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1.
Front Public Health ; 9: 676838, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34650946

RESUMO

Introduction: The COVID-19 crisis provides an opportunity to reflect on what worked during the pandemic, what could have been done differently, and what innovations should become part of an enhanced health information system in the future. Methods: An online qualitative survey was designed and administered online in November 2020 to all the 37 Member States that are part of the WHO European Health Information Initiative and the WHO Central Asian Republics Information Network. Results: Nineteen countries responded to the survey (Austria, Belgium, Croatia, Czech Republic, Finland, Greece, Iceland, Ireland, Israel, Italy, Kazakhstan, Latvia, Lithuania, Romania, Russian Federation, Sweden, Turkey, United Kingdom, and Uzbekistan). The COVID-19 pandemic required health information systems (HIS) to rapidly adapt to identify, collect, store, manage, and transmit accurate and timely COVID-19 related data. HIS stakeholders have been put to the test, and valuable experience has been gained. Despite critical gaps such as under-resourced public health services, obsolete health information technologies, and lack of interoperability, most countries believed that their information systems had worked reasonably well in addressing the needs arising during the COVID-19 pandemic. Conclusion: Strong enabling environments and advanced and digitized health information systems are vital to controlling epidemics. Sustainable finance and government support are required for the continued implementation and enhancement of HIS. It is important to promote digital solutions beyond the COVID-19 pandemic. Now is the time to discuss potential solutions to obtain timely, accurate, and reliable health information and steer policy-making while protecting privacy rights and meeting the highest ethical standards.


Assuntos
COVID-19 , Sistemas de Informação em Saúde , República Tcheca , Humanos , Pandemias/prevenção & controle , SARS-CoV-2
2.
Int J Med Inform ; 152: 104507, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34049051

RESUMO

BACKGROUND: The recent, rapid development of digital technologies offers new possibilities for more efficient implementation of electronic health record (EHR) and personal health record (PHR) systems. A growing volume of healthcare data has been the hallmark of this digital transformation. The large healthcare datasets' complexity and their dynamic nature pose various challenges related to processing, analysis, storage, security, privacy, data exchange, and usability. MATERIALS AND METHODS: We performed a systematic review of systematic reviews to assess technological progress in EHR and PHR systems. We searched MEDLINE, Cochrane, Web of Science, and Scopus for systematic literature reviews on technological advancements that support EHR and PHR systems published between January 1, 2010, and October 06, 2020. RESULTS: The searches resulted in a total of 2,448 hits. Of these, we finally selected 23 systematic reviews. Most of the included papers dealt with information extraction tools and natural language processing technology (n = 10), followed by studies that assessed the use of blockchain technology in healthcare (n = 8). Other areas of digital technology research included EHR and PHR systems in austere settings (n = 1), de-identification methods (n = 1), visualization techniques (n = 1), communication tools within EHR and PHR systems (n = 1), and methodologies for defining Clinical Information Models that promoted EHRs and PHRs interoperability (n = 1). CONCLUSIONS: Technological advancements can improve the efficiency in the implementation of EHR and PHR systems in numerous ways. Natural language processing techniques, either rule-based, machine-learning, or deep learning-based, can extract information from clinical narratives and other unstructured data locked in EHRs and PHRs, allowing secondary research (i.e., phenotyping). Moreover, EHRs and PHRs are expected to be the primary beneficiaries of the blockchain technology implementation on Health Information Systems. Governance regulations, lack of trust, poor scalability, security, privacy, low performance, and high cost remain the most critical challenges for implementing these technologies.


Assuntos
Blockchain , Registros de Saúde Pessoal , Humanos , Registros Eletrônicos de Saúde , Revisões Sistemáticas como Assunto , Tecnologia
3.
Sci Rep ; 11(1): 3052, 2021 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-33542280

RESUMO

Societal concern with the welfare of egg laying hens housed in conventional cages is fostering a transition towards cage-free systems in many countries. However, although cage-free facilities enable hens to move freely and express natural behaviours, concerns have also been raised over the possibility that cage-free flocks experience higher mortality, potentially compromising some aspects of their welfare. To investigate this possibility, we conducted a large meta-analysis of laying hen mortality in conventional cages, furnished cages and cage-free aviaries using data from 6040 commercial flocks and 176 million hens from 16 countries. We show that except for conventional cages, mortality gradually drops as experience with each system builds up: since 2000, each year of experience with cage-free aviaries was associated with a 0.35-0.65% average drop in cumulative mortality, with no differences in mortality between caged and cage-free systems in more recent years. As management knowledge evolves and genetics are optimized, new producers transitioning to cage-free housing may experience even faster rates of decline. Our results speak against the notion that mortality is inherently higher in cage-free production and illustrate the importance of considering the degree of maturity of production systems in any investigations of farm animal health, behaviour and welfare.


Assuntos
Bem-Estar do Animal , Galinhas/fisiologia , Abrigo para Animais , Mortalidade , Criação de Animais Domésticos , Animais , Comportamento Animal/fisiologia , Fazendas
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