Ericles Andrei Bellei

Healthcare services have been shaped by a dynamic interplay between established quality paradigms and disruptive technological innovation (1,2). On the one hand, artificial intelligence (AI) is increasingly viewed as a key driver of healthcare transformation (3,4), with the potential to improve clinical decision-making, operational efficiency, and patient outcomes (5,6). In parallel, the enduring pursuit of quality and safety has been institutionalized through healthcare accreditation (7). Accreditation frameworks act as a cornerstone of organizational practice by providing structured approaches to patient safety, process standardization, and continuous quality improvement (8). In Brazil, the National Accreditation Organization (Organizac ¸ão Nacional de Acreditac ¸ão-ONA) offers a rigorous methodology recognized by the International Society for Quality in Health Care for evaluating healthcare service delivery (9), and it is widely adopted by healthcare organizations (10).Although AI implementation and accreditation are often pursued as distinct strategic initiatives, a more integrated perspective is warranted. We argue that the requirements embedded in accreditation frameworks can help build foundational organizational readiness for effective AI adoption. In other words, compliance with accreditation standards may support the governance structures and process maturity needed to leverage AI in healthcare services. Accordingly, we present an interpretive analysis mapping requirements from the ONA manual against AI implementation enablers and barriers synthesized in the 2024 systematic review by Rahimi et al. (11). By examining intersections across governance, data infrastructure, process maturity, and human factors, we show how accreditation can support a hospital's broader digital transformation journey.We adopted an interpretive approach to examine the alignment between hospital accreditation requirements and organizational readiness for AI implementation. Our analysis drew on two primary sources: (i) the Brazilian National Accreditation Organization (ONA) Accreditation Manual (2022-2026 edition) ( 9) and (ii) the 2024 systematic review by Rahimi et al. (11), which synthesizes enablers and barriers to AI implementation in hospital settings.The analysis followed three steps. First, AI enablers and barriers were extracted and grouped according to their original classification into People, Process, Information, and Technology dimensions. Second, the ONA standards were reviewed in full, with particular attention to sections addressing governance, leadership, quality and safety management, information systems, technology management, and workforce development. Third, we conducted an interpretive mapping to identify conceptual correspondences and shared organizational mechanisms, routines, and capabilities rather than one-to-one equivalence. This analysis was intentionally exploratory and theory-informed, aiming to generate conceptual insights while acknowledging that accreditation frameworks were not designed with AI implementation as an explicit objective. A simplified schematic representation of the identified connections is shown in Figure 1. Although accreditation is not a direct roadmap for AI, its principles can help build essential organizational capabilities, as we discuss below. Comprehensive patient assessment and individualized care plans, adherence to protocols, multidisciplinary team communication, safe medication and infection-control practices, clear patient identification and information transfer, early warning and triage, and continuity across ambulatory and inpatient settings.Sample and data traceability, rigorous quality control, validation and secure reporting of results, adherence to standardized criteria, and safe, efficient imaging and therapeutic procedures.Predictive maintenance, infrastructure safety and contingency planning, cleaning and disinfection protocols, sterilization and traceability of instruments, laundry and waste management, and staff competence in support functions.Figure 1. Clustered bipartite network illustrating the alignment between ONA accreditation requirements and enablers and barriers for AI implementation.Strategic governance and decisive leadership form the bedrock of major organizational transformation, and the integration of AI is no exception. This domain is critical for articulating a vision, allocating resources, and creating an institutional mandate for change. In this regard, ONA's leadership standardsparticularly those in Subsection 1.1, Organizational Leadership-align with the People and Process enablers for AI identified by Rahimi et al. (11).The ONA manual requires hospital leadership to establish formal strategic planning (Subsection 1.1, Level 1, Req. 3), to create documented institutional policies for critical areas such as information management, quality, and patient safety (Reqs. 8 and 10), and to clearly define organizational structures and responsibilities (Req. 19). This structured, top-down approach is conducive to launching and sustaining complex, resource-intensive initiatives such as AI implementation. In non-accredited institutions, by contrast, AI initiatives may emerge from departmental silos and lack the executive mandate-and resource protection-needed to survive budget cycles and internal politics.Moreover, the discipline of creating and maintaining documented policies (Reqs. 8, 10, 11, and 12) establishes routines for documentation, version control, and audit trails that are essential for AI model governance, validation, and (where applicable) regulatory submissions to bodies such as ANVISA or the FDA. These practices support the formal allocation of organizational resources (Enabler 6) and foster crossdepartmental collaboration, which is essential for forming a multidisciplinary team (Enabler 1) capable of bridging clinical, technical, and administrative domains. While governance sets...

