An Emergent Network for the Diffusion of Innovations Among Local Health Departments at the Onset of the COVID-19 Pandemic.

INTRODUCTION: Communication networks among professionals can be pathways for accelerating the diffusion of innovations if some local health departments (LHDs) drive the spread of knowledge. Such a network could prove valuable during public health emergencies such as the novel coronavirus disease 2019 (COVID-19) pandemic. Our objective was to determine whether LHDs in the United States were tied together in an informal network to share information and advice about innovative community health practices, programs, and policies. METHODS: In January and February 2020, we conducted an online survey of 2,303 senior LHD leaders to ask several questions about their sources of advice. We asked respondents to rank up to 3 other LHDs whose practices informed their work on new public health programs, evidence-based practices, and policies intended to improve community health. We used a social network analysis program to assess answers. RESULTS: A total of 329 LHDs responded. An emergent network appeared to operate nationally among 740 LHDs. Eleven LHDs were repeatedly nominated by peers as sources of advice or examples (ie, opinion leaders), and 24 acted as relational bridges to hold these emergent networks together (ie, boundary spanners). Although 2 LHDs played both roles, most LHDs we surveyed performed neither of these roles. CONCLUSION: Opinion leading and boundary spanning health departments can be accessed to increase the likelihood of affecting the rate of interest in and adoption of innovations. Decision makers involved in disseminating new public health practices, programs, or policies may find our results useful both for emergencies and for practice-as-usual.

[Role of the information systems and e-health in the COVID-19 pandemic. A call to action.] / Papel de los sistemas de información y la salud electrónica en la pandemia de COVID-19. Una llamada a la acción.

In March 2020, the World Health Organization declared the 2019 coronavirus disease (COVID-19) outbreak a pandemic, with the coronavirus disease spreading worryingly fast. In this context, information systems, digital health (electronic health, mobile health), the Internet of things, play a key role, since they can contribute to fight against COVID-19 by introducing smarter solutions to achieve a rapid control in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes the disease. However, these technologies need a solid regulatory framework that contributes to their implementation and integration in health systems, and to improve the national response in public health. In this context, coordination between administrations and the standardization and interoperability of information are necessary. Now is the time to establish the legal and knowledge bases so that everything that has been learned and advanced is integrated into health systems, promoting safe and evidence-based use.

En marzo de 2020, la Organización Mundial de la Salud declaró el brote de la enfermedad por coronavirus 2019 (COVID-19) como una pandemia, con una propagación preocupantemente rápida. En este contexto, los sistemas de información, la salud digital (salud electrónica, salud móvil) y/o el Internet de las cosas toman un papel relevante, ya que pueden contribuir a luchar contra la COVID-19, introduciendo soluciones más inteligentes para lograr un control rápido del síndrome respiratorio agudo severo coronavirus 2 (SARS-CoV-2), el virus que causa la enfermedad. Pero estas tecnologías necesitan de un marco regulatorio sólido que contribuya a su implantación e integración en los sistemas de salud y mejorar la respuesta nacional en materia de Salud Pública. En este contexto, es necesaria una coordinación entre administraciones, así como la estandarización e interoperabilidad de la información. Ahora es tiempo de sentar las bases, tanto legales como de conocimiento, para que todo lo que se ha aprendido y avanzado se integre en los sistemas sanitarios, promoviendo un uso seguro y basado en la evidencia.

Use of electronic health records to support a public health response to the COVID-19 pandemic in the United States: a perspective from 15 academic medical centers.

Our goal is to summarize the collective experience of 15 organizations in dealing with uncoordinated efforts that result in unnecessary delays in understanding, predicting, preparing for, containing, and mitigating the COVID-19 pandemic in the US. Response efforts involve the collection and analysis of data corresponding to healthcare organizations, public health departments, socioeconomic indicators, as well as additional signals collected directly from individuals and communities. We focused on electronic health record (EHR) data, since EHRs can be leveraged and scaled to improve clinical care, research, and to inform public health decision-making. We outline the current challenges in the data ecosystem and the technology infrastructure that are relevant to COVID-19, as witnessed in our 15 institutions. The infrastructure includes registries and clinical data networks to support population-level analyses. We propose a specific set of strategic next steps to increase interoperability, overall organization, and efficiencies.

Implications of telehealth and digital care solutions during COVID-19 pandemic: a qualitative literature review.

