{"id":17828,"date":"2022-10-24T15:05:30","date_gmt":"2022-10-24T15:05:30","guid":{"rendered":"https:\/\/globalhealthintelligence.com\/?p=17828"},"modified":"2025-12-01T13:29:14","modified_gmt":"2025-12-01T19:29:14","slug":"hospital-focus-with-clinica-alemana","status":"publish","type":"post","link":"https:\/\/globalhealthintelligence.com\/ghi-analysis\/hospital-focus-with-clinica-alemana\/","title":{"rendered":"HOSPITAL FOCUS with Clinica Alemana"},"content":{"rendered":"\n
\"\"<\/figure><\/div>\n\n\n\n

Interview with Dr. Alejandro Mauro<\/strong>
Head of the Biomedical Informatics Department
Clinica Alemana<\/p>\n\n\n\n

<\/div>\n\n\n\n

After the pandemic, which forced us to make traditional channels of communication with patients more flexible, Latin American health systems are now facing the challenge of managing institutional treatment by incorporating the technological adoption that grew rapidly over the last two years. One example of this is the development being carried out by Clinica Alemana in Santiago de Chile to solve the problem and avoid the associated risks.<\/p>\n\n\n\n

Dr. Alejandro Mauro \u2014Head of the\nBiomedical Informatics Department at Clinica Alemana in Santiago de Chile\u2014 says\nthe\noutbreak of the COVID-19 pandemic spurred the legislative\nchanges needed for the adoption of technology in medicine. According to\nthe innovation expert, that process was generally at a standstill in Latin\nAmerica because of two main factors: legal obstacles and pushback from\nhealthcare professionals. <\/p>\n\n\n\n

He also, however, points to a scenario that was not anticipated: the\nCOVID-19 pandemic has positioned Meta\u2019s instant messaging app as an unexpected\nchannel of communication between doctors and patients. Accordingly, Mauro says\nhealth systems are faced with the challenge of maintaining the management of\nmedicine within the institutions.  Here\nwe share his detailed answers to our questions.<\/p>\n\n\n\n

Why did the pandemic speed up the adoption of telemedicine or virtual consultations, solutions that were already developed in Latin America?<\/strong><\/p>\n\n\n\n

Because of the legal obstacles and because there was no funding to make\nthe technological changes; and if something isn\u2019t funded, it doesn\u2019t exist.\nTelemedicine had been adopted in places where it was the only option. The\nhistory of telemedicine is closely tied, for example, to the world of shipping.\nNot all ships have a doctor aboard, and there are thousands of ships.\nTelemedicine measures have been used on ships for more than a century. But\nthose circumstances aside, society was failing to take advantage of innovations\nin the field of telemedicine. They went no further than being pilots to the\nproduction and implementation stage, because there was no funding for them and\nbecause the legislation made it really difficult. <\/p>\n\n\n\n

What barriers were there to\nthe adoption of telemedicine?<\/strong><\/strong><\/p>\n\n\n\n

There were old regulations that meant prescriptions and a lot of medical\ndocuments could not be generated digitally at the source. Electronic\nprescriptions, for example, were not implemented because of legal obstacles.\nAll Latin American countries said that prescriptions had to be written out by\nhand. Then along came COVID and it upended everything. Doctors had no way of\ngetting to patients. Patients had no way of getting to hospitals, so then\ncountries had to completely change their whole philosophy of trying to avoid\nthis, which in a way is what had been happening. Even in countries that already\nhad payment policies in place, like the United States, there was a lot of\nopposition. For example, they would say, \u201cHow can we hold video consultations\nvia Zoom? No, there has to be a special system hosted on a secure server.\u201d  As if video were a problem. Then, there were\nnumerous limitations. For example, there were limitations that were built into\nthe HIPPA Act on personal data protection: medical consultations couldn\u2019t be\ndone via Google Meet or Zoom, or any of the traditional video conferencing\nplatforms. It meant having to get a specific company to make a dedicated video\ncomponent for the institution\u2019s medical informatics solution. When COVID\narrived, all those obstacles were lifted. Even using WhatsApp was allowed, and\nthe use of technology went from being within a very restrictive context to a\nvery permissive one.<\/p>\n\n\n\n

So is there now a context\nof risk in terms of data being shared?<\/strong><\/strong><\/p>\n\n\n\n

