RESUMO
WHO and UNICEF highlight vaccination as the most cost-effective method of prevention of infectious diseases. An effective public health strategy requires efficient tracking of vaccination to assess coverage, safety, and efficacy of these vaccines. Paper-based immunization records are still being used in most low and middle-income countries. Adequate Electronic Logistic Management Information Systems, Immunization Registries and Records are crucial for proper data collection and analysis, and for making better decisions at an individual and at a population level. In this paper we share our experience in the redesign of an interoperable immunization record to track vaccination, including the recently developed vaccines for the novel coronavirus SARS-CoV-2 (COVID-19).
Assuntos
COVID-19 , Vacinas , Argentina/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Hospitais , Humanos , Imunização , Programas de Imunização , Pandemias/prevenção & controle , SARS-CoV-2 , VacinaçãoRESUMO
A Chatbot or Conversational Agent is a computer application that simulates the conversation with a human person (by text or voice), giving automated responses to people's needs. In the healthcare domain, chatbots can be beneficial to help patients, as a complement to care by health personnel, especially in times of high demand or constrained resources such as the COVID-19 Pandemic. In this paper we share the design and implementation of a healthcare chatbot called Tana at the Hospital Italiano de Buenos Aires. Considering best practices and being aware of possible unintended consequences, we must take advantage of information and communication technologies, such as chatbots, to analyze and promote useful conversations for the health of all people.
Assuntos
COVID-19 , Argentina , COVID-19/epidemiologia , Atenção à Saúde , Hospitais Universitários , Humanos , PandemiasRESUMO
Digital Health is one of the three pillars for the effective implementation of Universal Health Coverage in Argentina. The Ministry of Health published the National Digital Health Strategy 2018-2024 in order to establish the conceptual guidelines for the design and development of interoperable health information systems as a state policy. The World Health Organization "National eHealth Strategy Toolkit", "Global Strategy on Digital Health" and other international and local evidence and expert recommendations were taken into account. The path to better healthcare involves adopting systems at the point of care, allowing for the primary recording of information and enabling information exchange through real interoperability. In that way, people, technology and processes will synergize to enhance integrated health service networks. In this paper, we describe the plan and the first two years of implementation of the strategy.
Assuntos
Sistemas de Informação em Saúde , Telemedicina , Argentina , Atenção à Saúde , Organização Mundial da SaúdeRESUMO
The Ministry of Health (MoH) stated the National Digital Health Strategy 2018-2024 in order to establish the conceptual guidelines for the design and development of interoperable health information systems. It included the creation of a National Digital Health Network, and a Citizen Health Portal to inform and empower patients about their rights. For instance, the Digital Vaccination Card is already available and has equal legal validity as its paper version. The platform also works as a personal privacy manager, to configure the consent for Health Information Exchange through the network, or to check the access logs. This paper outlines the implementation experience of this powerful tool at a national level.
Assuntos
Privacidade , Argentina , Troca de Informação em Saúde , HumanosRESUMO
The Introductory Course to the Electronic Medical Records (EMR) is part of the Digital Health Strategy of the Ministry of Health's Universal Health Coverage (UHC). One of its principles is achieving interoperability between different electronic medical records systems. The healthcare workforce training in these subjects is essential. During 2018, six editions of the course were developed in the Moodle Virtual Health Platform with 850 approved participants. We analysed the previous experience to reformulate the learning materials and create new instances for pedagogical support.
Assuntos
Registros Eletrônicos de Saúde , Cobertura Universal do Seguro de Saúde , Pessoal de Saúde , AprendizagemRESUMO
Correct patient identification is the cornerstone for the proper implementation of electronic health records. Up to 20% of the registered patients are duplicated in most systems. Strong identification policies and robust systems can minimize such errors. In this poster we share the Ministry of Health recommendations for the Master Patient Index improvement using search algorithms.
Assuntos
Sistemas de Informação em Saúde , Algoritmos , Argentina , Registros Eletrônicos de Saúde , Humanos , Sistemas de Identificação de PacientesRESUMO
The Ministry of Health (MoH) set the National Digital Health Strategy 2018-2024 as a state policy. It included a National TeleHealth Plan to enhance access and quality of healthcare in a wide territory like Argentina, leveraging more than 20 years of national telemedicine experiences and coordinating it with the territorial integrated health service networks proposed by the Universal Health Coverage strategy. In collaboration with the Ministry of Modernisation, the MoH developed and implemented a new TeleHealth Web Platform to perform eReferrals and eConsultations nationwide. This poster describes the first 2 months of usage.
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Telemedicina , Argentina , Atenção à Saúde , Consulta RemotaRESUMO
Many newborns at the neonatal intensive care unit are unable to feed themselves, and receive human milk through enteric nutrition devices such as orogastric or nasogastric probes. The mothers extract their milk, and the nursing staff is responsible for the fractionation, storage and administration when prescribed by physicians. It is very important to remind that it is a bodily fluid that carries the risk of disease transmission if misused. Health information technologies can enhance patient safety by avoiding preventable adverse events. Barcoding technology could track every step of the milk manipulation. Many processes must be addressed to implement it. Our goal is to explain our planning and implementation process in an academic tertiary hospital.
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Aleitamento Materno , Nutrição Enteral , Leite Humano , Feminino , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Mães , MédicosRESUMO
Among adverse events related to medication errors, the defects in parenteral nutrition administration pose a special threat to patient safety. Two high impact strategies to reduce these errors require implementing a Computerized Provider Order Entry and the use of bedside bar-code verification prior to medication administration. In this study, we share the deep field analysis of the current workflow performed to include inpatient bedside barcoding verification for parenteral nutrition administration in a large academic health center. Then, we propose a process optimization and a new parenteral nutrition ordering tool embedded in the prescription module. Structuring physicians' ordering and the bar-code verification of administration can increase patient safety. The next steps would involve the creation of a Clinical Decision Support System to improve patient nutrient goals.
Assuntos
Processamento Eletrônico de Dados , Sistemas de Registro de Ordens Médicas , Nutrição Parenteral , Segurança do Paciente , Humanos , Erros de MedicaçãoRESUMO
Decision support systems can alert physicians to the existence of drug interactions. The Hospital Italiano de Buenos Aires, Argentina, has an in-house electronic health record with computerized physician order entry and clinical decision support. It includes a drug-drug interaction alert system, initially developed under traditional engineering techniques. As we detected a high alert override rate, we rebuilt the knowledge database and redesigned the alert interface with User-Centered Design techniques. A laboratory crossover study using clinical vignettes showed that new alerts were more usable than traditional ones.This paper aimed to validate these results through a controlled and randomized experimental study with two branches (old vs. new design) in a real setting. We analyzed, quantitatively, every fired alert between April 2015 and September 2016. Finally, we performed user surveys and qualitative interviews to inquire about their satisfaction and perceptions.In real scenarios, user-centered design alerts were more usable, being more effective and satisfactory, but less efficient than traditional alerts. "Safe omission", as a new concept, emerged from our stratified analyses and interviews.