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Adalton Da Silva Ramos Júnior Saúde Digital Para Preparação E Resposta À Pandemia De COVID-19: Uma Pesquisa- Ação

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Adalton Da Silva Ramos Júnior Saúde Digital Para Preparação E Resposta À Pandemia De COVID-19: Uma Pesquisa- Ação Adalton da Silva Ramos Júnior Saúde digital para preparação e resposta à pandemia de COVID-19: uma pesquisa- ação Dissertação de Mestrado Dissertação apresentada como requisito parcial para obtenção do grau de Mestre pelo Programa de Pós- Graduação em Engenharia de Produção da PUC- Rio. Orientadora: Prof. Adriana Leiras Coorientador: Prof. Marcos Martins Borges Rio de Janeiro março de 2021 Adalton da Silva Ramos Júnior Saúde digital para preparação e resposta à pandemia de COVID-19: uma pesquisa- ação Dissertação apresentada como requisito parcial para obtenção do grau de Mestre pelo Programa de Pós- Graduação em Engenharia de Produção da PUC- Rio. Aprovada pela Comissão Examinadora abaixo: Prof. Adriana Leiras Orientadora Departamento de Engenharia Industrial - PUC-Rio Prof. Marcos Martins Borges Coorientador Universidade Federal de Juiz de Fora - UFJF Prof. Antônio Márcio Tavares Thomé Departamento de Engenharia Industrial - PUC-Rio Daniel Ricardo Eckhardt da Silva Nokia Siemens Networks do Brasil Sistemas de Comunicações Rio de Janeiro, 30 de março de 2021 Todos os direitos reservados. A reprodução, total ou parcial, do trabalho é proibida sem a autorização da universidade, do autor e dos orientadores. Adalton da Silva Ramos Júnior Graduou-se em Engenharia de Produção pela Universidade Federal de Juiz de Fora (UFJF) no ano de 2017. Possui formação técnica em Mecânica Geral com Ênfase em Produção Veicular pelo SENAI CIDT Juiz de Fora - Luiz Adelar Scheuer. Ficha Catalográfica Ramos Júnior, Adalton da Silva Saúde digital para preparação e resposta à pandemia de COVID-19 : uma pesquisa-ação / Adalton da Silva Ramos Júnior ; orientadora: Adriana Leiras ; coorientador: Marcos Martins Borges. – 2021. 99 f. : il. color. ; 30 cm Dissertação (mestrado)–Pontifícia Universidade Católica do Rio de Janeiro, Departamento de Engenharia Industrial, 2021. Inclui bibliografia 1. Engenharia Industrial – Teses. 2. Saúde digital. 3. Desastre epidêmico. 4. Pandemia. 5. COVID-19. 6. Pesquisa-ação. I. Leiras, Adriana. II. Borges, Marcos Martins. III. Pontifícia Universidade Católica do Rio de Janeiro. Departamento de Engenharia Industrial. IV. Título. CDD: 658.5 Aos meus amados pais, Adalton e Maria Heli, e ao meu amado irmão, Anderson. Agradecimentos Agradeço a Deus Pai, que em Sua infinita Misericórdia, deu ao mundo Seu Filho único, Nosso Senhor Jesus Cristo, por Quem somos redimidos de nossas faltas e temos o caminho certo a seguir, pois o coração do discípulo bate no compasso do Coração de Seu Mestre. Aos meus pais Adalton e Maria Heli, pelo exemplo, apoio, dedicação e incentivo dados a cada dia para que a conclusão deste trabalho fosse possível. Junto a meu irmão Anderson, fiel companheiro e amigo de todas as horas, formamos uma família abençoada que a cada momento faz-me aprender, sentir e viver o verdadeiro significado da palavra amor. A todos os meus familiares e amigos pelo carinho e orações, essenciais, como sempre, nesta jornada. À minha orientadora, professora Adriana Leiras, e ao meu coorientador, professor Marcos Martins Borges, pela oportunidade, confiança e partilha de conhecimento para construção deste trabalho. Enfim, a todas as pessoas que contribuíram de algum modo neste processo de formação, professores, colegas de turma e funcionários da PUC-Rio e da UFJF, aos quais peço as bênçãos do Alto e dou graças à Santíssima Trindade que guia, ilumina e sustenta a vida de cada um de nós. Por isso, Glória ao Pai, ao Filho e ao Espírito Santo, como era no princípio, agora e sempre, amém! O presente trabalho foi realizado com apoio da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Código de Financiamento 001. O presente trabalho foi realizado com apoio do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) - Brasil. Resumo Ramos Júnior, Adalton da Silva; Leiras, Adriana (Orientadora); Martins Borges, Marcos (Coorientador). Saúde digital para preparação e resposta à pandemia de COVID-19: uma pesquisa-ação. Rio de Janeiro, 2021. 