Calidad de la información en salud de México en el contexto de la OCDE: 2017-2021 / Quality of health information in Mexico in the OECD context: 2017-2021

Objetivo Evaluar el sistema de información en salud (SIS) de México según la información reportada a la Organización para la Cooperación y el Desarrollo Económicos (OCDE). El fin último es evidenciar las mejoras que se deberían considerar. Método Se analizan indicadores sobre salud publicados por la OCDE (2017 a 2021) según 11 grupos temáticos. Se valoraron cobertura (cantidad y tipo de indicadores reportados por grupo temático) y calidad de la información, según lineamientos de la OCDE. Resultados México reportó anualmente 14 de 378 indicadores (3,7%) y de forma discontinua 204. En ningún grupo se reportaron anualmente todos los indicadores, excepto los dos sobre COVID-19. Se reportan anualmente tres de 88 sobre utilización de servicios y ninguno sobre estado de salud, calidad de la atención y mercado farmacéutico. Con calidad óptima y reporte anual fueron 12 indicadores (5,5% de los reportados por México, 3,2% del set completo OCDE). El 57,7% de los indicadores reportados tuvieron al menos un defecto de calidad. Conclusiones En el marco de los estándares marcados por la OCDE, de la cual México es miembro, el SIS mexicano presenta déficits importantes de cobertura y de calidad de la información. Estos resultados deberían considerarse para implementar iniciativas de mejora. (AU)

Objective To evaluate the health information system (HIS) of Mexico according to the information reported to the Organization for Economic Co-operation and Development (OECD). The ultimate goal is to identify the improvements that should be considered. Method Health indicators published by the OECD (2017 to 2021) are analyzed according to 11 thematic groups. Coverage (quantity and type of indicators reported by thematic group) and quality of information were assessed, according to OECD guidelines. Results Mexico reported annually 14 of 378 indicators (3.7%), and discontinuously 204. In no group were all indicators reported annually, except for the two on COVID-19. Three out of 88 were reported annually on use of services; and none on health status, quality of care and pharmaceutical market. Twelve indicators (5.5% of those reported by Mexico, 3.2% of the full OECD set) had optimal quality and annual reporting. 57.7% of the reported indicators had at least one quality defect. Conclusions Within the framework of the standards set by the OECD, of which Mexico is a member, the Mexican HIS presents significant deficits in coverage and quality of information. These results should be considered to implement improvement initiatives. (AU)

Spatial distribution of acute cases of Chagas disease reported from 2010 to 2020 in the State of Amazonas / Distribuição espacial dos casos agudos de doença de Chagas notificados de 2010 a 2020 no Estado da Amazônia / Distribución espacial de los casos agudos de enfermedad de Chagas notificados de 2010 a 2020 en el Estado Amazónico

This study aimed to investigate the epidemiology of acute cases of Chagas disease notified in the State of Amazonas between the period from 2010 to 2020. Data were obtained from the portal of the Sistema de Informação de Agravos de Notificação- SINAN, considering the number of cases per municipality of notification. 140 cases of Acute Chagas Disease were notified, distributed in 23 of the 62 municipalities of the State of Amazonas, 82 (59%) were male individuals, with a greater predominance in the age group of 20-39 years old, having 45 (32.1%) cases. As for the race/color variable, the highest number was among brown people with 101 (72.1%) notifications. The oral route prevailed as the main form of disease transmission with 93 (66.4%) records. Infection by the oral route of T. cruzi is the most important route of transmission of CD in the State of Amazonas, the occurrence of transmission is associated in most cases with the consumption of foods such as açaí juice and has been reported frequently over the years between municipalities.

este estudo se propôs a investigar a epidemiologia dos casos agudos de Doença de Chagas notificados no Estado do Amazonas no período de 2010 a 2020. Os dados foram obtidos no portal do Sistema de Informação de Agravos de Notificação - SINAN, considerando o número de casos por município de notificação. Foram notificados 140 casos de Doença de Chagas Aguda, distribuídos em 23 dos 62 municípios do Estado do Amazonas, 82 (59%) eram indivíduos do sexo masculino, com maior predominância na faixa etária de 20-39 anos de idade com 45 (32,1%) casos. Quanto a variável raça/cor, a maior registro foi entre pardos com 101(72,1%) notificações. A via oral, prevaleceu como a principal forma de transmissão da patologia com 93 (66,4%) registros. A infecção pela via oral do T. cruzi, é a mais importante via de transmissão de DC no Estado do Amazonas, a ocorrência da transmissão está associada na maioria das vezes ao consumo de alimentos como o suco de açaí, e tem sido reportada com frequência ao longo dos anos entre os municípios.

