Data and Digital Solutions to Support Surveillance Strategies in the Context of the COVID-19 Pandemic

Background: In order to prevent spread and improve control of infectious diseases, public health experts need to closely monitor human and animal populations. Infectious disease surveillance is an established, routine data collection process essential for early warning, rapid response, and disease control. The quantity of data potentially useful for early warning and surveillance has increased exponentially due to social media and other big data streams. Digital epidemiology is a novel discipline that includes harvesting, analysing, and interpreting data that were not initially collected for healthcare needs to enhance traditional surveillance. During the current COVID-19 pandemic, the importance of digital epidemiology complementing traditional public health approaches has been highlighted. Objective: The aim of this paper is to provide a comprehensive overview for the application of data and digital solutions to support surveillance strategies and draw implications for surveillance in the context of the COVID-19 pandemic and beyond. Methods: A search was conducted in PubMed databases. Articles published between January 2005 and May 2020 on the use of digital solutions to support surveillance strategies in pandemic settings and health emergencies were evaluated. Results: In this paper, we provide a comprehensive overview of digital epidemiology, available data sources, and components of 21st-century digital surveillance, early warning and response, outbreak management and control, and digital interventions. Conclusions: Our main purpose was to highlight the plausible use of new surveillance strategies, with implications for the COVID-19 pandemic strategies and then to identify opportunities and challenges for the successful development and implementation of digital solutions during non-emergency times of routine surveillance, with readiness for early-warning and response for future pandemics. The enhancement of traditional surveillance systems with novel digital surveillance methods opens a direction for the most effective framework for preparedness and response to future pandemics

Drivers of telemedicine use: International evidence from three samples of physicians

The aim of the working paper is to analyse the determinants of telemedicine use. To that end, the study makes two basic contributions. First, it considers six working hypotheses in the context of technology acceptance models (TAMs). Second, it uses data obtained for three samples of 510 physicians: 113 in Spain, 118 in Colombia and 279 in Bolivia, and it performes binary logistic regression. In the three samples, it was found that the physician's level of ICT use in his/her personal life was the variable that had the highest explanatory power on telemedicine use. In the Spanish sample, the physicians' perceived ease-of-use of ICTs in clinical practice and propensity to innovate were the two other variables that determined telemedicine use, whereas in the Colombian and Bolivian samples, it was the level of optimism about ICTs. The results showed a more complete model that contemplated personal, usability and innovatory aspects in the explanation of telemedicine use in Spain, whereas the results for the Latin American samples indicated a more primary model in the explanation of telemedicine use, which was completed by an optimism factor that did not emerge in the Spanish sample

Desafíos y oportunidades de las herramientas 2.0 para el estudio interdisciplinar de la nutrición: el caso de la Wiki Dieta Mediterránea

