Blockchain apply to the supply chain of essential medicines for the treatment of Covid-19 in Colombia.

Introduction: The outbreak of SARS-CoV-2, called COVID-19, in Colombia as well as in a great part of the world, has been declared as a public health emergency of international concern, affecting different aspects of the daily life, being one of the most important the access and distribution of necessary medicine, not only for the known deceases but also for the mitigation of COVID 19. Objective: the distribution of medicines should maintain stability in the supply chain of essential medicines, thus ensuring high quality medicines that could help in the treatment to fight the virus. Methodology: through this work a detailed analysis of the variable and critical points in the supply chain of essential medicines to mitigate COVID-19 is developed. Results: A new architecture based on the Blockchain Hyperledger is presented. It will help to solve those critical points found, through the secure trace of the medicine supply chain. In Colombia, by using this architecture all actors take responsibilities in the distribution chain, ensuring a high level of transparency in the distribution process. Discussion: by verifying the proper functioning of the model, the main difficulty when using Hyperledger is the lack of suppliers with experience; besides, there are not enough standardization or regulations of Blockchain. Conclusion: It is proved that Blockchain is an optimal technology to ensure essential medicine supply chain for the COVID 19 treatment in Colombia.

Analysis of Colombia's Telemedicine Development, the Postconflict Potential Opportunity.

Aims: The goal of this study was to evaluate the development of telemedicine in Colombia. Materials and Methods: Searched for laws in the Colombian legal system; the statistics of services and health operators was extracted from the unique system of habilitation; we looked for reports from the Ministry of Information and Communication Technologies (ICT), the demographic statistics was obtained from the National Administrative Department of Statistics. Data analysis techniques were applied to identify possible relationships between them. Results: In Colombia, since the proclamation of the legality of telemedicine in 2007, there are five laws, five resolutions, and three government plans. A total of 3,245 services have been implemented in telemedicine, distributed throughout the territory by 51,490 operators, the ICT penetration rate is 21.17% by fixed internet and 39.3% by mobile internet; the Colombian population is 49,882,091 people, 25,228,444 women and 24,605,796 men, who are distributed 76.97% in the urban sector and 23.02% in the rural sector, and the coverage of health services is 94.8%. Conclusion: The development of health services in the telemedicine modality has been driven by Colombian regulations since 2007 and the plans for the growth of ICT infrastructure since 2009; however, these services have not yet reached 100% of the territory, especially areas with difficult access. The Colombian peace agreement creates the National Rural Health Plan (PNSR), which is presented as the obligation to carry out health coverage in all the territories, especially those in the rural areas, for the implementation of the strategy related to the implementation of services in telemedicine.

Internet of Things Applied in Healthcare Based on Open Hardware with Low-Energy Consumption.

OBJECTIVES: The Internet of Things (IoT) and its applications are growing simultaneously. These applications need new intelligent devices along heterogeneous networking. Which makes them costly to implement indeed. Platforms and open devices designed for open-source hardware are possible solutions. This research was conducted under an IoT design, implementation, and assessment model for the remote monitoring of pulse oximetry via oxygen partial saturation (SpO2) and heart rate (HR) with low-energy consumption. METHODS: This study focused on the development of SpO2 and HR measurements that will allow the monitoring and estimation in real time of the user's state and health related to the established parameters. Measurements were acquired and recorded using a remote web server that recorded the acquired variables for further processing. The statistical analysis data allows comparison of the registered data measured with theoretical models. RESULTS: The IoT model was developed use Bluetooth low-energy devices, which comply with low-cost and open-hardware solutions operated via 'HTTP requests' for data transmission and reception from a cloud server to an edge device. Network performance assessment was conducted to guarantee the availability and integrity of the acquired values and signals. The system measured SpO2 and HR variables. The most significant result was to achieve energy consumption 20% lower than that of devices in the market. CONCLUSIONS: In summary, the acquired data validation based on the IoT model had a transmission error of 0.001% which proves its applicability in healthcare.

Effective Validation Model and Use of Mobile-Health Applications for the Elderly.

OBJECTIVES: Due to the uncontrolled increase of the mobile health applications and their scarce use by elderly for reason of absence credibility of measurements by lack scientific support, the aim of this study was to evaluate the differences between the biophysical measurements based on standard instrument against a mobile application using controlled experiments with elderly to propose an effective validation model of the developed apps. METHODS: The subjects of the study (50 people) were elderly people who wanted to check their weight and cardiac status. For this purpose, two mobile applications were used to measure energy expenditure based on physical activity (Activ) and heart rate (SMCa) during controlled walking at specific speeds. Minute-by-minute measurements were recorded to evaluate the average error and the accuracy of the data acquired through confidence intervals by means of statistical analysis of the data. RESULTS: The experimental results obtained by the Activ/SMCa apps showed a consistent statistical similarity with those obtained by specialized equipment with confidence intervals of 95%. All the subjects were advised and trained on the use of the applications, and the initial registration of data to characterize them served to significantly affect the perceived ease of use. CONCLUSIONS: This is the first model to validate a health-app with elderly people allowed to demonstrate the anthropometric and body movement differences of subjects with equal body mass index (BMI) but younger. Future studies should consider not only BMI data but also other variables, such as age and usability perception factors.

