O prontuário eletrônico do cidadão na atenção à saúde bucal no SUS.

Abstract

Background: Implementing the Citizen's Electronic Medical Record (EMR) in the Oral Health Teams in Primary Health Care can change the workflow and the practices of these teams in the family health strategy. Objective: The present study evaluated the results of implementing the Citizen’s EMR in the dentists work process of the family health strategy in the city of Dias D'Ávila-BA. Methodology: This is a “quasi-experimental” study that uses quantitative and qualitative methods. The theoretical-logical model of the implementation of the Citizen’s EMR in Primary Care in the work process of the dentist in Primary Care was elaborated. In the exante stage, questionnaires were applied and semi-structured interviews were conducted with the dentists of five family health teams that would have the Citizen’s EMR implanted and with the dentists of the other five family health teams that did not undergo this implantation and constituted the “control” group, totaling 11 dentists participating in the study. The questionnaire of the ex-ante stage had 48 questions to mark and the interview script had six guiding questions. At the end of this stage, the electronic medical record was implemented in three family health units with oral health, as well as the training of the teams involved in the use of the electronic medical record. In the second stage, after a period of eleven months of implementation of the EMR in the health units, the ex-post evaluation was carried out with the participation of six dental surgeons. Results and Discussion: The change in the medical record system was seen as positive among dentists and the Citizen’s EMR effects on the dentists work process were perceived in the professional-patient interaction, agility in carrying out activities, work performance, productivity, system readability, sharing of interprofessional and professional manager information, service flow, and referral of users. However, the difficulties in registering with the Citizen’s EMR were poor typing skills, failure to cancel a registration made wrong after saving, completion is more complex than in the streamlined data collection system form, rework when sudden interruption occurs and analysis of epidemiological data and outcomes of care. Permanent education actions play a fundamental role in better using of the EMR's functionalities and their potential contributions to the healthcare qualification by improving the quality of information. Conclusions: The Citizen’s EMR produced important positive effects on communication, relationships and care production processes in oral health care. However, improvements and evaluations of this technology are needed to strengthen it as a support for decision-making and the development of work based on attention to first contact, longitudinality, comprehensiveness and coordination of care.