eHealth

Concern among the public and policymakers about current and future major staff shortages is increasing. Strengthening Human Resource (HR) practices and adopting HR technologies such as Human Resource Information Systems (HRIS), that can collect, store and report workforce data are often described as a potential solution to this problem. Indeed, examples from other industries show that HRIS can help to launch or manage, as well as provide ongoing insights concerning the whole career cycle of an employee. However, few of the existing studies that discuss technology or its impacts on the future of work have focused on health organizations, and those that do have not received sufficient attention in health literature. Furthermore, such contributions as there have been have either prioritized a particular type of technology or focused mainly on the effect of automation on health professionals' work. They have thus overlooked the full range of possible uses of these technologies and, specifically, have neglected the topic of HR for Health (HRH) management in health organizations. The primary aim of this paper is to address this lacuna, with specific reference to the existing categorization of HR technological disruptions. To conclude, health organizations and the health and HR professionals who work within them need to use HRIS responsibly, finding a balance between the drive for innovation, productivity and efficiency and respect for all potential legal, ethical and compliance issues, as well as taking account of the importance of HRH wellbeing and satisfaction.

This study investigates determinants of online health-related activities of Turkish individuals. By exploiting a data set from a household survey of Turkey, probit models are estimated for quantification of factors influencing participation of individuals in electronic health (e-health). Findings reveal that Turkish females are more likely to employ online tools for health-related purposes. Education level, household income and internet usage frequency have positive relationships with online information search and use of online scheduling for doctor appointments. Age has a non-linear relationship with e-health activities. While relatively younger and older individuals are less likely to engage in online health activities, middle-aged individuals are more likely to participate. While use of information technologies in health-related issues have potential to increase health literacy of the population; this study reveals that there are systematic differences in sub-samples in employment of e-health tools, which should be addressed by policy makers.

In an e-health cardiology environment, the current knowledge engineering systems can support two knowledge processes; the knowledge tracing, and the knowledge cataloguing. We have developed an n-tier system capable of supporting these processes by enabling human collaboration in each phase along with, a prototype scalable knowledge engineering tactic. A knowledge graph is used as a dynamic information structure. Biosignal data (values of HR, QRS, and ST variables) from 86 patients were used; two general practitioners defined and updated the patients' clinical management protocols; and feedback was inserted retrospectively. Several calibration tests were also performed. The system succeeded in formulating three knowledge catalogues per patient, namely, the ''patient in life'', the ''patient in time'', and the ''patient in action''. For each patient the clinically accepted normal limits of each variable were predicted with an accuracy of approximately 95%. The patients' risk-levels were identified accurately, and in turn, the errors were reduced. The data and the expert-oriented feedback were also time-stamped correctly and synchronized under a common time-framework. Knowledge processes optimization necessitates human collaboration and scalable knowledge engineering tactics. Experts should be responsible for resenting or rejecting a process if it downgrades the provided healthcare quality.

The development of e-health may provide powerful tools to improve health, but users’ health literacy plays a role in their ability to make the most of e-health applications. This study reviewed research focused on e-health and health literacy, using content analysis to assess 95 articles from 2000 to 2010 to provide an overview of work done in this emerging field. Articles were coded for use of theory, research methods, and clarity of reporting study results. Findings indicate a lack of theory-driven design and evaluation of e-health applications, low use of established general health literacy measures, and interdisciplinary work with somewhat limited contributions by communication scholars. Implications for advancing this field of research are discussed.

Nursing informatics serves global health care with information processing and communication functions like staff development and quality patient care services. The incorporation of computers into nursing in many developing countries though essential, has been on a decline growth. This qualitative study examined personnel and organizational factors that affect nursing informatics. A qualitative descriptive study design was employed. Respondents were registered nurses selected from the various health system levels. A total of 18 in-depth interviews were done. Interview data were analysed by using a thematic approach of qualitative analysis.Both senior and junior nursing staff had a fair knowledge of computers and some basic Microsoft applications. They both appreciated the need for immense incorporation of computers into Ghanaian nursing care although lacked organizational support. Rank, gender and age of respondents played immense role in their perception of importance computer skill...