99p. Dissertação de Mestrado – Departamento de Engenharia Industrial, Pontifícia Universidade Católica do Rio de Janeiro. Durante a pandemia de COVID-19, medidas de redução do contato social vêm sendo utilizadas para evitar aglomerações de pessoas na tentativa de contenção do avanço da doença e da consequente sobrecarga dos serviços de saúde. Soluções em saúde digital têm tido significativa importância ao serem empregadas em diversas frentes neste momento de crise humanitária. Esta pesquisa tem por objetivo apresentar o relato sobre o projeto, implementação, uso e revisão de uma plataforma de telessaúde para preparação e resposta à COVID- 19 em um município brasileiro. O estudo se configura como uma pesquisa-ação, subsidiada por uma revisão de escopo da literatura para identificação de funcionalidades e características a serem consideradas em um sistema de saúde digital empregado em cenários de surtos, epidemias e pandemias. Posteriormente, uma análise de relevância e priorização das funcionalidades e características é realizada no contexto da localidade estudada através do método multicritério de apoio à decisão Analytic Hierarchy Process (AHP). Como resultados, propõe-se um framework para um sistema de saúde digital direcionado ao enfrentamento de surtos, epidemias e pandemias, que serviu como base para avaliação da plataforma de telessaúde desenvolvida e pode ser utilizado para direcionar outros estudos em desastres epidêmicos. Além disso, tem-se a oferta de um produto tecnológico em auxílio ao enfrentamento da pandemia de COVID-19 em um município brasileiro, gerando impacto social pela constatação empírica de desafios e boas práticas vivenciadas no emprego de um sistema de saúde digital para preparação e resposta a um desastre epidêmico. Palavras-chave Saúde digital; desastre epidêmico; pandemia; COVID-19; pesquisa-ação. Abstract Ramos Júnior, Adalton da Silva; Leiras, Adriana (Advisor); Martins Borges, Marcos (Co-advisor). Digital health for preparedness and response to the COVID-19 pandemic: An action research. Rio de Janeiro, 2021. 99p. Dissertação de Mestrado – Departamento de Engenharia Industrial, Pontifícia Universidade Católica do Rio de Janeiro. During the COVID-19 pandemic, measures to reduce social contact have been used to prevent crowds of people trying to contain the spread of the disease and the consequent burden on health services. Digital health solutions have been of significant importance when used on several fronts at this time of humanitarian crisis. This research aims to present a report on the design, implementation, use and review of a telehealth platform for preparedness and response to COVID-19 in a Brazilian municipality. The study is based on an action research, supported by a scoping review of the literature to identify functionalities and characteristics to be considered in a digital health system used in outbreak, epidemic and pandemic scenarios. Subsequently, a relevance and prioritization analysis of functionalities and characteristics is carried out in the context of the studied location using the multicriteria decision support method Analytic Hierarchy Process (AHP). As a result, we propose a framework for a digital health system aimed at coping with outbreaks, epidemics and pandemics, which served as a basis for evaluating the developed telehealth platform and can be used to drive other studies in epidemic disasters. In addition, we offer a technological product to help facing the COVID- 19 pandemic in a Brazilian municipality, generating social impact through the empirical observation of challenges and good practices experienced in the structuring and operationalizing of a digital health system to preparedness and response to an epidemic disaster. Keywords Digital health; epidemic disaster; pandemic; COVID-19; action research. Sumário 1 Introdução 15 2 Metodologia 20 2.1 Pré-etapa 21 2.1.1 Contextualização do cenário de estudo 21 2.1.2 Revisão de escopo 23 2.2 Etapas principais 26 2.3 Meta-etapa 30 3 Revisão da literatura 32 3.1 Definição de categorias 32 3.2 Framework proposto 44 4 Desenvolvimento de uma plataforma de telessaúde para enfrentamento à COVID-19 48 4.1 Avaliação do sistema anterior 48 4.2 Projeto do novo sistema 49 4.3 Implementação do novo sistema 58 4.4 Uso e revisão do novo sistema 64 5 Análise da solução desenvolvida sob a ótica do framework proposto 69 6 Conclusão 75 7 Referências bibliográficas 79 Apêndice 1 93 Apêndice 2 95 Lista de figuras Figura 1: Metodologia de pesquisa .......................................................... 20 Figura 2: Fluxograma PRISMA do processo de seleção de estudos ....... 25 Figura 3: Framework proposto ................................................................. 44 Figura 4: Distribuição temporal das etapas de desenvolvimento da plataforma ................................................................................................ 48 Figura 5: Estratégia de barreira da COVID-19 ......................................... 53 Figura 6: Fluxo do serviço de atendimento remoto .................................. 54 Figura 7: Macroestrutura da plataforma desenvolvida ............................. 59 Figura 8: Quantidade de casos suspeitos de COVID-19 por semana epidemiológica ......................................................................................... 67 Figura 9: Quantidade de atendimentos à distância registrados por semana epidemiológica ......................................................................................... 68 Figura 10: Quantidade
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