| Integration of the tool into daily work |
Repercussions on the organization of the work process and productivity |
Data reliability |
“(...) what it measures is much more reliable, you know, because it brings us a much more real number” (GF2) |
“(...) it is great, it brings very real numbers” (GF2) |
| Agility in data visualization |
“I think it’s a cool [tool]. I think it’s exactly that, you know, everything in the area is more visible” (GF1) |
“I agree with what she said. There is also that alert part, you know, and we can fill in that he has diabetes and is taking medication (...) it is easier for us to see, locating this view helped a lot, it helped a lot, it helped rally a lot ” (GF1) |
| Reduction in the volume of instruments used and optimization of time |
“(...) so I don’t need to take all those files to know who the hypertensive people are and separate them there, there is a map of my area” (GF2) |
“ (...) the fact that you have the entire work process at hand there during the visit. I do the visit at e-SUS and launch it at the hive is very quick, you know, and saves time” (GF1) |
| Usability in routine activities |
Territory characterization/mapping and subpopulation identification |
“(...) the hive really helps a lot, you know, in characterizing the territory, it really helps, you know. As we already mentioned, it helps us to know, yeah, how much of the population, how many children there are who are less than one year old, less than two years old, how many children, how many... yes, older people, hypertensive people, these things that are on the marker today (...) I can identify through the hive where are the empty houses, where are the houses with people that I have to offer registration, where are the houses that have already refused registration” (GF2) |
“(...) we can do a study of the area, you know, this area has more hypertensive people, you know, this area has more elderly people” (GF2) |
| Planning and monitoring home visits |
“it also helps a lot with the visits we conduct to know exactly when it happened so as not to repeat it (...) In the hive, we can know exactly what day it was done so we don’t have to do it again, we have all this control of return visits, this part is also very good” (GF1) |
“We see our visits daily; we have greater control of the visits we missed and then the amount that has already been conducted” (GF2) |
| Production record |
“In the closing, we use now everything based on in the hive (...) I use it to know how many pregnant women there are (...) I think that in everyday life we use the hive data a lot, a lot, really a lot. In everyday life, we use it a lot. There is no day that I don’t open my hive or to visit, or to consult some data, there isn’t a day” (GF2) |
“In closing, we used a lot to have a real base of our territory” (GF2) |
| Assessment of the digital tool implementation process |
Acceptability of the digital tool |
Satisfaction, usability, and relevance |
“(...) to measure indicators like this, it’s great, I loved it, which is actually our schedule, but digitalized, you know, so I particularly liked it a lot, I just have to complement it. I wouldn’t change anything, just increase, just improve, so to speak” (GF2) |
“for example, my question is always this bureaucratic issue of papers because if you have a device with all this potential to be explored and then you are part of the digital work, we stay in the unit and have to deal with the paper, so the hive is much better precisely because of this because I’m in the patient’s home, I can conduct the visit at ESUS and fill in the hive because everything is right there at hand” (GF1) |
| Availability for change, adaptation, and professional engagement |
“It was fascinating because as everything new creates a certain concern, the bad thing is when it was said that the hive would be implemented, we were kind of like, wow, more work is coming. As my colleague reported, sometimes we have too much demand, you know, and then it is a big concern that demand will increase. However, when we started doing it, on the contrary, it will be very positive, as has already been said, it helps a lot, at least in closing. At the end of the month, it’s exciting” (GF1) |
“I still had difficulty in the first month, you know, because it really wasn’t just about the hive. There were other things too that we needed to deal with over time, but now this month I’ve felt that for me, concerning the hive, we already have a different reality, more as a help, indeed (...)” (GF1) |
| Assessment of the digital tool implementation process |
Challenges and barriers to routine use |
Technological resource restrictions |
“(...) it doesn’t make much sense for you to have access because sometimes it takes a long time depending on where you are, you know, at least my territory is made up of alleys, so I have difficulty accessing in this territory, you know, And so, it sometimes takes a while to open, you know” (GF2) |
