Implementación ágil: un proyecto de respuesta rápida a COVID-19

Webinar organizado por la Red Centroamericana de Informática en Salud (RECAINSA), con la participación de Juan Pablo Hurtado (Compunet Colombia) y Daniela Naranjo (Elsevier Clinical Solutions), realizado el 15 de mayo de 2020.

Evolution and differentiation of the cybersecurity communities in three social question and answer sites: A mixed-methods analysis.

Cybersecurity affects us all in our daily lives. New knowledge on best practices, new vulnerabilities, and timely fixes for cybersecurity issues is growing super-linearly, and is spread across numerous, heterogeneous sources. Because of that, community contribution-based, question and answer sites have become clearinghouses for cybersecurity-related inquiries, as they have for many other topics. Historically, Stack Overflow has been the most popular platform for different kinds of technical questions, including for cybersecurity. That has been changing, however, with the advent of Security Stack Exchange, a site specifically designed for cybersecurity-related questions and answers. More recently, some cybersecurity-related subreddits of Reddit, have become hubs for cybersecurity-related questions and discussions. The availability of multiple overlapping communities has created a complex terrain to navigate for someone looking for an answer to a cybersecurity question. In this paper, we investigate how and why people choose among three prominent, overlapping, question and answer communities, for their cybersecurity knowledge needs. We aggregated data of several consecutive years of cybersecurity-related questions from Stack Overflow, Security Stack Exchange, and Reddit, and performed statistical, linguistic, and longitudinal analysis. To triangulate the results, we also conducted user surveys. We found that the user behavior across those three communities is different, in most cases. Likewise, cybersecurity-related questions asked on the three sites are different, more technical on Security Stack Exchange and Stack Overflow, and more subjective and personal on Reddit. Moreover, there appears to have been a differentiation of the communities along the same lines, accompanied by overall popularity trends suggestive of Stack Overflow's decline and Security Stack Exchange's rise within the cybersecurity community. Reddit is addressing the more subjective, discussion type needs of the lay community, and is growing rapidly.

Human Factors and Organizational Issues Section Synopsis IMIA Yearbook 2021.

OBJECTIVE: To select the best papers that made original and high impact contributions in the area of human factors and organizational issues in biomedical informatics in 2020. METHODS: A rigorous extraction process based on queries from Web of Science® and PubMed/Medline was conducted to identify the scientific contributions published in 2020 that address human factors and organizational issues in biomedical informatics. The screening of papers on titles and abstracts independently by the two section editors led to a total of 1,562 papers. These papers were discussed for a selection of 12 finalist papers, which were then reviewed by the two section editors, two chief editors, and by three external reviewers from internationally renowned research teams. RESULTS: The query process resulted in 12 papers that reveal interesting and rigorous methods and important studies in human factors that move the field forward, particularly in clinical informatics and emerging technologies such as brain-computer interfaces. This year three papers were clearly outstanding and help advance in the field. They provide examples of applying existing frameworks together in novel and highly illuminating ways, showing the value of theory development in human factors. Emerging themes included several which discussed physician burnout, mobile health, and health equity. Those concerning the Corona Virus Disease 2019 (Covid-19) were included as part of that section. CONCLUSION: The selected papers make important contributions to human factors and organizational issues, expanding and deepening our knowledge of how to apply theory and applications of new technologies in health.

COVID-19 reveals the urgent need to strengthen nursing informatics competencies: a view from Peru.

The COVID-19 pandemic requires an urgent action to transform health-care delivery and to promote research and capacity-building nursing programs. Specifically, many countries at the global level have described nursing informatics as an essential competence for nurse professionals. In Peru, nursing personnel represents the largest health workforce group and nursing informatics is still emerging, but the field appear to hold much promise. In this sense, the Peruvian Ministry of Health (MoH) defined in 2020 the core nursing competences, which included a technology and innovation domain. The competence established to apply scientifically based technology and innovation to improve the processes or health service resources. The minimum competencies established by the MoH were as follows: to carry out innovations in processes or resources in their different professional performance areas, to creatively adapt technology in different areas of professional performance, to make rational and ethical use of health technologies with focus on new developments that will be evaluated and applied critically, and to manage information and communication technologies, and health information systems, with emphasis on telehealth (i.e. telemedicine, telecare management, tele-education, and tele-training). Besides the nursing competences defined by the MoH is a good starting point, this special contribution discusses the urgent need to strengthen nursing informatics competencies in Peru.

