COVID-19 reveals the urgent need to strengthen nursing informatics competencies: a view from Peru.

The COVID-19 pandemic requires an urgent action to transform health-care delivery and to promote research and capacity-building nursing programs. Specifically, many countries at the global level have described nursing informatics as an essential competence for nurse professionals. In Peru, nursing personnel represents the largest health workforce group and nursing informatics is still emerging, but the field appear to hold much promise. In this sense, the Peruvian Ministry of Health (MoH) defined in 2020 the core nursing competences, which included a technology and innovation domain. The competence established to apply scientifically based technology and innovation to improve the processes or health service resources. The minimum competencies established by the MoH were as follows: to carry out innovations in processes or resources in their different professional performance areas, to creatively adapt technology in different areas of professional performance, to make rational and ethical use of health technologies with focus on new developments that will be evaluated and applied critically, and to manage information and communication technologies, and health information systems, with emphasis on telehealth (i.e. telemedicine, telecare management, tele-education, and tele-training). Besides the nursing competences defined by the MoH is a good starting point, this special contribution discusses the urgent need to strengthen nursing informatics competencies in Peru.

COVID-19 e Telemedicina: ferramenta de medição do nível de maturidade das instituições de saúde para implementar serviços de telemedicina / COVID-19 y Telemedicina: herramienta de medición del nivel de madurez de las instituciones de salud para implementar servicios de telemedicina / COVID-19 and Telemedicine: tool for assessing the maturity level of health institutions to implement telemedicine services / COVID-19 et Télémédecine: outil de mesure du niveau de maturité des établissements de santé pour la mise en œuvre des services de télémédecine

A elaboração desta ferramenta faz parte do apoio às operações de resposta à pandemia. Baseia-se nos modelos implementados por diferentes instituições de saúde em vários países do mundo, com diferentes graus de complexidade. Instituições e especialistas em telemedicina e no uso de tecnologia da informação na área da saúde pública da Região das Américas e da Espanha colaboraram em seu desenvolvimento. A ferramenta foi desenvolvida com o entendimento de que existe uma intenção institucional de implementar serviços de telemedicina imediatamente. Porém, também será útil para instituições que já contam com programas de telemedicina e desejam fazer uma autoavaliação para redefinir as suas prioridades diante da pandemia. A ferramenta traz uma série de perguntas organizadas nas seis categorias.

La elaboración de esta herramienta forma parte del apoyo a las operaciones de respuesta a la pandemia. Se basa en los modelos que distintas instituciones de salud con diferente grado de complejidad han implementado en varios países del mundo. En su desarrollo han colaborado instituciones y expertos de la Región de las Américas y de España especializados en telemedicina y en el uso de tecnologías de la información en la esfera de la salud pública. La herramienta se ha desarrollado en el entendido de que existe la intención institucional de implementar de forma inmediata servicios de telemedicina. Pero también resultará útil a las instituciones que ya cuenten con programas de telemedicina en funcionamiento y que deseen autoevaluarse para redefinir prioridades frente a la pandemia. La herramienta consta de una serie de preguntas organizadas en las seis categorías.

This tool forms part of the support for pandemic response operations. Its design is based on the models that have been implemented by different health institutions with different levels of complexity in several countries. The tool was developed collaboratively with institutions and experts specialized in telemedicine and in the use of information technology (IT) in public health, from the Region of the Americas and. The tool has been developed with the understanding that there is an institutional commitment to immediately implement telemedicine services. However, it will also be useful to institutions that already have telemedicine programs up and running, which want to perform a self-assessment to redefine their priorities in light of the pandemic. The tool comprises a series of questions, organized into the six categories.

