How to cite: Fernández A, Beratarrechea A, Rojo M,Ridao M, Celi L. Starting the path of Digital Transformation in Health. Innovation in Digital Health:
Conference proceeding Ciencia e Innovación en Salud. 2020. e74:68-75.DOI 10.17081/innosa.74
Starting the path of Digital Transformation in Health
Innovation in Digital Health: Conference proceeding
Ariel Fernández
1
*, Andrea Beratarrechea
1
,Marina Rojo
2
,Marina Ridao
2
, Leo Celi
3
1
IECS. Instituto de Efectividad Clínica Sanitaria. Buenos Aires, Argentina.
2
Instituto de Salud Pública. FMED-UBA. Buenos Aires, Argentina
3
Massachusetts Institute of Technology. Cambridge, MA, USA.
*Dirigir correspondencia a: hardineros@hardineros.com.ar
I. INTRODUCTION
The digital transformation is a current global issue that involves different
sectors and social fields. Health institutions have not been left out of this
wave of transformation. The inclusion of information and communication
technologies (ICTs) in critical clinical and administrative processes in the
healthcare setting is becoming increasingly frequent (1,2).
The main goal of implementing ICTs is to ensure that information related
to health care is accessible by the right person, in the right place, at the
right time and in a safe manner, seeking to optimise efficiency, equity,
access, safety and quality of health care. The inclusion of information
technologies in the healthcare setting has ceased to be desirable and
has become a necessity and a must (3).
The need to introduce the Electronic Health Record (EHR) as the main
transforming project of hospitals and health centres is not currently
discussed. This decision is usually a priority step towards the overall
transformation of a country’s healthcare system. In this scenario with
fully computerised hospitals and EHR, it is possible to take advantage of
a large amount of generated data to provide better clinical care.
Likewise, the proliferation of mobile health (mHealth) allows the support
of medical care through smartphones or tablets, benefiting from its
associated characteristics, such as accessibility, portability, agility or
ease of use. Mhealth encompasses activities from prevention and
clinical diagnosis to the treatment of patients (4,5).Soon, it will be
possible to manage the health of individual patients and analyse the
health context of the population with a broader and richer vision applying
the new techniques of predictive statistical analysis and the
advancement of computer science to the flow of data generated by the
patient, data from EHR and other external sources. However, it is
essential to note that without interoperability standards, data governance
models and, above all, without a comprehensive digital strategy, the
immense flow of information generated becomes impossible to manage.
Article History
Received: 31 10 19
Accepted: 03 04 20
Published: 09 06 20
DOI10.17081/innosa.74
©Copyright 2020
Fernández
1
et al.
69
In this sense, digital transformation is not a simple change (6). It is not just a question of the
modernisation of medical infrastructures or technologies. It is a continuous and complex
process, multidimensional, linked to social, economic and technological factors that transcend
the walls of hospitals. It implies a change in the mentality of the whole process of care, placing
the patient at the centre of this transformation.
When it comes to tackling the digital transformation in a country, we are faced with multiple
challenges that range from budgetary limits to achieving acceptance of health professionals
who should be and feel like protagonists. Similarly, it is important to involve patients in this
transformative movement whose ultimate goal is to improve their care.
In this scenario, with the publication in the Official Gazette of the Resolution 189/2018 the
National Ministry of Health of Argentina has launched the National Strategy of Digital Health
2018-2024, an essential milestone- that marks the path towards obtaining interoperable
information systems that facilitate the recording of information during contact with the patient
and allow sharing of information between the different levels of care and jurisdictions (7).
In this transformation process, the training of the health team and technical assistance to
advance in its implementation is paramount.
Within this framework, the Institute of Clinical Health Effectiveness (IECS), the Division of
Health Science and Technology of Harvard University and the Massachusetts Institute of
Technology (MIT) in collaboration with the Program of Technological Innovation in Public
Health of the School of Medicine of the University of Buenos Aires (UBA) decided to organise
the conference Innovation in Digital Health as an opportunity to develop local capacity.
II. THE CONFERENCE
Innovation in Digital Health was held on May 11 and 12, 2018 at the School of Medicine of
UBA. This event was supported by both the Ministry of Health and the Ministry of
Modernization of Argentine. This scientific event was aimed at health professionals, students,
computer scientists and engineers working in the field of health information and
communication technologies.
The leading conference’s goals were
• To provide participants with a learning opportunity that is hands-on and interdisciplinary
• To provide participants with international exposure and collaboration
• To foster research and innovation in digital health.
