[Blockchain in health: Transforming security and clinical data management]. / Blockchain en salud: transformando la seguridad y la gestión de datos clínicos.

INTRODUCTION: Technological advances continue to transform society, including the health sector. The decentralized and verifiable nature of blockchain technology presents great potential for addressing current challenges in healthcare data management. DISCUSSION: This article reports on how the generalized adoption of blockchain faces important challenges and barriers that must be addressed, such as the lack of regulation, technical complexity, safeguarding privacy, and economic and technological costs. Collaboration between medical professionals, technologists and legislators is essential to establish a solid regulatory framework and adequate training. CONCLUSION: Blockchain technology has the potential to revolutionize data management in the healthcare sector, improving the quality of medical care, empowering users, and promoting the secure sharing of data, but an important cultural change is needed, along with more evidence, to reveal its advantages in front of the existing technological alternative.

Effectiveness of the contingency plan for social and health care during the COVID-19 pandemic in a health district in northwestern Spain / Efectividad del plan de contingencia sociosanitario durante la pandemia de la COVID-19 en un distrito sanitario del noroeste de España

Introduction During the COVID-19 pandemic, healthcare facilities have implemented contingency plans to minimize the consequences of this pathology however, the deployment and results of these contingency plans are scarcely shared. Objectives To describe the implementation of the contingency plan in the social and health care in the COVID-19 pandemic in the Public Hospital of Monforte (Lugo, Spain) and to evaluate the effectiveness of the measures included in this plan. Method Phenomenological sampling conducted between March 10 and May 15, 2020. Evaluation qualitative assessment by an external quality improvement team of the Galician Health Service (SERGAS), based on the Practicum Direct rapid structured checklist in risk management, organizational management, and evaluation of decision making. As outcome indicators, we assessed the number of hospital admissions, number of PCRs performed, telephone attention to social and health social-healthcare patients, number of hospitalizations avoided and estimation of their direct cost. Results After assessing and managing the risks, an information security plan was developed and solutions to minimize complications in our patients derived from this pandemic. An emergency decision making team was created, as well as an employee communication mechanism for employees through standardized documents and documentation channels. Conclusions The adaptation of the Practicum Direct rapid model to the healthcare setting is a useful and easy-to-apply tool that allows us to identify weak points and areas for improvement in our Service and thus to strengthen patient care in all clinical areas, improving the quality of care (AU)

Introducción Durante la pandemia de la COVID-19 los centros sanitarios han puesto en marcha planes de contingencia para minimizar las consecuencias de esta enfermedad. Sin embargo, el despliegue y los resultados de estos planes de contingencia son escasamente compartidos. Objetivos Describir la implantación del plan de contingencia en la atención sociosanitaria en la pandemia de la COVID-19 en el Hospital Público de Monforte (Lugo, España) y evaluar la efectividad de las medidas incluidas en dicho plan. Método Muestreo fenomenológico realizado entre el 10 de marzo y el 15 de mayo de 2020. Evaluación cualitativa por un equipo externo de mejora de la calidad del Servicio Gallego de Salud, basada en la lista de verificación rápida estructurada Practicum Direct en gestión de riesgos, gestión organizativa y evaluación de la toma de decisiones. Como indicadores de resultado se valoraron el número de ingresos hospitalarios, el número de PCR realizadas, la atención telefónica a pacientes sociosanitarios, el número de hospitalizaciones evitadas y la estimación de su coste directo. Resultados Tras evaluar y gestionar los riesgos se elaboró un plan de seguridad de la información y soluciones para minimizar las complicaciones en nuestros pacientes derivadas de esta pandemia. Se creó un equipo de toma de decisiones de emergencia, así como un mecanismo de comunicación para los empleados a través de documentos y canales de documentación estandarizados. Conclusiones La adaptación del modelo Practicum Direct rapid al ámbito sanitario es una herramienta útil y de fácil aplicación que nos permite identificar puntos débiles y áreas de mejora en nuestro servicio, y así reforzar la atención al paciente en todas las áreas clínicas, mejorando la calidad asistencial (AU)

Effectiveness of the contingency plan for social and health care during the COVID-19 pandemic in a health district in northwestern Spain.

