"As long as the pandemic lasts, universities will have a key role to play in identifying reliable sources of information"

Marcelo D'Agostino

Flickr: ITU Pictures

Imma Alberch
Marcelo D'Agostino, senior advisor for information systems and e-health at the Pan American Health Organization (PAHO), the regional office of the World Health Organization (WHO) for the Americas

Armed with applied e-health technologies, institutions and healthcare systems alike are fighting day in, day out to contain the spread of COVID-19. Indeed, information and communication technologies, especially teleconsultation systems, mobile contact and contagion tracing apps and big data analytics run to better understand the behaviour of the coronavirus, are proving their vital worth in the battle against this pandemic.

To find out more about the PAHO's activities in the field of digital health, the World Health Organization's (WHO) regional office for the Americas, we spoke to their senior advisor for information systems and e-health, Marcelo D'Agostino. He currently in charge of coordinating the information systems for health programme launched by PAHO's Department of Evidence and Intelligence for Action in Health. Namely, we learned more about the factsheets on e‑health that D'Agostino is currently drafting with help fromFrancesc Saig, a professor and researcher from the UOC Faculty of Health Sciences and member of the University's eHealth Center. 

During the ongoing coronavirus crisis, what does an average day at PAHO, specifically in your area of work, look like?

Since the pandemic broke out, the Pan American Health Organization (PAHO) has been working each day to support countries in managing the crisis as best as they can. Our work is based on well-established emergency protocols written by PAHO, which had previously been activated in response to a range of public health emergencies, such as the H1N1 pandemic and the cholera epidemic in Haiti, and to many climate-related natural disasters.

Targeting COVID-19 specifically, the department I work in, which is run by Dr Sebastin Garca Sais, has rolled out four main lines of action to combat the pandemic. I've been tasked with coordinating the line focused on e-health and information systems. We've already released a number of products, including an information systems for health website with helpful technical documents about the pandemic; a web page offering guidance on matters related to COVID-19, and a "window of knowledge" featuring the latest research on the coronavirus carried out in the Americas.

What relief efforts is PAHO making to aid American countries in their battle against the COVID-19 pandemic?

We're currently rolling out a number of country-focused actions, but there's one in particular I would like to highlight. PAHO has released a call to raise money, through donations and membership contributions, to better equip North and South American countries against COVID-19. The fundraising initiative has two core objectives: to curb the spread of the virus and soften the blow of COVID-19 on health in our region.

As an expert in information systems and e-health, what specific role would you say the latter is playing in this pandemic?

It's certainly playing a determining role, one that I'd say is more vital than ever. We've really zeroed in on technologies that help us meet people's core needs. These include websites, chatbots, dashboards, mobile apps, social media, call centres, virtual campuses, text messaging apps (SMS and web-based message, video and audio services), monitoring and tracking platforms, wikis and forums, not to mention other artificial intelligence-based tech with more complex purposes.

Many of these technologies and applications are being used by healthcare professionals to monitor and follow up on patients, to provide therapeutic support and to get second opinions from colleagues across the globe. Likewise, people are turning to them to interact with healthcare professionals and services, to find reliable facts and figures, and to self-diagnose. They're also being used to devise prevention mechanisms and, of course, to help us learn more and work better. 

What recommendations is PAHO giving to countries with respect to e-health technologies? 

PAHO's underlying mission is to strengthen healthcare systems and services, so it always supports countries and presents new information technologies with this in mind. Specifically, we recently put out a series of recommendations for restructuring and progressively expanding health services so that they can take on the COVID-19 pandemic. The initiative is being coordinated by Dr James Fitzgerald, who is the director of PAHO's Department of Health Systems and Services.

PAHO is also currently drafting a series of factsheets. Could you tell us more about what those are? 

Factsheets are brief, easy-to-understand documents providing strategic information to aid decision-making. We're now busy drafting factsheets to cover topics that may not typically be of concern to ministries of health under normal circumstances, but which have shot to the top of their lists since the onset of the pandemic. Our more recently published factsheets talk about the current infodemic and the importance of telemedicine during a pandemic, a time in which we must take all possible measures to keep our healthcare systems from collapsing.

In your opinion, what role should universities be playing in this pandemic?

Universities are playing a vital part in overcoming this crisis, and in more ways than one. First and foremost, like always, they play a key role by analysing and disseminating scientific evidence and identifying credible sources of information. It's their raison d'tre. Apart from the public health crisis, the world is facing an infodemic, so any stakeholder able to channel the excess of information out there will have an extremely important role to play. I would go so far as to say that universities are taking on a technical and strategic role like they never have before.

What about in preventing future pandemics?

I'm speaking from my heart when I say that I hope we never have to answer this question again. The way I see it, the best thing that academic institutions can do is to keep on doing what they're doing. Educating is one of the noblest undertakings to ever exist, and an educated society will always be better prepared to face what's to come. 

How much coordination is there between PAHO and the UOC, which is WHO's designated e-health collaborating centre?

At PAHO we view the UOC as an extension of ourselves; there's a mutual feeling of partnership and trust, both institutionally and personally speaking. I'm certain that our relationships are based on trust, and that trust is only there thanks to the people involved. I should underline the vital role played by Francesc Saig in forging the sturdy PAHO-UOC relationship and pushing it to unwaveringly outdo itself in terms of determination and innovation.

Do you believe that the global population is prepared to face future pandemics? 

I have neither the ability nor the authority to answer that question. However, I do hope so and feel compelled to say yes. In any case, based on what I see and hear every day – through my colleagues at PAHO, WHO and the country's institutions – if the answer solely relied on the level of commitment being demonstrated, I could give you a yes that's as definitive as the universe is infinite. I have so much respect for all the people out there, like yourselves, who are giving it their all at a time like this.

What changes will the pandemic set off? 

I honestly believe that the whole world will be different. I don't think I can give an opinion about every aspect of life, but I would venture so far as to say that technology use will increase and improve now that all of us have seen its true potential. That being said, we can't forget or stop worrying about all the people out there living without internet and, therefore, without access to technology. Reducing inequalities, ensuring gender equality and preserving people's rights should be the cornerstones of all our actions.