Patient Empowerment During the COVID-19 Pandemic by Ensuring Safe and Fast Communication of Test Results: Implementation and Performance of a Tracking System.

BACKGROUND: Overcoming the COVID-19 crisis requires new ideas and strategies for online communication of personal medical information and patient empowerment. Rapid testing of a large number of subjects is essential for monitoring and delaying the spread of SARS-CoV-2 in order to mitigate the pandemic's consequences. People who do not know that they are infected may not stay in quarantine and, thus, risk infecting others. Unfortunately, the massive number of COVID-19 tests performed is challenging for both laboratories and the units that conduct throat swabs and communicate the results. OBJECTIVE: The goal of this study was to reduce the communication burden for health care professionals. We developed a secure and easy-to-use tracking system to report COVID-19 test results online that is simple to understand for the tested subjects as soon as these results become available. Instead of personal calls, the system updates the status and the results of the tests automatically. This aims to reduce the delay when informing testees about their results and, consequently, to slow down the virus spread. METHODS: The application in this study draws on an existing tracking tool. With this open-source and browser-based online tracking system, we aim to minimize the time required to inform the tested person and the testing units (eg, hospitals or the public health care system). The system can be integrated into the clinical workflow with very modest effort and avoids excessive load to telephone hotlines. RESULTS: The test statuses and results are published on a secured webpage, enabling regular status checks by patients; status checks are performed without the use of smartphones, which has some importance, as smartphone usage diminishes with age. Stress tests and statistics show the performance of our software. CTest is currently running at two university hospitals in Germany-University Hospital Ulm and University Hospital Tübingen-with thousands of tests being performed each week. Results show a mean number of 10 (SD 2.8) views per testee. CONCLUSIONS: CTest runs independently of existing infrastructures, aims at straightforward integration, and aims for the safe transmission of information. The system is easy to use for testees. QR (Quick Response) code links allow for quick access to the test results. The mean number of views per entry indicates a reduced amount of time for both health care professionals and testees. The system is quite generic and can be extended and adapted to other communication tasks.

Development of a data utility framework to support effective health data curation.

OBJECTIVES: The value of healthcare data is being increasingly recognised, including the need to improve health dataset utility. There is no established mechanism for evaluating healthcare dataset utility making it difficult to evaluate the effectiveness of activities improving the data. To describe the method for generating and involving the user community in developing a proposed framework for evaluation and communication of healthcare dataset utility for given research areas. METHODS: Aninitial version of a matrix to review datasets across a range of dimensions wasdeveloped based on previous published findings regarding healthcare data. Thiswas used to initiate a design process through interviews and surveys with datausers representing a broad range of user types and use cases, to help develop afocused framework for characterising datasets. RESULTS: Following 21 interviews, 31 survey responses and testing on 43 datasets, five major categories and 13 subcategories were identified as useful for a dataset, including Data Model, Completeness and Linkage. Each sub-category was graded to facilitate rapid and reproducible evaluation of dataset utility for specific use-cases. Testing of applicability to >40 existing datasets demonstrated potential usefulness for subsequent evaluation in real-world practice. DISCUSSION: Theresearch has developed an evidenced-based initial approach for a framework tounderstand the utility of a healthcare dataset. It likely to require further refinementfollowing wider application and additional categories may be required. CONCLUSION: The process has resulted in a user-centred designed framework for objectively evaluating the likely utility of specific healthcare datasets, and therefore, should be of value both for potential users of health data, and for data custodians to identify the areas to provide the optimal value for data curation investment.

Digital Health during COVID-19: Informatics Dialogue with the World Health Organization.

