Yoshiura Vinicius Tohoru, de Azevedo-Marques João Mazzoncini, Rzewuska Magdalena, Vinci André Luiz Teixeira, Sasso Ariane Morassi, Miyoshi Newton Shydeo Brandão, Furegato Antonia Regina Ferreira, Rijo Rui Pedro Charters Lopes, Del-Ben Cristina Marta, Alves Domingos
Interunit Bioengineering Postgraduate Program, University of São Paulo, São Paulo, Brazil ; Center of Information and Informatics in Health, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil.
Center of Information and Informatics in Health, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil ; Department of Social Medicine, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil.
Int J Ment Health Syst. 2017 Jan 3;11:1. doi: 10.1186/s13033-016-0117-z. eCollection 2017.
Regional networking between services that provide mental health care in Brazil's decentralized public health system is challenging, partly due to the simultaneous existence of services managed by municipal and state authorities and a lack of efficient and transparent mechanisms for continuous and updated communication between them. Since 2011, the Ribeirao Preto Medical School and the XIII Regional Health Department of the Sao Paulo state, Brazil, have been developing and implementing a web-based information system to facilitate an integrated care throughout a public regional mental health care network.
After a profound on-site analysis, the structure of the network was identified and a web-based information system for psychiatric admissions and discharges was developed and implemented using a socio-technical approach. An information technology team liaised with mental health professionals, health-service managers, municipal and state health secretariats and judicial authorities. Primary care, specialized community services, general emergency and psychiatric wards services, that comprise the regional mental healthcare network, were identified and the system flow was delineated. The web-based system overcame the fragmentation of the healthcare system and addressed service specific needs, enabling: detailed patient information sharing; active coordination of the processes of psychiatric admissions and discharges; real-time monitoring; the patients' status reports; the evaluation of the performance of each service and the whole network. During a 2-year period of operation, it registered 137 services, 480 health care professionals and 4271 patients, with a mean number of 2835 accesses per month. To date the system is successfully operating and further expanding.
We have successfully developed and implemented an acceptable, useful and transparent web-based information system for a regional mental healthcare service network in a medium-income country with a decentralized public health system. Systematic collaboration between an information technology team and a wide range of stakeholders is essential for the system development and implementation.
在巴西分散式公共卫生系统中，提供精神卫生保健服务的机构之间进行区域联网颇具挑战，部分原因在于同时存在由市和州政府管理的服务机构，且它们之间缺乏高效、透明的持续及更新沟通机制。自2011年以来，巴西圣保罗州里贝朗普雷图医学院和第十三地区卫生部门一直在开发并实施一个基于网络的信息系统，以促进公共区域精神卫生保健网络的综合护理。
经过深入的实地分析，确定了网络结构，并采用社会技术方法开发并实施了一个用于精神科入院和出院的基于网络的信息系统。一个信息技术团队与精神卫生专业人员、卫生服务管理人员、市和州卫生秘书处以及司法当局进行了联络。确定了构成区域精神卫生保健网络的初级保健、专门社区服务、综合急诊和精神科病房服务，并划定了系统流程框架。该基于网络的系统克服了医疗系统的碎片化问题，并满足了特定服务需求，实现了：详细的患者信息共享；精神科入院和出院流程的积极协调；实时监测；患者状态报告；对每个服务机构和整个网络绩效的评估。在为期两年的运营期间，该系统登记了137个服务机构、480名医护人员和4271名患者，平均每月访问量为2835次。迄今为止，该系统运行成功并在进一步扩展。
我们已成功为一个中等收入国家、具有分散式公共卫生系统的区域精神卫生保健服务网络开发并实施了一个可接受、有用且透明的基于网络的信息系统。信息技术团队与广泛的利益相关者之间的系统协作对于系统的开发和实施至关重要。
