Paula Otero

Building A Health Informatics Workforce In Developing Countries

Information and communication technology can be used to improve the quality and safety of health care and to lower costs. But in both developed and developing countries, there is an inadequate supply of skilled individuals who have the technical skills to use this technology to improve health care. Some studies project workforce needs of tens of thousands in English-speaking developed countries, but it is not known what size workforce will be required in the developing world. It is important to identify and develop the skills, training, and competencies-consistent with local cultures, languages, and health systems-that will be needed to realize the full benefits of these technologies. We present a framework for answering these questions and for developing estimates of the size and scope of the workforce that may be needed.

Nanoinformatics: developing new computing applications for nanomedicine

Nanoinformatics has recently emerged to address the need of computing applications at the nano level. In this regard, the authors have participated in various initiatives to identify its concepts, foundations and challenges. While nanomaterials open up the possibility for developing new devices in many industrial and scientific areas, they also offer breakthrough perspectives for the prevention, diagnosis and treatment of diseases. In this paper, we analyze the different aspects of nanoinformatics and suggest five research topics to help catalyze new research and development in the area, particularly focused on nanomedicine. We also encompass the use of informatics to further the biological and clinical applications of basic research in nanoscience and nanotechnology, and the related concept of an extended “nanotype” to coalesce information related to nanoparticles. We suggest how nanoinformatics could accelerate developments in nanomedicine, similarly to what happened with the Human Genome and other -omics projects, on issues like exchanging modeling and simulation methods and tools, linking toxicity information to clinical and personal databases or developing new approaches for scientific ontologies, among many others.

A medical informatics distance-learning course for Latin America. Translation, implementation and evaluation.

BACKGROUND There is a growing need and interest worldwide for healthcare and information technology professionals trained in medical informatics. Distance learning technologies are increasingly used to deliver such education, but have mainly been limited to the English language. OBJECTIVE Describe the implementation and student satisfaction of a medical informatics course delivered in Spanish for a Latin American audience. METHODS The course was based on the 10 x 10 program of the American Medical Informatics Association and Oregon Health & Science University that was translated and adapted to the Latin American setting. The initial course consisted of ten one-week units, currently the course has 15 modules that are delivered in 16 weeks with topics that address the needs of medical informatics in the region. We also administered an anonymous questionnaire of student satisfaction. RESULTS A total of 499 individuals have enrolled in the course, and 70% have completed it. Most of the students have been healthcare professionals (86%), with the largest proportion from Argentina. Student satisfaction with all aspects of the course was high. After the initial experience and feedback from the students, the course has been adapted to better meet regional needs. CONCLUSION The initial experience obtained in training healthcare professionals in medical informatics in Latin America in their own language demonstrated that it could be used across the region, and this could represent a model for disseminating knowledge of medical informatics across other languages and cultures.

Usos de Internet en hogares con niños de entre 4 y 18 años: control de los padres sobre este uso. Resultados de una encuesta nacional

INTRODUCTION: Internet has become, since its beginning, the ideal media for information access. Children and adolescents use it frequently, and they usually reach inappropriate material, and their parents are not aware of this situation. The objective of the study was to evaluate the family perception of the use at home of the Internet by children and adolescents. POPULATION, MATERIAL AND METHODS: A web survey coordinated by the Working Group of Medical Informatics at the Sociedad Argentina de Pediatria was conducted between 09/01/2007 and 03/01/2008, and evaluated the household characteristics (number of children and their age) and their user internet profile. RESULTS: The survey was completed by 857 of the 1055 registered users. A total of 1380 children and adolescents were included, 83.5% were from Argentina. 25.8% of the children informed the adults about an unpleasant experience while using the web, 30.8% of the adults did not know their childs online nickname and only 28.6% used parental control software. 53.4% of the surveyed individuals reported talking with their children about their online activities. CONCLUSION: The results obtained from our survey show that children frequently have unpleasant experiences while using the web and there is very little supervision from parents, who underestimate the risk of the web access.