La mise au point de cet outil s'inscrit dans le cadre du soutien aux opérations d'intervention en cas de pandémie. Il repose sur les modèles que différents établissements de santé avec des degrés de complexité variables ont mis en œuvre dans plusieurs pays à travers le monde. Des institutions et des experts de la Région des Amériques et d'Espagne spécialisés dans la télémédecine et l'utilisation des technologies de l'information dans le domaine de la santé publique ont collaboré au développement du présent outil (voir annexe). L'existence d'une intention institutionnelle de mettre immédiatement en œuvre des services de télémédecine est un préalable au développement de cet outil. Néanmoins, ce dernier sera également utile pour les institutions qui ont déjà mis en place des programmes de télémédecine et qui souhaitent réaliser une auto-évaluation de manière à redéfinir leurs priorités face à la pandémie. L'outil comprend une série de questions organisées selon les six catégories.

Desafios do SUS / SUS challenges

Desafios do SUS é uma publicação que aborda a trajetória do Sistema Único de Saúde (SUS) desde a sua criação, ao mesmo tempo que traz reflexões nacionais e internacionais de forma precisa como o sistema de saúde brasileiro vem sendo operacionalizado, tendo como base estudos e acompanhamento in loco em diversos municípios do país. Diante da complexidade de operacionalizar o sistema em um país continental como o Brasil, o mais importante dessa publicação são as sugestões de como enfrentar os problemas e as dificuldades. O livro propõe um singular modelo de atenção às condições crônicas para o SUS e aborda os problemas do financiamento, sugerindo a passagem do sistema de pagamento aos prestadores por valor, por performance, por linhas de cuidado e por capitação. Aponta avanços, como ampliação do acesso, programas exitosos e uma grande produção de serviços. Entre os desafios, estão a organização macroeconômica do sistema de atenção à saúde, que se expressa no dilema fundamental entre a segmentação e a universalização; o modelo de atenção à saúde totalmente inadequado para a atual situação epidemiológica e demográfica no País; e a competição predatória entre o público e o privado.

[Incorporation of Information and Communication Technologies and quality of primary healthcare in Brazil]. / Incorporação de Tecnologias de Informação e Comunicação e qualidade na atenção básica em saúde no Brasil.

Information and Communication Technologies (ICTs) are means to handle information, streamline communication, and contribute to patient care. This article describes the incorporation of Information and Communication Technologies in primary care and its association with quality, based on the Brazilian National Program for the Improvement of Access and Quality in Primary Care (PMAQ in portuguese). This was a cross-sectional study with 17,053 teams. An Index of Incorporation of ICTs was created, which included: information infrastructure, systems, and utilization. Regression analysis was used to assess associations. Only 13.5% of the teams had a high degree of ICTs. The strongest association was seen in the utilization of information. ICTs can contribute to improving quality of primary care.

Incorporação de Tecnologias de Informação e Comunicação e qualidade na atenção básica em saúde no Brasil / Incorporation of Information and Communication Technologies and quality of primary healthcare in Brazil / Incorporación de Tecnologías de la Información y Comunicación y calidad en la atención básica en salud en Brasil

Resumo: As Tecnologias de Informação e Comunicação (TIC) - meios para tratar informação e agilizar comunicação - contribuem para o cuidado. Este artigo descreve a incorporação de TIC na atenção básica e sua associação com a qualidade, utilizando Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ). É um estudo transversal. O universo englobou 17.053 equipes. Criou-se o Índice de Incorporação de Tecnologias de Informação e Comunicação (ITIC) englobando: infraestrutura, sistemas e utilização de informação. Para as associações, realizou-se análise de regressão. Somente 13,5% das equipes possuem grau alto de TIC. É na utilização da informação que se observou a maior força de associação. As TIC contribuem para a melhoria da qualidade da atenção básica.

Abstract: Information and Communication Technologies (ICTs) are means to handle information, streamline communication, and contribute to patient care. This article describes the incorporation of Information and Communication Technologies in primary care and its association with quality, based on the Brazilian National Program for the Improvement of Access and Quality in Primary Care (PMAQ in portuguese). This was a cross-sectional study with 17,053 teams. An Index of Incorporation of ICTs was created, which included: information infrastructure, systems, and utilization. Regression analysis was used to assess associations. Only 13.5% of the teams had a high degree of ICTs. The strongest association was seen in the utilization of information. ICTs can contribute to improving quality of primary care.

