Enhancing Interoperability of Health Data (BR0117)

What is the public problem that the commitment will address? Currently, the federal, state and municipal bodies of the National Health Surveillance System (SNVS) do not have harmonized and standardized information/indicators that enable civil society to monitor their activities aimed at mitigating risks in the supply/consumption of products and services subject to health surveillance. In Brazil, 241 economic activities are monitored daily by federal, state and municipal health surveillance bodies to avoid risks to the population’s health. Some of the monitored economic activities are food services; drinking water treatment and distribution; meat, horticultural and dairy products retail and wholesale trade; beverage industry; food products industry; funeral services; hairdressers, manicures and pedicures; homes for the elderly and people with physical disabilities; schools; catering services for events and receptions; street food services; clinical laboratories; dialysis and nephrology services; magnetic resonance services; chemotherapy services and mobile ICU (a comprehensive list is provided in RDC 153/Anvisa 2017 and its amendments). Regulatory, enforcement, inspection and educational activities are carried out by the federal government, by the 27 state governments and by the 5,570 municipalities, under federal coordination and considering regional and local needs. Each health surveillance body establishes priority actions to mitigate risks in its territory, carrying out pre-market activities, such as licensing, verifying whether the necessary conditions for entering the market are met, and post-market activities, such as the continuous monitoring of business activities. To enable citizens to monitor health surveillance activities and results, it is essential that indicators, as well as the data underlying indicators, are made available to the public, which will also have the positive effect of strengthening the Brazilian National Health System (SUS). Regulatory, enforcement, inspection and educational activities are carried out by the federal government, by the 27 state governments and by the 5,570 municipalities, under federal coordination and considering regional and local needs. Each health surveillance body establishes priority actions to mitigate risks in its territory, carrying out pre-market activities, such as licensing, verifying whether the necessary conditions for entering the market are met, and post-market activities, such as the continuous monitoring of business activities. To enable citizens to monitor health surveillance activities and results, it is essential that indicators, as well as the data underlying indicators, are made available to the public, which will also have the positive effect of strengthening the Brazilian National Health System (SUS).

What is the commitment? With the aim of improving communication with the public, the commitment is an effort to harmonize standards and guidelines of operating systems and data of the various National Health Surveillance System bodies and therefore enable their alignment, interoperability and usability.

How will the commitment contribute to solve the public problem? By making available a data catalog containing technical information, it will be easier to inform the public about the information and databases available for monitoring and assessing results of health surveillance activities. This information will be published on a specific website, with a focus on proactive transparency.

Why this commitment is relevant to OGP values? OGP values are reflected in all commitment’s actions. The commitment, for instance, enhances transparency by disclosing more and better information on the theme. It encourages social participation by improving civil society capability to access relevant information and thus to influence the decision-making process. And, finally, it enhances accountability by improving mechanisms that will make public agents more accountable for their actions.

Additional information Ensure healthy lives is the Sustainable Development Goal (SDG) 3 designed by the United Nations (UN) to fulfill the 2030 Agenda agreements. SDG 3 aims to “ensure healthy lives and promote well-being for all at all ages.” This commitment is thus related to SDG 3, as it aims to inform the public about the information available for monitoring and assessing the results of health surveillance activities.

Milestones (with verifiable deliverable) Start Date: End Date: Milestone 1 - Mapping of information and its sources/systems in use by health surveillance bodies and delivery of a database catalog December 2021 June 2022 Milestone 2 - Qualification form for aligning the information in use by health surveillance bodies January 2022 August 2022 Milestone 3 - Qualification form for new indicators after identifying information of interest to health surveillance activities but not yet in use January 2022 August 2022 Milestone 4 - Metadata protocol for health surveillance data integration and transparency using web standards and FAIR principles April 2022 November 2022 Milestone 5 - Publication of National Health Safety Observatory/Pilot August 2022 December 2022

Action Plan Review

Commitment 7. Enhancing Interoperability and Usability of Health Data

Results Report

Commitment 7. Enhancing the interoperability and usability of health data

In Brazil, the federal, state, and municipal governments monitor 241 economic activities daily for health risks. Each body can set its own priority, taking into account regional and local realities. [90] Commitment 7 sought to harmonize health data standards across Brazilian state governments and municipalities, improve systems interoperability, and facilitate citizen monitoring by publishing guidelines on available databases and indicators.

The commitment noticeably advanced the mapping of the current information and available systems that would produce a data catalog (Milestone 1). [91] However, it was not published as planned during the commitment implementation period. [92] The main hurdle toward publication was attributed to the validation process by the three levels of government involved in health surveillance. [93] A civil society representative expressed that the catalog publication should hold a more significant weight than what was evaluated in the commitment final evaluation. [94] There were initial advancements in identifying common information of interest and protocols for data integration (Milestones 2, 3, and 4), [95] but no end results were delivered. A pilot version of a health observatory (Milestone 5), which had aimed to publish information of public interests, lacked a proactive transparency product as highlighted by civil society representatives. [96]

Commitment 7 was highly complex given the number of actors in the National Health Surveillance System. It was negatively impacted by the reduced implementation period, the necessary validation by the different levels of government, and lack of active participation by some parties. [97] The IRM recognizes that important and time consuming work was completed as the Brazilian Health Regulatory Agency (ANVISA) can now fulfill its stated goal of maintaining the work in the coming years. [98] Overall, the commitment recorded no notable early results but could improve if implementation continued beyond this action plan cycle.