This week, in Washington, US, the Pan American Health Organization (PAHO) and the Department of Health began the second phase of a technical collaboration project involving the newly established Information and Digital Health Secretariat. Headed by Ana Estella Haddad, the portfolio is responsible for formulating guiding public policies for managing digital health.
Since January of this year, the Secretariat has been responsible for supporting managers, operators and users of the Unified Health System (SUS) in the planning, use and integration of ICT products and services – including so-called telehealth, software development, integration and data protection and information dissemination .
From Washington, Ana Estela Haddad spoke to Agência Brasil about technical cooperation with the Pan American Health Organization and revealed that the country could become a kind of collaborating center in the field of digital health in the face of what she described as a pilot experience in the Americas.
In the interview, she also talked about the indicators of digital health, Conecta-SUS and the challenges of digitizing the health system in a country the size of Brazil.
Check out key excerpts from the interview:
Agência Brasil: What is the significance of this collaboration project with the Pan American Health Organization, which enters phase two this week?
I am Estella Haddad. An important partner, the Pan American Health Organization is the Americas arm of the World Health Organization, which creates a certain global association, with guidelines and principles for all its member states. We delve into all of the major products and projects that Opas is undertaking today that could have an interface with digital health. All this will give us the opportunity to expand and make the most of the scope of this cooperation agreement. And this collaboration is interesting for us, but it’s also interesting for the Pan American Health Organization. They invite us to become a collaborating center in the field of digital health because Brazil’s experience is pioneering in the Americas region. They realize that together we can learn from this experience, which can later serve as an inspiration and model for other countries in the region.
Agência Brasil: Why are we building indicators to measure the digital health of municipalities?
I am Estella Haddad. When we talk about building indicators, we are not talking about indicators of digital health only. Because the scope of our Secretariat is to produce and disseminate strategic information about public health, and that certainly starts with the Ministry’s priority policies, such as primary care, specialty care, women’s health, Indigenous health, and surveillance. These are the areas in which we work in partnership with the Ministry’s secretariats, and we define monitoring indicators for these policies that we will monitor.
Agência Brasil: What is the role of the new secretariat in the current context in Brazil?
I am Estella Haddad. The secretary performs two main roles: an intermediate role and a final role. The intermediate role is to support the three federal entities – the Ministry, but also the states, municipalities and the entire composition of the unified health system – to advance the digital transformation process in general. Of course, we have very different situations. There are more developed and lagging countries. There are idiosyncrasies in this digital transformation process. It is up to us to set some rules and guidelines that everyone must follow, that characterize best practices and offer technical collaboration and resources so that we can, in a joint way, advance in digital transformation. We are developing a project to mainstream, for example, connectivity in basic health units. There are 48 thousand units and we have a small number, 1.3 thousand or 1.5 thousand, that still need to connect or improve their connection in order to effectively enter into an effective circle of digital transformation, which is the first step.
Agência Brasil: Can digital technologies positively affect health?
I am Estella Haddad. Sure, but this is not an automatic process. It is not enough to decide to use technologies for this effect to be positive. This is why we are building this path. First, identify our critics and design ideas for these technologies. There are a series of principles that we need to follow, radical realignment. For example, regarding health data: on the one hand, we have data protection, which is fundamental and inalienable, the right to protect users’ personal data. On the other hand, we have the law of access to information. We also need to disseminate strategic information, process the data, and turn this data into relevant information – for the manager, the health professionals working in their clinical field, as well as the citizen himself, who has to develop a self-care situation with their own health and needs, so, evidence-based information the quality. It is not an automatic process.
Agência Brasil: In this pandemic, the digital transformation in health has clearly expanded. How can this expansion be reorganized in a way that avoids excluding people?
I am Estella Haddad. This expansion, in a pandemic, was so intense, even by the force of necessity. It was a global movement. But it was also bad planning because it arose out of need, where it could have been. He didn’t have perfect planning, he came in a way that was often piecemeal, meeting local needs, without thinking about the management process, managing care in the care network in a more systematic way. One of the primary challenges we face now is to have an inventory and mapping of at least the majority of these experiences. Identifying the most successful experiences as a model and promoting the process of integrating existing experiences. Organizing and integrating experiences, in addition, of course, to induce and encourage the implementation of new experiments so that we expand what has had good results. A good example of this is that we already have just over 36 million users, people who have downloaded Conecta-SUS on their mobile phones and are using the app for their health information.
Agência Brasil: How will SUS become more digital and how can residents benefit from this process?
I am Estella HaddadThe challenges are enormous. First of all, they include the scale and diversity of the situations in which we live. For example: We are working and planning to implement digital health in the native health subsystem, which has a completely separate structure, because it is not organized like the health districts that include states and municipalities. So, one of the issues is that we’ll have to plan this separately, addressing different needs – from infrastructure, geographic aspects, places that don’t have electricity and need a different connectivity solution. We need to plan technology according to the moment and context of each municipality, state or Indigenous Health District in which we work and collaborate. Promoting the needs of each place and building a national process in which everyone participates, at the same time, is one of the biggest challenges.
With the agency of Brazil
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