Design of a Vaccine Passport Validation System Using Blockchain-based Architecture: Development Study.

BACKGROUND: COVID-19 is an ongoing global pandemic caused by SARS-CoV-2. As of June 2021, 5 emergency vaccines were available for COVID-19 prevention, and with the improvement of vaccination rates and the resumption of activities in each country, verification of vaccination has become an important issue. Currently, in most areas, vaccination and reverse transcription polymerase chain reaction (RT-PCR) test results are certified and validated on paper. This leads to the problem of counterfeit documents. Therefore, a global vaccination record is needed. OBJECTIVE: The main objective of this study is to design a vaccine passport (VP) validation system based on a general blockchain architecture for international use in a simulated environment. With decentralized characteristics, the system is expected to have the advantages of low cost, high interoperability, effectiveness, security, and verifiability through blockchain architecture. METHODS: The blockchain decentralized mechanism was used to build an open and anticounterfeiting information platform for VPs. The contents of a vaccination card are recorded according to international Fast Healthcare Interoperability Resource (FHIR) standards, and blockchain smart contracts (SCs) are used for authorization and authentication to achieve hierarchical management of various international hospitals and people receiving injections. The blockchain stores an encrypted vaccination path managed by the user who manages the private key. The blockchain uses the proof-of-authority (PoA) public chain and can access all information through the specified chain. This will achieve the goal of keeping development costs low and streamlining vaccine transit management so that countries in different economies can use them. RESULTS: The openness of the blockchain helps to create transparency and data accuracy. This blockchain architecture contains a total of 3 entities. All approvals are published on Open Ledger. Smart certificates enable authorization and authentication, and encryption and decryption mechanisms guarantee data protection. This proof of concept demonstrates the design of blockchain architecture, which can achieve accurate global VP verification at an affordable price. In this study, an actual VP case was established and demonstrated. An open blockchain, an individually approved certification mechanism, and an international standard vaccination record were introduced. CONCLUSIONS: Blockchain architecture can be used to build a viable international VP authentication process with the advantages of low cost, high interoperability, effectiveness, security, and verifiability.

Global Infectious Disease Surveillance and Case Tracking System for COVID-19: Development Study.

BACKGROUND: COVID-19 has affected more than 180 countries and is the first known pandemic to be caused by a new virus. COVID-19's emergence and rapid spread is a global public health and economic crisis. However, investigations into the disease, patient-tracking mechanisms, and case report transmissions are both labor-intensive and slow. OBJECTIVE: The pandemic has overwhelmed health care systems, forcing hospitals and medical facilities to find effective ways to share data. This study aims to design a global infectious disease surveillance and case tracking system that can facilitate the detection and control of COVID-19. METHODS: The International Patient Summary (IPS; an electronic health record that contains essential health care information about a patient) was used. The IPS was designed to support the used case scenario for unplanned cross-border care. The design, scope, utility, and potential for reuse of the IPS for unplanned cross-border care make it suitable for situations like COVID-19. The Fast Healthcare Interoperability Resources confirmed that IPS data, which includes symptoms, therapies, medications, and laboratory data, can be efficiently transferred and exchanged on the system for easy access by physicians. To protect privacy, patient data are deidentified. All systems are protected by blockchain architecture, including data encryption, validation, and exchange of records. RESULTS: To achieve worldwide COVID-19 surveillance, a global infectious disease information exchange must be enacted. The COVID-19 surveillance system was designed based on blockchain architecture. The IPS was used to exchange case study information among physicians. After being verified, physicians can upload IPS files and receive IPS data from other global cases. The system includes a daily IPS uploading and enhancement plan, which covers real-time uploading through the interoperation of the clinic system, with the module based on the Open Application Programming Interface architecture. Through the treatment of different cases, drug treatments, and the exchange of treatment results, the disease spread can be controlled, and treatment methods can be funded. In the Infectious Disease Case Tracking module, we can track the moving paths of infectious disease cases. The location information recorded in the blockchain is used to check the locations of different cases. The Case Tracking module was established for the Centers for Disease Control and Prevention to track cases and prevent disease spread. CONCLUSIONS: We created the IPS of infectious diseases for physicians treating patients with COVID-19. Our system can help health authorities respond quickly to the transmission and spread of unknown diseases, and provides a system for information retrieval on disease transmission. In addition, this system can help researchers form trials and analyze data from different countries. A common forum to facilitate the mutual sharing of experiences, best practices, therapies, useful medications, and clinical intervention outcomes from research in various countries could help control an unknown virus. This system could be an effective tool for global collaboration in evidence-based efforts to fight COVID-19.

Health information privacy in the Philippines: Trends and challenges in policy and practice

CONTEXT: Evolution of the scope and context of privacy and confidentiality brought about by use of information and communications technology in healthcare. OBJECTIVE: To review the legal, professional and ethical landscape of health information privacy in the Philippines. METHODOLOGY: Systematic review of literature and policy frameworks. RESULTS: Philippine laws jurisprudence recognize and protect privacy of health information as a general rule; impose upon individual practitioners and institutions the obligation to uphold such right; and may apply in both the traditional and eHealth milieu. There is no existing policy framework that addresses issues relating to [a] access to health information by non-health professionals, [b] use of health information for non-health purposes, and [c] rules relating to collection, storage and utilization of electronically-derived or -stored information. A privacy culture, on either the provider's or client's side, is also lacking in the country. CONCLUSION: Technological developments have outpaced policy and practice. There is a need to unify the patchwork of regulations governing the privacy of health information; advocate for a privacy culture among professionals and patients alike; fortify the evidence base on patient and provider perceptions of privacy; and develop and improve standards and systems to promote health information privacy at the individual and institutional levels. 

