Hospital Italiano de Buenos Aires
Department of Health Informatics
IMIA Academic Representative:
Dr. Daniel Luna
Italian Hospital in Buenos Aires
Hospital Italiano de Buenos Aires (HIBA) is a non-profit health care academic center founded in 1853, with over 1,500 physicians and 3,500 employees. HIBA has a network of two hospitals with 750 beds (200 for intensive care), 500 home care patients under care, and 23 outpatient clinics. It has an insurance plan that covers more than 150,000 people and also coordinates insurance for another 1,500,000 people who are covered by affiliated insurers. Each year over 38,000 inpatients (pediatric and adult) are admitted to its hospitals that are located in Buenos Aires and its suburban area. HIBA has more than 2,400,000 outpatient visits annually from patients from across the country and Latin America.HIBA is a well-developed teaching hospital, with over 30 medical residency-training programs and 34 fellowships programs. There are currently 400 residents and fellows in training.
HIBA created its own university in 2001 with a School of Medicine and School of Nursing. It also offers over 65 postgraduate courses. Since 2004, a distance-learning system called the Virtual Campus has been in place. This e-learning platform is used for training courses and other continuing medical education (CME) activities for health care professionals within and outside of Argentina.HIBA also has a robust clinical research enterprise. Its researchers participate in over 400 papers and abstracts published in journals and/or presented at meetings of all medical specialties each year. It also has an Institute of Basic Sciences and Experimental Medicine, created in 1999.
Currently, the main topics of research include electrophysiology, experimental embryology, oncoimmunology, experimental fetal medicine, and isolation of pancreatic islets and porcine liver cells. The Institute has 31 researchers and 12 technical staff. Until the 1990s, HIBA was primarily focused on delivering acute care. Its hospital information system had been focused on the automation of administrative, billing, and reimbursement tasks. With the emergence of its own insurance plan and the growing need of the ambulatory care, a decision was made to expand information systems beyond the administrative area. In 1998, HIBA began to implement a Healthcare Information System (HIS) by coordinating clinical information with the administrative applications that were already in use. It was an in-house project that currently handles all the information related to health care both clinical and administrative from capture to analysis. As part of the project called ITALICA, a Department of Health Informatics was created in 2001, involving over 110 people, including clinicians, IT professionals and technicians. With the objective of developing human resources in medical informatics, a four-year Medical Informatics Residency Program was created in 2000 under the leadership of Dr. Quiros. It is currently the only program of its kind in Argentina. The main objective of the program is to train individuals who can serve as a liaison between the health care and IT areas in the life cycle of health information systems.
The HIBA Department of Health Informatics works on the development and maintenance of the HIS. In order to achieve interoperability, HL7 version 2.x was adopted for communication between three components of the system: the administrative component that included not only financial and administrative issues but also took care of admission, discharge and transfer (ADT); the ancillary services component that included Laboratory and Radiology that already had informatics applications working on their departments; and the clinical component that integrated with the other components so that the medical encounter was be the main axis of the information model.
HIBA created its own Schools of Medicine and Nursing in 2001. The Department of Health Informatics has the responsibility to develop the curriculum of medical informatics for students in both schools. The program aims to train students in the use of office-suite applications for paper and multimedia presentations and information retrieval. This first course is delivered in the first year of each curriculum and in a blended learning modality. All the classes, reading materials, and exercises are made available through the Virtual Campus system, with in-person classes given to reinforce important concepts and answer student questions. In the clinical training years, students are given specific courses on medical informatics and EHR applications integrated in the courses of Internal Medicine, Pediatrics and Public Health.
The Medical Informatics Residency Program (MIRHIBA) focuses on the integration of four areas of knowledge: health care science; computer science; health care information systems, management and quality indicators; and epidemiology, biostatistics and decision theory. The program aims to train individuals who already have a formal training in health care (mainly physicians) in the concepts and practice of the four areas. The trainees actively participate in the development and implementation of the EHR so that they can also evaluate the impact that they have on health care in general.The MIRHIBA program started in 2001 and is a four-year residency program. The first two years are mainly oriented to internal medicine, primary care and emergency medicine rotations so trainees can understand how a health care institution works and speak its language. In the last two years, residents are introduced to the specifics of medical informatics, being trained in the understanding of the importance of all data obtained from the EHR for analysis, management and health care. This type of training sums up different perspectives on specific care, management, and epidemiology that will help them in current and future projects. Since the residents’ work is on the implementation of HIS applications, they must acquire knowledge about the change on the workflow and the impact it has on health care delivery. As such, they also need to acquire skills in leadership, interpretation, and handling the human responses to change. The goal for residents graduating from the program is for them to assume roles in the redesign of health information systems based on the adequate knowledge of health sciences, information theory, human behavior, and project administration and management.