This system is concerned with the design and implementation of a community health information system which fulfils some of the local needs of fourteen nursing and para-medical professions in a district health authority, whilst satisfying the statutory requirements of the NHS Korner steering group for those professions. A national survey of community health computer applications, documented in the form of an applications register, shows the need for such a system. A series of general requirements for an informations systems design methodology are identified, together with specific requirements for this problem situation. A number of existing methodologies are reviewed, but none of these were appropriate for this application. Some existing approaches, tools and techniques are used to define a more suitable methodology. It is unreasonable to rely on one single general methodology for all types of application development. There is a need for pragmatism, adaptation and flexibility. In this research, participation in the development stages by those who will eventually use the system was thought desirable. This was achieved by forming a representative design group. Results would seem to show a highly favourable response from users to this participation which contributed to the overall success of the system implemented. A prototype was developed for the chiropody and school nursing staff groups of Darlington health authority, and evaluations show that a significant number of the problems and objectives of those groups have been successfully addressed; the value of community health information has been increased; and information has been successfully fed back to staff and better utilised.

Class of 2014 Abstract / Specific Aims: The purpose of this study is to quantitatively analyze the pharmacy department’s performance before and after the transition from a segmented set of information technology systems to an enterprise wide electronic health record. Methods: This prospective, observational study collected data from both the pre-implementation and post-implementation electronic systems. The enterprise wide electronic system was implemented on November 1, 2013. Medication turnaround time, missing medication requests, and profile-linked automated dispensing cabinet (ADC) override rates were measured before implementation (August and September 2013) and after implementation (November 2013 and January, February, and March 2014). This study did not use patient specific data and does not involve human subjects and therefore was exempt from Institutional Review Board review. Main Results: Average medication turnaround time in November 2013 (1243.6 seconds; 95% CI 1219.55-1267.73) was significantly slower than in September 2013 (697.71 seconds; 95% CI 685.45-709.97; p<0.001). In January 2014, there was no difference (695.45 seconds; 95% CI 678.17-712.73; p = 0.83) and February 2014 showed significant improvement (619.09 seconds; 95% CI 605.18-633.00; p<0.001). There were significantly more missing medication requests in February (19002) and March 2014 (18996) than in August 2013 (1319; p<0.001 for both). The ADC override rate was significantly higher in November 2013 (5.87%) than in August 2013 (3.98%; p<.001) and lower in February 2014 (3.16%; p<0.001). Conclusion: This study suggests that implementation of an enterprise-wide electronic health record has led to improved pharmacy order processing efficiency and allowed for increased communication between healthcare professionals, albeit with a loss of efficiency initially.

The Mountain Gorillas of Central Africa are one of the most highly endangered species in the world, with only 740 individuals surviving. One of the greatest threats to this species is disease. Health of wildlife is continually garnering more attention in the public arena due to recent outbreaks of diseases such as West Nile and High Pathogenic Avian Influenza. However, no system currently exists to facilitate the management and analysis of wildlife health data. The research conducted herein was the development and testing of a health information monitoring system for the mountain gorillas entitled Internet-supported Management Program to Assist Conservation Technologies or IMPACT?. The system functions around a species database of known or unknown individuals and provides individual-based and population-based epidemiological analysis. The system also uses spatial locations of individuals or samples to link multiple species together based on spatial proximity for inter-species comparisons. A syndromic surveillance system or clinical decision tree was developed to collect standardized data to better understand the ecology of diseases within the gorilla population. The system is hierarchical in nature, using trackers and guides to conduct daily observations while specially trained veterinarians are used to confirm and assess any abnormalities detected. Assessment of the decision tree indicated that trackers and guides did not observe gorilla groups or individuals within groups similarly. Data suggests that, to be consistent, trackers and guides need to conduct observations even on the day that veterinarians collect data. Validity and reliability remain to be tested in the observation instrument. Assessment of pathogen loads and distributions within species surrounding the gorillas indicates that humans have the greatest pathogen loads with 13 species, followed by cattle and chimpanzees (11), baboon (10), gorillas (9), and rodents (3). Spatial aggregation occurred in Cryptosporidium, Giardia, and Trichuris; however, there is reason to question the test results of the former 2 species. These data suggest that researchers need to examine the impact of local human and domestic animal populations on gorillas and other wildlife.