From Dyadic Ties to Information Infrastructures: Care-Coordination between Patients, Providers, Students and Researchers. Contribution of the Health Informatics Education Working Group.

OBJECTIVE To share how an effectual merging of local and online networks in low resource regions can supplement and strengthen the local practice of patient centered care through the use of an online digital infrastructure powered by all stakeholders in healthcare. User Driven Health Care offers the dynamic integration of patient values and evidence based solutions for improved medical communication in medical care. INTRODUCTION This paper conceptualizes patient care-coordination through the lens of engaged stakeholders using digital infrastructures tools to integrate information technology. We distinguish this lens from the prevalent conceptualization of dyadic ties between clinician-patient, patient-nurse, clinician-nurse, and offer the holistic integration of all stakeholder inputs, in the clinic and augmented by online communication in a multi-national setting. METHODS We analyze an instance of the user-driven health care (UDHC), a network of providers, patients, students and researchers working together to help manage patient care. The network currently focuses on patients from LMICs, but the provider network is global in reach. We describe UDHC and its opportunities and challenges in care-coordination to reduce costs, bring equity, and improve care quality and share evidence. CONCLUSION UDHC has resulted in coordinated global based local care, affecting multiple facets of medical practice. Shared information resources between providers with disparate knowledge, results in better understanding by patients, unique and challenging cases for students, innovative community based research and discovery learning for all.

Análisis de registros de tensión arterial en pacientes de 3-20 años por pediatras en la historia clínica electrónica

INTRODUCTION: Blood pressure measurement (BPM) is a recommended practice at least once a year for all of healthy children starting from 3 years old and before that age in population at risk. Pediatricians fulfilling of this recommendation is irregular. Objective. Identify the prevalence of records of BPM in a pediatric electronic health record (EHR) in patients from 3 to 20 years of age and the prevalence of records of hypertension (HBP) and prehypertension (preHBP) according to sex, age and percentile of height. POPULATION, MATERIAL AND METHODS: A cross-sectional and analytical study was conducted. 8140 patients from 3 to 20 years of age seen by their primary care physician at least in one opportunity between January and June 2005 were evaluated. Hypertension, prehypertension and normal BP was defined based on the recommendation published in Pediatrics 2004 Aug; 114: 555-76. RESULTS: 2.723 of the 8.140 patients had BP registered in the EHR (33.4%), 76% of the records were of normal BP, 17% of preHBP and 7% of HBP. The percentage of preHBP was significantly higher in males (21.7% vs. 13.4%) OR: 1.6 (IC 95% 1.3-1.9), but not in HBP (7.4% vs. 6.8%). 50% of the pediatricians registered 9% or less of their patients BP. CONCLUSIONS: The prevalence of BPM was a third; there is a need of generating actions that stimulate this practice.INTRODUCTION Blood pressure measurement (BPM) is a recommended practice at least once a year for all of healthy children starting from 3 years old and before that age in population at risk. Pediatricians fulfilling of this recommendation is irregular. Objective. Identify the prevalence of records of BPM in a pediatric electronic health record (EHR) in patients from 3 to 20 years of age and the prevalence of records of hypertension (HBP) and prehypertension (preHBP) according to sex, age and percentile of height. POPULATION, MATERIAL AND METHODS A cross-sectional and analytical study was conducted. 8140 patients from 3 to 20 years of age seen by their primary care physician at least in one opportunity between January and June 2005 were evaluated. Hypertension, prehypertension and normal BP was defined based on the recommendation published in Pediatrics 2004 Aug; 114: 555-76. RESULTS 2.723 of the 8.140 patients had BP registered in the EHR (33.4%), 76% of the records were of normal BP, 17% of preHBP and 7% of HBP. The percentage of preHBP was significantly higher in males (21.7% vs. 13.4%) OR: 1.6 (IC 95% 1.3-1.9), but not in HBP (7.4% vs. 6.8%). 50% of the pediatricians registered 9% or less of their patients BP. CONCLUSIONS The prevalence of BPM was a third; there is a need of generating actions that stimulate this practice.

