Digital Health in Brazil: Trends and Opportunities.

The aim of this paper is to present the evolution of Digital Health (DH) in Brazil, in relation to the adoption of DH as a basis for the development of public policies, with a focus on improving the delivery of health care to patients and expanding its coverage. Data from the ICT in Health survey from the Regional Centre for Studies on the Development of the Information Society (Cetic.br) were analysed. The main challenges identified are related to gaps in patient information, which requires interaction between different facilities and to more complex functionalities related to guidelines and guidance in patient care.

Recommendations of the International Medical Informatics Association (IMIA) on Education in Biomedical and Health Informatics: Second Revision.

BACKGROUND: The purpose of educational recommendations is to assist in establishing courses and programs in a discipline, to further develop existing educational activities in the various nations, and to support international initiatives for collaboration and sharing of courseware. The International Medical Informatics Association (IMIA) has published two versions of its international recommendations in biomedical and health informatics (BMHI) education, initially in 2000 and revised in 2010. Given the recent changes to the science, technology, the needs of the healthcare systems, and the workforce of BMHI, a revision of the recommendations is necessary. OBJECTIVE: The aim of these updated recommendations is to support educators in developing BMHI curricula at different education levels, to identify essential skills and competencies for certification of healthcare professionals and those working in the field of BMHI, to provide a tool for evaluators of academic BMHI programs to compare and accredit the quality of delivered programs, and to motivate universities, organizations, and health authorities to recognize the need for establishing and further developing BMHI educational programs. METHOD: An IMIA taskforce, established in 2017, updated the recommendations. The taskforce included representatives from all IMIA regions, with several having been involved in the development of the previous version. Workshops were held at different IMIA conferences, and an international Delphi study was performed to collect expert input on new and revised competencies. RESULTS: Recommendations are provided for courses/course tracks in BMHI as part of educational programs in biomedical and health sciences, health information management, and informatics/computer science, as well as for dedicated programs in BMHI (leading to bachelor's, master's, or doctoral degree). The educational needs are described for the roles of BMHI user, BMHI generalist, and BMHI specialist across six domain areas - BMHI core principles; health sciences and services; computer, data and information sciences; social and behavioral sciences; management science; and BMHI specialization. Furthermore, recommendations are provided for dedicated educational programs in BMHI at the level of bachelor's, master's, and doctoral degrees. These are the mainstream academic programs in BMHI. In addition, recommendations for continuing education, certification, and accreditation procedures are provided. CONCLUSION: The IMIA recommendations reflect societal changes related to globalization, digitalization, and digital transformation in general and in healthcare specifically, and center on educational needs for the healthcare workforce, computer scientists, and decision makers to acquire BMHI knowledge and skills at various levels. To support education in BMHI, IMIA offers accreditation of quality BMHI education programs. It supports information exchange on programs and courses in BMHI through its Working Group on Health and Medical Informatics Education.

Digital vaccine passports and digital health diplomacy: an online model WHO simulation.

In the wake of Coronavirus disease 2019 (COVID-19), several nations have sought to implement digital vaccine passports (DVPs) to enable the resumption of international travel. Comprising a minimum dataset for each unique individual, DVPs have the makings of a global electronic health record, broaching key issues involved in building a global digital health ecosystem. Debate simulations offer a safe, interactive space to foster participatory policy discussions for advancing digital health diplomacy. This study used an online simulation of a Model World Health Assembly to critically analyze the sociotechnical issues associated with the global implementation of DVPs, and to generate useful insights and questions about the role of diplomacy in global digital health. The debate arguments addressed and provided insights into the technological, scientific, ethical, legal, policy, and societal aspects of DVPs. Reflecting on the simulation, we discuss its opportunities and challenges for the digitalization, decolonization, decentralization, and democratization of participatory policymaking.

ICT health 2013: infrastructure and adoption by healthcare providers in Brazil.

The potential offered by intensive and strategic adoption of information and communication technologies for obtaining advances in the health sector is worldwide recognized. In order to monitor the implementation of ICT in health policies in Brazil and to establish internationally comparable indicators, a nationwide survey was conducted to identify the current implementation of information and communication technologies in Healthcare facilities and its adoption by providers. Data collection was carried out from February to August 2013 using two structured questionnaires. The results obtained showed that the access to internet is nearly universal in the country but clinical information systems are still in its infancy when it comes to more complex functionalities and linked to clinical decision support. Healthcare professionals indicated that the main barrier to adopt is the lack of availability related to the patient information.

A certificate program in health informatics: Brazil/USA experience.

Considering the continued demand for a large number of trained professionals we decided to offer a certificate program in health informatics. The objective is to prepare professionals to conduct research and implement the curriculum content in their original institutions. We selected 14 candidates from several national institutes. The disciplines are taught by Brazilian and US faculty. Researches conducted by the certificate students were relevant to Brazil's health needs. The goal is to promote better health informatics education, regardless of geographic distribution of students.

