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Celuppi IC, Mohr ETB, Felisberto M, Rodrigues TS, Hammes JF, Cunha CL, Wazlawick RS, Dalmarco EM. Ten years of the Citizen's Electronic Health Record e-SUS Primary Healthcare: in search of an electronic Unified Health System. Rev Saude Publica 2024; 58:23. [PMID: 38922270 PMCID: PMC11196093 DOI: 10.11606/s1518-8787.2024058005770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/08/2023] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVE Contextualize the adherence to the Prontuário Eletrônico do Cidadão (PEC - Citizen's Electronic Health Record) by Brazilian municipalities and the evolution of the electronic strategy of the Unified Health System (e-SUS) for Primary Healthcare (PHC) during its 10 years. METHODS This descriptive study added information on adherence to the use of medical records extracted from the database of the Secretaria de Atenção Primária à Saúde (SAPS- Primary Healthcare Secretary) of the Federal Government between 2017 and 2022. We analized the number of computerized basic healthcare units that used some electronic medical records, the number of those that used simplified data collection (SDC), and those that implemented the citizen's electronic health record (PEC) in the same period. A descriptive synthesis of the functionalities and modules implemented in the system during its 10 years of development was also carried out. RESULTS The adherence of Brazilian municipalities to the PEC has grown exponentially in the last five years, going from 8,930 healthcare units in 2017 to 26,091 in 2022. As expected, while the main functionalities and improvements developed in this decade sought to implement new flows and modules of administrative, clinical care, and care management processes and health service administration, improving aspects of usability and technological infrastructure of the application architecture was also crucial for the success of the system. CONCLUSIONS In 2023, the milestone of a decade will be celebrated since the beginning of health records implementation by Brazilian municipalities, marked by technological and infrastructure challenges and improvements and new functionalities that highlight the technological evolution of the e-SUS PHC system and strategy. Despite many other tools, the PEC is arguably Brazil's leading electronic medical record today, as it has always invested in evolution, updating itself in technological and usability opportunities.
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Affiliation(s)
- Ianka Cristina Celuppi
- Universidade Federal de Santa CatarinaCentro TecnológicoLaboratório BridgeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Laboratório Bridge. Florianópolis, SC, Brasil
- Universidade Federal de Santa CatarinaCentro de Ciências da SaúdeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro de Ciências da Saúde. Programa de Pós-Graduação em Enfermagem. Florianópolis, SC, Brasil
| | - Eduarda Talita Bramorski Mohr
- Universidade Federal de Santa CatarinaCentro TecnológicoLaboratório BridgeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Laboratório Bridge. Florianópolis, SC, Brasil
- Universidade Federal de Santa CatarinaCentro de Ciências da SaúdeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro de Ciências da Saúde. Programa de Pós-Graduação em Farmácia. Florianópolis, SC, Brasil
| | - Mariano Felisberto
- Universidade Federal de Santa CatarinaCentro TecnológicoLaboratório BridgeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Laboratório Bridge. Florianópolis, SC, Brasil
- Universidade Federal de Santa CatarinaCentro de Ciências da SaúdeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro de Ciências da Saúde. Programa de Pós-Graduação em Farmácia. Florianópolis, SC, Brasil
| | - Thiago Serafim Rodrigues
- Universidade Federal de Santa CatarinaCentro TecnológicoLaboratório BridgeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Laboratório Bridge. Florianópolis, SC, Brasil
| | - Jades Fernando Hammes
- Universidade Federal de Santa CatarinaCentro TecnológicoLaboratório BridgeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Laboratório Bridge. Florianópolis, SC, Brasil