Medical errors, such as patient misidentification, are the cause for around 2.6 million deaths per annum and $42 billion in cost to health organizations in low to middle-income countries. While wristbands are the most common method for identifying patients, they can be easily misplaced and may contain missing or inaccurate information as this study shows. This may result in wrong medications and surgeries and in some instances, even preventable deaths together with liabilities for health organizations. In this study, the current methods and process for identifying patients are investigated, accompanied by a comparison of existing patient identification solutions, as well as issues and concerns about health data protection and privacy. Following this, the effectiveness of biometric technology for patient identification is examined. The paper finally proposes and evaluates a proof of concept with promising results for minimizing patient identification errors.

Nursing informatics serves global health care with information processing and communication functions like staff development and quality patient care services. The incorporation of computers into nursing in many developing countries though essential, has been on a decline growth. This qualitative study examined personnel and organizational factors that affect nursing informatics. A qualitative descriptive study design was employed. Respondents were registered nurses selected from the various health system levels. A total of 18 in-depth interviews were done. Interview data were analysed by using a thematic approach of qualitative analysis.Both senior and junior nursing staff had a fair knowledge of computers and some basic Microsoft applications. They both appreciated the need for immense incorporation of computers into Ghanaian nursing care although lacked organizational support. Rank, gender and age of respondents played immense role in their perception of importance computer skill acquisition and usage while lack of programmed nursing software worsened the case.These findings suggest that measures focused on incorporating computers to aid nursing care in practice must look at the personnel and organizational issues critically to attain immense achievement.

El presente artículo integra reflexiones en torno a los Sistemas de Información Sanitaria en el derecho admi
nistrativo Español, su desarrollo y el potencial que permiten integrar en la mejora de la gestión de los recursos
económicos en coordinación con la entrada en vigor de la ley de Salud Pública en Andalucía,en un momento de
crisis económica

Este trabajo fin de máster es el resultado de una primera aproximación práctica al estándar ISO-CEN 13606 y al uso de terminologías clínicas como SNOMED CT; ambos relacionados con la  interoperabilidad semántica, para la implementación de un Registro Autonómico de Enfermedades Raras. El objetivo de este trabajo es ser una guía rápida para el proceso de modelado de información clínica, teniendo en cuenta una metodología de tres fases, así como el posterior  desarrollo del arquetipo mediante linkEHR. Fue elaborado por Fernando Báez Rodríguez, M. Ángeles López Orive y M. Victoria Díaz Guirado como proyecto final del Máster en Dirección de Sistemas y TIC de la Salud. Escuela Nacional de Sanidad. Madrid. 2016-2017.

The European Network for the Joint Evaluation of Connected Health Technologies (ENJECT) is a COST action that brings together an international consortium, including business and revenue modellers, clinicians, technologists, engineers, economists, ethnographers, and health researchers to help society to answer one question – how to connect therapies, patients, and care-givers to deliver optimum health results in an era of stretched resources and increasing demands. This report, which has grown out of an ENJECT survey of 19 European countries, examines the situation of Connected Health in Europe today. It focuses on creating a clear understanding of the current and developing presence of Connected Health throughout European healthcare systems under five headings: The Policy Environment, Education, Business and Health Models, Interoperability, and The Person. Quality, privacy, and safety, major elements of Connected Health, were evident policy concerns in the Connected Health context. ...