Criação de um Web Site para enfermeiros sobre Pé Diabético / Creation of Web Site for nurses about Diabetic Foot

OBJETIVOS: Descrever o processo de criação de um web site educacional para enfermeiros contendo informações sobre avaliação e cuidados preventivos dos pés em pacientes com diabetes mellitus. MÉTODOS: Pesquisa aplicada desenvolvida em 2004, baseada no modelo teórico de Tronchim (1999) para a construção de web sites, composto das fases de conceitualização, desenvolvimento, implementação e avaliação. RESULTADOS: O site possui 68 páginas contendo informações, orientações, fotos e ilustrações, estruturadas em tópicos com os conceitos básicos de diabetes mellitus, pé diabético, neuropatias, doença vascular periférica, infecções, amputações, educação e orientações de enfermagem. Foi avaliado por especialistas que referendaram seu conteúdo e fizeram sugestões para seu aperfeiçoamento. CONCLUSÕES: A criação e desenvolvimento do site foram descritos, podendo ser acessado no www.unifesp.br/nien na opção pesquisa.

Nursing informatics: learning from the past to build a new future.

Health care and health information have been around since the time of Hippocrates or even before. Through the historical evolution, it is observed that the knowledge and information that were simple and easy to learn and retain by that time, became much more complex. This paper presents a brief reviewing on the evolution of nursing informatics and how it grew up and made itself visible during all these years of International Medical Informatics Association (IMIA) conferences.

[Decision-support guideline in obstetrical nursing: application of fuzzy logic technique]. / Guia de Apoio à Decisão em Enfermagem Obstétrica: aplicação da técnica da Lógica fuzzy.

Fuzzy Logic has been used as an approach for knowledge representation and a technique for modeling Clinical Decision-Support Systems. In considering such technique underutilization for modeling nursing clinical decisions, this essay aims to present general notions about this technique and through it to develop a theoretical formulation of practice guideline to support decision in amniotomy cases for pregnant women in normal labor.

New frontiers for nursing and health care informatics.

Health care and health information have been around since the time of Hippocrates or even before. Through the historical evolution, it is observed that the knowledge and information that were simple and easy to learn and retain by that time, became much more complex. This paper presents a brief reviewing on the evolution of MEDINFO conferences, and how nursing informatics grew up and made itself visible during all these years of IMIA conferences.

Guia de apoio à decisão em enfermagem obstétrica: aplicação da técnica da lógica Fuzzy / Decision-support guideline in obstetrical nursing: application of Fuzzy logic technique

A Lógica Fuzzy tem sido utilizada como uma forma de representação de conhecimento e uma técnica para a modelagem de Sistemas de Apoio à Decisões Clínicas. Ao considerar a pouca utilização desta técnica para modelar decisões clínicas de enfermagem, este ensaio objetiva apresentar noções gerais sobre esta técnica e por meio dela desenvolver uma formulação teórica, em forma de guia prático, para o apoio à decisão nos casos de amniotomia em gestantes pimíparas em trabalho de parto normal.

Nursing informatics: learning from the past to build a new future

Health care and health information have been around since the time of Hippocrates or even before. Through the historical evolution, it is observed that the knowledge and information that were simple and easy to learn and retain by that time, became much more complex. This paper presents a brief reviewing on the evolution of nursing informatics and how it grew up and made itself visible during all these years of International Medical Informatics Association (IMIA) conferences.

Training health informatics professionals in Brazil: rationale for the development of a new certificate program.

Current graduate degree programs in Brazil cannot fulfill the demand for highly trained health informatics practitioners. We have developed an intensive six-month program to train 20 students per year. They will receive partial subsidy from our bilateral training program and receive the title of Specialist in Health Informatics. They will benefit from a curriculum involving coursework and collaborative research designed by Brazilian and US-based faculty.

Translating the International Classification for Nursing Practice (ICNP)--an experience from two countries.

The International Classification for Nursing Practice (ICNP) has been published in the alpha, beta 1, and beta 2 versions that, together with forthcoming versions, are going to be translated into many languages. It is important that the translation process facilitates a valid and reliable translation. Experiences from two countries are given as well as recommendations for future work. There is a need for an ongoing development of the ICNP, including feedback from numerous countries to ICN.

International training in health informatics: a Brazilian experience.

Technology is transforming not only the practice of health-care but also professional training and educational models. Developing countries, such as Brazil, are increasingly suffering from a severe shortage of health informatics specialists. Training of professionals in this field is expensive, and there is a limited supply of high-quality teaching resources available. We envision that training in health informatics can be better achieved if cultural and technological barriers are anticipated and the training program is prepared accordingly. We describe our four-year experience of a Brazil/USA training program and discuss lessons learned during its implementation. Eleven onsite courses, one seminar, and two conferences were developed under this unique initiative, which made possible the collaboration among different countries and distinguished leaders in the field of medical informatics.