Este estudio tuvo como objetivo investigar la epidemiología de los casos agudos de la enfermedad de Chagas notificados en el Estado de Amazonas en el período de 2010 a 2020. Los datos fueron obtenidos del portal del Sistema de Información de Enfermedades de Notificación - SINAN, considerando el número de casos por municipio de notificación. Se notificaron 140 casos de Enfermedad de Chagas Aguda, distribuidos en 23 de los 62 municipios del Estado de Amazonas, 82 (59%) fueron individuos del sexo masculino, con mayor predominio en el grupo etario de 20 a 39 años con 45 (32,1%) casos. En cuanto a la variable raza/color, el mayor número fue entre los morenos con 101 (72,1%) notificaciones. La vía oral predominó como principal vía de transmisión de la enfermedad con 93 (66,4%) registros. La infección por vía oral de T. cruzi es la vía de transmisión más importante de la EC en el Estado de Amazonas, la ocurrencia de la transmisión está mayoritariamente asociada al consumo de alimentos como el jugo de açaí, y ha sido reportada con frecuencia a lo largo de los años entre municipios.

Análise dos sistemas de informação sobre violência contra as mulheres / Analysis of information systems on violence against women

Esta tese tem como objetivo analisar três sistema de informação (SI) sobre violência contra as mulheres ­ Sistema de Controle Operacional (PCERJ), Central de Atendimento à Mulher ­ Ligue 180 e Sistema de Informação de Agravos de Notificação (SINAN) ­ a partir do exame dos seus processos de coleta, processamento/organização e disseminação e com recorte em violência por parceiro(a) íntimo(a). Trata-se de uma pesquisa qualitativa em que foram analisados documentos referentes à implantação dos SI, além dos relatórios produzidos. Ademais, foram realizadas quatorze entrevistas semiestruturadas com atores estratégicos de cada sistema de informação, sendo utilizada a análise temática como referencial analítico. O acervo foi submetido a uma leitura flutuante e foi categorizado a partir dos seguintes eixos temáticos: Violência por Parceiro Íntimo e Informação; Modos de coleta, processamento e disseminação da informação sobre VPI: limites e possibilidades; Informação sobre VPI e Políticas Públicas. Os resultados mostraram o caráter político dos sistemas de informação sobre violência contra as mulheres no processo de produção de informações sobre o fenômeno. Ademais, da importância da adoção da perspectiva interseccional, a fim de construir um conhecimento mais representativo e diversificado sobre as mulheres vítimas e sobre a magnitude do fenômeno. O estudo também chamou a atenção para a participação ativa dos usuários na produção da informação e para a necessidade de comunicação entre os SI dos diferentes setores das políticas públicas, em prol do enfrentamento da VPI. Conclui-se que a multiplicidade dos dados coletados e armazenados, seus sistemas tecnológicos, que garantem mais precisão e celeridade ao seu processamento e organização dos dados, e as informações geradas e disponibilizadas por meio dos relatórios e painéis interativos fazem com que os sistemas de informação examinados sejam plataformas para o desenvolvimento do Sistema Nacional de Dados e Informações sobre a violência contra as mulheres, previsto na Lei 11.340/06 e na PNEVM. Esse esforço exige a atenção ao conhecimento acumulado, ao trabalho coletivo, à capacidade de firmar alianças, não só com os diversos setores sociais, mas também com os movimentos feministas e, especialmente, com as próprias mulheres vítimas, que cotidianamente traçam estratégias para a superação da violência.

