Quito March 13, 2023
A team of technical advisers from the Pan American Health Organization PAHO/WHO, the Swiss Institute of Public and Tropical Health (SwissTPH) and the Vital Strategies organization visited the country for research and technical support purposes.
The institutions were the Ministry of Public Health (MSP), the National Institute of Statistics and Censuses (INEC), the General Directorate of Civil Registry and the National Service of Legal Medicine and Forensic Sciences. The objective was to collect information and experiences on process mapping, information systems, mortality and morbidity data management in the country.
The mission lasted for a week between March 6 and 10, 2023. It included two days of training on the management of Vital Statistics, as well as Information Systems for Health and Telemedicine.
Among the initial activities was the meeting between the technical teams of the MSP and the Pan American Health Organization. Sebastián García, director of the Department of Evidence and Intelligence for Action in Health of the PAHO/WHO Regional Office, and the Minister of Public Health, José Ruales, led the meeting in which they analyzed the cooperation instruments for the development of the Digital Health Transformation Agenda with an emphasis on applications for medical records, electronic prescriptions and service management to improve the response capacity of the health system in Ecuador.
Likewise, the mission carried out technical visits with a view to improving the quality of information from the Civil Registry and Vital Statistics (CRVS) systems in the field of mortality from external causes and preparation for the introduction of the International Classification of Diseases (ICD). eleven). The planned agenda included the General Docente Calderón and Gineco Obstétrico Isidro Ayora hospitals; Health Center People’s Committee; In addition, INEC and Civil Registry offices.
At the Calderón Teaching Hospital (HGDC), they verified the supervision and implementation of the processes and systems for managing statistical information and deaths. The delegation toured the areas of Emergency Admissions, Triage, Morgue and data processing office. They verified the flow and recording of patient statistical information. In these spaces, they also verified the technological infrastructure and the operation of the systems that the hospital has.
The observation visit at the Isidro Ayora Gynecological Obstetric Hospital allowed them to review the data processing in one of the Quito maternity wards.
The workshop called “Mapping of Processes for the Strengthening of Mortality Information Systems and ICD-11; Information Systems for Health IS4H and Telemedicine”, aimed at representatives and officials of the aforementioned institutions, took place on March 9 and 10. In face-to-face and virtual mode, it allowed introducing the basic principles of process mapping and providing skills for the analysis of information systems that record deaths in statistical data using the International Classification of Diseases and Related Health Problems (ICD).
With the work groups and the visits, the level of maturity of the health information systems in Ecuador was determined. In addition, the existing critical knots prior to making the IEDG General Death Statistics Report official, (Vital Statistics) by the INEC. The need for mandatory improvement of the registry of the basic cause of death, responsibility of the health personnel that certifies it. The duplication of components for IS4H Information and Telemedicine. And the transition from CIE 10 to CIE-11 as an interoperability standard, which should not be considered only as a registration method, but as an important input for decision making.
ICD-11 is the international standard for the recording, reporting, analysis, interpretation, and systematic comparison of mortality and morbidity data. Through its implementation and the strengthening of capacities in health personnel, it will make it possible to have accurate, complete, timely, consistent data to design policies and, above all, more effective public health policies.
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