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1.
Rev Panam Salud Publica ; 46, mayo 2022. Special Issue HEARTS
Article in English | PAHO, PAHOIRIS | ID: covidwho-2010591

ABSTRACT

[ABSTRACT]. An overview of an integrated approach to improve noncommunicable disease (NCD) management is pre- sented, along with tools on integrating NCD management as part of health system strengthening in the Americas. The study is based on an analysis of Pan American Health Organization/World Health Organization (PAHO/WHO) data and publicly available information on NCD care and capacity, disruptions in NCD services, and guidance on NCD management. Gaps in NCD care are highlighted, in which an estimated 43.0% of men and 28.0% of women with hypertension in Latin America remain undiagnosed; and for those with diabetes, 32.8% in Central and South America are undiagnosed. Yet, only 17/35 countries (49%) in the Americas report having evidence-based national guidelines for NCD management through a primary care approach and only 7/35 countries (20%) report provision of drug therapy, including glycaemic control for eligible persons. To improve NCD management, an integrated approach is needed to coordinate and deliver care across the levels of the health system. This includes increasing primary care capacity and competencies to address multiple chronic conditions, and integration with other complementary programs to avoid missing opportunities for NCD diagnosis and management. An integrated approach to NCD management, and implementation of avail- able tools, should be part of rebuilding health systems after the COVID-19 pandemic.


[RESUMEN]. En este artículo se presenta una visión general de un enfoque integrado para mejorar el manejo de las enfer- medades no transmisibles (ENT), así como herramientas para integrar el manejo de las ENT como parte del fortalecimiento de los sistemas de salud en la Región de las Américas. El estudio se basa en un análisis de datos de la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS) y en información disponible para el público sobre la atención de las ENT y la capacidad, las interrupciones en los servicios y la orientación sobre el manejo de las ENT. Se destacan las brechas en la atención de estas enfer- medades; se estima que 43,0% de los hombres y 28,0% de las mujeres con hipertensión en América Latina siguen sin recibir un diagnóstico, mientras que entre las personas con diabetes, 32,8% en América Central y del Sur no están diagnosticadas. Sin embargo, únicamente 17 de 35 países de la Región (49%) afirman disponer de pautas nacionales basadas en la evidencia para el manejo de las ENT mediante un enfoque de atención primaria, y solo 7 de 35 países (20%) refieren la provisión de farmacoterapia —por ejemplo, para el control glucémico— para las personas que reúnen los requisitos. Para mejorar el manejo de las ENT, es necesario un enfoque integrado para coordinar y brindar atención en todos los niveles del sistema de salud. Esto supone el aumento de la capacidad y las competencias de la atención primaria para abordar diversas enfermedades crónicas y su integración con otros programas complementarios y así no perder oportunidades de diagnosticar y gestionar las ENT. Un enfoque integrado para el manejo de las ENT y la aplicación de las herramientas disponibles deben formar parte de la reconstrucción de los sistemas de salud después de la pandemia de COVID-19.


[RESUMO]. O documento apresenta uma visão geral de uma abordagem integrada para melhorar o manejo de doenças não transmissíveis (DNT), bem com ferramentas para posicionar o manejo das DNT como parte integrante do fortalecimento dos sistemas de saúde nas Américas. O estudo tem como base uma análise dos dados da Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS) e informações dis- poníveis publicamente sobre cuidados e capacidade de atendimento a DNT, interrupções nos serviços de DNT e orientações sobre o manejo de DNT. São destacadas as lacunas na atenção às DNT. Estima-se que 43,0% dos homens e 28,0% das mulheres com hipertensão na América Latina permanecem sem diagnóstico, e entre aqueles com diabetes, 32,8% na América Central e do Sul permanecem sem diagnóstico. Apenas 17 de 35 países (49%) nas Américas relatam ter diretrizes nacionais baseadas em evidências para o manejo de DNT na atenção primária e apenas 7 de 35 países (20%) relatam o fornecimento de terapia medicamentosa, incluindo medicamentos para o controle glicêmico para pessoas elegíveis. Para melhorar o manejo das DNT, é necessária uma abordagem integrada para coordenar e prestar cuidados em todos os níveis do sistema de saúde. Isso inclui o aumento da capacidade e da competência da atenção primária para atender pessoas com múltiplas doenças crônicas e a integração com outros programas complementares para evitar a perda de oportunidades para o diagnóstico e o manejo das DNT. Uma abordagem integrada ao manejo das DNT e a implementação das ferramentas disponíveis devem fazer parte da reconstrução dos sistemas de saúde após a pandemia de COVID-19.


Subject(s)
Noncommunicable Diseases , Primary Health Care , Systems Integration , Delivery of Health Care, Integrated , Noncommunicable Diseases , Primary Health Care , Systems Integration , Delivery of Health Care, Integrated , Americas , Noncommunicable Diseases , Primary Health Care , Systems Integration , Delivery of Health Care, Integrated , Americas , COVID-19
3.
Br J Hosp Med (Lond) ; 82(7): 1-4, 2021 Jul 02.
Article in English | MEDLINE | ID: covidwho-1337826

ABSTRACT

The NHS has always struggled to effectively adopt innovative medical technologies. A report by The Medical Technology Group argues that a new system for the widespread adoption of technology is needed. The report argues that, considering the growing backlog of procedures caused by the COVID-19 pandemic, medical technology can increase efficiency and deliver better outcomes for patients, while helping the NHS to recover.