Swedish municipalities invest enormous amounts of resources in health information systems (HIS) in order to have a competitive edge, reduce cost in operations, faster storage and retrieval of patient information, foster transparency, efficiency and effectiveness in service delivery. This study examines the major challenges faced by the system end-users after the implementation of the new health information systems in the elderly and care homes in a municipality in a southern region of Sweden.  The rationale for the examination is derived from the discovery that the municipality is yet to fully utilize the new-HIS, despite huge investments in procurement, supervision and training of users.  The major reason why this topic was chosen was due to the challenges encountered while working as a care giver staff in one municipality in a southern region of Sweden. In this study, The technology acceptance model (TAM ) is used to better understand the current working of the new-HIS.   Mixed methods are utilized to conduct the case study; semi structured interviews and questionnaire survey. The findings of this study are presented in the findings chapter and have shown many shortcomings in the use of the new-HIS such as limited supervision from top management, inadequate skills, inadequate computers, long procedures thus time wasting, insufficient resources like financing and policies among others as further discussed in the research findings chapter in this report.  Finally, this study proposes the findings as contributions to the study of challenges faced by end-users after the introduction and reception of the new-HIS by the given case study; and it propagates share of experiences and lessons to be learned.

China is moving towards a market economy. The greater use of market forces has made China richer, accelerated modernisation and increased productive efficiency but has created new problems, including, in the health sector, problems of inequity and allocative inefficiency. From 1997, the Chinese government committed to a national policy of regional health planning (RHP), as part of a broader commitment to harmonising social and economic development. However, RHP has been slow to impact on the equity and efficiency problems in health care. Planning requires information; better health decision-making requires better health information. Information systems constitute a resource that is vital for the health planning and the management of the health system. Properly developed, managed and used, health information systems are a highly cost-effective resource for the nation and its regions. Bureaucratic resistance, one of critical reasons is that regional health planners gained insufficient support from information system. Health information needs to adopt into the new way of government health management. The objective of the study is to contribute to the development of China�s health information system (HIS) over the next 5-10 years, in particular to suggest how provincial health information systems could be made more useful as a basis for RHP. The existing HIS is examined in relation to its support for and relevance to RHP, including policy framework, institutional structures and resources, networks and relationships, data collection, analysis, quality and accessibility of information as well as the use of information in support of health planning. Data sources include key informant interviews, a questionnaire survey and various policy documents. Qualitative (questionnaire survey on provincial HIS) and quantitative (key informant interviews) approaches are used in this study. Document analysis is also conducted. The research examines information for planning within the macro and historical context of health planning in China, in particular having regard to the impacts and implications of the transition to a market economy. It is evident that the implementation of RHP has been retarded by poor performance of information system, particularly at the provincial level. However, the implementation of RHP has also been complicated by fragmented administrative hierarchies, weak implementation mechanisms and contradictions between different policies, for example, between improved planning and the encouragement of market forces in health care. To support RHP which is needs based, has a focus on improving allocative efficiency and is adapted to the new market development will require new information products and supports including infrastructure reform and capacity development. Provincial HIS needs to move from being data generators and transmitters to becoming information producers and providers. Health planning has moved to greater use of population-based benchmark and demand-side control. Therefore, information products should be widened from supply side data collection (in particular assets and resources) to include demand-side collection and analysis (including utilisation patterns and community surveys of opinion and experience). The interaction between users (the planners) and producers (the HIS) should be strengthened and regional networks of information producers and planners should be established.

China is moving towards a market economy. The greater use of market forces has made China richer, accelerated modernisation and increased productive efficiency but has created new problems, including, in the health sector, problems of inequity and allocative inefficiency. From 1997, the Chinese government committed to a national policy of regional health planning (RHP), as part of a broader commitment to harmonising social and economic development. However, RHP has been slow to impact on the equity and efficiency problems in health care. Planning requires information; better health decision-making requires better health information. Information systems constitute a resource that is vital for the health planning and the management of the health system. Properly developed, managed and used, health information systems are a highly cost-effective resource for the nation and its regions. Bureaucratic resistance, one of critical reasons is that regional health planners gained insufficient support from information system. Health information needs to adopt into the new way of government health management. The objective of the study is to contribute to the development of China�s health information system (HIS) over the next 5-10 years, in particular to suggest how provincial health information systems could be made more useful as a basis for RHP. The existing HIS is examined in relation to its support for and relevance to RHP, including policy framework, institutional structures and resources, networks and relationships, data collection, analysis, quality and accessibility of information as well as the use of information in support of health planning. Data sources include key informant interviews, a questionnaire survey and various policy documents. Qualitative (questionnaire survey on provincial HIS) and quantitative (key informant interviews) approaches are used in this study. Document analysis is also conducted. The research examines information for planning within the macro and historical context of health planning in China, in particular having regard to the impacts and implications of the transition to a market economy. It is evident that the implementation of RHP has been retarded by poor performance of information system, particularly at the provincial level. However, the implementation of RHP has also been complicated by fragmented administrative hierarchies, weak implementation mechanisms and contradictions between different policies, for example, between improved planning and the encouragement of market forces in health care. To support RHP which is needs based, has a focus on improving allocative efficiency and is adapted to the new market development will require new information products and supports including infrastructure reform and capacity development. Provincial HIS needs to move from being data generators and transmitters to becoming information producers and providers. Health planning has moved to greater use of population-based benchmark and demand-side control. Therefore, information products should be widened from supply side data collection (in particular assets and resources) to include demand-side collection and analysis (including utilisation patterns and community surveys of opinion and experience). The interaction between users (the planners) and producers (the HIS) should be strengthened and regional networks of information producers and planners should be established.

