BIREME Bulletin nº 88

Pioneering Decision Aids project for health in Brazil

The Latin American and Caribbean Center on Health Sciences Information (BIREME/PAHO/WHO) and the Department of Monitoring, Evaluation and Dissemination of Strategic Health Information (DEMAS) of the Secretariat of Information and Digital Health (SEIDIGI) of the Brazilian Ministry of Health began an innovative and pioneering project in Brazil to produce and implement an instrument to support decision-making in health called “Decision Aids”. With an execution period set at 36 months, the initiative was launched in May 2024 at an online meeting held with representatives of the counterparts.

Promoting Health Communication and Person-Centered Care

The Decision Aids project aims to promote effective health communication, strengthening the relationship between SUS professionals and users with scientific information on best practices. According to Ana Cyntia Baraldi, BIREME’s Partnerships and Special Projects Advisor, the project can also “provoke discussion about autonomy and self-management of health, being a tool with the potential to not only inform users, but to materialize the inversion of the logic of care and communication in health – favoring users and communities to be active in the care relationship”. This is because the tool’s theoretical basis is based on the concept of Person-Centered Care (PCC), which prioritizes individualized care, considering the needs, preferences and values of each person.

This model of care aims not only to cure or treat diseases, but also to promote and protect the general well-being of individuals and communities, through a collaborative and evidence-based decision-making process, ensuring that the user actively participates in their own care. Juliana Sousa, Digital Solutions Supervisor at BIREME, highlighted the importance of this innovation: “The integration of Decision Aids into the ‘Meu SUS Digital’ application will provide a more effective and person-centered dialogue, facilitating informed and shared decision-making.”

Strengthening and expanding the use of scientific evidence

Historically, the Pan American Health Organization (PAHO) has promoted the use of scientific evidence in decision-making by health professionals. This is a mission shared with BIREME which, through its products and services, promotes and facilitates access to information produced in Latin America and the Caribbean. The director of BIREME, João Paulo Souza, points out that this project, however, “brings a novelty by extending this practice to the lay public, expanding users’ ability to participate more actively in decision-making processes in the context of the care they need”, and exemplifies, “we intend for Decision Aids to be developed in conjunction with the new stage of the Second Opinion Formative (SOF) programThe idea, then, is to structure a whole line of care from which both the questions that generate SOF and the Decisional Aid tools for the user public can be derived. For example, in situations such as home care for people with Alzheimer’s disease, the project will be able to simultaneously support health teams and families in making decisions about medical procedures and diets, for example, providing them with quality scientific information about the possible interventions for the case, their risks and benefits, among other relevant aspects.”

Development and implementation

The development of the project will be monitored by the Steering and Scientific Committees set up specifically for this new information product, as well as by the teams responsible and representatives from PAHO and the Ministry of Health. The first prototype and a digital version of the product should be ready by the end of 2025, when they will be used to carry out a pilot implementation test. At the end of the schedule, the Decision Aids should be integrated into the “Meu SUS Digital” application and will be available on BIREME’s new Decision Support Technologies Portal, to be developed during the project, to be made available nationally.

According to Ana Cyntia Baraldi, the new project “represents an advance in the digital transformation of the products and services developed by the cooperation between the Organization and the Brazilian Ministry of Health to strengthen Primary Health Care. With the integration of innovative technologies, BIREME is advancing in the digital transformation necessary for products and services to be able to translate information into action in health, generating impact at the local level and contributing to the reduction of inequities. These are strategic priorities for PAHO, through BIREME, to achieve the goals set out in the 2030 Agenda”.

 

Links of interest

Decision aids for people facing health treatment or screening decisions – Stacey, D – 2024 | Cochrane Library

International Patient Decision Aids Standards (IPDAS) Collaboration (ohri.ca)

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