For two days, 30 experts participated in the different lectures and workshops that were part of
the agenda. The collegiate team was formed by 15 international guest and 15 local
representants. International experts were part of MIT; two came from Albert Einstein Institute
(Brazil), one from Clinic Hospital (Spain), two from Harvard University, one from Standford
University and one from Guanajuato University. Local speakers represented research,
academic and government area.
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The opening speeches of the conference were given by the Minister of Health, Adolfo
Rubinstein MD; the Dean of the Faculty of Medicine (UBA), Prof MD Ricardo Gelpi, and the
Director of the Department of Research in Chronic Diseases of the IECS, Vilma Irazola MD.
After the opening ceremony Alejandro López Osornio MD, representative of the Ministry of
Health introduced the National Digital Health Strategy in Argentina and Daniel Abadie MD
from the Ministry of Modernization presented the Digital Strategy for health in the public
sector, highlighting the value of innovation and technology applied to public health to create
products focused on the citizen.
The different conferences and workshops addressed the main problems, challenges and
opportunities faced by health organisations in the process of digital transformation, the
application of Big Data in health as well as the development of health strategies based on
MHealth. The schedule of the conferences and workshops, as well as the speakers and
chairs, are described in table 1.
III. THE ATTENDEES
A total of 204 participants attended the conference; 45 % (92/204) were females. The majority
of the attendees were professionals (184/204); only 9.8% (20/204) were students who
belonged mostly to the medical informatics career [45% (9/20)]; 25% (5/20) to clinical
specialities and 20% (4/20) to the research area.
Most professionals’ participants developed their activities in executive level and health
management (29%), 16% were healthcare practitioners, and only 9 % were data scientists,
medical informatics or engineers. Regarding their affiliations, members of academic
institutions were the most frequent group (31%) that participated in the conferences, 24%
belonged to industry and 13% to government institutions.
IV. CONFERENCES AND WORKSHOPS
72 % (147/204) of attendees participated in the workshops (147 on day 1 and 131 in day 2). A
minority of the enrolled audience (23%) attended only the lectures. The number of
participants in the different workshops according to their academic degree is shown in figure
1.
The attendance to the workshops varied according to the profession of the participants.
Researchers were most interested in the workshop about tools for collaborative research
using health data and design of digital health solutions for usability and sustainability. Instead,
participants with leadership role were more interested in the workshop “Decision trees with
applications to health care data.”
In the survey conducted at the end of the event, 90% of respondents rated the event as
excellent - very good (7-9/10 in all cases), 70% considered it interesting. Additionally, 90% of
the attendees said they were interested in other activities in the future. The qualification given
to the program was graded as excellent or very good by 90% of the participants, as well as
the guidance provided by tutors.
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Table 1 Conferences, Workshops and speakers
Conferences
Speakers-Chairs
1. From descriptive to predictive, the path of
digital transformation in a highly complex
hospital
2. Use of mobile technology to address
cardiometabolic conditions and other NTDs in
Latin America: challenges and opportunities
3. How to use REDCap
4. Public Health Technological Innovation
Program
Workshops Day 1
1. Tools for collaborative research using health
data.
2. Promoting entrepreneurial spirit for health
care and biotechnology
3. Building world-class data collection tools
4. How to transform an innovative idea into a
project financed
Workshops Day 2
1. Introduction to clinical medicine for the data
scientist.
2. Design of digital health solutions for usability
and sustainability.
3. Decision trees with applications to health care
data.
4. Creation of an electronic database of health
records for research.
Table 1 Innovation in digital health: conferences, workshops and speakers with their respective
affiliation
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Figure 1. Distribution of workshop attendance according to the participants’ academic
degree. The workshops were:
Workshops 1.Tools for collaborative research using health data; 2. Promoting entrepreneurial spirit
for health care and biotechnology; 3. Building world-class data collection tools; 4. How to transform an
innovative idea into a project financed; 5. Introduction to clinical medicine for the data scientist; 6.
Design of digital health solutions for usability and sustainability; 7. Decision trees applied to health
care data; 8. Creation of an electronic database of health records for research.
The attendance to the workshops varied according to the profession of the participants.
Researchers were most interested in the workshop about tools for collaborative research
using health data and design of digital health solutions for usability and sustainability. Instead,
participants with leadership role were more interested in the workshop “Decision trees with
applications to health care data.”
