Most widely used care management systems in Portugal

Portugal's public healthcare system, the Serviço Nacional de Saúde (SNS), serves the vast majority of the country's population through a network of primary care centres, hospital units, and local health units (Unidades Locais de Saúde). Over the past decade, the SNS has undergone sustained digital transformation, driven by a central health IT agency and aligned with broader European Union priorities around health data interoperability. For healthcare decision makers evaluating platforms, understanding which care management systems are actually deployed across Portuguese institutions, and how they connect, is an essential starting point. This article maps the current landscape, from the dominant public sector platforms to the private sector alternatives, and outlines what procurement teams need to consider when assessing fit.

What is a care management system?

In clinical settings, a care management system refers to any software platform that supports the recording, management, and sharing of patient health information across one or more care settings. The category spans medical record systems, patient administration systems, prescribing platforms, and integrated care platforms that bridge primary and secondary care. The distinction between these layers matters for procurement.

Medical record systems capture structured clinical documentation, including diagnoses, clinical codes, patient summaries, medication history, and encounter notes, at the point of care. Patient administration systems manage scheduling, admissions, discharge summaries, and bed management, primarily in inpatient care settings. Integrated care platforms connect data across settings, so a clinician in a hospital can access records generated in a primary care centre, and vice versa.

In Portugal, these three functions are served by a combination of nationally developed platforms and, in the private sector, by commercial vendors. The boundary between them is increasingly blurred as interoperability standards mature.

The national backbone: SNS systems and SPMS infrastructure

The central body responsible for building and maintaining health IT across the SNS is SPMS — Serviços Partilhados do Ministério da Saúde. SPMS functions as a shared services entity for the Ministry of Health, overseeing the development, deployment, and governance of all major clinical information systems used in public healthcare. Its portfolio includes medical record systems, prescribing systems, human resources platforms, oral health records, and organ donation registries.

Two platforms form the interoperability backbone of the SNS. The Registo de Saúde Eletrónico (RSE) is Portugal's national electronic health record layer, giving clinicians across different hospitals and health centres access to a patient's consolidated clinical history, including laboratory results, imaging reports, and medication records. Alongside this, the Portal do Utente (Patient Portal) gives citizens access to their own health data, appointment history, and clinical documents, reinforcing the patient-facing dimension of the national digital health infrastructure.

Together, these platforms reflect Portugal's alignment with the European Health Data Space (EHDS) initiative, which aims to make health data portable and accessible across EU member states under standardised governance frameworks.

SClínico: the primary and hospital care standard

SClínico is the most widely deployed clinical information system within the SNS. Development of SClínico began around 2013, consolidating the legacy SAM (Sistema de Apoio ao Médico) and SAPE (Sistema de Apoio à Prática de Enfermagem) systems into a unified, patient-centred platform that was progressively rolled out across the SNS and is now available in two distinct versions.

SClínico CSP (Cuidados de Saúde Primários) serves the primary care network. It has been adopted by over 300 institutions and is used by more than 13,000 health professionals, making it the de facto standard for general practitioners (GPs), nurses, and other clinicians working in USFs (Unidades de Saúde Familiares) and UCSPs (Unidades de Cuidados de Saúde Personalizados).

SClínico Hospitalar extends the same platform into secondary care, with deployment across more than 50 hospital centres, Misericórdias, and health institutes. Its core modules include clinical documentation and structured notes, electronic prescribing integrated with the national Prescrição Eletrónica de Medicamentos (PEM) system, clinical coding using SNOMED CT (Systematized Nomenclature of Medicine Clinical Terms) and ICD (International Classification of Diseases) standards, patient summaries accessible across care settings, and nursing care plans and documentation.

Research published in Clinical Nutrition ESPEN illustrates how deeply SClínico is embedded in clinical workflows. A study examining nutritional screening across 49 Portuguese public hospitals analysed performance data from the 38 institutions using SClínico, finding that integration of undernutrition screening into the medical record system was one of the primary facilitators of improved screening rates.

