Salud, Información y Tecnologías…..¿ hacia dónde vamos ?

Dr. José Sánchez LugoEscuela Graduada de Ciencias y Tecnologías de

Información

Agenda temática…

Servicios de

SALUD

HIT, HIE, y otras…

Información

Competencia

tecnológica

E -salud …. M-salud

Datos sobre la salud en PR

• Deterioro notable en la salud pública

• Costos crecen sin control

• Limitaciones, exigencias y potencial

• Necesidad e importancia de la información sobre salud

Deterioro en la salud pública *• Al inicio de la década Puerto Rico gastaba $3,324.00

per cápita en servicios de salud.

• La expectativa de vida era de 78.5

años.

* Alameda y Ramírez, 2012

Con esa inversión…*

Puerto Rico debia tener una expectativa de vida de 81 años.

Paraguay tenia una expectativa de vida de 75.8 años pero invierte sólo $159.00 per cápita…

* Alameda y Ramírez, 2012

Los costos son demasiados y siguen subiendo

Pero la calidad no…

- Los retos en el área de los servicios de salud se debaten diariamente en el país.

- Se anuncian nuevas iniciativas…

Health Information Technology for Economic and Clinical Health

Administración e Intercambio Electrónico de Información de Salud de Puerto RicoLey Núm. 40 del año 2012- cumplir con la ley federal

- El objetivo del IEIS es facilitar el acceso a y la recuperación de datos sobre el cuidado del paciente de una manera más segura, oportuna y eficiente.

Propósito de un sistema de IEIS• “ Utilización significativa”

(meaningful use).

• Coordinador de Informática Médica de Puerto Rico.

• Permite una mayor y mas profunda estructura para la información médica

• Establece una verdadera mirada sistémica a los servicios de salud desde la prevención hasta la intervención.

Propósito de un sistema de IEIS

Mayor seguridad

Mayor eficiencia

Mejor servicio

Meaningful Use

The meaningful use of health information technology provides the potential for greatly increasing the health of our citizens more than ever before. It offers the potential of greater efficiency, accuracy, and lower costs through the effective use of health IT. This includes maintaining and sharing patient information, electronic invoicing, home-based health monitoring for early detection and consistent treatment, and interoperable, global data exchange for tracking of contagious diseases.

Olga Rodriguez de Arzola, MD, FAAPInterim President & DeanPonce School of Medicine

Meaningful Use

The meaningful use of health information technology provides the potential for greatly increasing the health of our citizens more than ever before. It offers the potential of greater efficiency, accuracy, and lower costs through the effective use of health IT. This includes maintaining and sharing patient information, electronic invoicing, home-based health monitoring for early detection and consistent treatment, and interoperable, global data exchange for tracking of contagious diseases.

Olga Rodriguez de Arzola, MD, FAAPInterim President & DeanPonce School of Medicine

Health Information Exchange

Patient Care

Resolution

MPI and Record Locator

Transformation &

Translation

Business / Sector Rules

State and Federal Healthcare-related Agencies

Hospitals / IDNs

CDCFDA

SSADoH

Medicare / Medicaid

Labs.

Pharmacies

Hosted orOn-Site EHRs

PHR’s

Payers / Health Plans

State, Nationwide and International

HIE Networks

Clinical Encounter

Index of Where Patients Have Records Temporary Aggregation

of Patient History

Patient Authorized

Inquiry

Hospital Record Laboratory Results Specialist Record

Patient Data Delivered to

Physician

PR-HIO

RecordsReturned

Requests for Records

Community

¿ Qué les exige estos desarrollos…?

• Colaboración, interdisciplinariedad

• Eficiencia y sensibilidad

• Etica

• Competencia tecnológica

¿ Qué pueden aportar las enfermeras?In its 2010 report, The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine emphasizes the importance of nurses being a part of the selection, implementation, and execution of technology solutions for patient care.7

“Meaningful use” vinculado a la enfermería…“the type of patient documentation required of the EHR for Stage 1 meaningful use is what the staff and nurses capture when the patients come into the office for a visit (demographics, biometrics, current meds, smoking status, etc).  Patient engagement, administration, public health reporting, quality reporting, and analytics are primarily staff functions. Exchanging information is also the domain of nurses and staff, from completing and sending orders, to collecting results, to processing prescriptions, to coordinating referrals.

So, if an EHR were provided that met Stage 1 meaningful use only – it would be a nursing tool.”

http://www.medicity.com/thehieblog/2010/04/meaningful-use-and-the-nursing-centric-ehr-model/

Es beneficioso para enfermeras y pacientes…

A University of Pennsylvania study found that nurses working with EHRs consistently reported more improvements to nursing care and better health outcomes for patients than nurses working in hospitals without this technology. http://scienceofcaring.ucsf.edu/future-nursing/nurses-adopt-electronic-health-records

De e-salud…

El impacto de las tecnologías en la salud continuarán…y se incementarán mas rápidamente.

La sociedad digital puertorriqueña

…a m-salud

¿ El futuro…..?

Navegamos mares de incertidumbre pero vivimos en islas de certeza. (E. Morin)

GRACIAS…..

jose.sanchez18@upr.edu