[Integration of information for health interventions: from data to information and from information to action. 2008...

Spanish public health and health services information systems (HIS) have improved, but are still fragmented by areas of interest and have evolved independently from one another. Their format, structure, integrity and data quality vary widely, as do the programs, platforms and databases that support them. The latest innovations focus on isolated HIS and are hampered by obsolete models, tools, functionalities, and the inertial demand of information. Transfer of responsibilities without minimal agreements on HIS has eroded their national cohesion and, along with the absence of exchanges on experiences of computerization on a national basis, has weakened us, given the supply of immature computer applications. The evolution of HIS must be governed by integration. We have to redefine their strategic and operational objectives, review existing data and information, and determine the single identification of specific persons and patients. Variables, indicators, services and control panels should be reviewed and systematized through a single shared nomenclature. Personal health records and administrative and clinical registries should become the primary sources of health information data. Data collection, mechanization, registration and exploitation, and their quality control and maintenance, should be redefined regardless of setting. A national agreement is urgently required on the minimal functionalities of HIS, while respecting their technical nature and management by autonomous governments.