En aquest treball s’analitza la possibilitat d’integrar en programes de formació de postgrau de l’àrea de la salut noves pràctiques d’aprenentatge que permetin als estudiants adquirir competències específiques sobre el seu àmbit d’estudi, i alhora millorar altres competències transversals relacionades amb l’ús d’elements propis de la societat de la informació i el coneixement. Amb aquesta intenció es va dur a terme l’experiència wiki dieta mediterrània (wiki DM), una activitat col·laborativa entorn de diferents aspectes de la dieta mediterrània (DM) utilitzant wikispaces.Amb aquesta activitat, d’una banda, es pretenia desenvolupar una visió holística i transdisciplinària del fenomen de l’alimentació, no tan sols des del punt de vista de la seva relació amb la salut, sinó també remarcant-ne la importància del component social, cultural o econòmic; i, de l’altra, es buscava generar i tenir a disposició un conjunt de recursos bibliogràfics actualitzats i fàcilment accessibles sobre el tema, que fossin útils al llarg de tot el procés formatiu. En l’experiència van participar docents i estudiants de diferents programes formatius, de manera que, encara que estiguessin centrats en un àmbit relacionat amb la seva assignatura, pel fet de treballar en un espai comú i amb un objectiu comú poguessin accedir a un conjunt d’informació multidisciplinària i amb una visió més holística de la DM. Després de l’experiència es van analitzar els resultats mitjançant l’avaluació de l’activitat, la participació a la wiki i una enquesta anònima. Els resultats van demostrar que la wiki DM és una eina efectiva per a abordar el fenomen de l’alimentació des de diferents perspectives, i també un sistema útil per a treballar en competències transversals, com ara el domini de les TIC, la cerca bibliogràfica i el treball col·laboratiu.This article analyses the possibility of integrating new learning practices into health-related postgraduate programmes to enable students to acquire specific competencies in their field of study while improving other cross-disciplinary competencies related to the use of elements inherent to the information and knowledge society. To that end, a decision was taken to develop a Mediterranean Diet Wiki experience; a collaborative activity on the different aspects of the Mediterranean diet, using Wikispaces.The activity had two objectives. First, to develop a holistic, transdisciplinary vision of the phenomenon of nutrition, in terms not only of its relationship to health, but also of its importance as a social, cultural and economic component. And second, to have a set of up-to-date, easy-to-access bibliographic resources available on the topic, which would prove useful throughout the students’ educational process. Students and lecturers on different educational programmes took part in the experience. While focusing on a field of study related to their respective subjects, the experience offered them the opportunity to work in a shared space towards a common goal, by providing them with access to a range of multidisciplinary information and a more holistic vision of the Mediterranean diet. On completion of the experience, activity assessment and wiki participation data were analysed, as were data obtained from the anonymous questionnaire. The results showed that the Mediterranean Diet Wiki was an effective tool for approaching the phenomenon of nutrition from different angles, as well as a useful system for working on cross-disciplinary competencies such as the mastery of ICTs, searching effectively for bibliographic references, and collaborative work.En este trabajo se analiza la posibilidad de integrar en programas de formación de posgrado del Área de la Salud nuevas prácticas de aprendizaje que permitan a los estudiantes adquirir competencias específicas sobre su ámbito de estudio, al mismo tiempo que mejorar otras competencias transversales relacionadas con el uso de elementos propios de la sociedad de la información y del conocimiento. Con tal intención se desarrolló la experiencia Wiki DM, una actividad colaborativa en torno a diferentes aspectos de la dieta mediterránea (DM) usandowikispaces.Con esta actividad se pretendía, por un lado, desarrollar una visión holística y transdisciplinar del fenómeno de la alimentación, no solo en su relación con la salud, sino también resaltando la importancia de su componente social, cultural o económico; y, por otro, se buscaba generar y disponer de un conjunto de recursos bibliográficos actualizados y fácilmente accesibles sobre el tema, que fueran de utilidad a lo largo de todo su proceso formativo. En la experiencia participaron docentes y estudiantes de diferentes programas formativos, de manera que, aunque centrados en un ámbito relacionado con su asignatura pero trabajando en un espacio y con un objetivo común, pudieran acceder a una serie de información multidisciplinar y con una visión más holística de la DM. Tras la experiencia se analizaron los resultados mediante la evaluación de la actividad, la participación en la wiki y una encuesta anónima. Los resultados demostraron que la Wiki DM resulta una herramienta efectiva para abordar el fenómeno de la alimentación desde diferentes perspectivas, así como un sistema útil para trabajar en competencias transversales, tales como el dominio de las TIC, la búsqueda bibliográfica y el trabajo colaborativo

Hesitation about coronavirus vaccines in healthcare professionals and general population in Spain

This study attempts to provide a picture of the hesitancy to vaccination against COVID-19 in Spain during the 2021 spring-autumn vaccination campaign, both in the general population and in healthcare professionals. The participants were recruited using social media such as Facebook and Twitter, in addition to the cooperation of health personnel contacted with the collaboration of medical scientific societies. A cross-sectional study was carried out that included the response of an online questionnaire. The data were collected from April 30 to September 26, 2021. To assess the different associations between variables to be measured, we fit Poisson regression models with robust variance. Responses were obtained from 3,850 adults from the general population group and 502 health professionals. Of the overall sample, 48.6% of participants from the general population were vaccinated against COVID-19, whereas in the healthcare professionals, 94.8% were vaccinated. The prevalence of general population vaccination increased with age, and was higher in women than men. Most participants did not show a preference for any vaccine itself. However, the prevalence of people vaccinated with their preferred vaccine was higher for the ones vaccinated with Pfizer's vaccine. 6.5% of the general population reported being reticent to be vaccinated. People from younger age groups, people with lower educational levels and those who were not from a risk group showed greater reluctance to be vaccinated. No gender differences in reluctancy were found. Health professionals were significantly less likely to refuse vaccination even though they had more doubts about the safety and efficacy of vaccines. On the other hand, younger people, those with a lower level of education and those who were not from a risk group were the most hesitant

Efficiency as a determinant of loyalty among users of a community of clinical practice: a comparative study between the implementation and consolidation phases

