title: A web-based information system for a regional public mental healthcare service network in Brazil.
abstract: BACKGROUND
  Regional networking between services that provide mental health care in Brazil's decentralized public health system is challenging, partly due to the simultaneous existence of services managed by municipal and state authorities and a lack of efficient and transparent mechanisms for continuous and updated communication between them. Since 2011, the Ribeirao Preto Medical School and the XIII Regional Health Department of the Sao Paulo state, Brazil, have been developing and implementing a web-based information system to facilitate an integrated care throughout a public regional mental health care network.
  
  
  METHODS
  After a profound on-site analysis, the structure of the network was identified and a web-based information system for psychiatric admissions and discharges was developed and implemented using a socio-technical approach. An information technology team liaised with mental health professionals, health-service managers, municipal and state health secretariats and judicial authorities. Primary care, specialized community services, general emergency and psychiatric wards services, that comprise the regional mental healthcare network, were identified and the system flow was delineated. The web-based system overcame the fragmentation of the healthcare system and addressed service specific needs, enabling: detailed patient information sharing; active coordination of the processes of psychiatric admissions and discharges; real-time monitoring; the patients' status reports; the evaluation of the performance of each service and the whole network. During a 2-year period of operation, it registered 137 services, 480 health care professionals and 4271 patients, with a mean number of 2835 accesses per month. To date the system is successfully operating and further expanding.
  
  
  CONCLUSIONS
  We have successfully developed and implemented an acceptable, useful and transparent web-based information system for a regional mental healthcare service network in a medium-income country with a decentralized public health system. Systematic collaboration between an information technology team and a wide range of stakeholders is essential for the system development and implementation.
authors.affiliation: Interunit Bioengineering Postgraduate Program, University of São Paulo, São Paulo, Brazil ; Center of Information and Informatics in Health, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Vinicius Tohoru
authors.initials: VT
authors.lastname: Yoshiura
authors.affiliation: Center of Information and Informatics in Health, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil ; Department of Social Medicine, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: João Mazzoncini
authors.initials: JM
authors.lastname: de Azevedo-Marques
authors.affiliation: Community Health Postgraduate Program, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Rzewuska
authors.affiliation: Center of Information and Informatics in Health, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: André Luiz Teixeira
authors.initials: AL
authors.lastname: Vinci
authors.affiliation: Center of Information and Informatics in Health, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Ariane Morassi
authors.initials: AM
authors.lastname: Sasso
authors.affiliation: Center of Information and Informatics in Health, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Newton Shydeo Brandão
authors.initials: NS
authors.lastname: Miyoshi
authors.affiliation: Department of Psychiatry and Human Sciences, Ribeirao Preto College of Nursing, University of São Paulo, São Paulo, Brazil.
authors.forename: Antonia Regina Ferreira
authors.initials: AR
authors.lastname: Furegato
authors.affiliation: School of Technology and Management, Polytechnic Institute of Leiria, Leiria, Portugal.
authors.forename: Rui Pedro Charters Lopes
authors.initials: RP
authors.lastname: Rijo
authors.affiliation: Department of Neuroscience and Behaviour Science, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Cristina Marta
authors.initials: CM
authors.lastname: Del-Ben
authors.affiliation: Center of Information and Informatics in Health, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil ; Department of Social Medicine, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Domingos
authors.initials: D
authors.lastname: Alves
keywords: Health information systems; Health management; Health networks; Mental health; Public health informatics