| | - Célio Luiz Cunha
- Universidade Federal de Santa CatarinaCentro TecnológicoLaboratório BridgeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Laboratório Bridge. Florianópolis, SC, Brasil
| | - Raul Sidnei Wazlawick
- Universidade Federal de Santa CatarinaCentro TecnológicoLaboratório BridgeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Laboratório Bridge. Florianópolis, SC, Brasil
- Universidade Federal de Santa CatarinaCentro TecnológicoDepartamento de Ciências da ComputaçãoFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Departamento de Ciências da Computação. Florianópolis, SC, Brasil
| | - Eduardo Monguilhott Dalmarco
- Universidade Federal de Santa CatarinaCentro TecnológicoLaboratório BridgeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Laboratório Bridge. Florianópolis, SC, Brasil
- Universidade Federal de Santa CatarinaCentro de Ciências da SaúdeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro de Ciências da Saúde. Programa de Pós-Graduação em Farmácia. Florianópolis, SC, Brasil
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Silva ÉT, Ferreira RC, Diniz FC, Gomes MR, Martins AMEDBL, Chalub LLFH, Senna MIB. Disparities in the protagonism of oral health teams in the work process of Primary Healthcare. Rev Saude Publica 2024; 58:14. [PMID: 38695443 PMCID: PMC11037909 DOI: 10.11606/s1518-8787.2024058005759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/08/2023] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVE Evaluate and compare the protagonism of Oral Health teams (OHt) in the teamwork process in Primary Healthcare (PHC) over five years and estimate the magnitude of disparities between Brazilian macro-regions. METHODS Ecological study that used secondary data extracted from the Sistema de Informação em Saúde para a Atenção Básica (SISAB - Health Information System for Primary Healthcare) from 2018 to 2022. Indicators were selected from a previously validated evaluative matrix, calculated from records in the Collective Activity Form on the degree of OHt's protagonism in team meetings and its degree of organization concerning the meeting agendas. A descriptive and amplitude analysis of the indicators' variation over time was carried out, and the disparity index was also calculated to estimate and compare the magnitude of differences between macro-regions in 2022. RESULTS In Brazil, between 3.06% and 4.04% of team meetings were led by OHt professionals. The Northeast and South regions had the highest (3.71% to 4.88%) and lowest proportions (1.21% to 2.48%), respectively. From 2018 to 2022, there was a reduction in the indicator of the "degree of protagonism of the OHt" in Brazil and macro-regions. The most frequent topics in meetings under OHt's responsibility were the work process (54.71% to 70.64%) and diagnosis and monitoring of the territory (33.49% to 54.48%). The most significant disparities between regions were observed for the indicator "degree of organization of the OHt concerning case discussion and singular therapeutic projects". CONCLUSIONS The protagonism of the OHt in the teamwork process in PHC is incipient and presents regional disparities, which challenges managers and OHt to break isolation and lack of integration, aiming to offer comprehensive and quality healthcare to the user of the Unified Health System (SUS).
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Affiliation(s)
- Érika Talita Silva
- Universidade Federal de Minas GeraisFaculdade de OdontologiaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Belo Horizonte, MG, Brasil.
| | - Raquel Conceição Ferreira
- Universidade Federal de Minas GeraisFaculdade de OdontologiaDepartamento de Odontologia Social e PreventivaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Departamento de Odontologia Social e Preventiva. Belo Horizonte, MG, Brasil
| | - Fabiano Costa Diniz
- Universidade Federal de Minas GeraisFaculdade de OdontologiaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Belo Horizonte, MG, Brasil.
| | - Milena Ribeiro Gomes
- Universidade Federal de Minas GeraisFaculdade de OdontologiaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Belo Horizonte, MG, Brasil.