BACKGROUND: On December 16, 2020 representatives of the International Medical Informatics Association (IMIA), a Non-Governmental Organization in official relations with the World Health Organization (WHO), along with its International Academy for Health Sciences Informatics (IAHSI), held an open dialogue with WHO Director General (WHO DG) Tedros Adhanom Ghebreyesus about the opportunities and challenges of digital health during the COVID-19 global pandemic. OBJECTIVES: The aim of this paper is to report the outcomes of the dialogue and discussions with more than 200 participants representing different civil society organizations (CSOs). METHODS: The dialogue was held in form of a webinar. After an initial address of the WHO DG, short presentations by the panelists, and live discussions between panelists, the WHO DG and WHO representatives took place. The audience was able to post questions in written. These written discussions were saved with participants' consent and summarized in this paper. RESULTS: The main themes that were brought up by the audience for discussion were: (a) opportunities and challenges in general; (b) ethics and artificial intelligence; (c) digital divide; (d) education. Proposed actions included the development of a roadmap based on the lessons learned from the COVID-19 pandemic. CONCLUSIONS: Decision making by policy makers needs to be evidence-based and health informatics research should be used to support decisions surrounding digital health, and we further propose next steps in the collaboration between IMIA and WHO such as future engagement in the World Health Assembly.

Health Information Management Reimagined: Assessing Current Professional Skills and Industry Demand.

This paper examines the changes affecting the health information management (HIM) professional skill set and industry demand to determine differences affecting practitioners. As the industry continues to experience technological innovation, the responsibilities of the HIM professional are in flux, affecting the required skill set of the changing environment. This research used the American Health Information Management Association salary survey and current job postings to determine whether the workforce has experienced deskilling and whether a theory-practice-gap exists. It also assesses if industry competencies align with the Health Information Management Reimaged perspectives. The results indicate that the workforce has not experienced deskilling, that a theory-practice gap does exist, and that Health Information Management Reimaged is aligned with industry needs.

What it means to be a woman in the field of biomedical informatics: exploring the lived experiences of women managers in the kingdom of Saudi Arabia.

OBJECTIVE: Although women in the field of biomedical informatics (BMI) are part of a golden era, little is known about their lived experiences as informaticians. Guided by feminist standpoint theory, this study aims to understand the impact of social change in the Kingdom of Saudi Arabia- in the form of new policies supporting women and health technological advancements-in the field of BMI and its women informaticians. MATERIALS AND METHODS: We conducted semistructured telephone interviews with 7 women managers in the field of BMI, identified through LinkedIn. We analyzed interview transcripts to generate themes about their lived experiences, how they perceived health information technology tools, identified challenges that may hinder the advancement of the field, and explored the future of BMI from their perspectives. During our analysis, we utilized a feminist theoretical approach. RESULTS: Women managers in the field of BMI shared similar experiences and perspectives. Our analysis generated 10 themes: (1) career beginning, (2) opportunities given, (3) career achievements, (4) gender-based experiences, (5) meaning of BMI, (6) meaning of health information technology tools, (7) challenges, (8) overcoming challenges, (9) future and hopes, and (10) meaning of "2030 Saudi vision." Early in their careers, participants experienced limited opportunities and misperceptions in understanding what the field of informatics represents. Participants did not feel that gender was an issue, despite what feminist theory would have predicted. CONCLUSIONS: Recognizing the lived experiences of women in the field of BMI contributes to our collective understanding of how these experiences may enhance our knowledge of the field.

Medical and health informatics services during and after the COVID-19 pandemic should be virtual, tailored, responsive and interactive: a case study in Belgium.

This is part of a new series in this regular feature regarding trends in the provision of information by health science libraries. By sharing expertise and drawing together relevant trends the series intends to serve as a road map for both health science librarians and health informatics professionals. This article shows how a medical and biomedical research library changed practices, and reassessed user needs for the COVID-19 emergency. Discusses changes to online education (and collaborative working) to provide user-friendly services, researcher support tailored to need and re-visioning library space. J.M.

Development and Optimization of Clinical Informatics Infrastructure to Support Bioinformatics at an Oncology Center.

Translational bioinformatics for therapeutic discovery requires the infrastructure of clinical informatics. In this chapter, we describe the clinical informatics components needed for successful implementation of translational research at a cancer center. This chapter is meant to be an introduction to those clinical informatics concepts that are needed for translational research. For a detailed account of clinical informatics, the authors will guide the reader to comprehensive resources. We provide examples of workflows from Moffitt Cancer Center led by Drs. Perkins and Markowitz. This perspective represents an interesting collaboration as Dr. Perkins is the Chief Medical Information Officer and Dr. Markowitz is a translational researcher in Melanoma with an active informatics component to his laboratory to study the mechanisms of resistance to checkpoint blockade and an active member of the clinical informatics team.

