Os repositórios arquivísticos na difusão de conhecimentos em saúde: subsídios para a cadeia de custódia dos organismos produtores do Sistema Único de Saúde

Abstract

The initiatives of the Department of Informatics of the Unified Health System (DATASUS) are relevant to the access and retrieval of health information. In the repositories of DATASUS and the Health Care Service Producing Organisms it is not evidenced how the information is generated, received, accumulated and treated to guarantee the authenticity and preservation of the Electronic Health Records considering the guidelines about the chain of custody of these records to subsidize the generation and diffusion of health knowledge. This research aims to propose a model of digital archival repositories for the diffusion of health knowledge based on the characterization and contextualization between the authenticity of Electronic Health Records and the SUS chain of custody (i.e. hospitals, DATASUS). The research is exploratory, descriptive and explanatory in relation to the objectives and applied in nature with a quantitative and qualitative approach. In the bibliographic and documental review procedures, elements of the systematic review technique were used. The techniques for analyzing the information collected in this research are descriptive dtatistics and content analysis. The epistemic basis is the Polylogic Theory and the Complexity Theory. Prospecting the authenticity and preservation of Electronic Health Recordsand the SUS chain of custody through the systematic review supported the identification of custodians, systematized for the conceptual modeling of the phenomenon (i.e. archival repositories for the diffusion of health knowledge) between Health Care Service Producing Organisms and the DATASUS. Empirical research revealed that hospitals and DATASUS have a robust technological infrastructure to implement a reliable digital archival repository; participants are unaware of the criteria used in the implementation of Health Information Systems; and the software, standards, policies and models aimed at digital preservation that enable the preservation and preservation of Electronic Health Records were not identified. The results point to the absence of appropriate qualification of the professionals involved, it is recommended the execution of a multidisciplinary work to deal with organic information in health. DATASUS managers report that the initiatives are based on the Digital Health Strategy in Brazil, but it is not clear how such an initiative is being operationalized in a way that enables the authenticity and preservation of Electronic Health Records. The polylogical approach in the context of managing organic health information can contribute to the adoption and implementation of models, standards and technological innovations through methodologies that are suited to the reality of each health district; the qualification of health professionals; and, the needs of their respective communities respecting their characteristics, diversity and culture. The pondered/reflected/equated criteria and requirements for the digital archival repositories in health associated with the socioeconomic, health and cultural perspectives of the institutional agents of the SUS and the realities of the different territorialities of Brazil influence the effectiveness of any model to be proposed. It is expected that the modeled custodians assimilate subsidies for the creation of digital repositories in health and it is recommended the incorporation of archival management processes of documents articulated with those of information technology.