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      Implementation of the e-SUS Primary Care Strategy: an analysis based on official data

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          ABSTRACT

          OBJETIVE

          Analyze the implementation of the strategy e-SUS Atenção Básica (e-SUS AB – e-SUS Primary Care) in Brazil between the first years of the system, from 2013 to 2019.

          METHODS

          This is a quantitative, descriptive, and exploratory study. We considered official data from the Ministry of Health, submitted by Brazilian municipalities, in the period from April 2013 to December 2019. We categorized the municipalities as ‘not implemented’, ‘initial implementation’, ‘partial implementation’ and ‘implemented’ according to the criteria defined in this study. We also verified whether the type of municipality, according to the IBGE classification, influenced the degree of implementation of the e-SUS AB strategy. We performed descriptive analyses and investigated the association between the degrees of implementation of e-SUS AB and the typology of the IBGE classification and characterization of rural and urban spaces.

          RESULTS

          The implementation increased in the analyzed period. The implementation status of the e-SUS AB strategy in 2019 was ‘implemented’ in 20.2% (1,117) of the municipalities, ‘partial implementation’ in 32.9% (1,819), ‘initial implementation’ in 39.1% (2,159) and ‘not implemented’ in 7.8% (432). The South and Southeast regions presented the best implementation situation in all years, and the states of Rio Grande do Sul, São Paulo and Santa Catarina reached a higher percentage of municipalities with ‘implemented’ status in 2019.

          CONCLUSIONS

          We confirmed the progress in the implementation of the e-SUS AB strategy over the years. Most of the municipalities are between the status ‘initial implementation’ and ‘partial implementation’. Therefore, we conclude that investments in technological resources, training of professionals, and support are necessary to qualify the implementation and use of information systems in the country, especially for the e-SUS AB strategy.

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          Most cited references26

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          Revisão das dimensões de qualidade dos dados e métodos aplicados na avaliação dos sistemas de informação em saúde

          No Brasil, o monitoramento da qualidade dos dados dos Sistemas de Informação em Saúde (SIS) não segue um plano sistemático de avaliações. Este artigo revê as iniciativas de avaliação da qualidade das informações dos sistemas brasileiros, identificando as dimensões de qualidade abordadas e o método utilizado. Foram consultadas as bases de dados SciELO, LILACS e as referências bibliográficas dos artigos identificados. Identificaram-se 375 estudos, resultando em 78 estudos após as exclusões. As quatro dimensões mais freqüentes nos artigos totalizaram cerca de 90% das análises realizadas. Os estudos identificados priorizaram as dimensões de qualidade confiabilidade, validade, cobertura e completitude. Metade dos estudos se limitou a estudar dados do Rio de Janeiro e de São Paulo. O pequeno número de estudos realizados sobre alguns sistemas e sua distribuição desigual entre as regiões impossibilitam que se conheça de forma ampla a qualidade dos sistemas de informação em saúde do país. A importância de informações de qualidade indica a necessidade de que se institua no Brasil uma política de gerenciamento dos dados dos sistemas de informação em saúde.
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            Adopting electronic medical records in primary care: lessons learned from health information systems implementation experience in seven countries.

            The adoption of health information systems is seen world wide as one method to mitigate the widening health care demand and supply gap. The purpose of this review was to identify the current state of knowledge about health information systems adoption in primary care. The goal was to understand factors and influencers affecting implementation outcomes from previous health information systems implementations experiences. A comprehensive systematic literature review of peer reviewed and grey literature was undertaken to identify the current state of knowledge regarding the implementation of health information systems. A total of 6 databases, 27 journal websites, 20 websites from grey sources, 9 websites from medical colleges and professional associations as well as 22 government/commission websites were searched. The searches returned almost 3700 article titles. Eighty-six articles met our inclusion and exclusion criteria. Articles show that systems' graphical user interface design quality, feature functionality, project management, procurement and users' previous experience affect implementation outcomes. Implementers had concerns about factors such as privacy, patient safety, provider/patient relations, staff anxiety, time factors, quality of care, finances, efficiency, and liability. The review showed that implementers can insulate the project from such concerns by establishing strong leadership, using project management techniques, establishing standards and training their staff to ensure such risks do not compromise implementation success. The review revealed the concept of socio-technical factors, or "fit" factors, that complicate health information systems deployment. The socio-technical perspective considers how the technical features of a health information system interact with the social features of a health care work environment. The review showed that quality of care, patient safety and provider/patient relations were not, positively or negatively, affected by systems implementation. The fact that no articles were found reviewing the benefits or drawbacks of health information systems accruing to patients should be concern to adopters, payers and jurisdictions. No studies were found that compared how provider-patient interactions in interviews are effected when providers used electronic health information systems as opposed to the paper equivalent. Very little information was available about privacy and liability.
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              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Revisão das dimensões de qualidade dos dados e métodos aplicados na avaliação dos sistemas de informação em saúde

