M. Graziella Volpi, visiting researcher at the eHealth Center and home emergency doctor
María Graziella Volpi, a visiting researcher at the eHealth Center this November, is a doctor and holds a master's degree in Healthcare Business Management. She has worked in the clinical field for more than twenty years in her home country of Uruguay, which has one of the oldest populations in Latin America. While working in home emergency care, she was inspired to create a telemonitoring project for older people, in order to improve these patients' quality of life and make the healthcare system more efficient.
What sparked your interest in e-health?
My interest in e-health came about by chance, when I was deciding on the topic for my thesis in my master's degree in Healthcare Business Management. In 2015, working with a friend who had graduated in Nursing, we conducted a survey to find out the level of acceptance of telemonitoring among diabetic patients in Uruguay (83% thought it was positive). We then presented the work at the Telemedicine Congress of the Americas, where it won first prize. I heard about telemedicine at the congress, and decided that I had to find out more. After looking around for centres where I could train, I arrived at the UOC, where I was part of the first class to study the University Master's Degree in E-Health. I have continued my training since then, and I am more enthusiastic every day!
To what extent has health been digitalized in Uruguay?
In Uruguay we have a government agency, Salud.uy, where health professionals and IT professionals work, and they have done a great deal of work to develop and launch the National Electronic Clinical History (HCEN). The process of integrating it into all the country's healthcare providers is now being completed. A Minimum Data Set (MDS) of the users is shared in the HCEN. There is also the National Dictionary of Medicines and Related Items, and work on electronic prescriptions is under way. In the private sphere, it depends on the provider.
The most widely used technology is teleconsultation, which gained a high profile during the COVID-19 pandemic. There have been excellent innovations in e-health from Uruguay, which have been successful all over the world, although it has been more difficult to introduce them into the Uruguayan market. For example, there are a medication dispenser with alerts (Pills&Care), a cardiac arrhythmia monitoring system with alerts (Galeno Sys), and three-dimensional anatomical models to help with surgery (Armor Bionics), among others.
You're working on a project to improve the quality of life of older people through telemonitoring and telecare. Can you tell us what it consists of, and what stage it is at?
My project consists of the telemonitoring of various parameters at home, in adult patients over 65 years of age: blood pressure, diabetes, temperature, oxygen saturation, body weight and even a sudden loss of a standing position. It provides alerts, and enables communication with the patient or a relative, telephone support, and a professional can be sent to the home if needed. It also means that the patient can be followed up regularly by teleconsultation. These data are passed on to the patient's primary healthcare physician, and they are subsequently shared with the patient's electronic clinical history (agreements with healthcare providers will be put in place). The project will benefit both older people, by giving them a better quality of life, and the healthcare system, which will be more efficient.
It is currently supported by a Uruguayan business incubator (Xeniors), and we are looking to find investors. We have plans to include our solution in a Uruguayan start-up. Like all new technology, it is difficult to launch in our country. But with time and perseverance, we know it will happen. Patient care at home is a worldwide trend, and Uruguayans will end up accepting it. It is already happening in countries like Chile, and we have even begun conversations with colleagues in the region to bring it to Uruguay. We are working to make this project happen.
How would you define a liquid hospital, and what is its potential? How do you plan to apply the experience of a liquid hospital in Catalonia in your country?
A liquid hospital, considered in terms of a "hospital open to the community" which "breaks down its walls", is the perfect model for patient care. Patients have everything they need to become literate about their health from their home or workplace, and they are supported by web tools and professionals. It is a hospital in which the patient is hospitalized for the shortest possible time, and provides continuity of care at home until they are finally discharged. I saw the model for myself at Sant Joan de Déu Barcelona Hospital when I was taking my master's degree in E-Health. I admire their work, and I'd like to take it to Uruguay. It should first be implemented in the public system, since that is where care inequality needs the most work, and where there is the greatest need for financial efficiency.
Why do you believe it is important to include the gender perspective in e-health?
According to UNESCO, only 29.3% of researchers worldwide were women in July 2019. There is a gender gap in the workplace, and in managerial positions in particular. This gap is most evident in the STEM area. A 2021 report by UN Women and the UN Regional Bureau for Sciences in Latin America and the Caribbean shows that giving equal opportunities to women in STEM benefits both women and the workplace. This gender inequality persists in e-health, especially in management positions, and it has become more apparent to me since I've been working with RECAINSA (the Central American Network of Health Informatics).
I am studying how to include gender equality and inclusion in the field of e-health, for example by encouraging women to enrol for STEM qualifications and to create support networks, among other initiatives.
Why did you want to come to the UOC to conduct your research? What contribution do you think you can make?
I've been interested in visiting the UOC and seeing its facilities and research for myself ever since I did my master's degree with them. I believe that I can contribute my perspective as a Latin American professional, and the knowledge I've acquired in my work with scientific e-health societies in the Americas. Any new experience is enriching, and during my stay at the UOC I want to absorb everything I can, and see at first hand the work that is being done in the first world on e-health issues.
What new projects do you have planned for the short and long term?
I'm currently the co-president of the RECAINSA Older Adults Committee, and I'm taking a course on Women Leaders in Digital Health, with the support of RECAINSA and El Bosque University in Colombia. The perspective from the region and the contact we have with professionals from different countries at RECAINSA is enriching, and I want to focus on improving e-health in Latin America and the Caribbean. I'm working with RISAD (the Ibero-American Digital Health Network), and I'm organizing the next congress in Punta Cana for June 2023. In Uruguay, my plan is to begin introducing new technologies, starting with tools that enable users to become digitally literate and improve their health. We have to improve connectivity all over the country for that to be possible.