Resumo A implantação do registro eletrônico nos estabelecimentos de saúde tem refletido soluções isoladas, que contribuem para a fragmentação do Sistema Único de Saúde (SUS). Essa investigação utiliza ferramenta de planejamento estratégico, a fim de acompanhar o percurso da implantação do registro em instituto nacional de média e alta complexidade, referência na área da saúde da mulher e da criança. O objetivo foi delinear possíveis contribuições para a informatização de estabelecimentos de saúde em geral. A metodologia se baseia nas práticas da etnografia nos hospitais. O desenho do estudo foi qualitativo, descritivo com análise documental. As fontes consultadas foram as atas dos encontros para implementação do prontuário eletrônico realizados entre 2012 e 2015. Uma narrativa síntese aponta a falta de infraestrutura, de recursos e a ocorrência de conflito de interesses, envolvendo vários atores no processo. O registro eletrônico legitima o desenho institucional e organiza o trabalho, além de mapear a geografia hospitalar. A associação do prontuário físico com o digital exige uma mudança de cultura institucional. O registro é um ato de cidadania e se torna um documento fundamental no controle de qualidade e na acreditação hospitalar.
Background: This review aimed to map initiatives for measuring the satisfaction of vulnerable populations with teleconsultation services offered by public and private health care providers in their territories, during the coronavirus disease (COVID-19) pandemic. Systematic studies on the opinions of people most affected by health inequities are limited. Therefore, we included evaluations of teleconsultation-based services offered to socioeconomically disadvantaged and clinically vulnerable populations globally, with a focus on surveillance, treatment, and prevention of COVID-19. Materials and Methods: This review includes analytical and descriptive observational studies primarily from MEDLINE, EMBASE, SCOPUS, and Web of Science databases, published after the World Health Organization received the first warnings about COVID-19 from Chinese authorities in December, 2019, until December 2020. The search strategy combined aspects of COVID-19, telemedicine, patient satisfaction, and key concepts of vulnerable populations. Results:We selected 33 studies for full-text reading and 10 for critical appraisal. Two categories emerged from the qualitative analysis: telehealth evaluation and services during COVID-19, and opinions of vulnerable populations. Television and social networks play a crucial role in providing information. Although teleconsultations are practical and cost effective for patients, the majority preferred receiving inperson treatment in primary care clinics. Conclusions: Listening to the opinions of vulnerable groups and their caregivers is critical both before and during adoption of COVID-19 control measures. Health managers need to monitor the health of and delivery of services to socioeconomically and clinically vulnerable people closely, to improve services, and provide care from a human rights perspective.
Resumo Este artigo visa descrever e analisar o percurso e as construções para implantação da Rede Universitária de Telemedicina (RUTE) em hospital terciário, tendo como objetivo delinear um campo institucional de pesquisa e intervenção relacionado à Telessaúde, contribuindo para mudanças nas relações de pesquisa, ensino e assistência. O estudo compreendeu o período de março a outubro de 2013, com a participação de nove profissionais-membros da comissão de Telessaúde. Foram utilizados conteúdos das reuniões da comissão, cronograma das ações, e a produção gerada a partir do processo de trabalho para implantação do núcleo de Telessaúde. A interdisciplinaridade constituinte dos projetos de Telessaúde está intimamente atravessada pelos modelos estabelecidos nas práticas de saúde e a gestão do trabalho se configura como possibilidade de construir outros tipos de objetos e outras formas de cuidar. A experiência com a implantação da RUTE é uma interessante ferramenta para dar passagem não só ao que exista de mais eficaz em termos de tecnologia da informação e comunicação, procedimentos, e equipamentos, mas também gera a oportunidade de nos remeter à complexidade inerente aos modos de organização do trabalho, viabilizando a amplitude do diálogo entre os princípios do SUS e a formação em saúde.
Objective: This scoping review aims to map initiatives of measuring the vulnerable populations' satisfaction with teleconsultation and remote consultation services offered by public and private healthcare providers in their respective territories during the COVID-19 pandemic.Introduction: New teleconsultation-based services were implemented during the pandemic with their monitoring and evaluation processes. It is necessary to know these assessments if services worsen the disparities between vulnerable and economically disadvantaged populations. Understanding whether the services meet the population's expectations concerning the care to contain the pandemic in their territory can support inclusive policies.Inclusion criteria: This review will include studies on evaluations of teleconsultation-based services offered to the socioeconomically disadvantaged population of a given territory focused on the surveillance, treatment, and prevention of COVID-19. The assessments should describe the process of determining the satisfaction of the population served.Methods: A comprehensive search will be performed in MEDLINE, EMBASE, Web of Science databases, and other documents in Scopus to identify gray literature. Documents published in English, Portuguese and Spanish will be included from December 2019. The strategy combines descriptors and keywords related to telehealth, Covid-19, patient satisfaction, and vulnerable populations. According to the inclusion criteria, two reviewers will screen titles and abstracts and select the articles for evaluation. The articles selected for full-text screening will be submitted to data extraction, using a tool developed by the third reviewer and approved by the other authors. The data will be presented in semantic networks and narrative summary, aligning with the reviews' objectives and scope.
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