This thesis aims to analyze three information systems (IS) on violence against women - Operational Control System (PCERJ), Women's Assistance Center - Call 180 and Information System for Notifiable Diseases (SINAN) - from the examination of their collection, processing/organization and dissemination processes, with a focus on intimate partner violence. This is a qualitative research in which documents referring to the implementation of IS were analyzed, in addition to the reports produced. Furthermore, fourteen semi-structured interviews were carried out with strategic actors from each information system, using thematic analysis as an analytical framework. The collection was subjected to a floating reading and was categorized based on the following thematic axes: Violence by Intimate Partners and Information; Ways of collecting, processing and disseminating information on IPV: limits and possibilities; Information on VPI and Public Policies. The results showed the political character of information systems on violence against women in the process of producing information about the phenomenon. Furthermore, the importance of adopting an intersectional perspective, in order to build a more representative and diversified knowledge about women victims and about the magnitude of the phenomenon. The study also drew attention to the active participation of users in the production of information and to the need for communication between the IS of the different sectors of public policies, in order to face IPV. It is concluded that the multiplicity of data collected and stored, its technological systems, which guarantee more precision and speed in its processing and organization of data, and the information generated and made available through interactive reports and panels, make the information systems examined are platforms for the development of the National System of Data and Information on violence against women, provided for in Law 11.340/06 and in the PNEVM. This effort requires attention to the accumulated knowledge, to collective work, to the ability to establish alliances, not only with the various social sectors, but also with the feminist movements and, especially, with the women victims themselves, who daily devise strategies to overcome this problem. of violence.

Búsqueda y evaluación de la literatura científica: juego de escape / Searching and evaluating scientific literature: escape room

La elaboración de una estrategia de búsqueda en las bases de datos de ciencias de la salud para obtener un resultado de evidencias equilibrado entre sensibilidad y especificidad resulta un auténtico reto. Es imprescindible conocer bien los diferentes tipos de recursos para seleccionar los más apropiados en cada caso, así como los operadores, vocabularios, filtros y otras opciones de la interfaz implementados en cada una de ellos. En este artículo, con un ejercicio práctico a modo de juego, se han descrito los elementos correspondientes a la lista de verificación PRISMA-S para la presentación de una revisión rápida: criterios de elegibilidad de los estudios en formato PICO, fuentes de información obligatorias, estrategias de búsqueda en PubMed y el formulario peer review para describir la metodología de todo el proceso. (AU)

Developing a search strategy in health sciences databases to obtain a balanced evidence result between sensitivity and specificity is a real challenge. It is essential to have a good understand- ing of the different types of resources in order to select the most appropriate in each case, as well as the operators, vocabularies, filters and other interface options implemented in each of them. In this article, with a practical exercise as a game, the elements corresponding to the PRISMA-S checklist for the presentation of a rapid review have been described: eligibility criteria for studies in PICO format, mandatory information sources, search strategies in PubMed, and the peer review form to describe the methodology of the entire process. (AU)

Panorama regional de estándares de informática en salud

Presentación hecha por Alejandro Benavides, Sub-coordinador de la Red Centroamericana de Informática en Salud, durante el Webinar "Panorama Regional de Estándares de Informática en Salud" realizado el día 4 de diciembre de 2019.

Iniciativa de Sistemas de Información para la Salud (IS4H) de la OPS/OMS [infografía]

Área estratégica 1: Gestión de datos y tecnologías de la información

PAHO/WHO Information Systems for Health initiative (IS4H): Strategic framework of operation

Emphasis on data management, Information and communication technologies, applications and related ICT infrastructure.

Iniciativa de Sistemas de Información para la Salud (IS4H) de OPS/OMS [infografía]

Definición de Sistemas de Información para la Salud: Un mecanismo para gestionar sistemas interoperables con datos abiertos que provienen de diferentes fuentes, y que se utiliza de forma ética, a través de herramientas TIC eficaces, para generar información estratégica en beneficio de la salud pública.

Apresentação do lançamento em Alagoas: Brasil será referência mundial na implementação da estratégia de saúde digital - 11/11/2019

Brasil será referência mundial na implementação da estratégia de saúde digital ao promover a troca de informações entre os pontos da Rede de Atenção à Saúde, permitindo a transição e continuidade do cuidado nos setores público e privado.