Desde 1980 observa-se um crescente registro de ocorrências de causas externas no Brasil, que passaram a ocupar o segundo lugar dentre as causas de morte em grandes centros urbanos, superando as neoplasias. Foram analisados os dados de pacientes vítimas de trauma com internação na Unidade de Emergência do HCFMRP, em Ribeirão Preto (SP) entre 2006 e 2009. Foi realizada uma análise descritiva, envolvendo informações sobre o evento traumático, índices de gravidade RTS, ISS e TRISS, provenientes do software IntegraVep, de uso do Núcleo Hospitalar de Epidemiologia do HCFMRP, além de quantificações de exames laboratoriais e radiológicos demandados aos referidos pacientes, com o intuito de analisar as características e evolução dos pacientes. Foi possível observar a alta quantia de exames radiológicos e laboratoriais solicitados para pacientes com lesões leves além da distribuição dos pacientes quanto a faixa etária, sexo, mecanismos de trauma e gravidade de lesão. A utilização de um software específico para análise dos dados existentes no banco de dados do HCRP se mostrou adequada ao ser usado para os pacientes vítimas de trauma, podendo ser expandido para os demais setores do hospital. / Since 1980 there has been a growing record of occurrences of external causes in Brazil, which now occupy the second place among the causes of death in large urban centers, beating cancer. We analyzed the data of trauma patients with admission to the Emergency Unit of HCFMRP in Ribeirão Preto (SP) between 2006 and 2009. We performed a descriptive analysis, involving information about the traumatic event, severity indices RTS, ISS and TRISS, from the IntegraVep software, use of the Center for Hospital Epidemiology of HCFMRP, and quantitions of laboratory and radiological defendants to those patients with the aim of analyzing the characteristics and outcomes of patients. It was possible to observe the high amount of radiological and laboratory-only bid for patients with minor injuries and the distribution of patients by age, sex, mechanism of trauma and injury severity. The use of specific software for the analysis of existing data in the database of the HCRP was adequate to be used for trauma patients and can be expanded to other hospital departments.

As repercussões do trabalho na vida e na saúde do Homem há muito vêm sendo objeto de estudo na história da humanidade. No Brasil esta questão necessita ser melhor compreendida, principalmente após as recentes mudanças ocorridas na Constituição, onde observamos uma atenção maior ao capítulo da Saúde e, em especial, à Saúde do Trabalhador. A municipalização da saúde impõe mudanças profundas no lidar com estas questões. A informação fidedigna é pré-requisito básico para a efetivação de ações que visem a prevenção e a promoção de saúde. Para tanto delineamos como objeto de nosso trabalho o estudo da dinâmica da Comunicação do Acidente do Trabalho no município de Ribeirão Preto, no ano de 1996. Elegemos como método investigativo o estudo descritivo transversal da trajetória da notificação do Acidente do Trabalho e de suas repercussões, traçando um paralelo entre este sistema de notificação compulsória e o sistema utilizado pelo Serviço de Vigilância Epidemiológica, também compulsório. Os dados foram obtidos através da análise de documentos e da aplicação de entrevista semi-estruturada com representantes de todos os serviços envolvidos com o Acidente do Trabalho no município. Verificamos que na prática, apesar do preconizado legalmente, as transformações necessárias não foram efetivamente implementadas. O Sistema de Informações em Saúde do Trabalhador apresenta-se incompleto, persistindo um fluxo de Comunicações de Acidentes do Trabalho (CATs) fragmentado, não permitindo o desencadeamento de ações preventivas e de controle dos agravos. Ações conjuntas entre os níveis de atuação possíveis inexistem, não havendo uma interface entre as instituições. Em razão da precariedade das informações e da atual organização destes serviços, fica inviabilizada a execução de estudos epidemiológicos, diferentemente do que ocorre no sistema utilizado pelos Serviços de Vigilância Epidemiológica municípal. Faz-se necessário o enfrentamento desta problemática, de maneira a permitir a transformação do sistema de notificação dos Acidentes do Trabalho em instrumento eficaz à prevenção e à promoção de saúde. / The effect of work in the Man’s life and health has from long been object of studies in the human kind history. In Brazil, this point must be better understood, mainly after the recent changes occurred in the Brazilian Constitution, where we can see a greater attention to the Workman’s Health. The municipalization of the Health Service urges deep changes to deal with these items. The reliability of information is a basic pre-requisite for the rendering of actions the aim the prevention of diseases and the promotion of health. For this purpose, the object of our research is the study of the dynamics of the Communication of the Work Accident, in