MS: Yes, but it isn’t completely synchronized. In terms of operations and technology, SISA is ahead while the legislation and regulations lag behind a little. Generally, there are two ways in which state technical development progresses: The resolution, regulation, law or whatever appears and after that a project is created that tries to fulfill its parameters. An example of this is ANMAT (National Administration of Medications, Foods and Medical Technology): Firstly, the famous traceability resolution was issued and now every actor is adapting its systems or looking at ways in which they can follow and meet the resolution. Then there’s the other path, which was the one taken by SISA which consists of starting out with a technical proposal, the development of a technological project that includes certain aspects such as records, strategies and plans, which later leads to resolutions being issued. For example: the Blood Donor Registry (REDOS) is a project that was originally discussed with the person responsible, Mabel Maschio. We started out with her, discussed the registry and then I put my team to work on its technical development and we’re currently carrying out pilot test projects. It will start operations in the next few months and Mabel has only recently started on getting the resolution approved. But the reason she’s doing that is she knows that she now has SISA, which can house the registry.

EHRLA: What other examples are there of a development path in which the construction project was followed by regulations after the fact?

MS: The same thing happened with the Federal Code of Establishments. Today there is a resolution that approves its existence but that approval came a year and a half after the record was operational. The record started operations, started to interact with the different provinces and after the product and record were functional in technical terms, the resolution appeared.

EHRLA: In percentage terms, how far has SISA’s implementation progressed?

MS: It’s definitely at 50 per cent.

EHRLA: What needs to be done for it to become fully functional?

MS: Currently SISA has three functioning pillars that you’ll already be aware of: healthcare resources, which are interdisciplinary establishments and the citizen’s record, which is a concept that includes nominal records for the citizen and healthcare services. Both are 80 per cent complete, developed, functioning and being improved as new options are added. The quality of the information is also improving. The third key to SISA is made up by the nominal records, this aspect is a little behind due to its complexity and because we only started on it relatively recently.

EHRLA: What are nominal records? 

MS: For example, a professional will log in to SISA and upload a vaccination they administered to a patient, but the complete vaccination record is not yet completely implemented. The implementation of a nominal record, which is what NOMIVAC (Nominal Federal Vaccination Record) will be, is a job beyond the remit of the most dedicated programmer; it requires strategic planning by the authorities. You have to reach 7000 areas, 1500 hospitalization facilities, and private healthcare providers, it requires interaction, determining who will use the web service and who will provide patch updates, all of which needs several months of implementation work. And we still need to develop several more records.

EHRLA: Do these records exist physically on paper?