The coronavirus disease 2019 (COVID-19) pandemic has brought changes to the way medical care is delivered to keep health workers safe while simultaneously managing available resources. The well-being of patients and healthcare workers is crucial and has become a topic of debate as the world faces adjusts to the COVID-19 pandemic. Therefore, there is need to consider innovative methods of delivering medical care. Telehealth and digital health care which is the provision of medical care via Information Communication Technology (ICT) with highspeed telecommunications systems, has increasingly becoming popular in providing medical care services can be adopted to reduce infections during quarantine and social distancing practices. Specifically, by means of document and literature review this paper discusses the role of telehealth and digital care solutions, types and application of telehealth, and current policies for COVID-19. More importantly, findings from the article present the human, infrastructure, and institutional determinants that influence the adoption of telehealth and digital care solutions during the pandemic. The findings discuss how telehealth and digital care technologies can benefit the society. This study provides implications to informs medical staffs on the potential of digital technologies to provide support during and after the pandemic.

Wait-time reporting systems for elective surgery in Canada: a content analysis of provincial and territorial initiatives.

BACKGROUND: In Canada, a substantial barrier to the accessibility of surgical procedures is wait times. The objective of this study was to develop and describe an inventory of wait-time reporting systems for elective surgical procedures. METHODS: Between June and August 2019, we searched all Canadian provincial and territorial ministry of health websites to identify the wait-time reporting systems in place. We conducted content analysis and used a qualitative descriptive approach to compare the variables of interest across the provinces and territories. RESULTS: There were websites available for assessment in all 13 provinces and territories. Seven provinces have comprehensive, centralized wait-time reporting systems. The rest of the provinces have highly decentralized wait-time reporting, and the territories do not have wait-time reporting systems in place. There is substantial variation in the comprehensiveness, purpose, data sources and data collection methods among the wait-time reporting systems across the provinces and territories. INTERPRETATION: Wait-time reporting for elective surgery in Canada is diverse, and it varies in comprehensiveness across the provinces and territories. The present findings can help direct future investigations of Canadian reporting systems, which would provide useful information for policy-makers and those interested in reducing wait times in Canada.

Encuesta Nacional de la SEFH-2019: características generales, recursos humanos, materiales y sistemas de información en los Servicios de Farmacia Hospitalaria en España / SEFH National Survey-2019: general characteristics, staffing, material resources and information systems in Spain's hospital pharmacy departments

OBJETIVO: Dar a conocer los resultados referentes a características generales, recursos humanos, materiales y sistemas de información de la encuesta nacional de la Sociedad Española de Farmacia Hospitalaria (SEFH) 2019 sobre la situación de los Servicios de Farmacia Hospitalaria españoles. MÉTODO: Se envió un cuestionario on line a los responsables de los 368 Servicios de Farmacia Hospitalaria españoles registrados en el directorio de socios de la SEFH. El cuestionario incluía 77 preguntas agrupadas en ocho dimensiones. La información se recogió entre marzo y septiembre de 2019. RESULTADOS: La tasa global de respuesta fue del 54,3%. El 69% de los hospitales eran de titularidad pública y el tamaño más representado de 101-250 camas. El 9% permanecía abierto durante las 24 horas y el 57,5% no disponía de ninguna modalidad de atención continuada. La dispensación a pacientes externos durante la tarde se realizaba en el 41,9% de los centros. El 52,7% de los Servicios de Farmacia estaban acreditados por una norma de calidad. La media de farmacéuticos especialistas por Servicio de Farmacia fue 5,34 (desviación estándar [DE]: 6,22). El 47% de los farmacéuticos trabajaban al menos media jornada en las unidades clínicas. En cuanto a los sistemas automatizados rotativos de almacenamiento y dispensación, de media los Servicios de Farmacia disponían de 0,3 (DE: 0,7) y 0,9 (DE: 1,4) según fueran de tipo horizontal o vertical, respectivamente. El 16,1% de las camas hospitalarias estaban asistidas por sistemas automatizados de dispensación, llegando al 33,5% en hospitales con > 1.000 camas. El 3% de los Servicios de Farmacia Hospitalaria disponía de un sistema robotizado para la preparación de quimioterapia y el 24,8% de un sistema de trazabilidad y seguridad. Las bombas de infusión inteligentes se utilizaban en el 21,4% de los centros. La prescripción electrónica estaba implantada en el 98,8% de los hospitales para pacientes ingresados y en el 62% para pacientes ambulantes. CONCLUSIONES: En los Servicios de Farmacia Hospitalaria españoles existe una infradotación de farmacéuticos especialistas, a pesar de haberse duplicado su incorporación a las unidades clínicas. Destaca un crecimiento en la automatización de las actividades logísticas de dispensación, pero existe un importante margen de mejora en sistemas robotizados y de trazabilidad de las preparaciones. Conocer estos resultados puede resultar de gran utilidad para establecer planes de actuación