Health services management differs from the traditional definition of a profession, as it lacks a standardized body of knowledge and a single entry credential (1). Instead, it is an applied field that integrates competencies from medicine, economics, public administration, engineering, and social sciences (2).Due to the need for diverse skill sets, no universal educational pathway exists for health service managers (3). Comparative studies demonstrate significant variation in managers' educational backgrounds, ranging from postgraduate qualifications to clinical experience without formal management training (4,5,6). Despite this diversity, the strategic importance of this workforce is increasing. Factors such as rising costs, demographic shifts, and heightened accountability expectations (7,8) demand leaders capable of coordinating resources, interpreting data, and guiding improvement initiatives. The lack of a standardized pathway complicates the definition of professional training, underscoring the need to examine current educational preparation.In Brazil, where a universal public health system operates alongside a substantial private sector and governance is decentralized, managerial preparation significantly influences access to care, operational efficiency, and the sustainability of services (9). While the education of physicians and other healthcare professionals has received increasing attention due to its impact on the system's future (10,11,12), the preparation of healthcare managers also merits close examination, as they are essential in primary care, hospitals, diagnostic networks, and regulatory agencies (13,14). Job titles such as coordinator, supervisor, director, and manager encompass a range of functions that vary by setting and region (15). Professional competencies are developed through formal education, training, and ongoing professional development, with requirements differing by sector and management level (16). Delivering health services with consistent quality depends on the training and qualifications of those in leadership roles (17). In this context, a narrow professional definition is insufficient, as no universally mandated educational pathway exists.Analyzing training and education offers a concrete approach to defining and understanding health service management as a profession. Systematic evaluation of courses can identify areas for improvement, inform decision-making, and clarify which topics are most relevant for graduates' societal roles (18). In the Brazilian higher education system, post-bachelor's programs are divided into two legal categories (19): lato sensu programs, which include specialization courses and MBAs classified as continuing education (20,21), and stricto sensu programs, which are research-oriented master's and doctoral degrees. Lato sensu programs, offered by accredited institutions, require a minimum of 360 hours, emphasize practical skill development, and primarily serve professionals seeking additional credentials. In contrast, stricto sensu programs confer academic titles and develop research expertise. Specialization programs play a critical role in professional upskilling and lifelong learning, but they face challenges as knowledge requirements shift in response to market and societal changes (18). Variability in duration, workload, delivery mode, and competency focus creates uncertainty regarding the knowledge and skills that graduates bring to the health system. Lato sensu courses are especially significant, with approximately 173,000 active offerings enrolling around 1.4 million students in 2023 (22). A flexible regulatory environment enables institutions to rapidly introduce or update programs, adapting curricula to emerging areas such as hospital quality improvement, digital health operations, and value-based care (21). These certificates, typically delivered in modular weekend, evening, or distance-learning formats, are accessible to professionals who continue working full-time. Consequently, analyzing these programs provides a practical means to map the educational pipelines that supply Brazil's managerial workforce.Despite its significance, comprehensive evidence on national management curricula is limited, as most studies address only specific regions or small samples (15,23). This lack of system-wide perspective hinders efforts to understand and improve training pathways. The Brazilian government maintains an official registry of specialization and certification programs, which, if analyzed, can clarify the educational content that defines the field on a national scale. Previous studies have not fully utilized this registry to provide a structured curriculum overview. This study addresses this gap by compiling a dataset of instructional topics from registered lato sensu specialization and certification courses in health services management.Rather than ranking programs or evaluating outcomes, it offers a descriptive, system-level reference to inform accreditation, workforce planning, employer expectations, and future educational assessments.By consolidating dispersed national data, this study establishes a foundation for targeted improvements and informed discussion among educators, employers, and regulators regarding the enhancement of management education.Initial data were extracted from the National Registry of Higher Education Courses and Institutions (24) (e-MEC, Cadastro Nacional de Cursos e Instituic ¸ões de Educac ¸ão Superior). This official electronic information system underpins the federal regulation, accreditation, and supervision of Brazilian highereducation institutions and their academic programs. The e-MEC platform began operations in January 2007. Subsequent normative acts, most recently a Ministerial Ordinance in 2017 (25), reaffirmed e-MEC as the exclusive environment for registering, updating, and disseminating course-level information within the federal higher education...