For decision makers, SClínico's position as the SNS standard means that any third-party platform operating in the public sector, whether a specialist module, an AI assistant, or an analytics tool, must be able to integrate with it.

SONHO: hospital administration and inpatient management

While SClínico handles clinical documentation, SONHO (Sistema Integrado de Informação Hospitalar) manages the administrative and operational layer of hospital care. It covers patient admissions, scheduling, bed management, inpatient care tracking, and discharge summaries, the functions that sit alongside clinical records in any secondary care environment.

SONHO has been the dominant hospital information system in Portuguese public hospitals for many years. SPMS is currently rolling out SONHO v2, a modernised successor designed to replace legacy installations across all SNS entities. As of early 2025, SONHO v2 had been deployed in more than 25 institutions, with a further 23 planned for subsequent rollout phases. The original target of full SNS coverage by end of 2024 was not achieved; as of early 2025, deployment remained ongoing across a further 23 institutions.

A concrete example of how SONHO and SClínico operate together is the integration project at ULS Coimbra, where the two systems were connected via the LIGHT interoperability platform to create a unified view of patient data across administrative and clinical workflows. This architecture, with SONHO managing the operational layer, SClínico managing clinical records, and LIGHT handling data exchange, represents the model SPMS is replicating across the SNS.

The practical value of this integration for research is significant. A study published in BMC Health Services Research used 15 years of medical record data from a Portuguese hospital, covering 925,508 patients and 9.7 million visits, to evaluate multimorbidity measurement strategies for predicting hospital utilisation. This demonstrates the depth of structured data that integrated systems like SONHO and SClínico can generate when properly connected.

Pharmacy and prescribing: PEM and the electronic prescription ecosystem

PEM is Portugal's national electronic prescribing system. According to SPMS, PEM is used by approximately 10,000 doctors per day and processes around 250,000 prescriptions and over one million medication packages registered daily. SPMS has stated that PEM accounts for over 70 per cent of all daily prescriptions in Portugal, though the date of this figure and whether it refers to all prescriptions (including private sector) or SNS prescriptions only should be verified against current SPMS publications for the most up-to-date information. Given that PEM is described as the mandatory national prescribing system for SNS clinicians, clarification on the scope and currency of this coverage figure would help assess whether it reflects full adoption or an earlier baseline.

PEM connects prescribing clinicians across primary and secondary care settings directly to pharmacies nationwide. For any care management platform seeking to operate within the Portuguese healthcare ecosystem, interoperability with PEM is a baseline requirement rather than an optional feature. Prescriptions generated within SClínico or any third-party clinical system must flow through PEM to be dispensed, which means vendors must either build native PEM integration or rely on SPMS-managed interfaces.

This architecture also has implications for medication reconciliation and patient safety. Because PEM sits at the intersection of clinical and dispensing workflows, it provides a near-complete view of a patient's active prescriptions regardless of which care setting generated them. This is particularly relevant for managing patients with multimorbidity across multiple providers.

Private sector platforms: key systems in use

Portugal's private healthcare sector, which includes major hospital groups, specialist clinics, and diagnostic centres, operates largely outside the SNS system portfolio. Some private institutions do interface with national platforms for prescribing and patient identification.

Glintt is the most prominent health IT vendor in the Portuguese private sector. The company provides clinical information systems, hospital management platforms, and pharmacy solutions to a wide range of private hospitals and clinics across Portugal and internationally. Glintt's platforms cover clinical documentation, patient administration, scheduling, and laboratory information management, and the company has a significant presence in both hospital and outpatient settings.

Private sector deployments differ from public sector ones in several important ways. Private organisations select and contract systems independently, without the centralised governance of SPMS. Private providers must still connect to PEM for prescribing and may interface with the RSE for patient summary access, but they are not required to use SClínico or SONHO. Private sector contracts typically allow for greater platform customisation to reflect specific clinical workflows or specialty requirements. Beyond Glintt, private clinics may use international medical record platforms or specialist systems tailored to specific care areas such as dentistry, physiotherapy, or mental health.