Resumen: Las Tecnologías de la Información y Comunicación (TIC), los medios para tratar información y agilizar la comunicación, contribuyen al cuidado de los pacientes. Este artículo describe la incorporación de las TIC en la atención básica y su asociación con la calidad, utilizando Programa Nacional para el Mejoramiento del Acceso y Calidad de Atención Primaria (PMAQ). Es un estudio transversal. El universo englobó a 17.053 equipos. Se creó el Índice de Incorporación de las Tecnologías de la Información y Comunicación (ITIC) englobando: infraestructura, sistemas y utilización de la información. Para las asociaciones, se realizó un análisis de regresión. Solamente un 13,5% de los equipos poseen un grado alto de TIC. Es en la utilización de la información donde se observó la mayor fuerza de asociación. Las TIC contribuyen a una mejora de la calidad de la atención primaria.

Social Network Analysis and Mining to Monitor and Identify Problems with Large-Scale Information and Communication Technology Interventions.

The published literature reveals several arguments concerning the strategic importance of information and communication technology (ICT) interventions for developing countries where the digital divide is a challenge. Large-scale ICT interventions can be an option for countries whose regions, both urban and rural, present a high number of digitally excluded people. Our goal was to monitor and identify problems in interventions aimed at certification for a large number of participants in different geographical regions. Our case study is the training at the Telecentros.BR, a program created in Brazil to install telecenters and certify individuals to use ICT resources. We propose an approach that applies social network analysis and mining techniques to data collected from Telecentros.BR dataset and from the socioeconomics and telecommunications infrastructure indicators of the participants' municipalities. We found that (i) the analysis of interactions in different time periods reflects the objectives of each phase of training, highlighting the increased density in the phase in which participants develop and disseminate their projects; (ii) analysis according to the roles of participants (i.e., tutors or community members) reveals that the interactions were influenced by the center (or region) to which the participant belongs (that is, a community contained mainly members of the same region and always with the presence of tutors, contradicting expectations of the training project, which aimed for intense collaboration of the participants, regardless of the geographic region); (iii) the social network of participants influences the success of the training: that is, given evidence that the degree of the community member is in the highest range, the probability of this individual concluding the training is 0.689; (iv) the North region presented the lowest probability of participant certification, whereas the Northeast, which served municipalities with similar characteristics, presented high probability of certification, associated with the highest degree in social networking platform.

Sistemas de información en salud: integrando datos clínicos en diferentes escenarios y usuarios / Health information systems: integrating clinical data in different scenarios and users

Pese al avance tecnológico de las últimas décadas y a los múltiples beneficios documentados, la implementación de tecnologías de información y comunicación (TIC) en salud continúa siendo un importante desafío para las organizaciones de salud. Buscando contribuir al análisis de las múltiples variables involucradas a la hora de lograr implementaciones exitosas, aplicamos un modelo sociotécnico para analizar la experiencia de informatización de la capa clínica en el Hospital Italiano de Buenos Aires (HIBA). El marco conceptual aplicado consta de ocho dimensiones interconectadas que permiten revisar diferentes aspectos a tener en cuenta a la hora de diseñar, desarrollar, implementar, usar y evaluar la aplicación de TIC. Teniendo en cuenta la evolución de nuestro proyecto, lo dividimos en tres etapas, de forma tal que cada una de las dimensiones es analizada en cada una de las etapas. El modelo sociotécnico aplicado resultó en una adecuada herramienta de evaluación de nuestra implementación de TIC en salud, permitiéndonos el análisis de las ocho dimensiones, incluso de forma retrospectiva. Aplicando este análisis a cada una de las etapas de la evolución de nuestro proyecto institucional pudimos evidenciar que al tener en cuenta todos los aspectos en conjunto se facilitó la ejecución del mismo y nos permitió identificar aspectos por mejorar.