| | | | - Loliza Luiz Figueiredo Houri Chalub
- Universidade Federal de Minas GeraisFaculdade de OdontologiaDepartamento de Odontologia Social e PreventivaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Departamento de Odontologia Social e Preventiva. Belo Horizonte, MG, Brasil
| | - Maria Inês Barreiros Senna
- Universidade Federal de Minas GeraisFaculdade de OdontologiaDepartamento de Clínica, Patologia e Cirurgia OdontológicasBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Departamento de Clínica, Patologia e Cirurgia Odontológicas. Belo Horizonte, MG, Brasil
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Almeida DPDS, Oliveira Junior PLD, Prazeres GAD, Belotti L, Domingues J, Bonassi NM, Eshriqui I, Martins RS, Almeida LYD, Bonfim D. Implementation of a digital tool for population management in Primary Health Care. Rev Saude Publica 2024; 57Suppl 3:6s. [PMID: 38629670 PMCID: PMC11037907 DOI: 10.11606/s1518-8787.2023057005321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/26/2023] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE Describe the implementation of a digital diagnostic and territorial monitoring tool in primary healthcare. METHODS Quantitative and qualitative study, developed in 14 basic healthcare units in São Paulo, with community health workers, coordinators, nurses, and physicians. Data collection occurred in four phases: analysis of the instruments used by the team for territory management; development of the digital tool; training and implementation; and evaluation after 90 days using focus groups. Descriptive analyses were conducted by calculating absolute and relative frequencies to treat quantitative data. Qualitative data were subjected to content analysis. RESULTS Three hundred thirty-four professionals participated in the study. In the first step, territory management's main challenges were filling out various instruments, system failures, data inconsistency, internet infrastructure/network, and lack of time. Therefore, a digital tool was developed consisting of 1) a spreadsheet recording the number of family members and markers of health conditions, date of visit, and number of return visits; 2) a spreadsheet with a summary of families visited, not visited, and refusals; and 3) a panel with a summary of the data generated instantly. In the evaluation, after the initial use of the tool, the themes that emerged were integration of the tool into daily work, evaluation of the digital tool implementation process, and improvement and opportunities for improvement. CONCLUSIONS Faced with the challenges faced by family healthcare teams when filling out systems and managing the territory, the tool developed provided greater reliability and agility in data visualization, reduced the volume of instruments, and optimized the work process.
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Affiliation(s)
- Debora Paulino da Silva Almeida
- Hospital Israelita Albert Einstein - Albert Einstein Center for Studies, Research, and Practices in Primary Health Care and Networks, Sao Paulo, Brazil
| | - Paulo Leandro de Oliveira Junior
- Hospital Israelita Albert Einstein - Albert Einstein Center for Studies, Research, and Practices in Primary Health Care and Networks, Sao Paulo, Brazil
| | - Glauber Alves Dos Prazeres
- Hospital Israelita Albert Einstein - Albert Einstein Center for Studies, Research, and Practices in Primary Health Care and Networks, Sao Paulo, Brazil
| | - Lorrayne Belotti
- Hospital Israelita Albert Einstein - Albert Einstein Center for Studies, Research, and Practices in Primary Health Care and Networks, Sao Paulo, Brazil
| | - Jessica Domingues
- Hospital Israelita Albert Einstein - Albert Einstein Center for Studies, Research, and Practices in Primary Health Care and Networks, Sao Paulo, Brazil
| | - Natalia Martins Bonassi
- Hospital Israelita Albert Einstein - Albert Einstein Center for Studies, Research, and Practices in Primary Health Care and Networks, Sao Paulo, Brazil
| | - Ilana Eshriqui
- Hospital Israelita Albert Einstein - Albert Einstein Center for Studies, Research, and Practices in Primary Health Care and Networks, Sao Paulo, Brazil
| | - Renata Soares Martins
- Hospital Israelita Albert Einstein - Albert Einstein Center for Studies, Research, and Practices in Primary Health Care and Networks, Sao Paulo, Brazil
| | - Leticia Yamawaka de Almeida
- Hospital Israelita Albert Einstein - Albert Einstein Center for Studies, Research, and Practices in Primary Health Care and Networks, Sao Paulo, Brazil
| | - Daiana Bonfim
- Hospital Israelita Albert Einstein - Albert Einstein Center for Studies, Research, and Practices in Primary Health Care and Networks, Sao Paulo, Brazil
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Barros RDD, Silva LA, Souza LEPFD. [Evaluation of the impact of the implementation of the new primary health care information system on records of patient care and home visits in Brazil]. CAD SAUDE PUBLICA 2024; 40:e00081323. [PMID: 38198386 PMCID: PMC10775966 DOI: 10.1590/0102-311xpt081323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/23/2023] [Accepted: 09/01/2023] [Indexed: 01/12/2024] Open
Abstract
The replacement of the Primary Care Information System (SIAB, 1998-2015), as of January 2016, by the new Health Information System for Primary Care (SISAB) determined new forms of collecting, processing, and using information, with a possible impact on the records of activities carried out in primary health care in Brazil. This study aimed to evaluate the implementation impact of the new information system on records of physicians' and nurses' patient care and home visits of community health workers (CHW) in Brazil from 2007 to 2019. To this end, a Bayesian structural time-series model approach was used, based on a diffuse state-space regression. From 2016 to 2019, 463.47 million physician care, 210.61 million nursing care, and 1.28 billion CHW visits were recorded. Following the trend recorded before the implementation, 598.86 million, 430.46 million, and 1.5 billion physician and nursing appointments and CHW visits would be expected, respectively. In relative terms, there was a decrease of 25% in physician care, 51% in nursing care, and 15% in CHW visits when compared to the value expected by the Bayesian method. The negative impact on the records of patient care and home visits identified in this study, whether due to difficulties in adapting to the new system or a reduction in improper records, must be investigated so that the challenge of improving the primary care information system can be understood and overcome in a planned way.