Informatics Education in Low-Resource Settings

Developing countries have the burden of acute and chronic diseases with the greatest health disparities. There is also a shortfall of more than four million healthcare workers worldwide, and the proportion is higher in less economically viable countries where the lack of proper trained healthcare workers is also compromised by the migration and departure of skilled personnel together with a frail infrastructure and a shortage of resources that cannot provide a proper scenario for an adequate healthcare system that will fulfill the population needs. The need for both technology infrastructure and individuals who have the skills to develop these systems is great, but so are the challenges in developing the needed workforce who are well-trained in informatics. This chapter describes the current informatics education efforts in three regions: Latin America, Sub-Saharan Africa and the Asia-Pacific region. The description of specific healthcare informatics education programs, the educational methods used and the challenges encountered are explored.

Crowdfunding. A new option for funding health projects.

INTRODUCCIÓN Definición La f inanciación colect iva de proyectos en la web por medio de plataformas virtuales se conoce como crowdfunding. Otras denominaciones que se emplean son financiación en masa, micro mecenazgo, o micro patronazgo. En la actualidad se está afianzando como una forma de obtener fondos para financiar proyectos que no p u e d e n a c c e d e r a l a f o r m a d e financiación habitual como préstamos, subsidios y becas, ya que por su carácter o tipología no encajan ni en los requisitos de apoyo de entidades públicas ni llaman la atención de la iniciativa privada. El crowdfunding tiene como objetivo que cualquier persona que desee llevar adelante un proyecto pueda conseguir la financiación para su lanzamiento con la ayuda de una gran cantidad de personas que aportan micro-donaciones.1 Esta modalidad se ha iniciado en Estados Unidos pero ya ha avanzado en Europa y lentamente se está introduciendo en Latinoamérica. A nivel mundial, durante el año 2013, el crowdfunding ha logrado financiar más de 1 200 000 proyectos sin que intervenga financiación estatal o gubernamental. El mecanismo de crowdfunding también está relacionado con las redes sociales, donde los consumidores p a r t i c i p a n a c t i v a m e n t e e n l a s comunidades en línea para compartir i n f o r m a c i ó n , c o n o c i m i e n t o s y sugerencias acerca de una nueva iniciativa y/o marca. La participación activa de los usuarios hace que sean el eje del éxito de varios proyectos ya que ellos determinan qué iniciativa desean seleccionar para apoyar y proporcionar su apoyo financiero.2

Developing a survey to assess factors that contribute to physician involvement in clinical research.

BACKGROUND Investment in research, including clinical research, has positive effects both on health of a population and economic growth of a country. Several factors have been suggested as being related to the performance of clinical research. The goal of this work was to develop and perform initial validation of a survey that measures both current research involvement of physicians, as well as previously noted factors and additional informatics factors affecting this involvement. The survey was developed in both English and Spanish with the goal of its use in Latin America. METHODS The initial survey was developed primarily from experience with other validated surveys developed for similar purposes. It was validated in three stages with modification or elimination of questions as indicated by this testing. RESULTS The final survey contains 33 questions in the categories of research experience, education in research, environmental factors, computer experience, and collaboration.

[Facebook and Twitter, are they already in the pediatrician's office? Survey on the use of social networks].

The Web 2.0 has democratized the use of services and applications, being Facebook and Twitter its leading exponents and it even has been proposed that there exists a Medicine 2.0. A survey for professionals subscribed to discussion lists of Argentine Pediatric Society (SAP) and for visitors to the Website was carried out to know the use of Web 2.0. In 377 responses (76% pediatricians), 81.3% of users use Facebook and Twitter 16.5%. Facebook is used in an 85% for personal purposes, while the professional use of it is 41.2%. Pediatricians frequently use other web 2.0 applications such as YouTube (80.3%), sharing images (52.2%) and listening to Podcasts (34.8%). Around 50% of the professionasl surveyed showed interest in receiving information on the professional activites carried out by SAP. Clinicians should recognize these new tools to incorporate them into their professional activities.