Despite the technological advances of recent decades and the many documented benefits, the implementation of information and communication technologies (ICT) in health remains a major challenge for healthcare organizations. Looking to contribute to the analysis of multiple variables involved at the time of achieving successful implementation, we apply a sociotechnical model to analyze the experience of computerization of the clinical layer in the Italian Hospital of Buenos Aires. The conceptual framework applied consists of eight interconnected dimensions that allow the review of different aspects to consider at the time of design, development, implementation, use and evaluation of the application of ICT. Considering the evolution of our project, we divided it into three stages, so that each of the dimensions is analyzed in each of the stages. The socio-technical model applied resulted in an appropriate tool for assessing our implementation of ICT in health, allowing us the analysis of the eight dimensions, including retrospectively. Applying this analysis to each of the stages of the evolution of our institutional project we were able to show that by taking into account all aspects together, its execution was facilitated and allowed us to identify areas for improvement.

Palliative care from a medical informatics perspective in Chile, Germany, and Peru.

This work explores a) the use of e-health systems in the context of palliative care and b) the information needs of patients, care givers and healthcare professionals in palliative care. To achieve this we conducted a systematic literature review and interviewed health professionals in Germany, Peru, and Chile. All countries have in common that specific e-health systems are rarely used in this context and the presence of a gradient of available care between rural and urban areas.

A survey of rural hospitals' perspectives on health information technology outsourcing.

A survey of rural hospitals was conducted in the spring of 2012 to better understand their perspectives on health information technology (HIT) outsourcing and the role that hospital-to-hospital HIT partnerships (HHPs) can play as an outsourcing mechanism. The survey sought to understand how HHPs might be leveraged for HIT implementation, as well as the challenges with forming them. The results suggest that HHPs have the potential to address rural hospitals' slow rate of HIT adoption, but there are also challenges to creating these partnerships. These issues, as well as avenues for further research, are then discussed.

SIDATRAT: informatics to improve HIV/AIDS care.

AIDS is a major cause of death in the Caribbean, a region with a high prevalence of HIV. However, prevalence in Cuba's population aged 15 to 49 years, despite a slight increase in recent years, is considered extremely low (0.1%). At the close of 2010, 5692 Cuban patients were receiving antiretroviral therapy. SIDATRAT, an informatics system, was developed at the Pedro Kourí Tropical Medicine Institute in Havana to ensure proper monitoring and followup of drug administration. Functioning on a web platform utilizing an Apache server, PHP and MySQL, it records patients' general information, CD4 counts, viral load and data from other laboratory tests, as well as endoscopic and imaging studies. It also compiles information on their AIDS classification, opportunistic infections, HIV subtype and resistance studies, followup consultations, drug regimen, adverse reactions to medications, changes in drug combinations, and survival; and tracks total number of individuals under treatment. SIDATRAT follows the client-server philosophy and enables access by authorized users throughout Cuba via the health informatics network. SIDATRAT has been found effective in supporting quality care for persons living with HIV/AIDS and universal access to antiretroviral therapy, compiling most of the information needed for decisionmaking on patient health and therapies. SIDATRAT has been offered to the UNDP office in Havana for sharing with other developing countries that may wish to adapt or implement it.

Dealing with the archetypes development process for a regional EHR system.