“(...) I think that when there are a lot of people using it at the same time, it has to sort it out, you know? I have to update it, so I close the tab and open it again” (GF1) |
| Preference for other resources/strategies |
“The easiness of having a lot of time in the area is that I have a good part of all this in my head, you know. The hive is more for closing; it’s not so common in my daily life” (GF2) |
| Complex use of the digital tool |
“(...) several colleagues here, who from experience, you know, we see, and we help, have a lot of difficulties in return visits and placing return visits in the hive” (GF2) |
“Recently, we had a new CHW on our team, and she was really lost seeing the hive. She didn’t understand much (...) it was very novel for us, we had little training time, you know, to be able to learn and insert it. (...) training one day, and the next, I was on vacation. When I came back, I was racking my brain so that I couldn’t explain myself, so it was a little difficult” (GF2) |
| Dynamics of the home visit |
“We have the report in our hand, we have the tablet in our hand, and then we have to put it in the hive, and whether we like it or not, it delays the visit a little, you know” (GF2) |
“I try to make and use my hive at the actual time of my visit. Sometimes, it’s a little complicated, considering there’s so much we have to do with the visit, which is conducting it on the tablet, plus doing the report, filling out the hive, answering the patient’s doubts, and passing on instructions to the patient. So, sometimes we start to eliminate some things that are not essential for us to do there to optimize the time in visit further, you know (...)” (GF2) |
| Improvement and opportunities for improvement |
Review of existing elements |
Adaptation in markers |
“And yes, there is a lot to improve too. (...) because there are hypertensive and diabetic patients combined (...) I think it could also be separated, you know” (GF2) |
“(...) maybe put some field because there is a refusal from CHW and a refusal from the patient who doesn’t want us to go, so there are two types of refusal. I know that there is one in the field, you know, but I think it could also add something about it because there isn’t, you know” (GF2) |
| Layout adjustments |
“(...) there’s one thing that bothers me: when I enter the hive, I find the space very small, you know? The space we have to be able to put it there and the dates I think are poor, concerning when you are going to fill it out. Since we are talking about improvements, I think the visualization of the instrument is not as efficient for me. Sometimes, I put the number there, for example, but then the other part of the screen disappears, so I can’t see it. I have to wait a while for this part to return to insert these numbers on the rest, so I think it has to improve in this area.” (GF1) |
| Inclusion of new fields |
Inclusion of report field |
“(...) and the question that doesn’t want to mention that it would be even more wonderful if it could also have a report in it or in another tool like the one from EPHEALTH.” (GF1) |
“I think 99% of CHWs agree that if you could include the report in the hive, it would be wonderful, perfect” (GF1) |
| Inclusion of observation field |
“(...) if there was a field to fill in information that both the nurse and the physician could view, I think it would be much more effective” (GF2) |
| Inclusion of new subpopulation markers |
“(...) I think that we have a lot more than just hypertensive people, diabetics, pregnant women, those who are bedridden, you know, those who we follow up, there are older people, you know, that we follow up, there are women of childbearing age. These are points that we also need to take into account, you know, we need to have control” (GF2) |
“Or what the colleague pointed out, about the markers that are in our goal were also included in the hive (...) so if we could put all the markers that we had to follow, it would be quite interesting” (GF1) |
| Inclusion of nominal identification of subpopulations |
“It would be interesting to highlight who are the hypertensive and diabetic people” (GF2) |
“I think trying to mark, having some marker so that another person can visualize who that person is” (GF2) |
| Inclusion of field quantifying families and visits conducted |
“Do you know what I think is missing from the hive? (...) the number of visits on that day, got it?” (GF2) |
“(...) one thing I also have a little difficulty with, which I keep seeing, is to total the number of families, let’s assume: at this moment I now have 213 families just so I can have this count, I have to keep counting them one by one, you know?” (GF2) |
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Note: 2a: Spreadsheet recording the number of family members and markers; 2b: Spreadsheet with a summary of families visited, not visited, and refusals; 2c: Panel with a summary of data generated on time; 2d: Power BI with indicators from all FHS.