INTRODUCTION: During the COVID-19 pandemic, healthcare facilities have implemented contingency plans to minimize the consequences of this pathology however, the deployment and results of these contingency plans are scarcely shared. OBJECTIVES: To describe the implementation of the contingency plan in the social and health care in the COVID-19 pandemic in the Public Hospital of Monforte (Lugo, Spain) and to evaluate the effectiveness of the measures included in this plan. METHOD: Phenomenological sampling conducted between March 10 and May 15, 2020. Evaluation qualitative assessment by an external quality improvement team of the Galician Health Service (SERGAS), based on the Practicum Direct rapid structured checklist in risk management, organizational management, and evaluation of decision making. As outcome indicators, we assessed the number of hospital admissions, number of PCRs performed, telephone attention to social and health social-healthcare patients, number of hospitalizations avoided and estimation of their direct cost. RESULTS: After assessing and managing the risks, an information security plan was developed and solutions to minimize complications in our patients derived from this pandemic. An emergency decision making team was created, as well as an employee communication mechanism for employees through standardized documents and documentation channels. CONCLUSIONS: The adaptation of the Practicum Direct rapid model to the healthcare setting is a useful and easy-to-apply tool that allows us to identify weak points and areas for improvement in our Service and thus to strengthen patient care in all clinical areas, improving the quality of care.

Dataísmo (de la salud), tecnología y privacidad / (Health) dataism, technology and privacy

El dataísmo puede privar al individuo de su privacidad. Las personas reflexionan sobre el coste de oportunidad que supone ceder sus datos y otorgan mayor importancia a la efectividad en la lucha contra enfermedades y pandemias frente a su uso ilícito, ilegal o poco ético. El big data es un bien común de la humanidad, y compartir datos puede salvar vidas, pero aprovechémoslo aplicando correctamente la ética de los datos, donde los gobiernos y organizaciones estén implicados y se respete el derecho fundamental de protección de datos. (AU)

Dataism can deprive the individuals of their privacy. People are reflecting on the opportunity cost of giving away their data and are placing greater importance on the effectiveness of fighting diseases and pandemics than on its illicit, illegal or unethical use. Big data is a common good of humanity, and sharing data can save lives, but let’s harness it with the right application of data ethics, where governments and organisations are involved and the fundamental right to data protection is respected. (AU)

¿Cómo se muestra la actividad de las enfermeras por las Consejerías de Salud? / How is the nursing activity shown by the Spanish regional health ministries?

Objetivo: Analizar los indicadores de enfermería y los resultados de su actividad publicados por las Consejerías de Salud de las comunidades autónomas. Método: Estudio observacional descriptivo por 2 observadores con buscadores web localizando las memorias de actividad de las organizaciones sanitarias autonómicas. Para cada página web institucional se evaluó la existencia de información de actividad relacionada con «enfermería/enfermera/matrona». Se analizaron los indicadores de resultados asistenciales, de calidad y seguridad clínica y su presentación. Resultados: Configuración de listado de 19 entradas de servicios públicos de salud con los indicadores específicos de actividad enfermera de cada uno, partiendo de 56 webs institucionales analizadas. El perfil de indicadores más frecuentes resultante es: actividad mostrada desagregada por áreas de salud, de 2019, en «PDF», sin visión de género ni de edad, centrados en el número de consultas, frecuentación y presión asistencial en atención primaria. Conclusiones: La oferta de indicadores sanitarios presenta una gran variabilidad estatal. Se puede valorar los aportes cualitativos y cuantitativos autonómicos, centrados más en la estructura, en medir la actividad para la gestión y en el nivel de la atención primaria, pero con un escaso enfoque en la medición de buenas prácticas. Se confirma que la información publicada no refleja la realidad de la actividad enfermera, siendo llamativa la deficiencia de indicadores a nivel hospitalario.(AU)

Objective: To analyse the nursing records and the results of their activity published by the Spanish regional health ministries. Method: Descriptive observational study by two observers with web search engines locating the activity reports of the regional health organizations. The existence of activity information related to «nursing/nurse/midwife» was evaluated for each institutional web page. The indicators of care results, quality and clinical safety and their presentation were analysed. Results: Preparation of a table including 19 public health services entries with specific indicators/records of nursing activity for each one, based on 56 institutional websites. The most frequently resulting profile of indicators is activity shown disaggregated by health areas, from 2019, in «PDF» format, without gender or age vision, focused on the number of consultations, frequentation and healthcare pressure in primary care. Conclusions: The supply of health indicators presents a great state variability. Regional qualitative and quantitative contributions can be valued, focused more on structure, on measuring activity for management and at the level of primary care but with little focus on measuring good practices. It is confirmed that the published information does not reflect the reality of nursing activity. Being striking the deficiency of hospital activity indicators.(AU)

How is the nursing activity shown by the Spanish regional health ministries?