Yes, because all this use of informal channels has several implications.\nWhen medical information is delivered on certain networks with automatic\nreading mechanisms that are shared with users, these users need to be aware\nthat they are ultimately providing Google, Facebook, or Apple with their\npersonal information. And they will use that information to then sell us\nsomething. It\u2019s a dilemma that is still quite open because today, effectively,\nthe largest digital health system in the world is WhatsApp. That\u2019s why it is\ncurrently the platform that knows the most about health.<\/p>\n\n\n\n

\"Telemedicine\"<\/figure>\n\n\n\n

What a revelation!<\/strong><\/strong><\/p>\n\n\n\n

WhatsApp has the greatest amount of health information today because\ndoctors are currently communicating with patients through that app, and because\ndoctors are communicating with each other through WhatsApp; they interact with\nthings about the patient. It\u2019s an app that everyone has, and that is used more\nthan email\u2014there are loads of email providers besides Google\u2014but WhatsApp is\nMeta\u2019s alone. That sort of set the stage for what, to me, is a problem that\nwe\u2019re in and that we still don\u2019t know how to get out of. As I see it, a lot of\npeople\u2019s information is going through that network. <\/p>\n\n\n\n

Do we know if there is any\nkind of policy or pronouncement from Meta, the company that owns WhatsApp,\nabout this issue?<\/strong><\/strong><\/p>\n\n\n\n

No, not at the moment. But the issue of Facebook sharing patients\u2019 mental health information is being looked at. A paper<\/a> by JAMA (Journal of the American Medical Association<\/em>) looked at apps for smoking cessation and depression. These apps that are in the stores for anyone to download, they take the data or health information of their users, for their clients. The study found that Facebook was sharing that mental health information with third parties. What does that mean? It means a person who, for example, is depressed may get offers of all kinds that will supposedly cure their depression: a course on how to be positive, drops, whatever, that are based on dubious scientific evidence. We start getting into a gray area that is difficult to work out.<\/p>\n\n\n\n

Algorithms don\u2019t\ndifferentiate <\/strong><\/strong><\/p>\n\n\n\n

It\u2019s not even done by a human; it\u2019s done by a machine. This means the\nmachine could make the decision to start sending out advertising about the\ntopic related to your data. It isn\u2019t a question of somebody programming it\nmaliciously, it\u2019s just the way e-commerce works: it\u2019s guided by machine\nlearning algorithms. A machine learning algorithm will correctly identify that\nthis user needs to be sold some therapy. <\/p>\n\n\n\n

Could we say that the\nborders between health and pseudo-health are being expanded or blurred, that it\nis more about providing a health service as an excuse to sell something? Do you\nthink that is the danger?<\/strong><\/strong><\/p>\n\n\n\n

It is a danger that the medical world is aware of, but the problem is that there is so much ignorance around how the technologies work. We don\u2019t know how Facebook\u2019s data center functions. I have no way of knowing the risks, except when a complaint occurs. There is a JAMA article<\/a> highlighting this problem of data privacy in the use of health apps. I think there was a boom in the use of social media by doctors during the pandemic, and we don\u2019t know how that will impact health management. All we know is that the pandemic led many more people to use digital channels to talk to healthcare professionals, and it got the most reluctant healthcare professionals to finally come around to using those channels for communication.<\/strong> Digital channels, meaning the social media channels, set to work on solving health issues. I believe that is a big problem because the institutions are not thinking about putting a solution forward. <\/p>\n\n\n\n

\u201cThe largest digital health system in the world is WhatsApp.\u201d<\/strong><\/em><\/p><\/blockquote><\/figure>\n\n\n\n

\"WhatsApp<\/figure>\n\n\n\n

Doctor\u2013patient contact\nshifted to informal channels.<\/strong><\/strong><\/p>\n\n\n\n

Now what needs to be done is to move the conversation that is happening\ntoday on public channels over to institutional channels, which will enable us\nto not only guarantee the security of the information being shared, but also\nhelp ensure that this won\u2019t fuel a problem that is impossible to solve.\nHealthcare professionals, in addition to caring for patients, have families. I\nget video calls at three in the morning telling me that Jos\u00e9 has a fever. At\nthree in the morning, I\u2019m asleep. You start to see a certain level of abuse\nthat normally occurs with this kind of thing, and it creates conflict.\nEverybody has my phone number now. What do I do? Change my number? Do I need\ntwo phones? There are some doctors with two phones, some with three. In the\nend, telemedicine actions start to get blurred, or sometimes lines are crossed,\nwhich is a problem. One of the pending topics we have as institutions is to put\nforward alternatives. At Clinica Alemana, we\u2019re building a formal channel for\ncommunication with patients. <\/p>\n\n\n\n