Resumo O objetivo primário deste artigo é analisar a política de implementação da telemedicina, à luz das possíveis repercussões que a sua difusão pode induzir, quer na prática médica quotidiana, quer, mais em geral, na organização do SNS. A análise baseia-se em dados secundários obtidos a partir de atos normativos e relatórios publicados pelo Ministério da Saúde e pela Comissão Europeia, tanto no âmbito específico da e-Health, quanto naquele mais abrangente da inovação tecnológica em saúde. Após avaliar os principais eixos da estratégia pública de promoção da telemedicina, realçamos a necessidade de uma visão crítica que acompanhe a difusão dos serviços à distância na prática médica, a fim de evitar repercussões negativas, entre as quais o aumento da tendência de privatização dos serviços de saúde e o agravamento das desigualdades, com o risco inerente de criar um sistema de cuidados de saúde "a duas velocidades". Palavras-chave: telemedicina, telemonitorização, tecnologias da informação e comunicação em saúde, saúde em linha, saúde móvel, desigualdades em saúde. The spread of telemedicine in Portugal: from the promised benefits to the risks of a two-speed healthcare system Abstract This article's primary goal is to analyse the policy for implementing telemedicine in the light of the possible repercussions its dissemination may have for both daily medical practice and, in more general terms, for the organisation of the Portuguese National Health Service (SNS). The authors base themselves on secondary data taken from regulations and reports published by the Ministry of Health and the European Commission, both specifically with regard to eHealth, and in relation to the broader subject of technological innovation in the health field. After assessing the main lines of the public strategy for promoting telemedicine, they highlight the desirability of a critical vision to accompany the spread of remote medical services, which is needed to avoid negative repercussions such as an increase in the trend towards the privatisation of health services and a worsening of inequalities, with the inherent danger of creating a "two-speed" healthcare system. La diffusion de la télémédecine au Portugal: des avantages promis aux risques d'un système médical à deux vitesses Résumé Le premier objectif de cet article est d'analyser la politique de mise en place de la télémédecine, à la lumière des répercussions que sa diffusion peut avoir, non seulement sur la pratique médicale quotidienne, mais aussi sur l'organisation du système national de santé (SNS) en général. L'analyse se base sur des données secondaires obtenues à partir de textes réglementaires et de rapports publiés par le Ministère de la Santé et par la Commission européenne, dans le domaine spécifique de l'e-Health, mais aussi dans le domaine plus vaste de l'innovation technologique dans la santé. Après avoir évalué les principaux axes de la stratégie publique de promotion de la télémédecine, l'article souligne la nécessité de porter un regard critique à la diffusion des services à distance dans la pratique médicale, afin d'éviter les répercussions négatives, parmi lesquelles l'augmentation de la tendance à la privatisation des services de santé et l'aggravation des inégalités, avec le risque de créer un système de santé "à deux vitesses". Mots-clés : télémédecine, télésurveillance, technologies de l'information et de la communication dans le domaine de la santé, santé en ligne, inégalités dans le domaine de la santé.

Telehealth refers to the delivery of health care services at a distance by the use of information and communication technologies (ICT). Due to numerous advantages such as the enhancement of the treatment or reaching remotely located people who need treatment at affordable cost, telehealth is nowadays widely used in speech-language pathology (SLP) services. This paper presents the results of two empirical studies carried out among SLP stakeholders. The objective of the first study was to determine the state-of-the-art in using ICT among speech-language professionals and their clients in Croatia. The objective of the second study was to examine content validity and relevance of the introduced set of attributes meant for evaluating quality of educational artefacts employed in SLP therapies. Findings of both studies can be employed as a foundation for the design and implementation of the telerehabilitation systems aimed to assist in the delivery of remote speech-language therapies.

Objectives: Cognitive-behavioral therapies (CBT) for fibromyalgia syndrome (FMS) are important interventions in the management of this condition. Empirical evidence reports that although the results are promising, further research is needed to respond more appropriately to these patients. This study focuses on exploring the use of Virtual Reality (VR) as an adjunct to the activity management component. The aim of this study is to present the results of a small-sized randomized controlled trial to test the preliminary efficacy and acceptability of this component. Materials and Methods: The final sample was composed of 61 women diagnosed with FMS according to the American College of Rheumatology. The sample was randomly allocated to 2 conditions: VR treatment and treatment as usual. Results: Participants in the VR condition achieved significant improvements in the primary outcome: disability measured with the FIQ. The improvement was also significant in secondary outcomes, such as perceived quality of life and some of the coping strategies included in the Chronic Pain Coping Inventory: task persistence and exercise. There were no differences in other secondary outcome measures like pain intensity and interference and depression. Participants reported high satisfaction with the VR component. Discussion: The effects were related to the psychological aspects targeted in the treatment. The component was well accepted by FMS patients referred from a public hospital. These findings show that the VR component could be useful in the CBT treatment of FMS and encourage us to continue exploring the use of integrating VR with CBT interventions for the treatment of FMS.

