Abstract
BackgroundRegional 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.Case presentationAfter 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.ConclusionWe 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.
Highlights
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
Systematic collaboration between an information technology team and a wide range of stakeholders is essential for the system development and implementation
We have explored the local context, and we delineated the exact structure of the mental healthcare system and the existing legal mechanisms of partnerships
Summary
We have explored the local context, and we delineated the exact structure of the mental healthcare system and the existing legal mechanisms of partnerships. To the best of our knowledge we provide the first description of exact structures and flow of the regional and local mental health care system network in the region of the XIII RHD that may serve as a guide for understanding healthcare system in other parts of Brazil. 2 Center of Information and Informatics in Health, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil. 3 Department of Social Medicine, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil. 4 Community Health Postgraduate Program, Ribeirao Preto Medi‐ cal School, University of São Paulo, São Paulo, Brazil. 7 Department of Neuroscience and Behav‐ iour Science, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil
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