Leveraging Pathology Informatics Concepts to Achieve Discrete Lab Data for Clinical Use and Translational Research.

Clinical practice is most efficient when physicians have the right information, including pathology and laboratory results, at the point of contact with the patient. In downstream workflows, subsequent groups using lab data want to have it available in a format that is easy to manipulate. With the complexity of electronic medical records, hospital information systems, and the need to accommodate data from outside systems, this is not easy to accomplish. By utilizing a group of concepts from clinical and pathology informatics, system implementations may be improved to achieve relevant laboratory data in a format that is usable by healthcare entities to improve patient care and forward endeavors in precision medicine.

Human Factors and Organizational Issues.

OBJECTIVE: To select the best papers that made original and high impact contributions in the area of human factors and organizational issues in biomedical informatics in 2019. METHODS: A rigorous extraction process based on queries from Web of Science® and PubMed/Medline was conducted to identify the scientific contributions published in 2019 that address human factors and organizational issues in biomedical informatics. The screening of papers on titles and abstracts independently by the two editors led to a total of 30 papers. These papers were discussed for a selection of 15 finalist papers, which were then reviewed by the two editors and by three external reviewers from internationally renowned research teams. RESULTS: The query process resulted in 626 papers that reveal interesting and rigorous methods and important studies in human factors that move the field forward, particularly in clinical informatics and emerging technologies such as brain-computer interfaces. This year three papers were clearly outstanding and help advance the field. They provide examples of applying existing frameworks together in novel and highly illuminating ways, showing the value of theory development in human factors. CONCLUSION: The selected papers make important contributions to human factors and organizational issues, expanding and deepening our knowledge of how to apply theory and applications of new technologies in health.

A mid-South chronic disease registry and practice-based research network to address disparities.

OBJECTIVES: To describe an innovative health information technology (HIT) model for supporting community-wide health improvement through multiprovider collaboration in a regional population health registry and practice-based research network (PBRN). STUDY DESIGN: Case study. METHODS: We describe the HIT data structure and governance of the Diabetes Wellness and Prevention Coalition (DWPC) Registry and PBRN based in Memphis, Tennessee. The population served and their characteristics were assessed for all adult patients with at least 1 encounter in a participating health care delivery system from January 1, 2013, to March 31, 2019. Disparities in access and health care utilization were assessed by residential zip code. RESULTS: The DWPC Registry is a chronic disease and population health data warehouse designed to facilitate chronic disease surveillance and tracking of processes and outcomes of care in medically underserved areas of the mid-South. The Registry primarily focuses on obesity-associated chronic conditions such as diabetes, hypertension, hyperlipidemia, and chronic kidney disease. It combines patient data from 7 regional health systems, which include 6 adult hospitals and more than 50 outpatient practices, covering 462,223 adults with 2,032,425 clinic visits and 602,679 hospitalizations and/or emergency department visits from January 1, 2013, to March 31, 2019. The most prevalent chronic conditions include obesity (37.2%), hypertension (34.4%), overweight (26.4%), hyperlipidemia (18.0%), and type 2 diabetes (14.0%). The Registry provides quarterly practice improvement reports to participating clinics, facilitates surveillance of and outreach to patients with unmet health needs, and supports a pragmatic clinical trial and multiple cohort studies. CONCLUSIONS: Regional registries and PBRNs are powerful tools that can support real-world quality improvement and population health efforts to reduce disparities and improve equity in chronic disease care in medically underserved communities across the United States.

HDR UK supporting mobilising computable biomedical knowledge in the UK.

Computable biomedical knowledge (CBK) represents an evolving area of health informatics, with potential for rapid translational patient benefit. Health Data Research UK (HDR UK) is the national Institute for Health Data Science, whose aim is to unite the UK's health data to enable discoveries that improve people's lives. The three main components include the UK HDR Alliance of data custodians, committed to making health data available for research and innovation purposes for public benefit while ensuring safe use of data and building public trust, the HDR Hubs, as centres of expertise for curating data and providing expert domain-specific services, and the HDR Innovation Gateway ('Gateway'), providing discovery, accessibility, security and interoperability services. To support CBK developments, HDR UK is encouraging use of open data standards for research purposes, with guidance around areas in which standards are emerging, aims to work closely with the international CBK community to support initiatives and aid with evaluation and collaboration, and has established a phenomics workstream to create a national platform for dissemination of machine readable and computable phenotypical algorithms to reduce duplication of effort and improve reproducibility in clinical studies.

