Background:
Within Brazil’s Unified Health System (SUS), several health information systems support cervical cancer prevention and early detection. However, limited interoperability across data sources restricts longitudinal follow up and timely programme performance assessment. In Pernambuco, recognition of a high disease burden and persistent operational constraints in 2019 prompted a project led by the State Health Secretariat, with technical collaboration from PAHO and IARC, to reorganise the cervical cancer care pathway and implement organised, population based screening using HPV PCR as the primary test. This transition required a digital solution to consolidate nominal target lists, integrate laboratory results, and capture key diagnostic and treatment information for continuous monitoring and evaluation.
Objectives:
To develop and implement the Jornada Inteligente da Mulher Pernambucana (JORDANA), an integrated digital platform to support traceability and continuity of care across organised HPV based screening, diagnosis, and treatment, and to enable automated computation of core programme indicators, including care pathway time intervals.
Methods:
We conducted a development and implementation study in Pernambuco. An operational assessment of SUS information systems interfacing with the cervical cancer care pathway identified data availability and integration opportunities. Where information was unavailable, structured digital forms were created for direct entry by healthcare professionals. JORDANA was organised into three modules, Screening, Diagnosis, and Treatment, and configured to integrate primary care registries, laboratory HPV results, and essential clinical records needed to generate programme indicators and time intervals.
Results:
Organised screening was operationalised using e SUS APS registration data to define the target population of women aged 25 to 64 years, generate invitation lists, and support individual follow up from invitation through treatment completion. High risk HPV PCR results were integrated from the Laboratory Environment Manager (GAL) via business intelligence workflows managed by the Pernambuco Central Public Health Laboratory (LACEN PE). Cytology and histopathology results were captured in a structured summary format, and a standardised colposcopy report was completed directly within the platform. Treatment for intraepithelial lesions via excision of the transformation zone (EZT) was recorded in the Treatment module. JORDANA enabled routine calculation of key programme indicators and intervals between invitation, diagnosis, and treatment, supporting implementation monitoring and operational adjustments.
Conclusions:
JORDANA strengthened monitoring and evaluation of organised HPV based screening in Pernambuco by enabling traceability and continuity of care across screening, diagnosis, and treatment, with automated indicators and time interval measurement to support ongoing programme improvement.