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Ricci JMS, Romito ALZ, Silva SAD, Carioca AAF, Lourenço BH. Food intake markers in Sisvan: temporal trends in coverage and integration with e-SUS APS, Brazil 2015-2019. CIENCIA & SAUDE COLETIVA 2023. [DOI: 10.1590/1413-81232023283.10552022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Abstract The aim of the present study was to estimate the population coverage of recording food intake markers in Brazil’s Food and Nutrition Surveillance System (Sisvan) and mean annual percent change (APC) in coverage according to the system used for data entry (e-SUS APS and Sisvan Web). We conducted an ecological time series study of the period 2015-2019. The data were stratified into region and age group. APC in coverage was calculated using Prais-Winsten regression and the correlation between APC and HDI, GDP per capita and primary healthcare coverage was assessed using Spearman’s correlation coefficient. Population coverage of recording food intake markers at national level was 0.92% in 2019. Mean APC in coverage throughout the period was 45.63%. The region and age group with the highest coverage rate were the Northeast (4.08%; APC=45.76%, p<0.01) and children aged 2-4 years (3.03%; APC=34.62%, p<0.01), respectively. There was an upward trend in data entry using e-SUS APS, to the detriment of Sisvan Web. There was a positive correlation between APC in coverage using e-SUS APS and HDI and GDP per capita in some age groups. Population coverage of recording Sisvan food intake markers remains low across the country. The e-SUS APS has the potential to be an important strategy for expanding food and nutrition surveillance.
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Ricci JMS, Romito ALZ, Silva SAD, Carioca AAF, Lourenço BH. Food intake markers in Sisvan: temporal trends in coverage and integration with e-SUS APS, Brazil 2015-2019. CIENCIA & SAUDE COLETIVA 2023; 28:921-934. [PMID: 36888874 DOI: 10.1590/1413-81232023283.10552022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/03/2022] [Indexed: 03/08/2023] Open
Abstract
The aim of the present study was to estimate the population coverage of recording food intake markers in Brazil's Food and Nutrition Surveillance System (Sisvan) and mean annual percent change (APC) in coverage according to the system used for data entry (e-SUS APS and Sisvan Web). We conducted an ecological time series study of the period 2015-2019. The data were stratified into region and age group. APC in coverage was calculated using Prais-Winsten regression and the correlation between APC and HDI, GDP per capita and primary healthcare coverage was assessed using Spearman's correlation coefficient. Population coverage of recording food intake markers at national level was 0.92% in 2019. Mean APC in coverage throughout the period was 45.63%. The region and age group with the highest coverage rate were the Northeast (4.08%; APC=45.76%, p<0.01) and children aged 2-4 years (3.03%; APC=34.62%, p<0.01), respectively. There was an upward trend in data entry using e-SUS APS, to the detriment of Sisvan Web. There was a positive correlation between APC in coverage using e-SUS APS and HDI and GDP per capita in some age groups. Population coverage of recording Sisvan food intake markers remains low across the country. The e-SUS APS has the potential to be an important strategy for expanding food and nutrition surveillance.
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Affiliation(s)
- Joanna Manzano Strabeli Ricci
- Programa de Pós-Graduação Nutrição em Saúde Pública, Faculdade de Saúde Pública, Universidade de São Paulo (USP). Av. Dr. Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
| | | | - Sara Araújo da Silva
- Coordenação-Geral de Alimentação e Nutrição, Ministério da Saúde. Brasília DF Brasil
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