For decision makers in the private sector, the absence of a mandated national platform creates more flexibility but also more complexity, particularly around ensuring that systems can still interface with the national prescribing and patient identification infrastructure.

Interoperability standards and integration requirements in Portugal

Portugal's national health IT strategy is built around a set of interoperability standards that any platform operating in the ecosystem must support. Understanding these standards is essential for procurement teams assessing whether a new system can integrate with existing infrastructure.

HL7 FHIR (Fast Healthcare Interoperability Resources) is the primary standard for data exchange between health systems in Portugal, consistent with its adoption across the EU. SPMS has progressively aligned national platforms with FHIR-based application programming interfaces (APIs), and the LIGHT interoperability platform, which connects SONHO v2 and SClínico, uses this architecture.

Clinical coding in Portuguese hospitals uses a combination of ICD-10 for diagnosis and procedure coding in hospital settings, and SNOMED CT for clinical terminology within medical record systems including SClínico. Any platform seeking to exchange structured clinical data with SNS systems must be able to map to these coding standards.

OpenEHR is also gaining traction as a standardisation framework in Portugal. Research published in JMIR Medical Informatics describes the implementation of openEHR structures in a Portuguese hospital for corneal transplantation records, demonstrating how the framework can improve the quality and interoperability of clinical documentation in specialist settings. The study found that adopting openEHR specifications improved task control and patient follow-up, though completion rates were affected by external clinical factors.

EHDS alignment is an increasingly important consideration. The EHDS regulation was formally adopted in 2025, with member states required to meet cross-border data exchange obligations on a phased timeline extending to 2027 and beyond. Portuguese institutions will need to ensure their systems can support EHDS data exchange requirements as the framework matures.

Regulatory and compliance considerations

Care management systems operating in Portugal are subject to a layered compliance framework. Procurement teams should verify the following before selecting a platform.

All health data processed in Portugal is subject to the General Data Protection Regulation (GDPR). Health data is classified as a special category of personal data under Article 9, requiring explicit legal bases for processing, data minimisation, and documented data protection impact assessments. The national supervisory authority is the CNPD (Comissão Nacional de Proteção de Dados).

Software that meets the definition of a medical device under EU Medical Device Regulation (MDR) (Regulation 2017/745) must be CE marked before it can be placed on the market. Clinical decision support tools and AI-assisted diagnostic features embedded within care management platforms may fall within this scope, depending on their intended purpose and risk classification. Procurement teams should request evidence of MDR conformity assessment for any software component that makes or supports clinical decisions.

For public sector deployments, data residency within the EU is typically a contractual and regulatory requirement. SPMS-managed systems process data within Portuguese national infrastructure. Private sector organisations should verify where data is stored and processed, particularly when using cloud-based platforms from international vendors.

Information security certification to ISO 27001 is widely expected by public sector procurers and is increasingly a baseline requirement in private sector contracts. Vendors should be able to provide current certification documentation.

For systems intended to integrate with SNS platforms, SPMS may require technical certification or formal integration agreements. Vendors should be able to demonstrate prior SPMS engagement or existing certified integrations.

How to evaluate a care management system for your organisation

The following framework reflects the key criteria relevant to both public and private healthcare organisations in Portugal. It addresses the dimensions most likely to determine whether a platform will function effectively within the national ecosystem.

Interoperability with national systems. Can the platform integrate with SClínico, SONHO v2, and PEM? For public sector organisations, this is non-negotiable. For private sector organisations, PEM integration is required for prescribing, and RSE access may be needed for patient summary retrieval. Ask vendors for documented evidence of existing integrations, not just stated capability.

Regulatory compliance. Verify GDPR compliance documentation, MDR status for any AI or decision support features, data residency arrangements, and ISO 27001 certification. Request copies of relevant certificates and assessments rather than relying on vendor self-declaration.

