Universidade Federal de São Paulo. Escola Paulista de Medicina. Programa de Pós-Graduação em Saúde Coletiva. São Paulo, SP, Brasil.
Rev Saude Publica. 2021 Dec 1;55:93. doi: 10.11606/s1518-8787.2021055002931. eCollection 2021.
To measure the degree of integration of the Electronic Citizen's Record (PEC - Prontuário Eletrônico do Cidadão) of the e-SUS Primary Care Strategy (e-SUS AB - Estratégia e-SUS Atenção Básica) in the view of other Brazilian´s National Health Information Systems (SNIS - Sistemas Nacionais de Informação em Saúde), relating to the internal political-organizational structure of the Brazilian Ministry of Health (MH).
This is a qualitative case study. Data collection was carried out through document analysis and semi-structured interviews. In the first stage, we sought to clarify how many SNIS were in use in the Primary Care (PC) of the Unified Health System between 2013 and 2017. Then, we defined as criterion the maintenance of data collection interfaces by the Ministry of Health even after the implementation of the PEC/e-SUS Primary Care in order to measure the integration.
31 SNIS were identified in Primary Care. We observed that 12 of them were completely integrated and 15 presented no unification of interfaces related to PEC/e-SUS Primary Care. Another 4 have partial integration. By correlating these data with the political-organizational structure of the MS, we observed a greater integration with the systems managed by the Department of Primary Care and a persisted fragmentation in SNIS, especially those under the management of the Health Surveillance Department (Secretaria de Vigilância em Saúde). The disparity between the integration of the PEC/e-SUS Primary Care with the Health Surveillance SNIS is a sign of the persistence of the division and the false dichotomy between Health Care and Health Surveillance practices and processes in the Ministry of Health - even 30 years after the foundation of the SUS and unification of the state structures of social security hospital care and federal public health in MH.
Although still insufficient, the systems integration carried out by the e-SUS Primary Care Strategy, which focuses on reducing user interfaces, can be considered a new fact on the SUS information and information policy agenda.
从巴西卫生部（MH）的内部政治-组织结构角度，衡量电子公民记录（PEC - Prontuário Eletrônico do Cidadão）在电子初级卫生保健战略（e-SUS AB - Estratégia e-SUS Atenção Básica）中的整合程度，关联其他巴西国家卫生信息系统（SNIS - Sistemas Nacionais de Informação em Saúde）。
这是一项定性案例研究。通过文件分析和半结构化访谈进行数据收集。在第一阶段，我们试图澄清在 2013 年至 2017 年期间，有多少个 SNIS 在统一卫生系统的初级保健中使用。然后，我们将卫生部即使在实施 PEC/e-SUS 初级保健后仍维护数据收集接口定义为标准，以衡量整合程度。
在初级保健中确定了 31 个 SNIS。我们观察到，其中 12 个完全整合，15 个与 PEC/e-SUS 初级保健相关的接口没有统一。另外 4 个具有部分整合。将这些数据与 MS 的政治-组织结构相关联，我们观察到与初级保健部门管理的系统具有更大的整合度，而在 SNIS 中仍存在碎片化，特别是在卫生监督部门（Secretaria de Vigilância em Saúde）管理下的那些系统。PEC/e-SUS 初级保健与卫生监督 SNIS 的整合程度存在差异，这表明卫生部在保健和卫生监督实践和流程之间仍然存在分裂和错误的二分法，即使在 SUS 成立 30 年后，以及州社会安全医院保健和联邦公共卫生机构在 MH 中的统一之后也是如此。
尽管仍然不足，但 e-SUS 初级保健战略所进行的系统整合，侧重于减少用户接口，可以被视为 SUS 信息和信息政策议程上的一个新事实。
