InforSalud 2022 shines a spotlight on data and Artificial Intelligence

The slogan for the 25th National Congress on Information Technology in Healthcare (InforSalud 2022) was ‘Sharing data, information and knowledge in healthcare’. The event was organised by the Spanish Society of Information Technology in Healthcare and it took place from March 22-24 in Madrid, Spain. It drew together healthcare experts and professionals involved in the digitalisation and innovation sectors from the different regional healthcare systems and research centres, as well as from the technology and healthcare industry.

The main topics under discussion at this edition centred on the application of Artificial Intelligence in the healthcare sector; public health data, the national health data repository and its interoperability; how new healthcare models will affect patients and professionals; cultural change and digital competencies in healthcare; and the role of nurses in the digitalisation process. In addition to the debates, there were several presentations on research work and innovative projects, including two led by the TIC Salut Social Foundation: COMPDIG-Salut for the digital training of healthcare professionals in Catalonia, and the deployment of the remote care model (LATITUD) across the healthcare system of the Comarques Centrals in Catalonia.

Application of Artificial Intelligence in the healthcare sector

Artificial Intelligence proved to be the hot topic in most of the debates at the congress, both in terms of the great challenges as well as the opportunities it presents, especially since the injection of European funds. Besides the debates, there were also a series of presentations on the successful implementation of AI in healthcare centres.

The Director of the Department of Artificial Intelligence of the TIC Salut Social Foundation and Head of Medical Imaging and Pathology Systems of the Department of Health of the Generalitat de Catalunya, Carlos Gallego, took part in the symposium on the uses of this technology in the healthcare sector. In his talk, he highlighted the reasons why this technology is at present rarely used in clinical practice, despite the multitude of recent scientific publications and regular coverage in the media.

“There are three main factors that account for the difficulties in applying Artificial Intelligence to the healthcare system, for it is a very complex system and has many participants with many different responsibilities and functions; there is also a regulatory framework in place that involves following a certain process, just as a medical team would, and this makes it very difficult to implement changes along the whole line and, finally, we have yet to define a formal and scientific model that will enable us to develop applications”, explained Gallego.

Participants in the debate also stressed that Artificial Intelligence will be at the heart of the change and transformation of the healthcare system. Thus, the system will have to transition from studying the process to analysing the data, with a focus on safety and protection. Along these lines, the need to establish mechanisms for monitoring the ethical use of this technology and to cultivate the trust of medical staff regarding its effectiveness, reliability and ease of use was also highlighted.

During another session on the interoperability of the Spanish National Health System, the head of System Planning of the Catalan Healthcare Service, Jordi Piera, remarked that “we need to establish federated learning environments through which we can use data from outside our own organisation and thus train artificial intelligence algorithms”. And for this to work, he explained, “the data must be standardised and we have to find a forum through which we can share the algorithms and use them collectively”.

Health data

One of the most reiterated messages at the congress was the need to establish a common language, not only between the autonomous communities, but also between the different healthcare centres within a given community. “The data repository project is necessary, interesting, complex, and will have to be carefully defined to ensure that we are all on the same page,” said Pol Pérez, Director of the Information Systems Department of the Catalan Health Service and Head of ICT. During his talk, Pérez also stressed the need to decouple technology from the use of data, so that its constant evolution does not have repercussions on the data model.

On the other hand, the head of the Office of the Secretary General for Digital Health, Information and Innovation of the Spanish National Health System, Lucía Escapa, stressed that the Ministry of Health is working alongside the autonomous regions to ensure that “data is used for the benefit of those who use said data”. More precisely, she explained that the different working groups engaged in defining the use of data are focusing on its secondary uses since the regulatory framework that is already in place is more than sufficient to ensure that it can be followed easily. There was a disagreement among some participants in the debate on this point, with some stressing that the law is lagging behind current requirements and that we are seeing different interpretations of the regulatory framework among the various centres and organisations within the system.

How will new healthcare models affect patients and professionals?

The COVID-19 pandemic has marked a turning point in the use of ICTs by the general public and healthcare services, as was noted at last year’s congress, held in June 2021, and reiterated again this year. However, a number of gaps have already begun to emerge in this new model which, in the words of the Director of Healthcare Programmes of the Canary Islands Health Service, Elizabeth Hernández, cannot be swept under the rug: “we need to go one step further, we need to reconnect with the patient from a different point of view, and not exclusively in terms of reconciling them with technology, since we have already received a number of complaints from patients who do not use these technologies”.