A community of clinical practice called the Online Communication Tool between Primary and Hospital Care (ECOPIH) was created to enable primary care and specialist care professionals to communicate with each other in order to resolve real clinical cases, thereby improving communication and coordination between care levels. The present work seeks to analyse whether ECOPIH makes it possible to reduce the number of referrals. To that end, the objectives are: (1) To find out the degree of loyalty among ECOPIH users, by comparing the medical professionals' profiles in the tool's implementation phase to those in its consolidation phase. (2) To evaluate the degree of fulfilment of users' expectations, by establishing the determining factors that had an influence on the physicians' intention to use ECOPIH in the implementation phase and observing whether its use had an effective, direct impact on the number of patient referrals that primary care physicians made to specialist care professionals. Two studies were conducted. Based on a survey of all the physicians in a Primary Care area, Study 1 was a descriptive study in ECOPIH's implementation phase. Study 2 was a randomised intervention study of ECOPIH users in the tool's consolidation phase. The results from both studies were compared. Various bivariate and multivariate statistical techniques (exploratory factor analysis, cluster analysis, logistic regression analysis and ANOVA) were used in both studies, which were conducted on a sample of 111 and 178 physicians, respectively. We confirmed the existence of an ECOPIH user profile stable across both phases: under-50-year-old women. Regarding the second objective, there were two particular findings. First, the discriminant factors that had an influence on greater ECOPIH use were habitual Social media website and app use and Perceived usefulness for reducing costs. Second, PC professionals who were ECOPIH members made fewer referrals to SC professionals in Cardiology, Endocrinology and Gastroenterology than older PC professionals who were not ECOPIH members. The use of a community of clinical practice by primary care and specialist care professionals helps to reduce the number of referrals among medical professionals

Understanding the discriminant factors that influence the adoption and use of clinical communities of practice : the ECOPIH case

The aim of the study presented in this article is to analyse the discriminant factors that have an influence on the use of communities of practice by primary and specialist healthcare professionals (physicians and nurses) for information sharing. Obtaining evidence from an ex-ante analysis to determine what factors explain healthcare professionals' clinical community of practice use allows aspects of its use to be identified. A theoretical model based on a modified technology acceptance model was used as the analysis tool, and a discriminant analysis was performed. An ad-hoc questionnaire was designed and sent to a study population of 357 professionals from the Badalona-Sant Adrià de Besòs Primary Care Service in Catalonia, Spain, which includes nine primary care centres and three specialist care centres. The study sample was formed by the 166 healthcare professionals who responded. The results revealed three main drivers for engagement in a CoP: First, for the whole sample, perceived usefulness for reducing costs associated with clinical practice was the factor with the greatest discriminant power that distinguished between users and non-users, followed by perceived usefulness for improving clinical practice quality, and lastly habitual social media website and application use. Turning to the two sub-samples of healthcare professions (physicians and nurses, respectively), we saw that the usefulness stemming from community of practice use changed. There were differences in the levels of motivation of healthcare professionals with regards to their engagement with CoP. While perceived usefulness for reducing costs associated with clinical practice was the main factor for the physicians, perceived usefulness of the Web 2.0 platform use for communication for improving clinical practice quality and perceived ease of use were the main factors for the nurses. In the context of communities of practice, the perception of usefulness of Web 2.0 platform use for communication is determined by organisational, technological and social factors. Specifically, the position that professionals have within the healthcare structure and particularly the closer healthcare professionals' activity is to patients and their professional experience of using social networks and ICTs are crucial to explaining the use of such platforms. Public policies promoting Web 2.0 platform use for communication should therefore go beyond the purely technological dimension and consider other professional and social determinants

Factors que influencien l'adopció i l'ús de les comunitats virtuals de pràctica clínica

L'any 2009 es va implementar a diferents centres mèdics de Badalona i Sant Adrià de Besòs ECOPIH, una plataforma de comunicació online entre professionals d'Atenció Primària i Atenció Especialitzada per tal d'establir un sistema de comunicació que permeti agilitzar i optimitzar l'atenció que reben els pacients. Aquest estudi ha analitzat l'ús d'ECOPIH entre els cossos mèdic i d'infermeria. Els resultats mostren que la percepció d'utilitat d'aquesta plataforma web 2.0 ve determinada per factors organitzacionals, tecnològics i socials.En el año 2009 se implementó en diferentes centros médicos de Badalona y Sant Adrià de Besòs ECOPIH, una plataforma de comunicación online entre profesionales de Atención Primaria y Atención Especializada para establecer un sistema de comunicación que permita agilizar y optimizar la atención que reciben los pacientes. Este estudio ha analizado el uso de ECOPIH entre los cuerpos médico y de enfermería. Los resultados muestran que la percepción de utilidad de esta plataforma web 2.0 viene determinada por factores organizacionales, tecnológicos y sociales

Aula Invertida: Descripción de una experiencia de aprendizaje multisectorial en salud