Ribeirão Preto, in the year of 1996. We chose as a researching method the transversal descriptive study of the process of notification of the work accident and its effects, comparing this type of compulsory notification with the as well compulsory system used by the Epidemiology Vigilance Service. The data was obtained upon the analysis of documents and the application of semi-structured interview with representatives of all the services involved with Work Accident in this town. We could observed that, in fact, despite legally advocated, the necessary changes were not effectively implemented. The Information System of the Workman Health Care shows incomplete, with a fragmented flux of Work Accidents Communications (WACs) what hinders the development of preventive actions, and the control of damages. No joiner proceedings are held between institutions. Due to the precariousness of information and to the present organization of this service, evident is the unfeasibility of the execution of epidemiologic studies, different from what happens in the system used by the Municipal Epidemiology Service. It’s urgent, therefore, to face this problem, in order to transform the system of notification of work accidents into an efficient instrument of health promotion and prevention.

Objetivo: Desenvolver um sistema de distribuição de conteúdo por meio de mensagens curtas de texto por celular (SMS - short message service) e avaliar se a utilização deste tipo de serviço direcionado a gestantes aumenta a adesão às práticas recomendadas de cuidado pré-natal. Desenho: Ensaio clínico controlado aleatorizado por conglomerados. Local do estudo: 20 unidades básicas de saúde (UBSs) de Ribeirão Preto, Brasil. População: Mulheres com mais de 18 anos, em seguimento de pré-natal nas UBSs selecionadas, com até 20 semanas de gestação no período de recrutamento. Métodos: Foi desenvolvido e implantado um sistema de informação e comunicação em saúde capaz de distribuir automaticamente conteúdo relevante para gestantes no período de pré-natal e pós-parto, o SISPRENACEL. Apesar de construído utilizando as boas práticas em engenharia de software e seu uso ter sido monitorado de perto, o sistema em si não foi avaliado neste trabalho. Para avaliar o impacto da intervenção, foram selecionadas as 20 UBSs que apresentaram os maiores números de gestantes nos anos anteriores. As UBS foram aleatorizadas em 2 grupos de 10 unidades para receber a intervenção e servir como controle. Em cada UBS alocada para receber a intervenção foram afixados cartazes convidando as gestantes a receber um pacote de SMS com conteúdo relacionada a gestação e ao parto (PRENACEL). Também nestas unidades, cada gestante recebeu uma filipeta reiterando o convite e com informações sobre o PRENACEL. As mulheres que se interessaram pelo projeto foram avaliadas quanto sua elegibilidade, forneceram consentimento e então passaram a receber as SMS, enviadas automaticamente pelo SISPRENACEL, durante a gestação em adição ao cuidado pré-natal de rotina. Nenhuma intervenção foi realizada nas UBS do grupo controle e as gestantes daquele grupo receberam apenas o cuidado pré-natal de rotina. As gestantes advindas dos dois grupos foram entrevistadas nas maternidades participantes após o parto. Principal medida de desfecho: A proporção de mulheres que apresentaram uma alta cobertura de práticas recomendadas durante o cuidado pré-natal, avaliada por um escore de cuidados (EC). Resultados: 350 mensagens demonstrando interesse em participar do PRENACEL foram recebidas e 157 mulheres elegíveis foram cadastradas pelo sistema. Durante o pré-natal foram enviadas 21.703 mensagens IX programadas, 1087 mensagens foram recebidas contendo dúvidas, sugestões ou comentários do serviço e 1230 mensagens foram enviadas em resposta as gestantes. Um total de 1210 mulheres elegíveis para participar do estudo recebeu cuidado pré- natal nas UBS participantes do projeto e tiveram seus desfechos avaliados nas maternidades participantes, sendo 770 oriundas das unidades intervenção e 440 das unidades controle. 157 mulheres elegíveis para receber a intervenção se interessaram pelo PRENACEL (20.4%, 157/770) e 73.9% delas (116/157) receberam e acessaram o pacote de mensagens. Houve desbalanço entre algumas características de base entre os grupos estudados e, em que pese o escore médio de cuidados pré-natais do grupo Intervenção ter sido maior que a do grupo Controle [46,6 (±8,0) vs 45,2 (±8,7), p=0,0002], a análise ajustada de intenção de tratamento não demonstrou diferença nos resultados entre os grupos intervenção e controle para a ocorrência de um alto escore de cuidados pré-natais. A análise por protocolo (bruta e ajustada para características sociodemográficas) sugere benefício da intervenção (RR ajustado para um alto escore de cuidados pré-natais: 1,12 (IC95%1,05-1,21)). Houve maior frequência de realização de 6 ou mais consultas (96,9% vs. 84,8%, p=0,01) e de exames para Sífilis (40,5% vs. 24,8%, p=0,03) e HIV (46,6% vs. 25,7%, p=0,0006) no