The 8th HIBA Academic Congress on Healthcare Information Systems 2013, which took place between the 4th and 6th of December, introduced advances in the digitalization of local and international healthcare.
“We have a commitment to promoting the advances in Health IT around the world”, said Doctor Fernán González Bernaldo de Quirós at the congress’s opening ceremony, organized by the Department of Health IT at the Hospital Italiano of Buenos Aires and the HL7 Argentina Association.
Public Policies of the Argentine Ministry of Health. What’s on the Agenda?
Doctor Pedro Kremer, representing the Argentine Ministry of Health, spoke about the need to understand why information and communication technologies are being incorporated at the conference “Public Policies and Health IT Systems”.
“ICTs create access, and regulate and extend possibilities: establishing IT systems is a tool for expanding rights”, he said. He then recognized that the country needs to make progress with electronic health records and said that the pending issues that the Ministry are: to complete a national ICT plan, to informatize processes and to promote interoperability.
Finally, he noted that the healthcare portfolio recorded more than 80 good practices in e-Health in the country, that the Integrated Argentine Healthcare Information System (SISA) makes it possible to regulate the supply of needs, and that the Ministry of Health has functions such as the Development of Human Capital, Healthcare Vigilance and Regulation and Planning.
Toward connected healthcare
The speech “A model for the transformation of the healthcare sector to achieve connected healthcare” was organized by the company Telefónica Digital. Juan Manuel Aguilar, an expert in E-Health Business Development, and Diego Ignacio Henin, Head of Business Consultancy in IT and Outsourcing, presented a pilot plan for home care which is supported by the Department of Medical IT at the Hospital Italiano.
“The efficiency of the care provided must be improved. To start with, bureaucratic issues could be eliminated to improve care”, said Henin, assessing the opportunities for improvement via the application of diagnosis technology, digitalization of processes and remote care. To achieve this, Aguilar emphasized, communication between professionals and access to information are key.
Personal Health Portals
In both the public and private sectors, several health centers place personal health portals at users’ disposition. Beyond design, development and functionality, they all have the same common purpose: sharing information.
Doctor Martín Díaz, from the Hospital Alemán; Doctor Diego Lunansky, from the Hospital El Cruce – Néstor Kirchner; and Doctor Analía Baum and the medical student Julieta Goldenberg, from the Hospital Italiano, provided information about the web services offered by their heath establishments.
Díaz explained the benefits of the Medical Plan Portal at the Hospital Alemán, among other factors emphasizing the appointment schedule – which makes it possible to select a specific professional for medical consults – access to different health reports and monitoring of prolonged treatments or chronic diseases. In fact, he said, patients can upload certain data to their Health Record.
Lunansky, who is also a visual communication designer, introduced the different aspects of the Patient Portal at the Hospital El Cruce on which users can access all the data related to their health – such as clinical information – and advice and activities for a healthy life. “The portal opened three months ago, so it only has 130 registered users, but the idea is to expand it and thus get to know patients’ needs,” he said.
Baum and Goldenberg said that the objective of the HIBA Heath Portal is to increase and improve communication with users to encourage them to take responsibility for their health – self management.
“The concept is to create a connection with patients from another point of view, to provide them with a place where they can offer their opinion and where they feel safe”, said Baum. Goldenberg, meanwhile, noted that: “We achieve communication by generating a fluid channel between patients and doctors with a secure record of the information”.
Visualization of images and clinical documents
Dr. Jordi López, CEO de ALMA IT System; the engineer Juan Pablo Devoto, HCIS Implementation at Carestream Health; the engineer Ezequiel Mazzoni, a member of the Laboratory of Clinical Engineering at the Hospital “El Cruce-Néstor Kirchner”; and Damián Rossi, Systems Administrator at said public health institution, offered their opinions on PACS.
López demonstrated the Universal Clinical Visor solution by ALMA IT Systems, a company dedicated to the commercial development of advanced imaging software. He said that the company’s products can be integrated with a wide range of systems and added: “We have placed a lot of emphasis on research. We work on very important projects, many of them financed by the European Union”.
Representing Carestream, Devoto presented VueMotion, a solution created with the philosophy of sharing images with the entire community. “The objective is to provide a universal visualizer that can be implemented with any device that can read HTML”.
The digitalization process for image diagnostics carried out by the Hospital El Cruce in Florencio Varela is possible thanks to RAIM. “The optimal integrated solution for the hospital was Philips’ PACS MDC visualizer”, said Mazzoni.
Rossi also showed how the data flow of the public institution (including appointments, patient data, and images taken) is managed.
