[Health Information Systems: from closed systems to social citizenship. A challenge for the reduction of inequalities in local management].

The traditional concept of health information systems (HIS) poses numerous problems when attempting to support local management orientated to the reduction of health inequalities. How does one design a local HIS, and what would its characteristics be? We view HIS as open and complex systems of which we ourselves are a part. The hypothesis is that a HIS that provides support to local management must be conceived as a set of processes including data, information, knowledge, communication, and action (DIKCA). Data constitute a complex structure with five components. Information is a set of processed data; meanwhile knowledge output involves a subject's understanding and grasp of the phenomenon. Communication links the previous concepts to action. Strategic and communicative actions should be priorities in local management. This proposal aims at management support by the HIS to eliminate health inequalities and build an inclusive society.