Dinámica cardiaca del adulto evaluada mediante las proporciones de la entropía / Adult dynamic heart evaluated by the proportions of entropy

Resumen Introducción: A partir de la teoría de los sistemas dinámicos, junto con la teoría de la probabilidad y el concepto de entropía se ha desarrollado una nueva metodología matemática de aplicación clínica. Objetivo: Aplicar la metodología previamente desarrollada para evaluar la dinámica cardíaca de adulto utilizando para ello la probabilidad y proporciones de la entropía del atractor. Materiales y métodos: Se desarrolló un estudio ciego tomando como Gold Standard el diagnóstico convencional emitido por un experto con 480 holter, 30 dinámicas normales y 450 con diferentes patologías; para cada holter se generó un atractor numérico cuantificando la probabilidad de aparición de parejas ordenadas de frecuencias cardiacas consecutivas, evaluando posteriormente la entropía, relación S/k y proporciones para cada dinámica durante mínimo 18 horas. Fueron hallados los valores de sensibilidad, especificidad y coeficiente Kappa. Resultados: La metodología aplicada permitió diferenciar cuantitativamente normalidad de enfermedad, encontrando los valores de las proporciones en los rangos establecidos. Los valores de sensibilidad y especificidad fueron de 100%, y el coeficiente Kappa fue de 1. Conclusión: A partir de las distribuciones de probabilidad de la aparición de parejas ordenadas de frecuencias cardiacas consecutivas y de su entropía es posible diagnosticar la dinámica cardiaca durante mínimo 18 horas.

Abstract Introduction: A new mathematical methodology of clinical application has been developed from the theory of dynamic systems, together with the theory of probability and the concept of entropy. Objective: To apply the methodology previously developed to evaluate the heart dynamics of adult through the probability and proportions of entropy of the attractor. Materials and methods: A blind study was developed taking as Gold Standard the conventional diagnosis issued by an expert with 480 Holter, 30 normal dynamics and 450 with different pathologies. For each Holter, a numerical attractor was generated by quantifying the probability of appearance of consecutive pairs of cardiac frequencies, subsequently evaluating entropy, S/K ratio and proportions for each dynamic for at least 18 hours. The values of sensitivity, specificity and Kappa coefficient were found. Results: The applied methodology allowed to differentiate quantitatively normality of disease, finding the values of the proportions in the established ranges. The sensitivity and specificity values were 100%, and Kappa coefficient was 1. Conclusion: It is possible to diagnose cardiac dynamics for at least 18 hours based on the probability distributions of the appearance of consecutive pairs of cardiac frequencies and their entropy.

Modelo de evaluación de requerimientos de privacidad, seguridad y calidad de servicio para aplicaciones médicas móviles / Model of assessment of requirements of privacy, security and quality of service for mobile medical applications

Resumen Introducción: El desarrollo de tecnologías móviles ha facilitado la creación de aplicaciones mHealth, las cuales son consideradas herramientas clave para la atención segura y de calidad a los pacientes de poblaciones apartadas y con carencia de infraestructura para la prestación de servicios de salud. El artículo considera una propuesta de un modelo de evaluación que permite determinar las debilidades y vulnerabilidades a nivel de seguridad y calidad de servicio (QoS) en aplicaciones mHealth. Objetivo: Realizar una aproximación de un modelo de análisis que apoye la toma de decisiones referentes al uso y producción de aplicaciones seguras, minimizando el impacto y la probabilidad de ocurrencia de los riesgos de seguridad informática. Materiales y métodos: El tipo de investigación aplicada es de tipo descriptivo, debido a que se detallan cada una las características que deben tener las aplicaciones móviles de salud para alcanzar un nivel de seguridad óptimo. La metodología utiliza las normas que regulan las aplicaciones y las mezcla con técnicas de análisis de seguridad, empleando la caracterización de riesgos planteadas por Open Web Application Security Project -OWASP y las exigencias de QoS de la Unión Internacional de Telecomunicaciones -UIT. Resultados: Se obtuvo un análisis efectivo en aplicaciones reales actuales, lo que muestra sus debilidades y los aspectos a corregir para cumplir con parámetros de seguridad adecuados. Conclusiones: El modelo permite evaluar los requerimientos de seguridad y calidad de servicio (QoS) de aplicaciones móviles para la salud que puede ser empleado para valorar aplicaciones actuales o generar los criterios antes de su despliegue.

Abstract Introduction: The development of mobile technologies has facilitated the creation of mHealth applications, which are considered key tools for safe and quality care for patients from remote populations and with lack of infrastructure for the provision of health services. The article considers a proposal for an evaluation model that allows to determine weaknesses and vulnerabilities at the security level and quality of service (QoS) in mHealth applications. Objective: To carry out an approximation of a model of analysis that supports the decision making, concerning the use and production of safe applications, minimizing the impact and the probability of occurrence of the risks of computer security. Materials and methods: The type of applied research is of a descriptive type, because each one details the characteristics that the mobile health applications must have to achieve an optimum level of safety. The methodology uses the rules that regulate applications and mixes them with techniques of security analysis, using the characterization of risks posed by Open Web Application Security Project-OWASP and the QoS requirements of the International Telecommunication Union-ITU. Results: An effective analysis was obtained in actual current applications, which shows their weaknesses and the aspects to be corrected to comply with appropriate security parameters. Conclusions: The model allows to evaluate the safety and quality of service (QoS) requirements of mobile health applications that can be used to evaluate current applications or to generate the criteria before deployment.