Telepathology in the Philippines: A review and future prospects

BACKGROUND: Challenged with insufficient number and maldistribution of pathologists, the Philippines seemed poised to benefit from telemedicine. METHODS: The first modern Internet-based telepathology consultation was conducted between the University of the Philippines Manila and the Armed Forces Institute of Pathology in 1997. RESULTS: While the first remote telepathology consult was a success, more than a decade after this historic referral, telepathology remains in the fringes of mainstream pathology practice despite its huge potential to benefit the underserved population. Challenges with human, organizational, and technology factors hinder its progress. CONCLUSIONS: While the original consultation faced difficulties in human capacity, connectivity and infrastructure, rapid developments in governance and technology have the potential to eliminate these problems. Substantial improvements in recent years now provide a more conducive environment to deliver telepathology services to remote areas. This paper proposes a framework for the establishment of mature telepathology services to enable its use in areas of greatest need in the country

Information-seeking trends of medical professionals and students from middle-income countries: a focus on the Philippines.

BACKGROUND: Increased emphasis has been given to the practice of evidence-based medicine (EBM) worldwide. Access to quality health information is essential to the practice of EBM in developing countries. OBJECTIVES: To understand the information needs and sources of information of physicians from low- and middle-income countries (LMICs). METHODS: Medical doctors and students participated in an 18-question online or paper study. RESULTS: Of the 156 respondents from six LMICs, 146 (94%) came from the Philippines. Eighty-eight per cent encountered at least one clinical question daily, while 58% were very likely to search for answers. A basic mobile phone was the most used device at home (94%) and at work (82%). More than half had Internet connectivity at home (62%) and just under half at work (46%). In decreasing order, short messaging services (SMS), email, instant messaging and multimedia messaging services (MMS) were the most commonly used messaging tools at home and at work. The primary source for medication questions was a formulary, but for diagnostic dilemmas, colleagues were consulted first. PubMed use was high for therapy and management questions. CONCLUSION: The use of health information from the Internet through mobile devices may be increasing. Access to health information was higher at home than at work. These results may be useful when planning resources for healthcare givers in resource-poor settings.

ESP: an expert system for poisoning diagnosis and management.

We describe a clinical decision support system (CDSS) designed to provide timely information germane to poisoning. The CDSS aids medical decision making through recommendations to clinicians for immediate evaluation. The system is implemented as a rule-based expert system with two major components: the knowledge base and the inference engine. The knowledge base serves as the database which contains relevant poisoning information and rules that are used by the inference engine in making decisions. This expert system accepts signs and symptoms observed from a patient as input and presents a list of possible poisoning types with the corresponding management procedures which may be considered in making the final diagnosis. A knowledge acquisition tool (KAT) that allows toxicological experts to update the knowledge base was also developed. This article describes the architecture of the fully featured system, the design of the CDSS and the KAT as web applications, the utilisation of the inferencing mechanism of C Language Integrated Production System (CLIPS), which is an expert system shell that helps the system in decision-making tasks, the methods used as well as problems encountered. We also present the results obtained after testing the system and propose some recommendations for future work.

Telemedicine via Short Messaging System (SMS) in rural Philippines.

The University of the Philippines National Telehealth Center extended its services to the Doctor-to-the-Barrios program of the Department of Health through Short Messaging System telereferral system. This system enables physicians from remote and underserved rural communities to refer cases to domain experts from the University of the Philippines Philippine General Hospital. Two hundred eighty-four cases were sent in a six-month period.

Nursing informatics: challenges to Philippine nursing curriculum.

The University of the Philippines College of Nursing curriculum has been the foundation of most of the curriculum in the country. But such is inferior with the current global health care delivery system. With Telehealth as the current program launched as an alternative medium to address health-care needs in geographically isolated areas through the use of ICT, nurses provide care for populations through electronic communication media and act as triage nurses who advise/consult with patients.

Geographical information systems in health research and services delivery in the Philippines.

Accessible public data emanating from remote sensing from earth-observing satellites, as well as geographical information systems in general, are playing an increasing role in the public health sector in the Philippines. This paper reviews currently available systems in the country in this area, emphasizing the utility in complementing field studies with the development of disease models. The goal is to map out important biological threats by characterizing the niches infectious agents, and their vectors or intermediate hosts, occupy temporally and spatially.

Analysis of Sciellin (SCEL) as a candidate gene in esophageal squamous cell carcinoma.

BACKGROUND: The aim of this study was to investigate whether a candidate gene, Sciellin (SCEL), mapping to the chromosome 13q21-q31 is mutated in esophageal cancer. MATERIALS AND METHODS: The coding region and intron-exon junctions of SCEL were sequenced in 13 esophageal squamous cell cancers and matching normal esophageal samples to detect mutations. RESULTS: Three single nucleotide polymorphisms were detected in SCEL of which two were silent mutations (L640L and H654H) and one missense mutation (R366K). CONCLUSION: Single nucleotide polymorphisms were detected in both matching tumor and normal esophageal tissues but no disease-associated mutations suggesting that SCEL is not a major factor in esophageal squamous cell carcinogenesis.