Doctor Daniel Luna, Head of the Health IT Department at the Hospital Italiano, spoke about the visualization structure for clinical documents and explained that the stages of the record vary according to the levels of care. “During the development of the clinical documentation process at the hospital several stages were created in the different spheres of care”, he said.
In this regard, he emphasized that the integration of the different levels of care and documentation is focused on each patient and that the paradigm for visualizing clinical documents revolves around faster access to information.
Electronic/Digital Signature
Digital signatures and electronic signatures are not the same thing, but as the terms are misinterpreted on occasions, Doctor Iris Cidale, the legal advisor to the Undersecretary of Management Technologies of the Head of Cabinet, organized the panel “Electronic/Digital Signatures: update – National Office of Information Technologies (ONTI)”.
“A digital signature is not a scanned signature, an electronic signature requires a username and a password”, she noted.
In addition to arguing that it’s much easier to alter a paper document than a digital one, the Doctor said that today it is possible to have both electronic and digital signatures but not in the same infrastructure.
“Digital signatures, certificates that can be given to sign for a certain issue in a certain place, invert the burden of proof. It is impossible to deny its legitimacy, because it is assumed that the only person who knows the code is the professional who has set up the digital signature.”
Finally, Cidale explained that private organizations that need digital signatures must follow the steps of the current law, which is currently being reformed. “There is no law or special authority for licensing digital signatures in healthcare”, she said.
Ubiquitous IT systems in healthcare: U-health and the debate over the concepts of e-Health
Coordinated by Doctor Fernán González Bernaldo de Quirós, the debate over U-health gave food for thought during the congress, as he invited attendees to question the concepts related to the use of technology in healthcare.
Quirós recommended that when e-Health and m-Health projects are put forward, professionals should ask themselves if they are applicable and sustainable over time and whether they will improve the service to patients. “IT projects that resolve healthcare problems and can be scaled for the healthcare system should be presented”, said Quirós.
He went on to discuss the existence of technologies that fragment the system and said: “The meaning is in the information and not the technology”.
So, what is ubiquity? According to the Doctor, it is the ability to be everywhere at a determined place and time, without fragmenting the information.
Also participating in the panel was Doctor Fernando Plazzotta, who spoke about his experience of telemedicine and m-Health at the Hospital Italiano and briefly announced several pilot projects – such as asynchronous tele-consults and tele-monitoring of vital signs.
Qualitative research into health IT
Sharing conclusions drawn from field studies with patients and doctors at HIBA, Doctor Adriana Dawidowski moderated the panel “Techniques in qualitative research into Health IT.”Dawidowski.
“Qualitative research allows us to understand social processes”, said Dawidowski.
The issues addressed at the event included: “Information needs during pregnancy”, led by Doctor Agustina Briatore and Dr. Gabriela García; “Legitimacy of access to Electronic Health Records”, led by Leandro Alassia; “Doctor’s answers to electronic messages generated by patients”, introduced by Doctor Alfredo Almerares and Doctor Estefanía Tarsetti; and “Doctor-patient electronic communication”, presented by Doctor Bayan Khorsandnia.
“As a Health IT Department, the tools we have to offer are digital. We are trying to understand pregnant women’s (at HIBA) perceptions of the information they receive”, said Briatore.
With regard to the legitimacy of access to EHR, Alassia stated that people are ignorant of their rights and the privacy of sensitive information and that informatization in the field of healthcare makes better care possible on individual and mass scales. However, he emphasized: “Universal access creates many contradictions and tensions among doctors, which arise in both their professional and personal lives”.
According to Almerares, electronic messaging would be useful for improving the doctor-patient relationship. “In recent surveys carried out with patients in outpatient practices, electronic messaging was considered to be the most valued function. 80% of those surveyed stated that it was the best benefit of having a health portal”.
In this regard, Tarsetti noted that doctors don’t respond in the same way to the different messages produced by patients.
Khorsandnia, meanwhile, noted that traditional communication based on communication in person could be insufficient in answering the needs of continuous care. “ICTs are offering new forms of interaction with the potential to increase and improve access to healthcare”, he said.
The close of HIBA 2013
The HL7 Argentina Association brought the congress to a close with a panel coordinated by the Engineer Fernando Campos, who spoke about the standard architecture for quality reports.
Another member of the organization, the engineer Javier Solá, presented an overview of the institutional activities carried out during the year and said that he hopes that the state will be the main adopter of HL7 standards.
Repercussions and results of the 2013 edition
With a major presence on social networks, the 8th HIBA Academic Congress on Health Information Systems was supported by 400 participants in person and 800 people who registered at HIBA’s virtual classrooms.
This edition established itself as a chance to find out about the different measures being taken to increase the implementation of advanced technologies, techniques and innovation in the digitalization of healthcare.