OBJECTIVE: To publicize the results regarding the general characteristics, human resources, materials and information systems of Spanish hospital pharmacy departments arising from SEFH's 2019 Survey on the Situation of Spanish Hospital Pharmacy Departments. METHOD: An online questionnaire was sent to the heads of the 368 hospital pharmacy departments affiliated to SEFH. The questionnaire included 77 questions grouped into 8 dimensions. The information was collected between March and September 2019. RESULTS: The overall response rate was 54.3%. Sixty-nine percent of hospitals were public and the most commonly reported hospital size was 101-250 beds. Nine percent of responding hospitals remained open round the clock and 57.5% did not offer a continued care service. A total of 41.9% of hospitals dispensed medications to outpatients in the afternoon and 52.7% of hospital pharmacy departments were accredited to some quality standard. The mean number of specialist pharmacists per pharmacy Department was 5.34 (SD: 6.22); 47% of pharmacists spent at least half their working day in a clinical unit. Hospital pharmacy departments had a mean of 0.3 (SD: 0.7) or 0:9 (SD: 1.4) automated storage and dispensing carousels, depending on whether they were horizontal or vertical, respectively. A total of 16.1% of beds were assisted by automated dispensing systems, a figure that reached 33.5% in hospitals with more than 1,000 beds. Three percent of hospital pharmacy departments had a robotized system for compounding chemotherapy medications and 24.8% had a traceability and safety system. Smart infusion pumps were used by 21.4% of hospitals. Electronic prescriptions were implemented in 98.8% of hospitals for inpatients and in 62% for outpatients. CONCLUSIONS: Spanish hospital pharmacy departments face a shortage of specialist pharmacists, although incorporation of such professionals to clinical units has doubled in the last few years. There has been an increase in the level of automation of the logistic processes involved in medication dispensing, but there is still significant room for improvement in the area of robotized dispensing and compounding traceability systems. This data could play an invaluable role in the design of future action plans

Sistemas de Información y Salud Digital: por qué esta área es clave durante y después de la pandemia. Dra. Giselle Ricur, Salud Digital

El 27 de agosto de 2020, un webinar sobre Sistemas de Información y Salud Digital y su importancia durante y después de la pandemia COVID-19 reunió a diez expertos, que respondieron a una pregunta en su área de especialización. Los siguientes podcasts se extrajeron de este seminario web. On August 27th 2020, a webinar on Information Systems and Digital Health and its importance during and after the COVID-19 pandemic reunited ten experts that answered to one question in their area of expertise. The following podcasts were extracted from this webinar.

Sistemas de Información y Salud Digital: por qué esta área es clave durante y después de la pandemia. Dr. Daniel Luna, Registros clínicos electrónicos y registros personales de salud

El 27 de agosto de 2020, un webinar sobre Sistemas de Información y Salud Digital y su importancia durante y después de la pandemia COVID-19 reunió a diez expertos, que respondieron a una pregunta en su área de especialización. Los siguientes podcasts se extrajeron de este seminario web. On August 27th 2020, a webinar on Information Systems and Digital Health and its importance during and after the COVID-19 pandemic reunited ten experts that answered to one question in their area of expertise. The following podcasts were extracted from this webinar.

Sistemas de Información y Salud Digital: por qué esta área es clave durante y después de la pandemia: Sr. Daniel Doane, Systemas de Información para la Salud (IS4H)

El 27 de agosto de 2020, un webinar sobre Sistemas de Información y Salud Digital y su importancia durante y después de la pandemia COVID-19 reunió a diez expertos, que respondieron a una pregunta en su área de especialización. Los siguientes podcasts se extrajeron de este seminario web. On August 27th 2020, a webinar on Information Systems and Digital Health and its importance during and after the COVID-19 pandemic reunited ten experts that answered to one question in their area of expertise. The following podcasts were extracted from this webinar.