Cloud computing in eHealthis an emerging area for only few years. There needs to identify the state of
the art and pinpoint challenges and possible directions
for researchers and applications developers. Based
on this need, we have conducted a systematic review of
cloud computing in eHealth. We searched ACM Digital Library, IEEE Xplore, Inspec, ISI Web of Science and Springer as well as relevant open-access journals for relevant articles. A total of 237 studies were first searched, of which 44 papers met the
Include Criteria. The studies identified three types of studied areas about cloud computing in eHealth, namely(1)
cloud-based eHealth framework design (n=13);(2) applications of cloud computing (n=17); and (3) security or privacy control mechanisms of healthcare data in the cloud (n=14). Most of the studies in the review were about designs and concept-proof. Only very few studies have evaluated their research in the
real world, which may indicate that the application
of cloud computing in eHealth is still very immature.
However, our presented review could pinpoint that a
hybrid cloud platform with mixed access control and security protection mechanisms will be a main research area for developing citizen centred home-based healthcare applications.

Recent years have seen an influx of medical technologies capable of remotely monitoring the health and behaviours of individuals to detect, manage and prevent health problems.  Known collectively as personal health monitoring (PHM), these systems are intended to supplement medical care with health monitoring outside traditional care environments such as hospitals, ranging in complexity from mobile devices to complex networks of sensors measuring physiological parameters and behaviours.  This research project assesses the potential ethical implications of PHM as an emerging medical technology, amenable to anticipatory action intended to prevent or mitigate problematic ethical issues in the future.

PHM fundamentally changes how medical care can be delivered: patients can be monitored and consulted at a distance, eliminating opportunities for face-to-face actions and potentially undermining the importance of social, emotional and psychological aspects of medical care.  The norms evident in this movement may clash with existing standards of ‘good’ medical practice from the perspective of patients, clinicians and institutions.    By relating utilitarianism, virtue ethics and theories of surveillance to Habermas’ concept of colonisation of the lifeworld, a conceptual framework is created which can explain how PHM may be allowed to change medicine as a practice in an ethically problematic way.  The framework relates the inhibition of virtuous behaviour among practitioners of medicine, understood as a moral practice, to the movement in medicine towards remote monitoring. 

To assess the explanatory power of the conceptual framework and expand its borders, a qualitative interview empirical study with potential users of PHM in England is carried out.  Recognising that the inherent uncertainty of the future undermines the validity of empirical research, a novel epistemological framework based in Habermas’ discourse ethics is created to justify the empirical study.  By developing Habermas’ concept of translation into a procedure for assessing the credibility of uncertain normative claims about the future, a novel methodology for empirical ethical assessment of emerging technologies is created and tested.  Various methods of analysis are employed, including review of academic discourses, empirical and theoretical analyses of the moral potential of PHM.  Recommendations are made concerning ethical issues in the deployment and design of PHM systems, analysis and application of PHM data, and the shortcomings of existing research and protection mechanisms in responding to potential ethical implications of the technology.

The adoption of technology in healthcare over the last twenty years has steadily increased, particularly as it relates to medical robotics and Multi-User Virtual Environments (MUVEs) such as Second Life. Both disciplines have been shown to improve the quality of care and have evolved, for the most part, in isolation from each other. In this paper, we present four synergies between medical robotics and MUVEs that have the potential to decrease resource utilization and improve the quality of healthcare delivery. We conclude with some foreseeable barriers and future research directions for researchers in these fields.

Applying four analytic lenses (consumption, communication, community, and responsibility) and three forms of agency (objectivation, activation, and engagement) this paper develops a conceptual platform for the analysis of the impact of health-care ICTs. It is argued that a closer study of applications within tele-medicine, health informatics, and e-health needs to take into account (changes in) patient roles to tie innovation to the act of health-care delivery. The typological multi-faceted concept of digital patient is suggested as an inspiration towards a continued and strengthened multi-disciplinary approach to research on and development of information systems within health-care.