OBJECTIVE: To analyse the nursing records and the results of their activity published by the Spanish regional health ministries. METHOD: Descriptive observational study by two observers with web search engines locating the activity reports of the regional health organizations. The existence of activity information related to "nursing/nurse/midwife" was evaluated for each institutional web page. The indicators of care results, quality and clinical safety and their presentation were analysed. RESULTS: Preparation of a table including 19 public health services entries with specific indicators/records of nursing activity for each one, based on 56 institutional websites. The most frequently resulting profile of indicators is activity shown disaggregated by health areas, from 2019, in "PDF" format, without gender or age vision, focused on the number of consultations, frequentation and healthcare pressure in primary care. CONCLUSIONS: The supply of health indicators presents a great state variability. Regional qualitative and quantitative contributions can be valued, focused more on structure, on measuring activity for management and at the level of primary care but with little focus on measuring good practices. It is confirmed that the published information does not reflect the reality of nursing activity. Being striking the deficiency of hospital activity indicators.

Análisis descriptivo de los indicadores de actividad hospitalaria publicados por las consejerías de salud / Descriptive analysis of hospital activity indicators published by the Autonomous Regional Governments in the Spanish National Health System

Fundamentos: La oferta de datos de actividad sanitaria por las consejerías de salud no dispone de un estudio actual de la cuestión. El objetivo de este trabajo fue analizar y describir los indicadores de actividad hospitalaria relacionada con las organizaciones sanitarias públicas (consejerías de salud/sanidad en el Sistema Nacional de Salud español) mostrando las experiencias más notables en este sentido. Métodos: Estudio observacional. Se utilizaron buscadores generales de Internet para encontrar y valorar portales web institucionales (Ministerio de Sanidad, consejerías de sanidad/salud autonómicas) detallando existencia, disponibilidad, accesibilidad y calidad de la información (agregación, actualización, formato, visión de género y edad) de actividad de gestión hospitalaria ofrecida entre 2015-2019. Se usó estadística descriptiva con la estimación de la concordancia interobservadores. Resultados: Se generó un listado de 22 webs de servicios públicos de salud. Todas las instituciones valoradas disponían de información sobre actividad hospitalaria. Es compleja de encontrar, de libre acceso, desagregada (14), actualizada (2018), en formato PDF (15), visión de género: 2 (Catalunya y Madrid). Nº de indicadores por región: entre 10 y 99 (promedio=54). Índice de acuerdo Kappa (κ)=0,84. Aportaciones notables: Cataluña y Madrid, con otras prácticas a resaltar (Castilla y León, Murcia). Conclusiones: El análisis de la información de gestión ofrecida por las consejerías de salud muestra un patrón genérico de información de difícil acceso, desagregada y actualizada como mínimo a dos años vista desde el momento del estudio, con un rango amplio de indicadores, reducida aportación de la visión de género y en formato PDF que dificulta la investigación y docencia.(AU)

Background: The supply of health activity data by health regional governments does not have a current study of the issue. The aim of this study was to analyze and describe the indicators of hospital activity related to public health organizations (health departments in the Spanish National Health System) showing the most notable experiences in this regard. Methods: Observational study. General Internet search engines were used to find and evaluate institutional web portals (Ministry of Health, regional health governments) detailing existence, availability, accessibility and quality of information (aggregation, update, format, gender and age vision) of hospital management activity offered between 2015-2019. Descriptive statistics were used with estimation of interobserver concordance. Results: Generation of a list of 22 web portals for public health services. All the institutions evaluated had information on hospital activity. It is complex to find, freely available, disaggregated (14), updated (2018), in PDF format (15), gender vision: 2 (Catalonia and Madrid). No. of indicators per region: between 10 and 99 (average=54). Kappa agreement index (κ)=0.84. Notable contributions: Catalonia and Madrid, with other practices to highlight (Castilla y León, Murcia). Conclusions: The analysis of the management information offered by health regional governments shows a generic pattern of information that is difficult to access, disaggregated and updated at least two years from the time of the study, with a wide range of indicators, reduced contribution of the gender vision and in PDF format, which makes research and teaching difficult.(AU)

[What indicators of primary care activity are offered in the Spanish National Health System? Comparison between regionals governments health departments]. / ¿Qué indicadores de actividad de atención primaria se ofrecen en el Sistema Nacional de Salud? Comparación entre consejerías de salud.