Presentations are usually offered at academic events, which attract the attention of participants, but fundamental messages are quickly forgotten. In this sense, the strategy based on the pedagogical principles of the flipped classroom or Coworking allows participants, in multidisciplinary teams, to solve problems by learning and consolidating their knowledge and other areas, while they are accompanied and moderated by experts. In this work, the experience of a flipped classroom in the “IV Workshop de Investigación en Salud” has been described. The workshop was part of the “I Congreso Internacional de Ciencia, Tecnología e Innovación, al Servicio del Desarrollo Territorial 2019” held on December 2-4 Organized by Centro de Servicios de Salud, SENA, Regional Antioquia in Medellín, Colombia. Flipped classroom activity was setup to resolve, in multidisciplinary teams, four problems related to diseases of interest in the Colombian context: chronic obstructive pulmonary disease (COPD), diabetes mellitus, breast cancer and adult alone or in a vulnerable state. The impact and reaction of the participants and the teams formed was highlighted, as well as the desire to overcome, empowerment and resistance despite their own barriers and those established by the moderators as the activity progressed. Finally, the moderators have followed the profiles of the participants, identifying their strengths and weaknesses, this has been an important source of information for decision making. Keywords: Reverse classroom, coworking, digital transformation, health, pathology.En los Congresos habitualmente se ofrecen conferencias magistrales, que atraen la atención de los asistentes, pero los mensajes fundamentales rápidamente se olvidan. En este sentido, la estrategia basada en los principios pedagógicos del aula inversa o Coworking permite a los participantes, en equipos multidisciplinarios, resolver problemas aprendiendo y afianzando conocimientos propios y de otras áreas, mientras son acompañados y moderados por expertos. En este trabajo, se describe la experiencia de un aula invertida en el IV Workshop de Investigación en Salud en el marco del I Congreso Internacional de Ciencia, Tecnología e Innovación, al Servicio del Desarrollo Territorial 2019 celebrado en los días 2-4 de diciembre organizada por el Centro de Servicios de Salud, SENA, Regional Antioquia, en la ciudad de Medellín, Colombia. La actividad de aula invertida se configuró para resolver, en equipos multidisciplinarios, cuatro problemas relacionados con patologías de interés en el entorno colombiano: diabetes mellitus, enfermedad pulmonar obstructiva crónica (EPOC), cáncer de mama y el adulto solo o en estado vulnerable. Se destaca el impacto y reacción de los participantes y los equipos conformados, así como el deseo de superación, empoderamiento y la resiliencia a pesar de sus propias barreras y las que el grupo moderador establecían a medida que avanzaba la actividad. Finalmente, los moderadores permiten llevar a cabo el seguimiento de los perfiles de los integrantes, identificando fortalezas y debilidades tanto individuales como colectivas, las cuales son importante fuente de información en el momento de toma de decisiones. Palabras clave: Aula Inversa, coworking, transformación digital, salud, patología

Keys to success of a community of clinical practice in primary care : a qualitative evaluation of the ECOPIH project

The current reality of primary care (PC) makes it essential to have telemedicine systems available to facilitate communication between care levels. Communities of practice have great potential in terms of care and education, and that is why the Online Communication Tool between Primary and Hospital Care was created. This tool enables PC and non-GP specialist care (SC) professionals to raise clinical cases for consultation and to share information. The objective of this article is to explore healthcare professionals' views on communities of clinical practice (CoCPs) and the changes that need to be made in an uncontrolled real-life setting after more than two years of use. A descriptive-interpretative qualitative study was conducted on a total of 29 healthcare professionals who were users and non-users of a CoCP using 2 focus groups, 3 triangular groups and 5 individual interviews. There were 18 women, 21 physicians and 8 nurses. Of the interviewees, 21 were PC professionals, 24 were users of a CoCP and 7 held managerial positions. For a system of communication between PC and SC to become a tool that is habitually used and very useful, the interviewees considered that it would have to be able to find quick, effective solutions to the queries raised, based on up-to-date information that is directly applicable to daily clinical practice. Contact should be virtual - and probably collaborative - via a platform integrated into their habitual workstations and led by PC professionals. Organisational changes should be implemented to enable users to have more time in their working day to spend on the tool, and professionals should have a proactive attitude in order to make the most if its potential. It is also important to make certain technological changes, basically aimed at improving the tool's accessibility, by integrating it into habitual clinical workstations. The collaborative tool that provides reliable, up-to-date information that is highly transferrable to clinical practice is valued for its effectiveness, efficiency and educational capacity. In order to make the most of its potential in terms of care and education, organisational changes and techniques are required to foster greater use. The online version of this article (10.1186/s12875-018-0739-0) contains supplementary material, which is available to authorized users