the instrument of public consultations and roundtables. The idea of the integrated ATuServicio platform emerged precisely from one of these consultations and was immediately based on an innovative Country approach from an institutional point of view since it was shared between the government and civil society. In fact, the associations and the government focused on simplifying the service to the citizen going beyond simple data collecting and public sharing but also providing the opportunity to supply feedback to the service providers themselves. ATuServicio allows the user to set various parameters in addition to the geographical location in order to compare the various services provided on the basis of the indicators. This allows the user to see all the available choices at once, with the possibility of making the choice that best suits his needs.

How it works

The website provides information concerning service compliance, setting the parameters on two main health care focuses: the percentage of patients correctly followed during pregnancy (five checks during pregnancy, dental exams and tests for HIV and syphilis) and the percentage of children under one year effectively treated (ten checks during the first year of life and vaccination certificates). User satisfaction is measured based on the availability calendar, ease of procedures, availability of drugs, the information provided concerning users’ rights and the receipt and handling of complaints. On a scale from 1 to 10, the last survey carried out showed the degree of satisfaction of users who employed the platform and gathered from the web ran from 7.5 to 9 points.

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The catchment area 

ASSE is the largest nationwide provider of healthcare services with more than 1 million and 300 thousand users, it reaches 36% of the integrated national health service members, followed by Medical Uruguaya, with 304,710 members (8%); Casmu, with 208,743 (5%); ASOCIACIÓN ESPAÑOLA with 186,156 (5%); SMI, with 130,345 (3%); Cosem, Catholic Circulo which total 2% of the system’s members. As for the number of professionals, per 10,000 users, the Cooperativa Florida and the Federation of resident doctors is the one that has the largest number of adherents to the platform: 32 out of 10,000. The following category is that of GPs which reaches the ratio of 8.6 per 10,000 patients.

Future developments

The platform was officially launched in early February 2015; at that time over 1,500,000 people had the possibility of changing their supplier, but they needed to do so by the end of February: in just one month, over 34,000 users accessed the website. Obviously this figure nationally represented only about 2% of the population of potential users, but it is important to note that the vast majority of these same users had never before taken into consideration the first real chance of changing their health care provider, including because of the excessive bureaucracy and difficulty in obtaining information and of acquiring information and comparing the services of the various institutions which the integrated platform now allows.

Undoubtedly the access data are still modest, but it is still a pilot project on an experimental basis which both parties (government and civil society) are trying to improve. It also worth mentioning that the Government did not impose compliance with any legislation on this matter, therefore it’s an innovative push towards the use of open data in a shared and joint planning context between the institutions and the public. This therefore constitutes an excellent example of how national health services can also be improved through a collaboration between public institutions, civil society and private parties in order to create applications and tools which will improve citizens’ access to essential healthcare services. Moreover, it is also the first step of a much broader effort i.e. the use of open data to monitor the compliance of the service and to improve citizens’ access to information concerning these services.

(Photo by Nicolas Raymond Flickr, CC BY 2.0)

Emma Pietrafesa