É objetivo deste trabalho aprofundar o conhecimento sobre a evolução e a prática da telemedicina em Portugal e o grau de aceitação e participação dos intervenientes, com especial enfoque na classe médica e nos utentes. Como sublinha Rita Espanha (2013: 37), “a principal alteração introduzida na mediação no contexto da saúde é o facto de se abandonar uma relação construída essencialmente na interação paciente-profissional de saúde, para uma relação contruída a partir de múltiplas interações, face a face e mediadas (...).”
A escolha da telemedicina enquanto objecto deste estudo surge, inicialmente, a partir da constatação de Castells, de que vivemos numa sociedade em rede onde as relações sociais se desenvolvem num cenário mediado pelas novas tecnologias de informação e comunicação e estas interferem nas estruturas sociais. Na saúde, inevitavelmente, surgem novas formas de relacionamento entre os profissionais e os utentes como consequência desta comunicação mediada. A telemedicina, em particular, detém as maiores potencialidades para modificar e revolucionar a prestação de cuidados de saúde (Craig e Patterson, 2005).

Purpose – Connected Health is an emerging and rapidly developing field never before witnessed across the healthcare sector. It has the potential to transform healthcare service systems by increasing its safety, quality and overall efficiency. However, as healthcare technologies or medical devices continuously rely more on software development, one of the core challenges is examining how Connected Health is regulated – often impacting Connected Health innovation. The purpose of this paper is to present an understanding of how Connected Health is regulated. Many of these regulatory developments fall under " medical devices " , giving rise to Software-as-a-Medical Device (SaaMD).

Design/methodology/approach – Through an extensive literature review, this paper demystifies Connected Health regulation. It presents the outcome of expert discussions which explore the key regulatory developments in the context of Connected Health to provide a practical guide to understanding how regulation can potentially shape healthcare innovation.

Findings – Several key issues are identified, and the authors present a comprehensive overview of regulatory developments relating to Connected Health with a view to support the continued growth of IT-enabled healthcare service models. The authors also identify the key challenges in Connected Health and identify areas for future research.

Originality/value – A key outcome of this research is a clearer understanding of the opportunities and challenges that regulation and standards present to Connected Health. Furthermore, this research is of critical importance in a first attempt towards recognising the impact of regulation and standards compliance in Connected Health.

During the past few years a lot of PKI (Public Key Infrastructures) infrastructures have been proposed for healthcare networks in order to ensure secure communication services and exchange of data among healthcare professionals. However, there is a plethora of challenges in these healthcare PKI infrastructures. Especially, there are a lot of challenges for PKI infrastructures deployed over large-scale healthcare networks. In this paper, we propose a PKI infrastructure to ensure security in a large-scale Internet-based healthcare network connecting a wide spectrum of healthcare units geographically distributed within a wide region. Furthermore, the proposed PKI infrastructure facilitates the trust issues that arise in a large-scale healthcare network including multi-domain PKI infrastructures.

— Over the years health care has seen major improvement due to the introduction information and communication technology with electronic medical prescription being one the areas benefiting from it. Within the overall context of protection of health care information, privacy of prescription data needs special treatment. This paper presents an e-prescription system that addresses some challenges pertaining to the prescription privacy protection in the process of drug prescription. The developed system uses spread spectrum image steganography algorithm with Advanced Encryption Standard (AES) key implementation to provide a secure means of delivering medical prescription to the parties involved. The architecture for encoding and decoding was implemented with an electronic health record. The software development tools used were PHP and MySQL database management system for front end and backend data management respectively. The designed system demonstration shows that the synergistic comb...

Marking the 25th anniversary of the “digital divide,” we continue our metaphor of the digital inequality stack by mapping out the rapidly evolving nature of digital inequality using a broad lens. We tackle complex, and often unseen, inequalities spawned by the platform economy, automation, big data, algorithms, cybercrime, cybersafety, gaming, emotional well-being, assistive technologies, civic engagement, and mobility. These inequalities are woven throughout the digital inequality stack in many ways including differentiated access, use, consumption, literacies, skills, and production. While many users are competent prosumers who nimbly work within different layers of the stack, very few individuals are “full stack engineers” able to create or recreate digital devices, networks, and software platforms as pure producers. This new frontier of digital inequalities further differentiates digitally skilled creators from mere users. Therefore, we document emergent forms of inequality that...

Introduction: The primary-secondary care interface provides significant opportunities for medication errors to arise. There has been limited research into mechanisms to facilitate seamless transfer across this interface. The aim of this study was to focus on the potential contribution of community pharmacy services at the interface.

Materials & Methods: The opinions of community and hospital pharmacists were sought in relation to the current situation by means of questionnaires. A log book of communications between a community pharmacy and hospitals was maintained. A comparison of new discharge and post-discharge prescriptions was also performed. The data was coded and analysed in SPSS v.16.

