Brazilian permanent council of health standards (COPISS)

In Brazil, 25% of the population (46 million) have voluntary double coverage through private health insurance. This market comprises 1880 Health Plans (HP) and health care providers such as hospitals, laboratories, medical and dental offices. The lack of information standards and the complexity of information exchange between HP and providers have led the Federal Regulatory Agency for Health Plans and Insurance (ANS) to elaborate a national standard for electronic health information exchange, known as TISS (Troca de Informação em Saúde Suplementar). From 2007 on, these mandatory standards has been enforced over the private health insurance market. It is recommended that, before considering mandating the use of a particular technology or standards through any official body, the players consent has to be achieved through a collaboration process (Aguilar, 2005). In order to improve the TISS standard, the Brazilian Permanent Council of Health Standards (Comitê de Padronização de Informação em Saúde Suplementar - COPISS) has been established since April 2006. This council was created to achieve consensus on every standard. The aim of this research is to present a case study of COPISS implementation. As its main results, the creation of COPISS has been fundamental to the evolution of health care standards in Brazil. Its members, both public and private, have been working all together in a collaborative way and have been disseminating the results for all health care organizations around the country. However, there are still relevant issues to discuss, like vocabularies, unique drugs terminology, reference model for data architecture, medical equipment, protocols for medical equipment and also standards for electronic prescribing and laboratory results. It was concluded that COPISS has greatly contributed to the development of the national standard TISS in the country and proved to be an important instrument to facilitate true interoperability on a national scale.