Live estratégia do ConecteSUS Profissional: CONASEMS - 16/07/2021

Ampliação do acesso à informação em saúde visando a continuidade do cuidado em todos os níveis de atenção à saúde, de forma a qualificar o atendimento e o fluxo de informações, fortalecendo o apoio a decisão clínica, a vigilância em saúde, a regulação, a gestão, o ensino e a pesquisa.

Pactuação da minuta de Portaria da ESD28 na 6ª Reunião Ordinária da CIT - 27/08/2020

Aprova a Estratégia de Saúde Digital para o Brasil, que define a visão e estabelece o plano de ação, monitoramento e avaliação para a sua incorporação ao Sistema Único de Saúde (SUS).

Epi InfoTM en los sistemas de información en salud para COVID-19 / Epi InfoTM in Health Information Systems for COVID-19

La COVID-19 ha desatado una emergencia internacional en Salud Pública al afectar millones de personas, provocar muertes, y causar una crisis humanitaria nunca antes vista. Esto ha saturado los sistemas de información en salud de los países afectados, donde resultan de utilidad las herramientas informáticas para el manejo de un gran número de casos, al menor costo económico posible. En este contexto resalta el paquete de programas epidemiológicos Epi InfoTM, que permite crear formularios electrónicos para la recolección de datos. La presente investigación tiene como objetivo describir las ventajas y facilidades de implementar Epi InfoTM para los casos de COVID-19. Con módulos para analizar la información mediante cálculos y representaciones de medidas epidemiológicas, además de crear mapas de casos sospechosos o confirmados, Epi InfoTM cuenta también con complementos para dispositivos móviles y la web; todos con experiencias probadas en situaciones de epidemias como la del Ébola, VIH y el MERS. Por lo que Epi InfoTM es una aplicación robusta y libre de costo muy útil para su implementación en los sistemas de información en salud para el manejo adecuado de casos de COVID-19(AU)

COVID-19 has unleashed an international Public Health emergency by affecting millions of people, causing deaths, and a humanitarian crisis never seen before. This has saturated the health information systems of the affected countries, where computer tools are useful for managing a large number of cases, at the lowest possible economic cost. In this context, the Epi InfoTM package of epidemiological programs which allows creating electronic forms for data collections, stands out in addition with modules to analyze the information through calculations and representations of epidemiological measures. It also allows creating maps of suspected or confirmed cases and has applications for mobile devices and web; all with proven experiences in epidemic situations such as Ebola, HIV, and the previous outbreaks of Coronavirus. Therefore, Epi InfoTM is a robust and free of cost application, very useful for its implementation in health information systems for the adequate management of COVID-19 cases(AU)

Intelligent machines and mental health in the era of COVID-19.

The idea of a network of small devices that would be able to connect each other, appeared in the early 80s. In a prophetic article, Mark Weiser,1 described such a connection, that it is now known under the term of Internet of Things (IoT). In a broadest sense, the term IoT encompasses everything connected to the internet, but it is increasingly being used to define objects that "talk" to each other, creating a network from simple sensors to smartphones and wearables connected. During the recent years this network of communicating devices has been combined with other technological achievements, and particularly with the Virtual Reality (VR)2 and the Artificial Intelligence (AI).3 The emerge of COVID-19 pandemic in 2019, resulted to the poor response and healthcare failures of many countries globally.4 One of the main reasons for such a failure, was the inability of accurate data collection from different sources. Apparently, it was the first time, humanity realized the need for massive amounts of heterogeneous data to be collected, interpreted, and shared. Amid the ongoing COVID-19 pandemic, several innovators and public authorities are looking to leverage IoT tools to reduce the burden on the healthcare systems.5 Mental health is one of the areas that seems to benefit the most of such technologies. A significant decrease of the total amount of ER visits and a dramatic increase of internet access from the patients and care givers along to the development of applications for mental health issues, followed the outbreak of SARS-CoV-2.6 Such technologies proved to be efficient to help mentally ill patients and pioneer the path in the future. Probably the most obvious use of these emerged technologies is the improvement of the telehealth options. Patients who suffer from mental illness face significant problems towards the continuity of care during the crisis.7 Nonetheless, they usually have other health problems, that deprive them from an equitable health care provision. Improved telehealth platforms can give them a single point access to address all their problems. The use of electronic health records can reduce the fragmentary health services and improve the outcome.8 However, this is only the beginning. The COVID-19 crisis and the subsequent social isolation, to reduce both the contamination and the spread of the disease, highlighted the necessity for providing accurate and secure diagnoses and treatments from a safe distance. Virtual reality combined with IoT and AI technologies seem to be a reliable alternative to the classic physical and mental examination and treatment in many areas of mental and neurological diseases.2 These novel techniques can spot the early signs and detect mental illnesses with high accuracy. However, caution and more work are required to bridge the space between these recently thrived technologies and mental health care.7 It is worth mentioning, that internet-oriented health care procedures can also help to reduce the gaps caused by the stigma of mental illness. For example, the development of AI chatbots (an application used to chat directly with a human) can alleviate the fears of judgment of the help seeking persons and provide the professionals with a supplemental support toward improved services to their patients.9 A final remark for conclusion. Humanity is more and more depended to the "intelligent" machines. However, we must not forget that we humans are responsible to set the rules of such co-existence.

