Highlights This review examined the literature on some digital advancements that may potentially impact and leverage in electronic health record systems. Existing digital transformation solutions have showed potential for optimizing electronic health records systems. Challenges for implementation remain such as lack of regulatory frameworks, trust, scalability, security, privacy, low performance, and cost.

Societal concern with the welfare of egg laying hens housed in conventional cages is fostering a transition towards cage-free systems in many countries. However, although cage-free facilities enable hens to move freely and express natural behaviours, concerns have also been raised over the possibility that cage-free flocks experience higher mortality, potentially compromising some aspects of their welfare. To investigate this possibility, we conducted a large meta-analysis of laying hen mortality in conventional cages, furnished cages and cage-free aviaries using data from 6040 commercial flocks and 176 million hens from 16 countries. We show that except for conventional cages, mortality gradually drops as experience with each system builds up: since 2000, each year of experience with cage-free aviaries was associated with a 0.35–0.65% average drop in cumulative mortality, with no differences in mortality between caged and cage-free systems in more recent years. As management knowledge evolves and genetics are optimized, new producers transitioning to cage-free housing may experience even faster rates of decline. Our results speak against the notion that mortality is inherently higher in cage-free production and illustrate the importance of considering the degree of maturity of production systems in any investigations of farm animal health, behaviour and welfare.

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Introduction: The COVID-19 crisis provides an opportunity to reflect on what worked during the pandemic, what could have been done differently, and what innovations should become part of an enhanced health information system in the future.Methods: An online qualitative survey was designed and administered online in November 2020 to all the 37 Member States that are part of the WHO European Health Information Initiative and the WHO Central Asian Republics Information Network.Results: Nineteen countries responded to the survey (Austria, Belgium, Croatia, Czech Republic, Finland, Greece, Iceland, Ireland, Israel, Italy, Kazakhstan, Latvia, Lithuania, Romania, Russian Federation, Sweden, Turkey, United Kingdom, and Uzbekistan). The COVID-19 pandemic required health information systems (HIS) to rapidly adapt to identify, collect, store, manage, and transmit accurate and timely COVID-19 related data. HIS stakeholders have been put to the test, and valuable experience has been gained. Despite critical gaps such as under-resourced public health services, obsolete health information technologies, and lack of interoperability, most countries believed that their information systems had worked reasonably well in addressing the needs arising during the COVID-19 pandemic.Conclusion: Strong enabling environments and advanced and digitized health information systems are vital to controlling epidemics. Sustainable finance and government support are required for the continued implementation and enhancement of HIS. It is important to promote digital solutions beyond the COVID-19 pandemic. Now is the time to discuss potential solutions to obtain timely, accurate, and reliable health information and steer policy-making while protecting privacy rights and meeting the highest ethical standards.

Decisões críticas no combate à pandemia causada pelo SARS-CoV-2 têm sido realizadas frequentemente com dados e informações ainda incompletas. Enquanto os órgãos pertinentes não solucionam os gargalos no fluxo de informações de vital importância, epidemiólogos e outros pesquisadores devem produzir subsídios técnicos para o enfrentamento da crise contornando essas limitações. No presente estudo, focado no Brasil, comparamos os óbitos pelo SARS-CoV-2, disponibilizados diariamente, com os dados de óbitos por doenças respiratórias e outras doenças nos anos de 2014 a 2018 (os últimos cinco anos completos para os quais os dados estão disponíveis). Adicionalmente, extraímos os sinais temporais anuais dos óbitos por doenças respiratórias para que o período típico de pico na mortalidade por essas doenças  possa ser considerado em cada estado Brasileiro. A porcentagem de óbitos pelo SARS-CoV-2 até o dia 15 de abril equivale a 24% da mortalidade esperada por causas respiratórias no mesmo período, com base em anos anteriores, com grande variação entre os estados (desde o Amazonas, 151%, até o Tocantins, com 3%). Estamos na época típica de pico de mortalidade associada a doenças respiratórias em grande parte do Norte e Nordeste (com exceção de Roraima). Nas regiões Sudeste e Sul, esse pico é mais tardio (junho–agosto). A evolução da pandemia em cada estado dependerá, no entanto, de vários outros fatores, como o comportamento do patógeno – ainda não conhecido suficientemente. Ressaltamos a necessidade de ações para aumento da agilidade na disponibilização dos dados atuais de mortalidade (por diversas causas), para que equipes de pesquisa com diferentes abordagens analíticas possam se somar no combate a este desafio sanitário global.