Sistemas de Información y Salud Digital: por qué esta área es clave durante y después de la pandemia. Dr. Ian Brooks, Big Data

El 27 de agosto de 2020, un webinar sobre Sistemas de Información y Salud Digital y su importancia durante y después de la pandemia COVID-19 reunió a diez expertos, que respondieron a una pregunta en su área de especialización. Los siguientes podcasts se extrajeron de este seminario web. On August 27th 2020, a webinar on Information Systems and Digital Health and its importance during and after the COVID-19 pandemic reunited ten experts that answered to one question in their area of expertise. The following podcasts were extracted from this webinar.

Sistemas de Información y Salud Digital: por qué esta área es clave durante y después de la pandemia. Dra. Theresa Bernardo, la internet de las cosas

El 27 de agosto de 2020, un webinar sobre Sistemas de Información y Salud Digital y su importancia durante y después de la pandemia COVID-19 reunió a diez expertos, que respondieron a una pregunta en su área de especialización. Los siguientes podcasts se extrajeron de este seminario web. On August 27th 2020, a webinar on Information Systems and Digital Health and its importance during and after the COVID-19 pandemic reunited ten experts that answered to one question in their area of expertise. The following podcasts were extracted from this webinar.

Sistemas de Información y Salud Digital: por qué esta área es clave durante y después de la pandemia. Dr. Walter Curioso, alfabetización digital

El 27 de agosto de 2020, un webinar sobre Sistemas de Información y Salud Digital y su importancia durante y después de la pandemia COVID-19 reunió a diez expertos, que respondieron a una pregunta en su área de especialización. Los siguientes podcasts se extrajeron de este seminario web. On August 27th 2020, a webinar on Information Systems and Digital Health and its importance during and after the COVID-19 pandemic reunited ten experts that answered to one question in their area of expertise. The following podcasts were extracted from this webinar.

Sistemas de Información y Salud Digital: por qué esta área es clave durante y después de la pandemia. Dr. Yuri Quintana, inteligencia artificial

El 27 de agosto de 2020, un webinar sobre Sistemas de Información y Salud Digital y su importancia durante y después de la pandemia COVID-19 reunió a diez expertos, que respondieron a una pregunta en su área de especialización. Los siguientes podcasts se extrajeron de este seminario web. On August 27th 2020, a webinar on Information Systems and Digital Health and its importance during and after the COVID-19 pandemic reunited ten experts that answered to one question in their area of expertise. The following podcasts were extracted from this webinar.

Sistemas de Información y Salud Digital: por qué esta área es clave durante y después de la pandemia. Dr. Edgar Tullo, estadísticas vitales

El 27 de agosto de 2020, un webinar sobre Sistemas de Información y Salud Digital y su importancia durante y después de la pandemia COVID-19 reunió a diez expertos, que respondieron a una pregunta en su área de especialización. Los siguientes podcasts se extrajeron de este seminario web. On August 27th 2020, a webinar on Information Systems and Digital Health and its importance during and after the COVID-19 pandemic reunited ten experts that answered to one question in their area of expertise. The following podcasts were extracted from this webinar.

Sistemas de Información y Salud Digital: por qué esta área es clave durante y después de la pandemia. Ms. Tina Purnat, Infodemía

El 27 de agosto de 2020, un webinar sobre Sistemas de Información y Salud Digital y su importancia durante y después de la pandemia COVID-19 reunió a diez expertos, que respondieron a una pregunta en su área de especialización. Los siguientes podcasts se extrajeron de este seminario web. On August 27th 2020, a webinar on Information Systems and Digital Health and its importance during and after the COVID-19 pandemic reunited ten experts that answered to one question in their area of expertise. The following podcasts were extracted from this webinar.

Sistemas de Información y Salud Digital: por qué esta área es clave durante y después de la pandemia. Pablo Orefice, transformación digital

El 27 de agosto de 2020, un webinar sobre Sistemas de Información y Salud Digital y su importancia durante y después de la pandemia COVID-19 reunió a diez expertos, que respondieron a una pregunta en su área de especialización. Los siguientes podcasts se extrajeron de este seminario web. On August 27th 2020, a webinar on Information Systems and Digital Health and its importance during and after the COVID-19 pandemic reunited ten experts that answered to one question in their area of expertise. The following podcasts were extracted from this webinar.