Clinical workflow fit. Assess whether the system supports the specific workflows of your clinical teams, including GPs, nurses, specialists, and administrative staff. A platform optimised for primary care may not serve hospital ward round workflows effectively, and vice versa. Involve clinicians from each affected specialty in the evaluation process.

Legacy system migration. Most Portuguese institutions are migrating from older platforms, whether SINUS (the original primary care administrative system now being phased out), older versions of SONHO, or proprietary systems in the private sector. Assess the vendor's migration track record, data conversion capabilities, and the risk of data loss or workflow disruption during transition.

Vendor support and local presence. Consider whether the vendor has local support capacity in Portugal, Portuguese-language documentation and training materials, and a track record of working within the SNS procurement and regulatory environment. International vendors without local presence may struggle to navigate SPMS integration requirements or respond effectively to support issues.

Total cost of ownership. Look beyond licence fees to include implementation costs, training, ongoing support, integration maintenance, and the cost of regulatory compliance activities such as MDR conformity assessments or data protection impact assessments. Cloud-based platforms may have lower upfront costs but higher ongoing costs at scale.

No single platform will optimally serve every use case. Organisations with complex cross-sector workflows, such as local health units (ULS) that span primary and secondary care, face different requirements from standalone specialist clinics or private hospitals. The right platform depends on the specific care setting, patient population, and integration context.

Emerging priorities in Portuguese health IT

Several developments are likely to shape care management system procurement decisions over the next two to three years.

AI-assisted clinical documentation is moving from early adoption to mainstream consideration. AI medical assistants capable of generating structured clinical notes, patient summaries, and referral letters from clinical encounters are being evaluated by health systems across Europe. In Portugal, the integration of such tools into existing medical record workflows, particularly SClínico, will depend on SPMS's approach to third-party integrations and on MDR compliance for AI features that influence clinical decisions.

Ambient voice technology (AVT), which captures and transcribes clinical conversations in real time to reduce documentation burden, is gaining traction in primary and secondary care settings internationally. Its adoption in Portugal will be shaped by data residency requirements, GDPR obligations around audio data, and the availability of high-quality Portuguese-language speech recognition models.

EHDS implementation will progressively require Portuguese institutions to support cross-border data exchange, which in turn will require systems to meet FHIR-based data standards at a higher level of granularity than is currently mandated domestically.

Multimorbidity and population health management are increasingly driving demand for analytics capabilities within care management platforms. Research using Portuguese medical record data, including the 925,508-patient cohort study and the METHIS digital platform trial for multimorbidity management in Lisbon and Tagus Valley primary care practices, reflects growing interest in using structured medical record data for risk stratification and proactive care management. Platforms that can support these use cases without requiring separate data warehousing infrastructure will have a competitive advantage.

For procurement teams, the practical implication is straightforward: evaluate platforms not only on their current feature set but on their architecture's capacity to support AI integrations, interoperability extensions, and data analytics workflows as national and EU requirements evolve. A system that meets today's requirements but cannot accommodate tomorrow's integration standards will require costly replacement sooner than anticipated.

Frequently asked questions

▶ What is the main clinical information system used in Portugal's public healthcare system?

SClínico is the most widely deployed clinical information system within the Serviço Nacional de Saúde (SNS), Portugal's public healthcare system. It comes in two versions: SClínico CSP for primary care, adopted by over 300 institutions and used by more than 13,000 health professionals, and SClínico Hospitalar for secondary care, deployed across more than 50 hospital centres. Any third-party platform operating in the public sector must be able to integrate with it.

▶ What does SONHO do, and how does it differ from SClínico?

SONHO (Sistema Integrado de Informação Hospitalar) manages the administrative and operational layer of hospital care, covering patient admissions, scheduling, bed management, inpatient care tracking, and discharge summaries. SClínico handles clinical documentation. The two systems work together: at ULS Coimbra, for example, they connect via the LIGHT interoperability platform to give clinicians a unified view of both administrative and clinical patient data.

▶ What is PEM, and why does it matter for care management system procurement in Portugal?