What does the solution\nentail?<\/strong><\/strong><\/p>\n\n\n\n

We are looking at building a formal channel that will somehow be able to\nmanage and govern all the information that gets exchanged. If you, as a patient,\nwrite to a doctor, a healthcare professional that attended to you, what we\nexpect first of all is that they will answer you, answer the patient. And that\nresponse to the patient may be that that professional is travelling or\nsomewhere else, meaning another would have to respond to you. It means you can\nmanage the \u201cI\u2019m not here, someone else will answer my messages,\u201d to be able to\nrefer and provide a service with the appropriate timing. Ultimately, a kind of\nlogic begins to prevail where we can first track the communications, and know\nhow long that takes. Today, it is something we can redimension. At present, we\ndon\u2019t know how many hours professionals spend in informal channels of\ncommunication with patients.<\/p>\n\n\n\n

That leads to billing issues because we don\u2019t know how many hours of\ntheir personal time doctors spend answering patient inquiries; and also legal\nissues, in cases of malpractice suits: there are medical decisions left out of\nthe clinical record. That is why the institutional solution must be integrated\nwith patients\u2019 electronic medical records.<\/p>\n\n\n\n

Are you considering\nimplementing bots?<\/strong><\/strong><\/p>\n\n\n\n

There are various health robots, but they are still very limited. The\nbot does what it was programmed and designed to do. Broadly speaking, no one is\ndesigning bots to make medical decisions because it is still not that easy for\nthem to diagnose and prescribe treatments. <\/p>\n\n\n\n

If you look at the big developments, like Ada Health or Babylon, they\nstill don\u2019t give medical indications, only recommendations. Their responses to\nhealth inquiries are still at that level. I believe the institutionalization of\ndoctor\u2013patient communication technology tools is the issue that needs to be\nlooked at. We have a plan for that and we are now sure that it is something we\nhave to take care of, and that the management is looking to develop. <\/p>\n\n\n\n

Are you developing it\nyourselves or through external providers?<\/strong><\/strong><\/p>\n\n\n\n

The development is being done partly by the Clinic and partly by the\nproviders; we\u2019re doing it jointly. <\/p>\n\n\n\n

About Clinica Alemana of Santiago de Chile and its Department of Biomedical Informatics <\/strong><\/p>\n\n\n\n

Clinica Alemana <\/a>in Chile is a leading private clinic for diagnostics and treatment in all medicine and health specialties, seeking to contribute to the development of medical knowledge for the benefit of the community. The mission of Clinica Alemana\u2019s Department of Biomedical Informatics is to generate evidence and develop innovative solutions that will help maximize the impact of information technologies in the field of health and promote telemedicine and telehealth in Chile.<\/p>\n\n\n\n

Learn more about the adoption of telemedicine in Latin America<\/strong>
Contact us to find out how we can offer you a study on telemedicine in Latin America. Our team\u2014in addition to recording in our HospiScope<\/a> database the hospitals in over 15 Latin American countries that have telemedicine systems\u2014can put together a telemedicine market study based on your needs. <\/p>\n","protected":false},"excerpt":{"rendered":"

Interview with Dr. Alejandro Mauro, Head of the Biomedical Informatics Department, Clinica Alemana<\/p>\n","protected":false},"author":24,"featured_media":17829,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[32],"tags":[],"class_list":{"0":"post-17828","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-ghi-analysis"},"_links":{"self":[{"href":"https:\/\/globalhealthintelligence.com\/wp-json\/wp\/v2\/posts\/17828","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/globalhealthintelligence.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/globalhealthintelligence.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/globalhealthintelligence.com\/wp-json\/wp\/v2\/users\/24"}],"replies":[{"embeddable":true,"href":"https:\/\/globalhealthintelligence.com\/wp-json\/wp\/v2\/comments?post=17828"}],"version-history":[{"count":1,"href":"https:\/\/globalhealthintelligence.com\/wp-json\/wp\/v2\/posts\/17828\/revisions"}],"predecessor-version":[{"id":28694,"href":"https:\/\/globalhealthintelligence.com\/wp-json\/wp\/v2\/posts\/17828\/revisions\/28694"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/globalhealthintelligence.com\/wp-json\/wp\/v2\/media\/17829"}],"wp:attachment":[{"href":"https:\/\/globalhealthintelligence.com\/wp-json\/wp\/v2\/media?parent=17828"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/globalhealthintelligence.com\/wp-json\/wp\/v2\/categories?post=17828"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/globalhealthintelligence.com\/wp-json\/wp\/v2\/tags?post=17828"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}