Results: There is currently little communication across the interface at the time of discharge, with 11% of community pharmacists reporting no contact by a hospital at this time and a further 80% stating that they were only contacted occasionally. Hospital pharmacists reported ongoing difficulties in attempting to obtain a medication history on admission. Both parties agreed that the introduction of standard protocols and a designated seamless care pharmacist would improve medication safety at the interface. Most communication occurred between the community pharmacy and hospital on a Friday and also after 3 pm in the evening. When communication did occur the issue was resolved in 81% of all cases. Medication that required a follow up prescription from a patient’s family doctor following a hospital visit was incorrectly transcribed by the family doctor in 27% of cases.

Discussions, Conclusion: The involvement of community pharmacists occurs irregularly at present. There is dissatisfaction with the current situation. Pharmacists at either side of the interface are aware of the importance of the role that the other plays in seamless care, with both parties favouring the introduction of processes to facilitate seamless care at the interface. The involvement of the community pharmacist in the discharge process, through the dispensing of hospital discharge prescriptions, helped to reduce the number of medication errors that could occur at the primary-secondary care interface.

Plagiarism is illicit behaviour in all of its kinds. It is unfair to steal someone else’s work or idea. Also, this behaviour is forbidden in all religions especially in Islam. In Islam great rules are established to prevent plagiarism and any type of cheating. Plagiarism has negative impact on the scientific research, so we must stop it to save the rights of others and to keep sciences flourished.

Electronic health record (EHR) systems are designed and deployed to store data accurately and to capture the state of a patient across time, and they have been one of the major drivers to advance care in the last decade. However, the EHR is not eligible in supporting a model that is beyond episodic visits, nor the idea of an integrated care plan that all care team members can view and contribute to. On the other hand, the concept of a longitudinal record and the idea of a "smart care plan" are key factors for paving the way toward Predictive, Preventive, Personalized and Participatory (P4-medicine), which arguably will be in a near future the only effective and sustainable approach for pandemics and “silent” chronic diseases. At the current state-of-the-art, the HL7 FHIR standard and distributed ledger technologies (DLTs) are two very promising areas of research and development in the context of health information management, and a proper synergy among their approaches, co...

The Internet of Things (IoT) is becoming an emerging trend and has significant potential to replace other technologies, where researchers consider it as the future of the internet. It has given tremendous support and become the building blocks in the development of important cyber-physical systems and it is being severed in a variety of application domains, including healthcare. A methodological evolution of the Internet of Things, enabled it to extend to the physical world beyond the electronic world by connecting miscellaneous devices through the internet, thus making everything is connected. In recent years it has gained higher attention for its potential to alleviate the strain on the healthcare sector caused by the rising and aging population along with the increase in chronic diseases and global pandemics. This paper surveys about various usages of IoT healthcare technologies and reviews the state of the art services and applications, recent trends in IoT based healthcare solutions, and various challenges posed including security and privacy issues, which researchers, service providers and end users need to pay higher attention. Further, this paper discusses how innovative IoT enabled technologies like cloud computing, fog computing, blockchain, and big data can be used to leverage modern healthcare facilities and mitigate the burden on healthcare resources.

Cutting edge communication technologies such as smartphones remain far from prevalent in most of the settings with the greatest need for improved health and development programs. As a result, designers of ICT4D initiatives often weigh difficult tradeoffs between the usability of smartphone applications for structured data collection versus the battery life, durability, cost and familiarity of basic phones. However, as this paper and our deployment experiences demonstrate, such tradeoffs are not always necessary. Most mobile network operators in sub-Saharan Africa offer value added services via simple, menu-driven applications that run directly from the SIM card. While conventional SIM applications can only be accessed by mobile network operators, this paper describes the design and implementation of a 'thin SIM' approach that does not require mobile network operator involvement. We have implemented this tool with more than 3,000 health workers and describe particular deployment experiences in Kenya, Benin, Nepal and Guatemala. We then reflect on a number of important limitations of the thin SIM approach, and opportunities for further development and deployment. Ultimately, we argue that there is an important role for SIM applications as one part of a configurable data collection toolkit for supporting global health and development programs.

