The relevance a technology ecosystem in the Brazilian National Health Service’s Covid-19 response: the case of Rio Grande do Norte, Brazil

Valentim, Ricardo Alexsandro de Medeiros; Lima, Thaisa Santos; Cortez, Lyane Ramalho; Barros, Daniele Montenegro da Silva; Silva, Rodrigo Dantas da; Paiva, Jailton Carlos de; Coutinho, Karilany Dantas; Morais, Philippi Sedir Grilo de; Lacerda, Juciano de Sousa; André, Fernando Rocha de

doi:10.1590/1413-81232021266.44122020

Ricardo Alexsandro de Medeiros Valentim ricardo.valentim@lais.huol.ufrn.br

Laboratório de Inovação Tecnológica em Saúde (LAIS), Universidade Federal do Rio Grande do Norte (UFRN). Av. Nilo Peçanha 620, Petrópolis. 59012-300 Natal RN Brasil.

http://orcid.org/0000-0002-9216-8593

Thaisa Santos Lima

Ministério da Saúde. Brasília DF Brasil.

http://orcid.org/0000-0001-8276-4124

Lyane Ramalho Cortez

Departamento de Saúde Coletiva, UFRN. Natal RN Brasil.

http://orcid.org/0000-0002-5096-9800

Daniele Montenegro da Silva Barros

Laboratório de Inovação Tecnológica em Saúde (LAIS), Universidade Federal do Rio Grande do Norte (UFRN). Av. Nilo Peçanha 620, Petrópolis. 59012-300 Natal RN Brasil.

http://orcid.org/0000-0001-5037-1545

Rodrigo Dantas da Silva

Laboratório de Inovação Tecnológica em Saúde (LAIS), Universidade Federal do Rio Grande do Norte (UFRN). Av. Nilo Peçanha 620, Petrópolis. 59012-300 Natal RN Brasil.

http://orcid.org/0000-0002-2549-2414

Jailton Carlos de Paiva

Instituto Federal de Educação, Ciência e Tecnologia do Rio Grande do Norte. Natal RN Brasil.

http://orcid.org/0000-0002-2080-9945

Karilany Dantas Coutinho

Laboratório de Inovação Tecnológica em Saúde (LAIS), Universidade Federal do Rio Grande do Norte (UFRN). Av. Nilo Peçanha 620, Petrópolis. 59012-300 Natal RN Brasil.

http://orcid.org/0000-0002-2051-8611

Philippi Sedir Grilo de Morais

Programa de Pós-Graduação em Engenharia Elétrica e de Computação, UFRN. Natal RN Brasil.

http://orcid.org/0000-0002-0636-7562

Juciano de Sousa Lacerda

Programa de Pós-Graduação em Estudos da Mídia, UFRN. Natal RN Brasil.

http://orcid.org/0000-0002-0876-377X

Fernando Rocha de André

Ministério Público Federal do Rio Grande do Norte. Natal RN Brasil.

http://orcid.org/0000-0002-9459-6065

ricardo.valentim@lais.huol.ufrn.br

Chief editors: Maria Cecília de Souza Minayo, Romeu Gomes, Antônio Augusto Moura da Silva

Collaborations

RAM Valentim and LR Cortez conceived, supervised and managed the development of the research project, articulated and organized technical cooperation for project development and implementation, defined the project methodology, analyzed and interpreted the data, and contributed to the discussion. They also critically revised the manuscript, contributed to the entire article development process and approved the final version to be published. TS Lima defined the project methodology, analyzed and interpreted the data and contributed to the discussion. She also critically revised the manuscript, contributed to the entire article development process and approved the final version to be published. DMS Barros participated in the definition of the project methodology, analyzed and interpreted the data, contributed to the discussion, critically revised the manuscript, contributed to the entire article development process, and approved the final version to be published. RD Silva participated in project development, analyzed and interpreted the data, critically revised the manuscript, partially contributed to the article development process and approved the final version to be published. JC Paiva was responsible for study conception and management of the development of the research project, partially contributed to the article development process and approved the final version to be published. KD Coutinho conceived, supervised and partially managed the development of the research project, partially contributed to the article development process and approved the final version to be published. PSG Morais participated in project development, analyzed and interpreted the data, critically revised the manuscript, partially contributed to the article development process, and approved the final version to be published; the article is part of his doctoral research. JS Lacerda critically revised the manuscript, partially contributed to the article development process, and approved the final version to be published. FR André revised the manuscript, partially contributed to the article development process, and approved the final version to be published.