COVID-19 e Telemedicina: ferramenta de medição do nível de maturidade das instituições de saúde para implementar serviços de telemedicina / COVID-19 y Telemedicina: herramienta de medición del nivel de madurez de las instituciones de salud para implementar servicios de telemedicina / COVID-19 and Telemedicine: tool for assessing the maturity level of health institutions to implement telemedicine services / COVID-19 et Télémédecine: outil de mesure du niveau de maturité des établissements de santé pour la mise en œuvre des services de télémédecine

A elaboração desta ferramenta faz parte do apoio às operações de resposta à pandemia. Baseia-se nos modelos implementados por diferentes instituições de saúde em vários países do mundo, com diferentes graus de complexidade. Instituições e especialistas em telemedicina e no uso de tecnologia da informação na área da saúde pública da Região das Américas e da Espanha colaboraram em seu desenvolvimento. A ferramenta foi desenvolvida com o entendimento de que existe uma intenção institucional de implementar serviços de telemedicina imediatamente. Porém, também será útil para instituições que já contam com programas de telemedicina e desejam fazer uma autoavaliação para redefinir as suas prioridades diante da pandemia. A ferramenta traz uma série de perguntas organizadas nas seis categorias.

La elaboración de esta herramienta forma parte del apoyo a las operaciones de respuesta a la pandemia. Se basa en los modelos que distintas instituciones de salud con diferente grado de complejidad han implementado en varios países del mundo. En su desarrollo han colaborado instituciones y expertos de la Región de las Américas y de España especializados en telemedicina y en el uso de tecnologías de la información en la esfera de la salud pública. La herramienta se ha desarrollado en el entendido de que existe la intención institucional de implementar de forma inmediata servicios de telemedicina. Pero también resultará útil a las instituciones que ya cuenten con programas de telemedicina en funcionamiento y que deseen autoevaluarse para redefinir prioridades frente a la pandemia. La herramienta consta de una serie de preguntas organizadas en las seis categorías.

This tool forms part of the support for pandemic response operations. Its design is based on the models that have been implemented by different health institutions with different levels of complexity in several countries. The tool was developed collaboratively with institutions and experts specialized in telemedicine and in the use of information technology (IT) in public health, from the Region of the Americas and. The tool has been developed with the understanding that there is an institutional commitment to immediately implement telemedicine services. However, it will also be useful to institutions that already have telemedicine programs up and running, which want to perform a self-assessment to redefine their priorities in light of the pandemic. The tool comprises a series of questions, organized into the six categories.

La mise au point de cet outil s'inscrit dans le cadre du soutien aux opérations d'intervention en cas de pandémie. Il repose sur les modèles que différents établissements de santé avec des degrés de complexité variables ont mis en œuvre dans plusieurs pays à travers le monde. Des institutions et des experts de la Région des Amériques et d'Espagne spécialisés dans la télémédecine et l'utilisation des technologies de l'information dans le domaine de la santé publique ont collaboré au développement du présent outil (voir annexe). L'existence d'une intention institutionnelle de mettre immédiatement en œuvre des services de télémédecine est un préalable au développement de cet outil. Néanmoins, ce dernier sera également utile pour les institutions qui ont déjà mis en place des programmes de télémédecine et qui souhaitent réaliser une auto-évaluation de manière à redéfinir leurs priorités face à la pandémie. L'outil comprend une série de questions organisées selon les six catégories.

The increasing value of eHealth in the delivery of patient-centred cancer care.

The increasing use of eHealth has ushered in a new era of patient-centred cancer care that moves beyond the traditional in-person care model to real-time, dynamic, and technology-assisted assessments and interventions. eHealth has the potential to better the delivery of cancer care through improved patient-provider communication, enhanced symptom and toxicity assessment and management, and optimised patient engagement across the cancer care continuum. In this Review, we provide a brief, narrative appraisal of the peer reviewed literature over the past 10 years related to the uses of patient-centred eHealth to improve cancer care delivery. These uses include the addressal of symptom management, health-related quality of life, and other patient-reported outcomes across cancer care. In addition, we discuss the challenges of, and opportunities for, accessibility, scalability, and implementation of these technologies, important areas for further development, and future research directions.