An Institutional Perspective of Health Information Systems in two Brazilian States

Health Information Systems (SIS) are technological artifacts allowing public managers in three government spheres to obtain essential information for the management and planning of the Brazilian Unified Health System (SUS - the public health system). Institutional Theory was chosen as the theoretical framework to analyze the incorporation of SIS in Brazilian public health, since there may be a direct influence from the organizational environment. This perspective makes it possible to find explanations for environmental factor influence, be they coercive, normative or mimetic, when deciding on the use of technology in government. The aim of this paper is to investigate the influence these institutional factors have on SIS use by State Health Departments (SES). In order to achieve our objective, we chose a qualitative approach, with multiple SES case studies in the states of Paraná and Rio Grande do Sul. The Mortality Information System (SIM) and the Decentralized Hospital Information System (SIHD) were considered the units of analysis for this study. Based on the proposed conceptual model, institutional factors that influence the use of these SIS, in the form of coercive, mimetic and normative pressures, are presented and analyzed.