Factors That Influence Data Use to Improve Health Service Delivery in Low- and Middle-Income Countries.

BACKGROUND: Health service delivery indicators are designed to reveal how well health services meet a community's needs. Effective use of the data can enable targeted improvements in health service delivery. We conducted a systematic review to identify the factors that influence the use of health service delivery indicators to improve delivery of primary health care services in low- and middle-income settings. METHODS: We reviewed empirical studies published in 2005 or later that provided evidence on the use of health service delivery data at the primary care level in low- and middle-income countries. We searched Scopus, Medline, the Cochrane Library, and citations of included studies. We also searched the gray literature, using a separate strategy. We extracted information on study design, setting, study population, study objective, key findings, and any identified lessons learned. RESULTS: Twelve studies met the inclusion criteria. This small number of studies suggests there is insufficient evidence to draw reliable conclusions. However, a content analysis identified the following potentially influential factors, which we classified into 3 categories: governance (leadership, participatory monitoring, regular review of data); production of information (presentation of findings, data quality, qualitative data); and health information system resources (electronic health management information systems, organizational structure, training). Contextual factors and performance-based financing were also each found to have a role; however, discussing these as mediating factors may not be practical in terms of promoting data use. CONCLUSION: Scant evidence exists regarding factors that influence the use of health service delivery indicators to improve delivery of primary health care services in low- and middle-income countries. However, the existing evidence highlights some factors that may have a role in improving data use. Further research may benefit from comparing data use factors across different types of program indicators or using our classification as a framework for field experiments.

What is the future of patient-reported outcomes in sickle-cell disease?

INTRODUCTION: Sickle cell disease (SCD) is a complex, chronic disease caused by abnormal polymerization of hemoglobin, which leads to severe pain episodes, fatigue, and end-organ damage. Patient reported outcomes (PROs) have emerged as a critical tool for measuring SCD disease severity and response to treatment. AREAS COVERED: Authors review the key issues involved when deciding to use a PRO in a clinical trial. We describe the most highly recommended generic and disease-specific PRO tools in SCD and discuss the challenges of incorporating them in clinical practice. EXPERT OPINION: PRO measures are essential to incorporate into SCD clinical trials either as primary or secondary outcomes. The use of PRO measures in SCD facilitates a patient-centered approach, which is likely to lead to improved outcomes. Significant challenges remain in adapting PRO tools to routine clinical use and in developing countries.

Factors related to the adoption of the Brazilian National Immunization Program Information System.

BACKGROUND: One way to optimize the adoption and use of technological innovations is to understand how those involved perceive, assess and decide to use them. This study aims to analyze the attributes that influence the adoption and use of the Brazilian National Immunization Program Information System (NIPIS) from the perspective of vaccination room workers. METHODS: This is a mixed method research, and a quantitative cross-sectional analytical study, with concomitant triangulation of data, carried out in a region of Brazil by using the Diffusion of Innovation Theory. We used a questionnaire with 183 nursing professionals who work at vaccination rooms in 12 municipalities. To test the research model, partial least squares structural equation modeling (PLS-SEM) and SmartPLS 2.3.0 have been applied to estimate the model. The qualitative research had a descriptive-exploratory character, using interviews (n = 18) analyzed through thematic analysis. RESULTS: The model proposed showed a mean correlation between the perceived attributes in the adoption and use of NIPIS. The results of the multiple regression indicated that the attributes "relative advantage" and "image" have a significant effect at 5% level (T > 1.97), positively influence the adoption and use of NIPIS; the attribute "voluntary use" negatively influences the adoption and use of the system; the attributes "experimentation", "compatibility", "profitability", and "ease of use" did not influence the adoption and use of NIPIS. Emphasis has been placed on aspects that weaken the adoption and use of NIPIS such as lack of good quality internet and resistance to use the technology by some professionals. Workers perceive the importance of NIPIS for the municipality and point out that technological innovation provides data at an individual level, inserted in real time, which makes it possible to assess vaccination coverage. Lack of an unstable internet compromises data release due to system slowness. CONCLUSIONS: The mixed method allowed an in-depth analysis of the adoption and use of NIPIS in the Western Health Macroregion of Minas Gerais State, and similarities were observed in the results. The attribute "relative advantage" is the one that most influences the adoption and use of NIPIS, which is the strongest predictor of innovation adoption rate.