Open-access Digital innovation in the regulation of specialized consultations and exams in Manaus, Brazil: challenges and impacts

The SUS Regulation System is strategic for organizing access to health services. In Manaus, it is managed by the Regulatory Complex. Traditionally, communication with users was conducted via SMS an expensive method that reached only 30% of those with scheduled appointments. The Municipal Health Secretariat (SEMSA) designed and implemented, as a nationwide first, a digital online inquiry solution to modernize communication and expand access. This study describes the development of the information system and analyzes its impacts. A mixed-methods approach was adopted: quantitative analysis of booking, confirmation, and no-show data (2021-2024) using Python, Matplotlib, and Seaborn, along with statistical projections; and qualitative analysis through interviews with managers. The system was developed in PHP and MySQL, using hybrid practices that combined agile and traditional methods. Results show growth in bookings (from 215,000 to 557,000), a reduction in the no-show rate, and a threefold increase in confirmations. Replacing SMS generated estimated savings of R$ 705,000. In 2025, the portal reached 80% of scheduled users, with an average of 10,000 authorizations per day. This experience reinforces that digital solutions yield concrete advances in management and access to public health care.

Key words:
Referrals and appointments; Teleconsultation; Digital health

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ABRASCO - Associação Brasileira de Saúde Coletiva Av. Brasil, 4036 - sala 700 Manguinhos, 21040-361 Rio de Janeiro RJ - Brazil, Tel.: +55 21 3882-9153 / 3882-9151 - Rio de Janeiro - RJ - Brazil
E-mail: cienciasaudecoletiva@fiocruz.br
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