              No Brasil, o monitoramento da qualidade dos dados dos Sistemas de Informação em Saúde (SIS) não segue um plano sistemático de avaliações. Este artigo revê as iniciativas de avaliação da qualidade das informações dos sistemas brasileiros, identificando as dimensões de qualidade abordadas e o método utilizado. Foram consultadas as bases de dados SciELO, LILACS e as referências bibliográficas dos artigos identificados. Identificaram-se 375 estudos, resultando em 78 estudos após as exclusões. As quatro dimensões mais freqüentes nos artigos totalizaram cerca de 90% das análises realizadas. Os estudos identificados priorizaram as dimensões de qualidade confiabilidade, validade, cobertura e completitude. Metade dos estudos se limitou a estudar dados do Rio de Janeiro e de São Paulo. O pequeno número de estudos realizados sobre alguns sistemas e sua distribuição desigual entre as regiões impossibilitam que se conheça de forma ampla a qualidade dos sistemas de informação em saúde do país. A importância de informações de qualidade indica a necessidade de que se institua no Brasil uma política de gerenciamento dos dados dos sistemas de informação em saúde.
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                Author and article information

                Journal
                Rev Saude Publica
                Rev Saude Publica
                rsp
                Revista de Saúde Pública
                Faculdade de Saúde Pública da Universidade de São Paulo
                0034-8910
                1518-8787
                23 February 2022
                2022
                : 56
                : 5
                Affiliations
                [I ] orgnameFundação Oswaldo Cruz orgdiv1Programa de Mestrado Profissional em Políticas Públicas em Saúde Brasília DF Brasil originalFundação Oswaldo Cruz. Programa de Mestrado Profissional em Políticas Públicas em Saúde. Brasília, DF, Brasil
                [II ] orgnameUniversidade de Brasília orgdiv1Faculdade de Ceilândia Brasília DF Brasil originalUniversidade de Brasília. Faculdade de Ceilândia. Brasília, DF, Brasil
                [I ] Brasil originalFundação Oswaldo Cruz. Programa de Mestrado Profissional em Políticas Públicas em Saúde. Brasília, DF, Brasil
                [II ] Brasil original Universidade de Brasília. Faculdade de Ceilândia. Brasília, DF, Brasil
                Author notes
                Correspondence: Ana Claudia Cielo Esplanada dos Ministérios - Bloco G 7° andar - Edifício Sede 70058-900 Brasília, DF, Brasil E-mail: anaclaudiacielo@ 123456gmail.com

                Contribution of the Authors: Conception and planning of the study: ACC, TR, JOMB. Data collection, analysis, and interpretation: ACC, TR, JOMB. Drafting or revising the manuscript: ACC, TR, JOMB, ENS. Approval of the final version: ACC, TR, JOMB, ENS. Public responsibility for the content of the article: ACC.

                Conflict of Interest: The authors declare no conflict of interest.

                Correspondência: Ana Claudia Cielo Esplanada dos Ministérios - Bloco G 7° andar - Edifício Sede 70058-900 Brasília, DF, Brasil E-mail: anaclaudiacielo@gmail.com

                Contribuição dos Autores: Concepção e planejamento do estudo: ACC, TR, JOMB. Coleta, análise e interpretação dos dados: ACC, TR, JOMB. Elaboração ou revisão do manuscrito: ACC, TR, JOMB, ENS. Aprovação da versão final: ACC, TR, JOMB, ENS. Responsabilidade pública pelo conteúdo do artigo: ACC.

                Conflito de Interesses: Os autores declaram não haver conflito de interesses.

                Author information
                https://orcid.org/0000-0002-7873-3744
                https://orcid.org/0000-0001-9948-5164
                https://orcid.org/0000-0001-8747-4185
                https://orcid.org/0000-0002-7648-0472
                Article
                00204
                10.11606/s1518-8787.2022056003405
                8869366
                35262613
                82113038-9f52-4ab4-9850-7dbd7945e304

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 December 2020
                : 2 May 2021
                Page count
                Figures: 8, Tables: 2, Equations: 0, References: 23
                Categories
                Original Article

                unified health system,electronic health records,health information systems,primary health care,ehealth strategies

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