OBJECTIVES: This paper aims to present the archetype modelling process used for the Health Department of Minas Gerais State, Brazil (SES/MG), to support building its regional EHR system, and the lessons learned during this process. METHODS: This study was undertaken within the Minas Gerais project. The EHR system architecture was built assuming the reference model from the ISO 13606 norm. The whole archetype development process took about ten months, coordinated by a clinical team co-ordinated by three health professionals and one systems analyst from the SES/MG. They were supported by around 30 health professionals from the internal SES/MG areas, and 5 systems analysts from the PRODEMGE. Based on a bottom-up approach, the project team used technical interviews and brainstorming sessions to conduct the modelling process. RESULTS: The main steps of the archetype modelling process were identified and described, and 20 archetypes were created. LESSONS LEARNED: -The set of principles established during the selection of PCS elements helped the clinical team to keep the focus in their objectives;-The initial focus on the archetype structural organization aspects was important;-The data elements identified were subjected to a rigorous analysis aimed at determining the most suitable clinical domain;-Levelling the concepts to accommodate them within the hierarchical levels in the reference model was definitely no easy task, and the use of a mind mapping tool facilitated the modelling process;-Part of the difficulty experienced by the clinical team was related to a view focused on the original forms previously used;-The use of worksheets facilitated the modelling process by health professionals;-It was important to have a health professional that knew about the domain tables and health classifications from the Brazilian Federal Government as member in the clinical team. CONCLUSION: The archetypes (referencing terminology, domain tables and term lists) provided a favorable condition for the use of a controlled vocabulary between the central repository and the EMR systems and, probably, will increase the chances of preserving the semantics from the knowledge domain. Finally, the reference model from the ISO 13606 norm, along with the archetypes, proved sufficient to meet the specificities for the creation of an EHR system for basic healthcare in a Brazilian state.

Technological iatrogenesis: the manifestation of inadequate organizational planning and the integration of health information technology.

The Institute of Medicine (IOM) views Health Information Technology (HIT) as an essential organizational prerequisite for the delivery of safe, reliable, and cost-effective health services. However, HIT presents the proverbial double-edged sword in generating solutions to improve system performance while facilitating the genesis of novel iatrogenic problems. Incongruent organizational processes give rise to technological iatrogenesis or the unintended consequences to system integrity and the resulting organizational outcomes potentiated by incongruent organizational-technological interfaces. HIT is a disruptive innovation for health services organizations but remains an overlooked organizational development (OD) concern. Recognizing the technology-organizational misalignments that result from HIT adoption is important for leaders seeking to eliminate sources of system instability. The Health Information Technology Iatrogenesis Model (HITIM) provides leaders with a conceptual framework from which to consider HIT as an instrument for organizational development. Complexity and Diffusion of Innovation theories support the framework that suggests each HIT adoption functions as a technological change agent. As such, leaders need to provide operational oversight to managers undertaking system change via HIT implementation. Traditional risk management tools, such as Failure Mode Effect Analysis and Root Cause Analysis, provide proactive pre- and post-implementation appraisals to verify system stability and to enhance system reliability. Reconsidering the use of these tools within the context of a new framework offers leaders guidance when adopting HIT to achieve performance improvement and better outcomes.

175 años de la National Library of Medicine, de los EE.UU. de NA: un tesoro científico y cultural digno de admiración / 175 years of the National Library of Medicine, of the Unites States of America: a scientific and cultural treasure worthy of admiration

The National Library of Medicine (NLM) of the United States of America, celebrates in 2011 its 175th anniversary. This Library, the largest biomedical library in the world, has a proud and rich history serving the health community and the public, especially since its transfer to the National Institutes of Health in Bethesda, Maryland, in 1968. It holds 17 million publications in 150 languages, and has an important collection of ancient and modern historical books as well as original publications of Vesalius and other founders of biomedicine. Its modern document collections illustrate the progress of medical sciences. These collections include laboratory notes from many scientists whose work forms the foundations of contemporary life sciences. The Library also provides several services for health research and for the public, including databases and services such as MedLine and BLAST. The NLM constantly strives to fulfill the information needs of its customers, whether scientists or the public at large. For example, as the Hispanic population of the Unites States has increased in recent years, the NLM has made larger and larger amounts of data available in Spanish to fulfill the health information needs of this population. NLM programs train professionals in library science and biomedical informatics and link biomedical libraries of 18 academic centers throughout the United States. The NLM funds competitive grants for training at the Library, organizing short instruction courses about library science and informatics, and writing books on health related matters including the history of medicine and public health. The NLM is managed and maintained by an outstanding and farsighted group of professionals and dedicated support staff. Their focus on serving and reaching both the biomedical community and the public at large has been crucial to its development into a world icon of biomedical sciences, information technology and the humanities.