Transforming the health information system using mobile and geographic information technologies, Papua New Guinea.

In the context of declining economic growth, now exacerbated by the coronavirus disease 2019 pandemic, Papua New Guinea is increasing the efficiency of its health systems to overcome difficulties in reaching global health and development targets. Before 2015, the national health information system was fragmented, underfunded, of limited utility and accessed infrequently by health authorities. We built an electronic system that integrated mobile technologies and geographic information system data sets of every house, village and health facility in the country. We piloted the system in 184 health facilities across five provinces between 2015 and 2016. By the end of 2020, the system's mobile tablets were rolled out to 473 facilities in 13 provinces, while the online platform was available in health authorities of all 22 provinces, including church health services. Fractured data siloes of legacy health programmes have been integrated and a platform for civil registration systems established. We discuss how mobile technologies and geographic information systems have transformed health information systems in Papua New Guinea over the past 6 years by increasing the timeliness, completeness, quality, accessibility, flexibility, acceptability and utility of national health data. To achieve this transformation, we highlight the importance of considering the benefits of mobile tools and using rich geographic information systems data sets for health workers in primary care in addition to the needs of public health authorities.

Dans un contexte de déclin de la croissance économique, exacerbé par la pandémie de maladie à coronavirus, la Papouasie-Nouvelle-Guinée a décidé d'augmenter l'efficacité de ses systèmes sanitaires afin de surmonter les difficultés à atteindre les objectifs globaux en matière de santé et de développement. Avant 2015, le système d'information sanitaire national était fragmenté, sous-financé, peu utile et rarement consulté par les autorités sanitaires. Nous avons donc conçu un système électronique intégrant des technologies mobiles et des ensembles de données géographiques provenant de chaque ménage, de chaque village et de chaque établissement de soins du pays. Entre 2015 et 2016, nous avons piloté le système dans 184 établissements de soins répartis sur cinq provinces. Fin 2020, les tablettes mobiles du système ont été distribuées dans 473 établissements de 13 provinces, tandis que les autorités sanitaires des 22 provinces du pays, y compris les services sanitaires confessionnels, ont pu accéder à la plateforme en ligne. Les silos de données fragmentées des programmes de santé antérieurs y ont été incorporés et une plateforme destinée aux registres d'état civil a été créée. Le présent document se penche sur la manière dont les technologies d'information mobiles et géographiques ont transformé les systèmes d'information sanitaire en Papouasie-Nouvelle-Guinée ces six dernières années en améliorant la ponctualité, l'exhaustivité, la qualité, l'accessibilité, la flexibilité, la recevabilité et l'utilité des données nationales sur la santé. Pour réaliser cette transformation, il est à nos yeux essentiel de tenir compte des avantages que représentent les outils mobiles, et de tirer profit des vastes ensembles de données géographiques non seulement pour les travailleurs des soins de santé primaires, mais aussi pour les besoins des autorités de santé publique.

