In Mexico City, since June of this year, the management team of the Health Secretariat of Mexico City (SEDESA) has been creating four dashboards that improve the availability of information for strategic decision-making in the Secretariat, evidence that technology can be crucial to the efficiency and quality of healthcare. This digital tool, based on open data from public hospitals, will help stakeholders in the system make more informed decisions.

The solution will offer data such as the availability of beds and services in different hospital institutions, the number of medical care provided, and the leading causes of care will be available in these dynamic dashboards - similar to those used during the pandemic to show the evolution of COVID-19 cases in a visual representation that is user-friendly and easy to understand.

Traditionally, in this country, tracking a patient's progress in the healthcare system has been difficult due to the fragmentation of the information. The arrival of COVID-19 brought a change aimed at facilitating the management and integration of information in the country. However, much of the healthcare system has focused on measuring success based on the number of hospitalizations and consultations without fully reaching certainty in issuing quality and efficiency indicators.

To overcome this obstacle, the Health Information and Institutional Systems Directorate team at SEDESA used available open data and developed four control panels with disaggregated information on demand (population served), supply (medical units and services available), and care in consultations, emergencies, and hospitalization - one for consultations, another for emergency care, and another for hospital discharges.

Although these dashboards are not yet available on a portal, they serve as a proof of concept for the main stakeholders in the healthcare system. Last June, the SEDESA information team, led by Dr. Consuelo Estephani Arellano, presented the tool to the Secretariat and senior officials of public health institutions in the capital. The impact achieved opened the opportunity to scale this model in these institutions.

This initiative results from a collaboration with the Movement Health Foundation and the government of Mexico City. The Health Secretariat of Mexico City conducted a root cause analysis hand in hand with the Copenhagen Institute for Futures Studies (CIFS), a partner of the Foundation, to improve the intake of information from the 35 hospitals under its jurisdiction. This process led to the idea of optimizing the extraction of original data and building a control panel, essential for transforming complex data into real-time visual information, resulting in improvements in decision-making.

The solution enabling the dashboard is Microsoft Power BI, provided by Core Group, a Microsoft partner in Mexico, that is a partner of the Movement Health Foundation. They, along with CIFS, provided training as well as theoretical and practical knowledge of the tool to SEDESA officials.

The benefit of having this information in real-time is invaluable: using indicators of both efficiency and quality, SEDESA will be able to make comparative analyses with other healthcare systems worldwide. It also enhances collaboration, promotes transparency, and allows for effective tracking of resource performance. Considering that different regions in the country face challenges similar to those in the capital, the systematic use of this type of command control tool would allow interoperability frameworks for a joint analysis of all data in the healthcare system with updated information in the future.

The government and the various healthcare service providers could benefit from a tool that allows for more efficient processes and optimal prioritization of resources according to very well-defined and comparable needs. For healthcare system leaders, the tool will also allow for the establishment of public policies and the facilitation of reforms to health laws.

"This project can positively impact the decisions made for the population of Mexico City, which has almost 9 million inhabitants, but we hope it can be expanded both in Mexico and other countries," says Arellano. The Mexican healthcare system is undergoing a series of transformations to make it a model for universal coverage, for which it established that state health secretariats, like SEDESA, focus on playing a leading role rather than concentrating on managing hospitals.

The project has raised awareness of the value of data in a country where a data culture still needs to be solidified. Information is not only collected with pen and paper, but also some resistance from healthcare personnel to using information systems and new technologies. For Arellano, this is understandable because these professionals have not been trained in these topics. "No one has ever told them why this data is important, and rarely do the data they record come back to them." Thus, the perception that a large part of the sector's personnel has is that healthcare statistics are more paperwork.

The first step, hand in hand with the Foundation, was to train healthcare personnel in hospitals, emphasizing the importance of recording this information. In that sense, the dashboard is not just a tool for visualizing data. Still, it is also an instrument to identify which information needs to reach each actor in the healthcare system when that actor needs it. "In the end, the tool doesn't matter; what matters is the cultural change, being sure this is possible. That's "where the gain is," says Arellano.

For Arellano, the contribution of the Health Movement Foundation has been very positive. "Other foundations come to give things away, which is very attractive to these resource-poor entities, but in general, that doesn't help fix things much," he says. The focus of the Health Movement Foundation is different from others because it strives to support and accompany in identifying where the problem is, what its cause is, and how to build a sustainable, scalable, and lasting solution that is closer to the country's goal of "health for all."