Análise da aplicação e dos resultados do modelo OPM3® para a área da saúde / Analysis of the model OPM3® application and results for health area / Análisis de la aplicación y de los resultados del modelo OPM3® para el área de salud

Esta pesquisa procurou analisar se um modelo de questionário criado por uma comunidade internacional de gerenciamento de projetos e se é aplicavél a organizações voltadas a área de saúde. O modelo OPM3® (Organizational Project Management Maturity Model) foi criado para que organizações de qualquer área ou porte pudessem identificar a presença, ou ausência, de boas práticas degerenciamento. O objetivo da aplicação desse modelo é avaliar sempre a organização e não o entrevistado. No presente artigo, sãoapresentados os resultados da aplicação desse modelo em uma organização que possuía produtos e serviços de tecnologia da informaçãoaplicados à área de saúde. Este estudo verificou que o modelo é aplicável de forma rápida e que a organização analisada possuía um número expressivo de boas práticas.

This research sought to analyze if a questionnaire model created by an international community of project management is applicable to health organizations. The model OPM3® (Organizational Project Management Maturity Model) was created in order that organizations of any area or size can identify the presence or absence of good management practices. The aim of applying this model is to always evaluate the organization and not the interviewee. In this paper, one presents the results of employing this model in an organization that has information technology products and services applied to health area. This study verified that the model is rapidlyapplicable and that the analyzed organization has an expressive number of good practices.

Esta investigación buscó analizar si un modelo de cuestionario creado por una comunidad internacional de administración de proyectos es aplicable a organizaciones volcadas al área de salud. El modelo OPM3® (Organizational Project Management Maturity Model) fue creado para que organizaciones de cualquier área o porte puedan identificar la presencia o no de buenas prácticas de administración. El objetivo de la aplicación de ese modelo es evaluar siempre la organización y no al entrevistado. En el presente artículoson presentados los resultados de la aplicación de ese modelo en una organización que tiene productos y servicios de tecnología de lainformación aplicados al área de salud. Este estudio verificó que el modelo es aplicable de forma rápida y que la organización analizada tiene un número expresivo de buenas prácticas.

[175 years of the National Library of Medicine, of the United States of America: a scientific and cultural treasure worthy of admiration]. / 175 años de la National Library of Medicine, de los EE.UU. de NA: un tesoro científico y cultural digno de admiración.

The National Library of Medicine (NLM) of the United States of America, celebrates in 2011 its 175th anniversary. This Library, the largest biomedical library in the world, has a proud and rich history serving the health community and the public, especially since its transfer to the National Institutes of Health in Bethesda, Maryland, in 1968. It holds 17 million publications in 150 languages, and has an important collection of ancient and modern historical books as well as original publications of Vesalius and other founders of biomedicine. Its modern document collections illustrate the progress of medical sciences. These collections include laboratory notes from many scientists whose work forms the foundations of contemporary life sciences. The Library also provides several services for health research and for the public, including databases and services such as MedLine and BLAST. The NLM constantly strives to fulfill the information needs of its customers, whether scientists or the public at large. For example, as the Hispanic population of the Unites States has increased in recent years, the NLM has made larger and larger amounts of data available in Spanish to fulfill the health information needs of this population. NLM programs train professionals in library science and biomedical informatics and link biomedical libraries of 18 academic centers throughout the United States. The NLM funds competitive grants for training at the Library, organizing short instruction courses about library science and informatics, and writing books on health related matters including the history of medicine and public health. The NLM is managed and maintained by an outstanding and farsighted group of professionals and dedicated support staff. Their focus on serving and reaching both the biomedical community and the public at large has been crucial to its development into a world icon of biomedical sciences, information technology and the humanities.

