Integrated electronic health records to strengthen care networks and continuity of care in urban public health systems
1
Department of Digital Health Innovation, EINSTEIN HOSPITAL ISRAELITA, SÃO PAULO/SP, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Fragmented health records across different levels of care hinder continuity, coordination, and safety in public health systems. The World Health Organization highlights integrated digital health systems as a strategic pillar to information governance¹. Integrated electronic health records (HER) represent a key digital health strategy to strengthen care networks by enabling information sharing among primary care, emergency services, mental health, and outpatient care, particularly in complex urban public health systems².
METHODS:
This study describes the implementation of an integrated EHR between 2023 and 2025 through a partnership between the Municipal Health Secretariat of São Paulo and Hospital Israelita Albert Einstein, Brazil. The project involved 14 primary care units, 4 psychosocial care centers, 3 outpatient urgent care services, 1 specialty outpatient unit, and 1 emergency care unit, serving approximately 411000 inhabitants with an average of 173000 visits per month. The implementation process included care flow mapping, customization of clinical documentation, validation with technical teams, and phased deployment supported by workforce training. The initiative was guided by the principles of the Primary Health Care Planning approach, which emphasizes coordinated, territorial, and population-based care networks².
RESULTS:
The integrated EHR improved articulation among levels of care, enhanced continuity of care, and strengthened patient safety. Primary care teams were able to share real-time clinical information with emergency and mental health services, supporting timely decision-making and reducing duplicated examinations, as described in prior studies on digital integration in public health systems³. To date, 5800 coordinated patient transfers were supported through the system. Digital integration also reinforced territorial health management, population monitoring, and collaborative care planning across services.
CONCLUSIONS:
Integrated EHR are a structural component for resilient and coordinated care networks. When aligned with health system planning frameworks, digital tools support longitudinal care, equity, and timely decision-making, contributing to more integrated and people-centered public health systems¹,².
Fragmented health records across different levels of care hinder continuity, coordination, and safety in public health systems. The World Health Organization highlights integrated digital health systems as a strategic pillar to information governance¹. Integrated electronic health records (HER) represent a key digital health strategy to strengthen care networks by enabling information sharing among primary care, emergency services, mental health, and outpatient care, particularly in complex urban public health systems².
METHODS:
This study describes the implementation of an integrated EHR between 2023 and 2025 through a partnership between the Municipal Health Secretariat of São Paulo and Hospital Israelita Albert Einstein, Brazil. The project involved 14 primary care units, 4 psychosocial care centers, 3 outpatient urgent care services, 1 specialty outpatient unit, and 1 emergency care unit, serving approximately 411000 inhabitants with an average of 173000 visits per month. The implementation process included care flow mapping, customization of clinical documentation, validation with technical teams, and phased deployment supported by workforce training. The initiative was guided by the principles of the Primary Health Care Planning approach, which emphasizes coordinated, territorial, and population-based care networks².
RESULTS:
The integrated EHR improved articulation among levels of care, enhanced continuity of care, and strengthened patient safety. Primary care teams were able to share real-time clinical information with emergency and mental health services, supporting timely decision-making and reducing duplicated examinations, as described in prior studies on digital integration in public health systems³. To date, 5800 coordinated patient transfers were supported through the system. Digital integration also reinforced territorial health management, population monitoring, and collaborative care planning across services.
CONCLUSIONS:
Integrated EHR are a structural component for resilient and coordinated care networks. When aligned with health system planning frameworks, digital tools support longitudinal care, equity, and timely decision-making, contributing to more integrated and people-centered public health systems¹,².
| eISSN: | 2654-1459 |
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