The identification and evaluation of specific health care activity indicators of primary care and family medicine of the regional health ministries is proposed, analyzing their experiences. A descriptive observational study of healthcare information on institutional websites and its availability, accessibility, and quality, offered between 2015-2020 has been developed. A sample of 19 websites has been compiled. The information is freely accessible, aggregated at the regional/area level, updated (2018) and in "pdf" format. Only Catalonia and Valencia discern by sex and age. Most used indicators: assigned cards (health coverage), attendance and healthcare pressure. Average indicators per community: 6. The current experiences in indicators and activity data of primary care and family medicine at the level of the Spanish National Health System are shown. Catalonia and Madrid have stood out in offering quality of care and health outcomes. The constructive debate focuses on offering a coordinated proposal of information on quality and health outcomes, accessible, relevant, understandable, and updated, learning from current best practices.

¿Cómo afectan los medios sociales a la confidencialidad de los pacientes? Revisión de los potenciales problemas y recomendaciones / How social media affects the confidentiality of patients? A review of potential problems and recommendations / Como mídias sociais afetam a confidencialidade dos pacientes? Revisão dos potenciais problemas e recomendações

Resumen: Los datos personales relativos a la salud de un individuo se consideran como datos sensibles, por lo que necesitan una "especial protección". Nos encontramos en una sociedad en la que las tecnologías de información y comunicación (TIC), especialmente en lo referente a las redes sociales, ofrecen amplias posibilidades de intercambio de información médica, sirviendo de apoyo, consejo o ayuda a los compañeros que se encuentran en el mismo ámbito o en cualquier lugar de la geografía mundial. Los avances tecnológicos en comunicación desafían el concepto de "público" y de "privado", de tal forma que la información que se comparte es casi imposible de eliminar, pudiendo llegar a propagarse rápidamente por las redes. En base a nuestra propia experiencia y a los diferentes trabajos revisados, creemos que resulta necesario capacitar a los profesionales de la salud y especialmente a los estudiantes de medicina durante su formación, para que utilicen de forma adecuada dichas herramientas, especialmente a la hora de publicar contenido sensible en lugares cuyo acceso sea público, ya que puede tener consecuencias importantes para la intimidad de las personas, tanto para los pacientes como para su propia vida personal.

Abstract: Personal health data are considered as sensitive information, so they need a "special protection". We are in a society where Information and Communications Technology (ICT), especially in relation to social networks, offer many opportunities for the exchange of medical information, serving as support, advice or assistance to colleagues who work in the same field or in any other place around the world. Technological advances in communication challenge the concept of "public" and "private," in a way that the shared information is almost impossible to remove, and could spread rapidly through social networks. Based on our own experience and the different papers reviewed, we believe it is necessary to train health professionals and especially medical students during their academic education to use these tools properly, especially when posting sensitive data in places of public access, as it may have important consequences for the privacy of individuals, both for patients and for their own life.

Resumo: Os dados pessoais relativos à saúde do indivíduo são considerados dados sensíveis, por esse motivo eles necessitam de uma "proteção especial". Nos encontramos em uma sociedade em que as tecnologias de informação e comunicação (TIC), especialmente em relação às redes sociais, oferecem amplas oportunidades para a troca de informações médicas, servindo como apoio, conselho ou assistência aos colegas que estão na mesma área ou em qualquer lugar na geografia mundial. Os avanços tecnológicos em comunicação desafiam os conceitos de "público" e de "privado", de tal maneira que a informação compartilhada é quase impossível de ser eliminada, podendo se propagar rapidamente através das redes. Com base em nossa própria experiência e em diferentes trabalhos revisados, acreditamos que é necessário capacitar profissionais de saúde e especialmente os estudantes de medicina durante sua formação, para que utilizem de forma adequada estas ferramentas, especialmente quando se trata de publicar conteúdo sensível em locais cujo acesso será público, uma vez que pode ter implicações importantes para a privacidade das pessoas, tanto para pacientes como para sua própria vida pessoal.