En el contexto de un crecimiento económico en declive, agravado ahora por la pandemia de la enfermedad por coronavirus, Papúa Nueva Guinea está aumentando la eficiencia de sus sistemas sanitarios para superar las dificultades para alcanzar los objetivos globales de salud y desarrollo. Antes de 2015, el sistema nacional de información sanitaria estaba fragmentado, carecía de fondos suficientes, su utilidad era limitada y las autoridades sanitarias accedían a él con poca frecuencia. Construimos un sistema electrónico que integraba tecnologías móviles y conjuntos de datos del sistema de información geográfica de cada casa, pueblo y centro de salud del país. Entre 2015 y 2016 pusimos a prueba el sistema en 184 centros de salud de cinco provincias. A finales de 2020, las tabletas móviles del sistema se implementaron en 473 centros de 13 provincias, mientras que la plataforma en línea estaba disponible en las autoridades sanitarias de las 22 provincias, incluidos los servicios de salud de las iglesias. Se han integrado los silos de datos fracturados de los programas sanitarios heredados y se ha establecido una plataforma para los sistemas de registro civil. Exponemos cómo las tecnologías móviles y los sistemas de información geográfica han transformado los sistemas de información sanitaria en Papúa Nueva Guinea en los últimos seis años, aumentando la puntualidad, la exhaustividad, la calidad, la accesibilidad, la flexibilidad, la aceptabilidad y la utilidad de los datos sanitarios nacionales. Para lograr esta transformación, destacamos la importancia de tener en cuenta los beneficios de las herramientas móviles y de utilizar conjuntos de datos ricos en sistemas de información geográfica para los trabajadores sanitarios de la atención primaria, además de las necesidades de las autoridades sanitarias públicas.

Revisión intra-acción (IAR) de COVID-19

Este video de 3 minutos presenta la Revisión intra-acción (IAR) de COVID-19 del país promovida por la OMS, incluida la metodología y los recursos disponibles para los países. Más información: https://www.who.int/publications/i/it...

Dr Tedros opening remarks: WHO-UN DESA technical advisory group on COVID-19 mortality assessment

The WHO - UN DESA Technical Advisory Group on COVID-19 Mortality Assessment acts as an advisory body to both WHO and UNDESA on COVID-19 mortality assessment. The TAG will advise and support efforts to assist WHO and UN Member States to obtain accurate estimates of the number of deaths attributable to the direct and indirect impacts of the pandemic. The TAG comprises a global network of experts from multidisciplinary backgrounds, including epidemiologists, data scientists and analysts, statisticians, demographers, national government officers, academics, and policy makers. The work of the TAG will contribute to future editions of the World Health Statistics and World Populations Prospects reports, as well as supporting vital global efforts towards strengthening health information systems.

Identifying heart failure in patients with chronic obstructive lung disease through the Canadian Primary Care Sentinel Surveillance Network in British Columbia: a case derivation study.

BACKGROUND: Heart failure (HF) poses a substantial global health burden, particularly in patients with chronic obstructive pulmonary disease (COPD). The objective of this study was to validate an electronic medical record-based definition of HF in patients with COPD in primary care practices in the province of British Columbia, Canada. METHODS: We conducted a cross-sectional retrospective chart review from Sept. 1, 2018, to Dec. 31, 2018, for a cohort of patients from primary care practices in BC whose physicians were recruited through the BC node of the Canadian Primary Care Sentinel Surveillance Network. Heart failure case definitions were developed by combining diagnostic codes, medication information and laboratory values available in primary care electronic medical records. These were compared with HF diagnoses identified through detailed chart review as the gold standard. Sensitivity, specificity, negative (NPV) and positive predictive values (PPV) were calculated for each definition. RESULTS: Charts of 311 patients with COPD were reviewed, of whom 72 (23.2%) had HF. Five categories of definitions were constructed, all of which had appropriate sensitivity, specificity and NPV. The optimal case definition consisted of 1 HF billing code or a specific combination of medications for HF. This definition had an excellent specificity (93.3%, 95% confidence interval [CI] 89.4%-96.1%), sensitivity (90.3%, 95% CI 81.0%-96.0%), PPV (80.2%, 95% CI 69.9%-88.3%) and NPV (97.0%, 95% CI 93.8%-98.8%). INTERPRETATION: This comprehensive case definition improves upon previous primary care HF definitions to include medication codes and laboratory data, along with previously used billing codes. A case definition for HF was derived and validated and can be used with data from electronic medical records to identify HF in patients with COPD in primary care accurately.