A countrywide clinical informatics project in Uruguay.

FEMI is a federation of 23 private not-for-profit health care organizations across Uruguay. It covers approximately 700 thousand people (20 percent of the Uruguayan population) and owns a tertiary center in Montevideo. Pressure from ongoing national changes in health funding and regulation have pushed FEMI to develop a project, in order to improve efficiency in health care through the use of information and communications technologies. In particular, a federal electronic health record and a strategic management system are pursued. This project is supported by the Inter American Development Bank. The project has four lines of action: Specification, construction and implementation of the systems; Alignment through the use of standards; Cultural change through training and prototype systems; and Infrastructure. Short term results include a federal balanced scorecard, federal identification and authorization services, a terminology service, telemedicine applications and massive training of interdisciplinary teams at the local level. The importance of collaboration at the regional level and the advantages of having a multi-institutional commitment are stressed.

Epidemiological surveillance using information technologies in Paraguay.

This article presents the early work on a project in Paraguay for epidemiological surveillance using information technologies. This project is a response of our university to a governmental request to establish links of cooperation and development between academic public sectors of Spain and Paraguay. The overall project objective is the promotion ofa healthy citizenry through the application of information and communication technologies to the monitoring of populations vulnerable to febrile syndromes (FS). The goal of this project is to create the infrastructure that will allow the population of the country to easily communicate with health centers and provide information on cases of FS. The telephone network will be the main physical support for this communication. The project was formally initiated in January 2009 with the implementation of the prototype system. During the first half of 2010, the pilot project will be implemented in Asunción, Paraguay.

Análise da funcionalidade do prontuário de atendimento do gerenciador de informações locais (GIL) em uma unidade de atenção primária no município do Rio de Janeiro / Analysis of the functionality of the service records of the local information manager (GIL) in a primary care unit in the municipality of Rio de Janeiro

Este trabalho apresenta o relato e a análise de uma experiência adrede planejada para a utilização do prontuário de atendimento do gerenciador de informações locais (GIL) – sistema de informação desenvolvido pelo MS/Datasus que visa processos de trabalho deestabelecimentos ambulatoriais do SUS – numa unidade de atenção primária do município do Rio de Janeiro: o Centro de Saúde Germano Sinval Faria, da ENSP/Fiocruz. Sucintamente, as principais ações em cada setor de trabalho foram: (i) no setor de atendimento clínico aos pacientes, a coleta de informações ambulatoriaisrealizadas diretamente no computador; (ii) no setor de documentação e informação em saúde, a reorganização dos processos de trabalho visando o alinhamento com a nossa pesquisa; (iii) no setor de coordenação do cuidado e gerência do nível local, a verificação do nível de utilização das informações em saúde geradas pelo SI. Uma das conclusões elaboradas é que, com os aperfeiçoamentos sugeridos pelo grupo de estudo, o prontuário de atendimento do GIL atenderá as necessidades de informações em saúde para a gestão de estabelecimentos de atenção primária do SUS.

This paper presents a description and analysis of an experience adrede planned to use the medical care of the local information manager (GIL) - information system developed by MS / Datasus designed to work processes of the SUS health clinics - a unit of primary care facilities in Rio de Janeiro: the Health Center Sinval Germano Faria, ENSP / Fiocruz. Briefly, the main actions in each sector of employment were: (i)sector clinical care provided to patients, the data collection procedures performeddirectly on the computer, (ii) in the field of documentation and information on health, the reorganization of work that will align with our research, (iii) sector coordination of care and management of local government, to verify the level of use of health information generated by SI. One conclusion drawn is that with the improvements suggested by the study group, the medical care of GIL meet the needs of health information for the management of establishments of primary care SUS.