Title	Description
Covid-19 Agency^* * Anchor technologies or processes.	Work process instituted by communicators to strengthen health sector communication during the response to the pandemic. Core actions: tackling the infodemic, informing the population, producing special reports, organizing press conferences, influencing press agendas to include topics of public concern, and strengthening autonomous and crosscutting public and governmental communication.
Situation Room https://portalcovid19.saude.rn.gov.br/	Intelligence room implemented in the SESAP in partnership with the LAIS to monitor data and produce analyses and information from the ecosystem to support state management and decision making.
AVASUS^* * Anchor technologies or processes. https://avasus.ufrn.br/	Part of a cooperation effort between the LAIS and Ministry of Health, AVASUS is an online platform that was added to the ecosystem to rapidly scale up and increase the capillarity of the training process in RN. This process was applied to both health workers (workforce training) and the general population, which needs quality information on the SARS-Cov 2 virus and Covid-19.
Telehealth RN http://www.telessaude.ufrn.br/	State platform that joined forces with the Covid-19 response. The platform focuses on primary care in the following core areas: clinical management of patients, care, diagnosis, welcoming and care networks.
Coronavirus Guidance RN https://orientacorona.saude.rn.gov.br/	Teleappointment system aimed primarily at providing guidance and information on Covid-19 to promote self-care and avoid overburdening health services.
Facepoint Quarantine https://quarentena.faceponto.com.br/	Information system integrated into the Coronavirus Guidance platform aimed at monitoring adherence to physical distancing measures.
Salus https://salus.lais.ufrn.br	System developed to enhance integration between epidemiological surveillance and health care. Implemented by the Natal City Council Department of Health Surveillance, the objective of the system is to address and correct errors generated by Ministry of Health notification systems such as the e-SUS VE. The system supports monitoring and care delivery in primary care services and care networks in Natal. It is important to highlight that Natal accounts for more than 48% of Covid-19 cases in the state. The system is essential for promoting the automation of previously manual work, increasing the time teams have to dedicate to comprehensive surveillance actions.
Vaccination of older persons https://natalvacinacaoidosos.lais.huol.ufrn.br/	The platform was developed to strengthen the Natal City Council Health Department's older person protection policy. It registers older persons living in vertical condominiums for home flu vaccination, enabling the vaccination of more than 6,034 older people living in 384 condominiums.
Volunteer system https://covid19.imd.ufrn.br/voluntarios/	Information system for health workforce recruitment in response to the pandemic.
Acolhe RN https://acolhe.saude.rn.gov.br/	Project implemented in partnership with the Rio Grande do Norte Federation of Trade in Goods, Services and Tourism (FECOMÉRCIO). The Hotel Barreira Roxa was used to provide accommodation for health staff who live with people in risk groups or infected persons. The system was developed to manage triage and the amount of time spent by staff in the project.
RegulaRN^* * Anchor technologies or processes. https://regulacao.lais.ufrn.br/sala-situacao/sala_publica/	Fully integrated into the e-SUS Notifica, this platform was developed to manage the regulation of beds for Covid-19 patients in the state. This platform resolved the problem of reworking, improving the quality of information and maintaining data integrity. Totally transparent, the platform increased public participation, strengthens oversight, disciplines the state regulation process, and played a decisive role in decision making about the number of beds for Covid-19 patients.
Oversight RN https://fiscalizarn.lais.ufrn.br/login	Platform developed jointly by the LAIS and Federal Prosecutor's Office (Covid-19 Working Group) to oversee state and municipal government spending on Covid-19.
CoronavirusRN^* * Anchor technologies or processes. https://covid.lais.ufrn.br/	Platform developed to work as an online monitoring panel for 149 Covid-19 indicators in RN; the indicators are updated at least three-times a day.

[1] ricardo.valentim@lais.huol.ufrn.br

Number of students reached^* * The difference between the number of students reached (AVASUS Covid-19 users) and subscriptions (number of subscriptions to AVASUS courses in the Covid-19 training pathway) is due to the fact that students can do more than one course, meaning the number of subscriptions is higher than the number of students.	121,193
Number of subscriptions^* * The difference between the number of students reached (AVASUS Covid-19 users) and subscriptions (number of subscriptions to AVASUS courses in the Covid-19 training pathway) is due to the fact that students can do more than one course, meaning the number of subscriptions is higher than the number of students.	241,238
Average number of students per course	12,064
Number of municipalities reached in RN	111
Number of students reached in RN	24,315
Number of states reached in Brazil	27
Number of students reached in Brazil	131,396
Number of countries reached	55
Number of foreign students reached	2,014
Number of Covid-19 response courses offered	20

Brasil

Brasil

The relevance a technology ecosystem in the Brazilian National Health Service’s Covid-19 response: the case of Rio Grande do Norte, Brazil

Abstract