Purpose: The progress of the Millennium Development Goals (MDGs) shows that sustained global action can achieve success. Despite the unprecedented achievements in health and education, more than one billion people, many of them in conflict-affected areas, were unable to reap the benefits of the MDG gains. The recently developed Sustainable Development Goals (SDGs) are even more ambitious then their predecessor. SDG 3 prioritizes health and well-being for all ages in specific areas such as maternal mortality, communicable diseases, mental health, and healthcare workforce. However, without a shift in the approach used for conflict-affected areas, the world's most vulnerable people risk being left behind in global development yet again. We must engage in meaningful discussions about employing innovative strategies to address health challenges fragile, low-resource, and often remote settings. In this paper, we will argue that to meet the ambitious health goals of SDG 3, digital health can help to bridge healthcare gaps in conflict-affected areas.

Methods: First, we describe the health needs of populations in conflict-affected environments, and how they overlap with the SDG 3 targets. Secondly, we discuss how digital health can address the unique needs of conflict-affected areas. Finally, we evaluate the various challenges in deploying digital technologies in fragile environments , and discuss potential policy solutions.

Discussion: Persons in conflict-affected areas may benefit from the diffusive nature of digital health tools. Innovations using cellular technology or cloud-based solutions overcome physical barriers. Additionally, many of the targets of SDG 3 could see significant progress if efficacious education and outreach efforts were supported , and digital health in the form of mHealth and telehealth offers a relatively low-resource platform for these initiatives. Lastly, lack of data collection, especially in conflict-affected or otherwise fragile states, was one of the primary limitations of the MDGs. Greater investment in data collection efforts, supported by digital health technologies, is necessary if SDG 3 targets are to be measured and progress assessed. Standardized EMR systems as well as context-specific data warehousing efforts will assist in collecting and managing accurate data. Stakeholders such as patients, providers, and NGOs, must be proactive and collaborative in their efforts for continuous progress toward SDG 3. Digital health can assist in these inter-organizational communication efforts.

Conclusion: The SDGS are complex, ambitious, and comprehensive; even in the most stable environments, achieving full completion towards every goal will be difficult, and in conflict-affected environments, this challenge is much greater. By engaging in a collaborative framework and using the appropriate digital health tools, we can support humanitarian efforts to realize sustained progress in SDG 3 outcomes.

El estudio que aquí se presenta se ha recogido durante los años —cursos escolares— comprendidos entre 2011 - 2016 en el I.E.S. Las Lomas, situado en la Zona Norte de Alicante; y, concretamente, junto a los barrios de Juan XXIII y Colonia Requena. Por su carácter personal, y partiendo de cuestiones previas que nos situaban en el porqué un 90% del alumnado de dicho centro no supera la secundaria y en cómo podíamos —junto a la comunidad educativa— ofrecer una vía de actuación que generase una transformación educativa y social, el trabajo se ha dividido en tres capítulos.
Primero, un repaso a la fundamentación teórica que nos ha ayudado a situarnos científicamente en la actualidad y también en el recorrido histórico habido hasta llegar a ésta y la exposición de la planificación previa a la investigación en lo referente a la metodología a emplear junto a las diferentes técnicas e instrumentos encontrados por parte de la Antropología, concretamente la Antropología de la Educación, así como las demás ciencias sociales aplicadas en ámbitos educativos y contextos marginados. Segundo, la parte etnográfica, que nos ha servido de análisis de la realidad actual de la zona y la sociedad que en ella ‘convive’; estos son, los barrios adyacentes, el alumnado (representado desde la ‘cultura juvenil’), el centro educativo, el profesorado, las familias y el resto de población, colectivos y entidades. Por último, en la parte tercera, encontramos la Investigación-acción participativa generada a través de la experiencia previa y los resultados conseguidos a través de un modelo de actuación conjunta, en comunión, donde se ha dado espacio y voz a los cuerpos y discursos hasta ahora silenciados. De ésta última experiencia, donde ha primado una investigación aplicada e implicada, que parte también de la experiencia como parte del alumnado, como vecino y activista de la zona, surge lo que presentamos como resultado (vía hacia la utopía) de transformación: un modelo de actuación educativa al que hemos llamado Modelo Educativo Discursivo.