Subject(s)
Biomedical Technology/organization & administration , COVID-19/epidemiology , Drug Industry/organization & administration , Efficiency, Organizational , Humans , Pandemics , Quality of Health Care , Quality of Life , SARS-CoV-2 , Systems Integration
4.
Lancet Digit Health ; 3(6): e383-e396, 2021 06.
Article in English | MEDLINE | ID: covidwho-1221078

ABSTRACT

Health information technology can support the development of national learning health and care systems, which can be defined as health and care systems that continuously use data-enabled infrastructure to support policy and planning, public health, and personalisation of care. The COVID-19 pandemic has offered an opportunity to assess how well equipped the UK is to leverage health information technology and apply the principles of a national learning health and care system in response to a major public health shock. With the experience acquired during the pandemic, each country within the UK should now re-evaluate their digital health and care strategies. After leaving the EU, UK countries now need to decide to what extent they wish to engage with European efforts to promote interoperability between electronic health records. Major priorities for strengthening health information technology in the UK include achieving the optimal balance between top-down and bottom-up implementation, improving usability and interoperability, developing capacity for handling, processing, and analysing data, addressing privacy and security concerns, and encouraging digital inclusivity. Current and future opportunities include integrating electronic health records across health and care providers, investing in health data science research, generating real-world data, developing artificial intelligence and robotics, and facilitating public-private partnerships. Many ethical challenges and unintended consequences of implementation of health information technology exist. To address these, there is a need to develop regulatory frameworks for the development, management, and procurement of artificial intelligence and health information technology systems, create public-private partnerships, and ethically and safely apply artificial intelligence in the National Health Service.


Subject(s)
COVID-19 , Learning Health System , Medical Informatics , Artificial Intelligence/trends , Contact Tracing/methods , Health Information Interoperability , Humans , Mobile Applications , Population Surveillance/methods , Public-Private Sector Partnerships , Robotics/trends , Systems Integration , United Kingdom
5.
Med Teach ; 42(10): 1123-1127, 2020 10.
Article in English | MEDLINE | ID: covidwho-917564

ABSTRACT

The current global crises, including climate, COVID-19, and environmental change, requires global collective action at all scales. These broad socio-ecological challenges require the engagement of diverse perspectives and ways of knowing and the meaningful engagement of all generations and stages of personal and professional development. The combination of systems thinking, change management, quality improvement approaches and models, appreciative/strength-based approaches, narratives, storytelling and the strengths of Indigenous knowledges, offer synergies and potential that can set the stage for transformative, strengths-based education for sustainable healthcare (ESH). The need for strong leadership to enact a vision for ESH is outlined here with the intent to enable and nurture the conditions for change, ultimately improving health and well-being across generations.


Subject(s)
Coronavirus Infections/epidemiology , Delivery of Health Care/organization & administration , Education, Medical/organization & administration , Pneumonia, Viral/epidemiology , Betacoronavirus , COVID-19 , Humans , Interprofessional Relations , Models, Organizational , Pandemics , SARS-CoV-2 , Systems Integration
6.
J Am Med Inform Assoc ; 27(11): 1716-1720, 2020 11 01.
Article in English | MEDLINE | ID: covidwho-873017

ABSTRACT

OBJECTIVE: Reducing risk of coronavirus disease 2019 (COVID-19) infection among healthcare personnel requires a robust occupational health response involving multiple disciplines. We describe a flexible informatics solution to enable such coordination, and we make it available as open-source software. MATERIALS AND METHODS: We developed a stand-alone application that integrates data from several sources, including electronic health record data and data captured outside the electronic health record. RESULTS: The application facilitates workflows from different hospital departments, including Occupational Health and Infection Control, and has been used extensively. As of June 2020, 4629 employees and 7768 patients and have been added for tracking by the application, and the application has been accessed over 46 000 times. DISCUSSION: Data captured by the application provides both a historical and real-time view into the operational impact of COVID-19 within the hospital, enabling aggregate and patient-level reporting to support identification of new cases, contact tracing, outbreak investigations, and employee workforce management. CONCLUSIONS: We have developed an open-source application that facilitates communication and workflow across multiple disciplines to manage hospital employees impacted by the COVID-19 pandemic.


Subject(s)
Coronavirus Infections/transmission , Data Management , Health Personnel , Occupational Health , Patient Identification Systems/methods , Pneumonia, Viral/transmission , Software , Workflow , Boston , COVID-19 , Disease Outbreaks , Hospitals, Veterans , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pandemics , Systems Integration , United States
8.
Am J Infect Control ; 48(10): 1244-1247, 2020 10.
Article in English | MEDLINE | ID: covidwho-693513

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has created many challenges for health care providers. At the forefront is the need to balance optimal patient care with the safety of those providing that care. This is especially true during resuscitations where life-saving procedures cause widespread aerosolization of the virus. Efforts to mitigate this exposure to front-line providers are therefore paramount. We share how we used simulation to prepare our pediatric emergency department for COVID-19 resuscitations.


Subject(s)
Coronavirus Infections/therapy , Emergency Service, Hospital , Health Personnel/education , Pneumonia, Viral/therapy , Resuscitation/education , Simulation Training/methods , Betacoronavirus , COVID-19 , Child , Humans , Pandemics , SARS-CoV-2 , Systems Integration
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