La ciberdefensa en los sistemas de información sanitarios militares / Cyberdefense in the Military Healthcare Information Systems

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Present and future of Spanish Military Telemedicine / Presente y futuro de la Telemedicina Militar Española. 25 años de la Unidad de Telemedicina en el Hospital Central de la Defensa «Gómez Ulla»

Telemedicine consists of the exchange of health information between healthcare professionals, and between healthcare professionals and patients, through the use of information and communications technologies (ICT). It is already considered an emerging technology in what is commonly called the «Productivity Plateau». It is also probably an exponential growth technology, in which the «trigger» for such growth will be a mixture of new technologies such as portable sensors/ wearables that detect multiple patient data (Blood Pressure, Heart Rate, Respiratory Rate, Glycaemia, Temperature, etc.), better communications (5G), augmented and mixed reality (augmented and virtual), artificial intelligence systems to improve diagnosis, etc. In Spain, Military Telemedicine is a pioneer in the field. The main mission is to provide remote health support to health professionals or military personnel deployed in Operations and remote or difficult-to-access locations. In 2021 the Spanish Telemedicine Unit at Central Defense Hospital «Gómez Ulla» will celebrate its 25Th anniversary. This article discusses the aforementioned aspects of telemedicine as an emerging technology and describes the current mission, organization and capabilities of Spanish military telemedicine, as well as its future

La Telemedicina consiste en el intercambio de información sanitaria entre profesionales sanitarios, o entre profesional sanitario y paciente, mediante el uso de las tecnologías de la información y comunicaciones (TIC). Se considera ya una tecnología emergente en el denominado «Plateau de productividad». Probablemente se trate de una tecnología de crecimiento exponencial, en la cual el «gatillo» para dicho crecimiento será una mezcla de diferentes tecnologías, como nuevos sensores portátiles que detecten múltiples datos de los pacientes (Tensión Arterial, Frecuencia cardiaca, Frecuencia respiratoria, Glucemia, Temperatura, etc), mejores comunicaciones (5G), realidad aumentada y mixta (aumentada y virtual), sistemas de inteligencia artificial para ayuda al diagnóstico, etc. En España, la Telemedicina Militar es pionera en este campo. Su misión fundamental es el apoyo y asesoramiento sanitario a distancia a personal sanitario y también no sanitario, tanto en Zona de Operaciones (ZO) como en situación de aislamiento y/o localización remota. En 2021 el Servicio de Telemedicina del Hospital Central de la Defensa «Gomez Ulla» celebrará su 25 aniversario. En el artículo se tratan los mencionados aspectos acerca de la Telemedicina como tecnología emergente y se describe la misión, organización y capacidades actuales de la Telemedicina Militar Española, así como sus perspectivas de futuro

[Influence of initial protocolized treatment with steroids in length of stay and costs of community acquired pneumonia]. / Influencia de la protocolización del tratamiento inicial con corticoides en la estancia y costo de las neumonías adquiridas en la comunidad. Estudio prospectivo 2015.

OBJECTIVE: The aim of the study was to analyze the impact of steroid treatment in patients with community acquired pneumonia (CAP), both in length of stay and economical cost of admission at a clinical university hospital. METHODS: Prospective study of admitted patients with the diagnosis of CAP, both in Internal Medicine and Infectious diseases department. The study was conducted from January to march 2015; patients receiving steroids from diagnosis to end of antibiotic treatment were classified as group I; otherwise, they were considered in group II. Administration of steroids was done according to the criteria of the responsible. Cost was stablished according to CAP Diagnostic Related Group (DRG). RESULTS: Prevalence of patients younger than 65 year-old was higher in group I (p<0.05). In bivariate analyses, mean admission time was lower in group I (5.37 vs 8.88 days) (p<0.0005) and also economical cost (2,361 euros vs 3,907 euros) (p<0.0005). In multivariate analysis, factors independently associated to higher cost (>3,520 euros) were COPD (OR=2.602; 95% CI 1.074-6.305) and group II (patients with no steroids) (OR=6.2; p=0,007). CONCLUSIONS: No administration of steroids in patients with CAP was associated, together with COPD, with higher economical cost (evaluated by DRG/length of stay).