In line with the above, the spokesperson for the Platform of Patient Organisations and president of Esclerosi Múltiple Espanya (Multiple Sclerosis Spain), Alfonso Castresana, called for empathy and to not dehumanise healthcare: “we know that information technology will advance and that the digitalisation process is absolutely necessary, but we do not want technological advances to leave the patient behind, rather, these should be at their disposal to assist them where needed. What we as patients want is to be seen by a human being”.

Cultural change and digital competencies in healthcare

“In order to achieve digital transformation, it is necessary to think digitally, and with a different mindset than before”. This was one of the key messages conveyed during the debate, which reviewed some of the most important advances in this area in recent years, as well as the difficulties encountered by healthcare professionals and administrators as they endeavour to implement these changes. The Deputy Director of Information Technology of the Balearic Islands Health Service, Maria Carmen Moreno, explained that, especially since the pandemic, the role of healthcare professionals who are not directly involved in the provision of care has become more visible and has been more widely acknowledged, as is the case of technologists, who are an indispensable group in the process of digital transformation, but “on whom the sole responsibility for the project cannot fall”, she warned.

The debate also addressed the challenge of improving communication between professionals. For José María Abad, Director General of Health Care of the Aragonese Health Service, “the digital transformation should help to change the ways in which professionals relate to each other”, in addition to with patients and social services.

Nursing, digitalisation of processes and their impact on healthcare

Another of the sectors to be represented at the congress was the nursing sector, which is a key player in the digital transformation. During the round table on nursing, participants discussed a series of interesting points relating to the digitalisation processes and their impact on the care of complex chronic patients, the integration of hospital and social healthcare, chronic childhood disease and support for decision making in paediatric emergencies. Mª Dolores Roldan, a qualified nurse from the Hospital Clínic Universitari Verge de l’Arrixaca, highlighted the “important role of nurses in managing information relating to chronic conditions”. Furthermore, the discussion featured a presentation of a project dealing with the fundamentals of information management in the integrated telecentres combining hospital care and social/health care. Nuria de Argila, Training Supervisor at the Geriatric Day Hospital (Hospital de Dia Geriàtric), also highlighted the important role of nurses in managing information between the different levels of care.

In the field of paediatrics, Dr. Sendoa Ballesteros, Assistant to the Director of Nursing at the Hospital Santa Marina (Bilbao) at Osakidetza, presented a mobile application to aid decision-making in emergencies, which includes support tools for care, drug prescription, the recording of constants or the use of techniques for this profile of patients. Finally, and also in the field of child care, Abraham Delgado, Technical Advisor of the Subdirectorate of Treatment at the Cantabrian Health Service (Subdirecció de Cures Servei Càntabre de Salut), discussed the TICHRON project for tackling chronic childhood disease.

Presentations in the context of the Catalan Health System

Catalonia had a prominent presence at InforSalud 2022, not only in the debate roundtables, but also in the following presentations selected by the jury:

COMPDIG-Salut: Working towards the digital training of health professionals in Catalonia. Erik Andrés, Project Manager of the TIC Salut Social Foundation presented the COMPDIG-Salut project, which aims to define the framework and accreditation model for the digital competencies of health professionals, as well as the training strategy in Catalonia.

Deployment of the remote care model across the healthcare system of the Comarques Centrals in Catalonia. Jesús Berdún, head of the TIC Salut Social Foundation’s LATITUD programme, reported on the progress made by the four hospitals in the region, highlighting critical aspects such as the definition of clear protocols and the integration of the professional’s agenda in order to ensure the effective deployment of remote care channels.

Reason programming WEB (PxM). Òscar Solans, head of the eSalut Office of the Catalan Health Service, presented a tool that allows for the stratification of the criteria for citizens’ consultations in primary care, improving accessibility and the ubiquitous nature of healthcare.

Development of a mobile application to send clinical images to the electronic medical record. David López, from the eSalut Office of the Catalan Health Service, demonstrated an application which allows professionals to send images via mobile phone to the patient’s medical record.

The transversal obstetric process in the framework of the HES (Electronic Medical Record) of Catalonia. Marta Espinalt, from the eSalut Office of the Catalan Health Service, presented a model of integrated care data, which is interoperable and equipped with a process viewer to facilitate professionals’ work, based on OpenEHR archiving standards.

Implementation and digitalisation of the transversal process of transition between levels of care. Anna Serra, from the eSalut Office of the Catalan Health Service, presented PREALT: clinical information generated before a patient is discharged, which is essential for referral teams to ensure continuity of care.