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.

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.

Assessing health systems' responsiveness in tackling COVID-19 pandemic.

Health systems' responsiveness is the key to addressing infectious disease threats such as pandemics. The article outlines an assessment of health systems based on World Health Organization's building blocks for select countries. It also compares these with the findings from a more comprehensive analysis of Global Health Security (GHS) Index, which assesses the preparedness of the health system for such pandemics. The GHS report (2019) spelt out very objectively that none of the countries of the world was prepared to effectively handle such emergencies, should they arise. Observations emerging from different countries highlight these findings although some of them seem to be discordant. Overall, it appears that Asian countries could fight the battle better than most developed nations in the Europe and America during the current pandemic, despite having poor GHS scores. Experiences of these countries in facing similar crisis in the past probably sensitized their strained health systems for a greater good. There are several lessons to be learned from such countries.