grupo PRENACEL que no controle. A proporção de gestantes com alto EC foi maior no PRENACEL que no Controle (94% vs. 80%, p<0,0001). O NNT foi de sete mulheres recebendo a intervenção para uma mulher adicional com um alto escore de cuidados pré-natais. Conclusões: A utilização de um sistema de distribuição de conteúdo relevante foi essencial para o gerenciamento do volume e controle das mensagens distribuídas. Houve aumento de adesão aos cuidados recomendados durante este período, particularmente às consultas pré-natais e a triagem sorológica para sífilis e HIV entre as mulheres que receberam e acessaram o conteúdo enviado por SMS. É necessário desenvolver uma estratégia de implementação capaz de maximizar o interesse das mulheres em receber um pacote de SMS com conteúdo relacionada a gestação e parto. / Objective: Increase adherence to recommended practices of prenatal care through the development and use of a system that distributes content to pregnant woman through short message service (SMS). Design: Cluster randomized controlled trial. Setting: 20 primary health care facilities (PHCF) in Ribeirão Preto, São Paulo, Brazil. Subject: Women older than 18 years, attending to prenatal care on selected facilities, and that had 20 weeks of gestational age or less during recruitment time. Methods: We developed and deployed an information system to automatically distribute relevant content to pregnant women during prenatal and postnatal care, called SISPRENACEL. The system itself was not evaluated, although we built it using the best practices of software engineering and it was closely monitored. To evaluate the intervention\'s impact, we selected 20 PHCF that presented the highest number of pregnant women in previous years. We randomized the PHCF in 2 groups with 10 facilities to receive the intervention and 10 to be in the control group. We pinned posters in each one of the PHCF allocated to receive the intervention, inviting the women to subscribe to our service (PRENACEL), which would send them a SMS package with pregnancy and delivery related content. The women attending to an intervention facility received also a flyer that reinforced the invitation and that showed more information about PRENACEL. We evaluated the interested women to verify their eligibility and to get their consent. From this moment onwards, they started to receive SMS automatically sent by SISPRENACEL in addition to standard prenatal care. We did not do any intervention on PHCF allocated in the control group and the pregnant women in this group received standard prenatal care. We interviewed pregnant women coming from both groups in the selected maternities after delivery. Main outcome: Proportion of high level of coverage in recommend practices during prenatal care, evaluated by a score of care (SC). Results: SISPRENACEL received 350 messages of pregnant women interested in enrolling into PRENACEL and 157 eligible women were registered in the system. During prenatal period, SISPRENACEL sent 21.703 scheduled SMS, received 1087 with questions, suggestions or comments about the service and sent 1230 answers. We screened 1210 eligible women coming from the selected facilities and evaluated the outcome in the maternities, 770 women were from intervention facilities and 440 from control facilities. In the intervention group, 157 XI eligible women had shown interest in enrolling into PRENACEL (20.4%, 157/770) and 73.9% (116/157) received and accessed the package content. The basal characteristics between the groups were unbalanced and also the average score of prenatal care practices was higher in the Intervention group compared to the control group [46,6 (±8,0) vs 45,2 (±8,7), p=0,0002], the intention to treat adjusted analyses did not show difference between the intervention and control group to the high level of care. The protocol analyses (brute and adjusted for socialdemographics characteristics) suggested a vantage of the intervention (adjusted RR to a high score of prenatal care: 1,12 (IC95%1,05-1,21)). There was a higher frequency of attendance in 6 or more appointments (96,9% vs. 84,8%, p=0,01) and exams for syphilis (40,5% vs. 24,8%, p=0,03) and HIV (46,6% vs. 25,7%, p=0,0006) in PRENACEL group compared to control group. The proportion of pregnant women with high SC was higher in PRENACEL group than in the control group. The NNT was 7 women receiving the intervention to an additional woman with high level of prenatal care practices. Conclusions: The use of a system to distribute relevant content was essential to manage the volume and control of the SMS. There was an increase of adherence to recommended prenatal practices during this time, especially related to prenatal appointments, screening of syphilis and HIV between women that received and accessed the content sent through SMS. Discussion: It is necessary to develop a strategy for an implementation capable of maximize the women interest in receiving the SMS package with the pregnancy and delivery content.