Objetivos: Mapear e analisar o uso de tecnologias digitais no contexto da doação e transplante de órgãos e tecidos. Métodos: Trata-se de uma revisão de escopo, conforme a metodologia do Instituto Joanna Briggs, utilizando as bases de dados PubMed, Scopus, Web of Science e Biblioteca Virtual em Saúde. Após os critérios de elegibilidade, 13 estudos foram incluídos para análise. Resultados: Foram identificados sistemas de suporte à decisão clínica baseados em inteligência artificial, aplicativos mHealth, programas de teleassistência e plataformas de treinamento digital. Estas tecnologias têm impactado positivamente os processos de doação e transplantes. Conclusão: A incorporação de tecnologias digitais neste contexto tem potencial para transformar práticas clínicas, otimizar processos e melhorar os resultados para os pacientes. Contudo, desafios como a equidade no acesso e a maturidade digital ainda precisam ser superados para maximizar os benefícios dessas inovações.

Background and Objective: Health services management faces increasing complexity, particularly in developing countries such as Brazil. Digital tools play a central role in optimizing health service operations, yet synthesized evidence on manager-focused applications remains limited. This study aimed to survey digital innovations for management within the Brazilian context. Methods: We systematically reviewed the complete proceedings of the Brazilian Symposium on Computing Applied to Health (SBCAS) from 2001 to 2024, identifying 26 studies that met eligibility criteria based on managerial relevance. Results: Applications identified predominantly addressed hospital management (e.g., resource scheduling and process optimization) and public health surveillance (e.g., disease prediction and monitoring), employing technologies such as machine learning and simulation. These tools primarily leveraged structured administrative data from national health information systems, reflecting existing data infrastructure capabilities. The reported implications suggest improvements in decision-making through optimized resource allocation (e.g., ICU beds and staffing), streamlined operational processes (e.g., bottleneck identification), enhanced planning and monitoring capabilities (e.g., endemic disease control and telemonitoring programs), and more timely, targeted public health surveillance (e.g., georeferenced analysis). Conclusions: The identified research aligns with global digital health trends but is also tailored to the complex realities of the healthcare system. Despite significant technical advancements, these digital solutions predominantly remain at the prototype stage, highlighting a gap between academic innovation and real-world deployment. Realizing the benefits of these tools will require a concerted effort to move beyond technical validation, focusing on implementation science, supportive policies, and strategic partnerships to integrate these solutions into managerial practice.

The paper reviews digital solutions for health services management in Brazil, focusing on certified software features. It reveals the integration of various functionalities in operational, financial, and clinical needs simultaneously, which are critical for enhancing operational efficiency and patient care. This study highlights the integration of critical features like interoperability, compliance management, and data-driven decision support, although advancing innovation and integration remains essential for broader impact.

In the face of growing patient volumes, health requirements, and economic constraints, modern healthcare systems are in dire need of innovative management solutions. Despite a range of tools available to tackle these challenges, there's a gap in the understanding of how these tools are tailored for health systems management. This review, conducted in October 2023 across key health administration and technology databases Medline, Embase, IEEE Xplore, and ACM Digital Library, aims to examine the applications, characteristics, and real-world impacts of health systems management tools. From a total of 2,048 records, 12 studies were selected that span a variety of technologies, including decision analysis tools, machine learning algorithms, and data dashboards, all of which have proven critical in optimizing resource allocation, financial management, and patient care. These technologies have shown substantial promise in improving decision-making processes, operational efficiency, and overall healthcare outcomes. This review highlights the role these technologies and tools play in enhancing the manageability and sustainability of complex healthcare systems. It also underscores the need for ongoing research to further align technological developments with the evolving needs of the healthcare sector, ultimately aiming to boost system efficiency and improve patient care.