In the survey conducted at the end of the event, 90% of respondents rated the event as
excellent - very good (7-9/10 in all cases), 70% considered it interesting. Additionally, 90% of
the attendees said they were interested in other activities in the future. The qualification given
to the program was graded as excellent or very good by 90% of the participants, as well as
the guidance provided by tutors.
V. DISCUSSION
EHealth, defined as the application of ICTs to health and health care systems to improve
quality of life, efficiency in service delivery, and the economic and social value of health, has
become a potential for improvement in health systems (8). The appropriation of ICTs requires
specific skills or competencies that people must acquire and develop.
In this scenario, local argentine authorities, in collaboration with international partners with a
particular interest in leveraging mobile health technology to improve health care delivery in
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resource-constrained settings, have organised the Digital Health Innovation Conference. The
event was an initiative of IECS, the Division of Health Science and Technology of Harvard
University and the Massachusetts Institute of Technology (MIT) in collaboration with the
Public Health Technological Innovation Program (School of Medicine. UBA). This first edition
2018 focused on two significant themes: Big data applied to health and development of health
strategies based on Mobile Health. It had the support of the Ministry of Health and the
Ministry of Modernization of Argentine in line with the launch of the National Digital Health
Strategy.
For two days, more than 20 national and international experts, representatives from the
Argentine government and the academic world participated in the event, in collaboration with
members of MIT and prestigious personalities from the Harvard School of Public Health. The
main objective of the conference was to build capacities for the use of tools that allow the
processing of massive data (Big Data) as well as to develop skills for the design and
implementation of strategies based on mobile health.
The meeting aroused great interest in the local scientific community; as demonstrated by the
high attendance; 204 participants from different affiliations and professions had the
opportunity to interact with the specialists and share experiences during the interactive
session. The favourite activity was the eight workshops; 72% of the participants attended to
them and worked interactively using their notebooks guided by the mentors.
The presentation of the main tools for collaborative research using health data and data
collection instruments were favourite themes. These two topics generated the most
considerable interest in attendance (40 attendees in each of the workshops), especially
among graduate professionals. Also of interest in this group were the workshops that dealt
with the design of sustainable health solutions and the application of decision trees in health.
Surprisingly, the students were most interested in those workshops focused on achieving
financing for project sustainability and how to promote entrepreneurship, and there is scarce
literature on the necessary digital competencies and the situation of the health workforce in
the world and especially in the region.
Health professionals currently working in the Argentinean health system present a wide range
of ages, including several generations of digital natives, for whom digital competencies could
also be a problem (9). Digital competencies include a wide range of skills ranging from using
a computer or other devices to browse the Internet and search for information. Other themes
were related with content development, social networks participation, learning and teaching in
virtual environments, and finally, more specific aspects linked to the use of health information
systems such as the generation of EHR and knowledge production through artificial
intelligence (10,11).
The high degree of response and concurrence demonstrates the interest of the health team
and the current need to provide training instances, especially in the form of workshops that
facilitate interaction with experts.
To reduce quality gaps in health care, it is necessary to implement information systems that
identify the characteristics and needs of the population, allow with longitudinal and
comprehensive monitoring of people throughout the health system, and provide innovative
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tools to health professionals and patients for the intelligent management of information. With
this vision and in order to ensure the success of the digital health strategy, it is essential to
strengthening human resources by creating new spaces for training health personnel
throughout the country, including representatives of all branches of health care and
technology. Without a doubt, the success of the implementation of the national digital health
concept will depend on the support and continuous training of all stakeholders.
VI. CONCLUSION
ICTs are recognised as a key element for the development of innovation of health care
processes and the improvement of the efficiency and quality of care in health systems. In this
setting, the skills of healthcare professionals are essential factors that impact digital health
strategies. Undoubtedly, the policies that achieve greater participation and commitment of the
different actors of the system, more considerable training of users and better change
management will be those that will have more chances of success.
Authors contribution: "Conceptualization, Fernandez A; Celi L; methodology, Fernandez
A.; software, not applicable.; validation, not applicable.; formal analysis, Fernandez A.;
research, not applicable.; resources, not applicable.; data healing, Fernandez A. writing:
preparation of original draft, Fernandez A.; writing: review and editing, Fernandez A,
Beratarrechea A, Ridao M, Rojo M, Celi L .; viewing, not applicable.; supervision, Celi L;
project management, Fernandez A.; fund acquisition, not applicable. All authors have read
and accepted the published version of the manuscript."
Acknowledgements. none.
Conflicts of interest. The authors declare no conflict of interest.
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