As repercussões do trabalho na vida e na saúde do Homem há muito vêm sendo objeto de estudo na história da humanidade. No Brasil esta questão necessita ser melhor compreendida, principalmente após as recentes mudanças ocorridas na Constituição, onde observamos uma atenção maior ao capítulo da Saúde e, em especial, à Saúde do Trabalhador. A municipalização da saúde impõe mudanças profundas no lidar com estas questões. A informação fidedigna é pré-requisito básico para a efetivação de ações que visem a prevenção e a promoção de saúde. Para tanto delineamos como objeto de nosso trabalho o estudo da dinâmica da Comunicação do Acidente do Trabalho no município de Ribeirão Preto, no ano de 1996. Elegemos como método investigativo o estudo descritivo transversal da trajetória da notificação do Acidente do Trabalho e de suas repercussões, traçando um paralelo entre este sistema de notificação compulsória e o sistema utilizado pelo Serviço de Vigilância Epidemiológica, também compulsório. Os dados foram obtidos através da análise de documentos e da aplicação de entrevista semi-estruturada com representantes de todos os serviços envolvidos com o Acidente do Trabalho no município. Verificamos que na prática, apesar do preconizado legalmente, as transformações necessárias não foram efetivamente implementadas. O Sistema de Informações em Saúde do Trabalhador apresenta-se incompleto, persistindo um fluxo de Comunicações de Acidentes do Trabalho (CATs) fragmentado, não permitindo o desencadeamento de ações preventivas e de controle dos agravos. Ações conjuntas entre os níveis de atuação possíveis inexistem, não havendo uma interface entre as instituições. Em razão da precariedade das informações e da atual organização destes serviços, fica inviabilizada a execução de estudos epidemiológicos, diferentemente do que ocorre no sistema utilizado pelos Serviços de Vigilância Epidemiológica municípal. Faz-se necessário o enfrentamento desta problemática, de maneira a permitir a transformação do sistema de notificação dos Acidentes do Trabalho em instrumento eficaz à prevenção e à promoção de saúde. / The effect of work in the Man’s life and health has from long been object of studies in the human kind history. In Brazil, this point must be better understood, mainly after the recent changes occurred in the Brazilian Constitution, where we can see a greater attention to the Workman’s Health. The municipalization of the Health Service urges deep changes to deal with these items. The reliability of information is a basic pre-requisite for the rendering of actions the aim the prevention of diseases and the promotion of health. For this purpose, the object of our research is the study of the dynamics of the Communication of the Work Accident, in Ribeirão Preto, in the year of 1996. We chose as a researching method the transversal descriptive study of the process of notification of the work accident and its effects, comparing this type of compulsory notification with the as well compulsory system used by the Epidemiology Vigilance Service. The data was obtained upon the analysis of documents and the application of semi-structured interview with representatives of all the services involved with Work Accident in this town. We could observed that, in fact, despite legally advocated, the necessary changes were not effectively implemented. The Information System of the Workman Health Care shows incomplete, with a fragmented flux of Work Accidents Communications (WACs) what hinders the development of preventive actions, and the control of damages. No joiner proceedings are held between institutions. Due to the precariousness of information and to the present organization of this service, evident is the unfeasibility of the execution of epidemiologic studies, different from what happens in the system used by the Municipal Epidemiology Service. It’s urgent, therefore, to face this problem, in order to transform the system of notification of work accidents into an efficient instrument of health promotion and prevention.