PEM (Prescrição Eletrónica de Medicamentos) is Portugal's national electronic prescribing system. According to SPMS (Serviços Partilhados do Ministério da Saúde), it's used by approximately 10,000 doctors per day and processes around 250,000 prescriptions daily. Any care management platform operating in the Portuguese healthcare ecosystem must integrate with PEM, because prescriptions generated within any clinical system must flow through it to be dispensed at pharmacies.

▶ Which interoperability standards must a care management system support in Portugal?

Platforms operating in Portugal's health IT ecosystem need to support HL7 FHIR (Fast Healthcare Interoperability Resources) for data exchange, as SPMS has progressively aligned national platforms with FHIR-based application programming interfaces. Clinical coding requires ICD-10 (International Classification of Diseases, 10th revision) for hospital diagnosis and procedure coding, and SNOMED CT (Systematized Nomenclature of Medicine Clinical Terms) for clinical terminology within medical record systems. OpenEHR is also gaining traction as a standardisation framework in specialist settings.

▶ What are the key regulatory requirements for care management systems in Portugal?

Care management systems in Portugal must comply with the General Data Protection Regulation (GDPR), which classifies health data as a special category of personal data requiring explicit legal bases for processing. Software that meets the definition of a medical device under EU Medical Device Regulation (MDR) must be CE marked before it can be placed on the market. Public sector deployments also typically require data residency within the EU, and ISO 27001 information security certification is widely expected by public sector procurers.

▶ How does the private sector in Portugal differ from the public sector when it comes to care management systems?

Private healthcare organisations in Portugal select and contract systems independently, without the centralised governance of SPMS. They're not required to use SClínico or SONHO, though they must still connect to PEM for prescribing and may interface with the RSE (Registo de Saúde Eletrónico) for patient summary access. Glintt is the most prominent health IT vendor in the Portuguese private sector, providing clinical information systems and hospital management platforms to a wide range of private hospitals and clinics.

▶ What is the RSE, and what role does it play in Portugal's health IT infrastructure?

The RSE (Registo de Saúde Eletrónico) is Portugal's national medical record layer. It gives clinicians across different hospitals and health centres access to a patient's consolidated clinical history, including laboratory results, imaging reports, and medication records. Alongside the RSE, the Portal do Utente (Patient Portal) gives citizens direct access to their own health data, appointment history, and clinical documents.

▶ What should procurement teams prioritise when evaluating a care management system for a Portuguese healthcare organisation?

Procurement teams should verify that the platform can integrate with SClínico, SONHO v2, and PEM, with documented evidence of existing integrations rather than stated capability alone. They should also confirm GDPR compliance documentation, MDR status for any AI or clinical decision support features, data residency arrangements, and ISO 27001 certification. Beyond compliance, it's worth assessing clinical workflow fit across all affected specialties, the vendor's migration track record, local support capacity in Portugal, and the total cost of ownership including implementation, training, and ongoing integration maintenance.

▶ How is AI-assisted clinical documentation expected to develop within Portugal's health IT ecosystem?

AI medical assistants capable of generating structured clinical notes, patient summaries, and referral letters from clinical encounters are being evaluated by health systems across Europe. In Portugal, integrating such tools into existing medical record workflows, particularly SClínico, will depend on SPMS's approach to third-party integrations and on MDR compliance for AI features that influence clinical decisions. The adoption of ambient voice technology, which captures and transcribes clinical conversations in real time to reduce documentation burden, will also be shaped by GDPR obligations around audio data and the availability of high-quality Portuguese-language speech recognition models.

▶ What is the European Health Data Space, and how does it affect Portuguese healthcare institutions?

The European Health Data Space (EHDS) is an EU initiative that aims to make health data portable and accessible across member states under standardised governance frameworks. The EHDS regulation was formally adopted in 2025, with member states required to meet cross-border data exchange obligations on a phased timeline extending to 2027 and beyond. Portuguese institutions will need to ensure their systems can support EHDS data exchange requirements, which in practice means meeting FHIR-based data standards at a higher level of granularity than is currently mandated domestically.