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7 days in healthcare (February 6th-12th, 2023)

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Summary

From the point of view of Biomedicine, vaccines against cancer; precision surgery in lung cancer; the use of bacteriophage viruses against antibiotic resistant bacteria; stem cells for a wide variety of diseases; and micromotor robots, great promise in the development of new advances in medicine.

With regard to Global Health, it should be noted that 839 million people around the world cannot eat with dignity, for various reasons; the magazine Nature calls for a treaty against new pandemics, since it estimates that the covid represented “a catastrophic failure of the international community in achieving solidarity and equity”. The malaria pandemic is still active in more than 30 countries .

Regarding International Health Policy, in the United States the practices of certain pharmaceutical companies to prevent the entry of generics and biosimilars are denounced. International effort in the search for antibiotics to combat bacterial resistance.

If we talk about National Health Policy (Spain), the incidence of the covid has a small rebound, hopefully in a context of falling incidence, although high mortality persists. The Spanish Public Health Agency, whose bill has just been approved, possibly the most important consequence of the covid crisis. The conflict of public health continues, focused on Primary Care. The Constitutional Court recognizes the constitutionality of the abortion law of deadlines. AESEG and BIOSIM request modification of the reference prices and urgent measures along these lines, since many medicines are at the limit of economic viability.

In the field of Companies, at the international level, it should be noted that Sanofi and Merck MSD significantly increase their profits in 2022. At the national level, Quirónsalud announces the start-up of a new hospital in Valencia. For its part, Consentino, a company that had plans to go public, may see its intentions cut short for health reasons, given the high incidence of silicosis among its workforce.

Biomedicine

Global Health

International Health Policy

  • USA

National Health Policy

Companies

Visit to the Command Center of the Sant Joan de Déu Hospital (Barcelona)

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Visit to the Command Center of the Sant Joan de Déu Hospital

Visit to the Command Center of the Sant Joan de Déu Hospital

Thanks to the kindness and long friendship with the Manager, Dr. Manuel del Castillo, and under the effective and detailed explanations of Dr. Francisco García Cuyás, I had the opportunity to visit on November 22, 2021, the Command Center of Hospital Sant Joan de Déu, from Barcelona.

Its start-up was carried out after the hospital’s own development, in which healthcare professionals, bioengineers, computer scientists, data analysts, experts in artificial intelligence, etc. participated. and, of course, the management team.

This center is divided into three main components:

• Command center (monitoring of general hospital activity)
• Contact Center (a space enabled for non-face care)
• eCare (specific telemonitoring of clinical parameters of some patients)

The command center

An overview of the command center is depicted in Figure 1:

Figure 1: Command center overview

 

 

 

In it, we already see that this center is chaired by a large screen, in turn subdivided into 6 components, according to the scheme in Table 1:

 

Table 1. General screen representation of the command center

 

 

The emergency room panel is represented in Figure 2:

Figure 2. Representation of the emergency panel of the command center

 

 

 

The panel of the hospitalization floor has this aspect of Figure 3, which incorporates an artificial intelligence algorithm that predicts the situation of the center for the next day, being able to see, in the lower part, a partial aspect of the monitoring of surgical activity (patient names are deleted):

Figure 3. Panel representation of the hospitalization floors

 

 

The panel with information about the ICU is represented in Figure 4:

 

Figure 4. Representation of the ICU panel

 

 

 

The COVID-specific monitoring panel is in Figure 5:

 

 

Figure 5. COVID-specific monitoring panel

 


In short, the command center provides a snapshot of all hospital activity. It is the evolution of the classic dashboard with real-time data and embedded AI algorithms. It is accessible to the entire steering committee and is evolving to continue incorporating predictive elements that accompany decision-making.

The contact center

Another component is the contact center, which is a place enabled to carry out visits, although each professional who is in this location of the hospital has on his computer the possibility of making visits from anywhere. What facilitates this site is an environment of privacy and adequate space so that these are developed in better conditions. It should be taken into account that the hospital performs about 100 visits / day, corresponding to approximately 45% of hospital visits, having reached, at the peak of the pandemic, 80% of the percentage of visits in the hospital .

A photo of this space is represented in Figure 6.

 

 

Figure 6. Contact center vision

The eCare

Finally, the so-called eCare is possibly the most innovative element, since it monitors cardiology patients on the ward, analyzing 65 variables and using a predictive decompensation algorithm. Logically, it has the potential to monitor patients from many other specialties and not just patients admitted to the hospital.

The eCare screen is represented (with deleted patient names) in the following photo in Figure 7:

Figure 7. eCare Patient Monitoring Screen

 

In short, a breakthrough

The hospital’s plans are to grow the Command Center, gaining in predictability and proactivity.

The challenges that the hospital had to address for this advance are those of work by processes, change management, multidisciplinarity, construction of data environments, etc.

The approach is very original and the concept can be very interesting for Health Departments, private and public hospital networks, pharmaceutical and medical technology companies that need to monitor patients to pay for results, etc.

This experience is unique in Spain and extremely innovative in the world. Another thing that we learn from this excellent and cutting-edge hospital as Sant Joan de Deu, in Barcelona.