9.30h - Antonio Hernandez

7/29/2019 9.30h - Antonio Hernandez

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Risk Management

PAHO Perspective

Antonio Hernandez

Regional Advisor on Physical Infrastructure & Technology

Pan American Health Organization / World Health Organization

Antonio Hernandez

Regional Advisor on Physical Infrastructure & Technology

Pan American Health Organization / World Health Organization

CURSOE

OFICIN

A

DE

TRABALHOS

OBRE

GERENCIAMENTOD

E

RISCOE

SEGUR

CURSOE

OFICIN

A

DE

TRABALHOS

OBRE

GERENCIAMENTOD

E

RISCOE

SEGURANANA

EMS

A

A

EMS

ADEDE

Sao

Paulo

-SP,

Brazil

Nov.

5

7,

2007


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OutlineOutline

The Pan American Health Organization PAHO

Risk Management (RM) Concepts

Health Technology Taxonomy & Trends

Physical Infrastructure & Technology - RM Perspective

Challenges & Opportunities

The Pan American Health Organization PAHO

Risk Management (RM) Concepts

Health Technology Taxonomy & Trends

Physical Infrastructure & Technology - RM Perspective

Challenges & Opportunities


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ORGANIZATIONS LEADERSHIPORGANIZATIONS LEADERSHIP

Director:

Dr. Mirta Roses Periago

Deputy Director:

Dr. Cristina V. Beato

Assistant Director:

Dr. Carissa Etienne

Director of Administration:

Mr. Michael Boorstein

Director:

Dr. Mirta Roses PeriagoDeputy Director:

Dr. Cristina V. Beato

Assistant Director:

Dr. Carissa Etienne

Director of Administration:

Mr. Michael Boorstein


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ORGANIZATIONS HISTORY

International Sanitary Bureau (ISB) is formed by the First GeneralInternational Sanitary Convention of American States

19021902

ISB renamed Pan American Sanitary Bureau19231923

Adoption of the Pan American SanitaryCode which continues in force today

19241924


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ORGANIZATIONS HISTORY

Ratification of the Pan American Sanitary Code by all the AmericanRepublics.

International Health Conference drafts the Constitution for a

World Health Organization.Pan American Sanitary Conference reorganizes the Bureau and its

Governing Bodies, and gives a new name to the organization: the PanAmerican Sanitary Organization (PASO).

Establishment of the World Health Organization (WHO).

PASO also becomes the WHO Regional Office for the Americas(AMRO).

PASO becomes the specialized agency for health for the InterAmericanSystem.

Pan American Sanitary Organization is renamed Pan American HealthOrganization (PAHO).

19361936

19461946

19471947

19481948

19491949

19501950

19581958


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AMROWashington, DC

USA

AMROWashington, DC

USA

AFROBrazzaville,

Rep. Du Congo

AFROBrazzaville,

Rep. Du Congo

EMROAlexandr ia,

Egypt

EMROAlexandria,

Egypt SEARONew Delhi,

India

SEARONew Delhi ,

India

WPRO

Manila,Philippines

WPRO

Manila,Philippines

EUROCopenhagen,

Denmark

EUROCopenhagen,

Denmark

HQGeneva,

Switzerland

HQGeneva,

Switzerland

Regional StructureRegional Structure


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HeadquartersHeadquarters

Country OfficesCountry Offices

CentersCenters

CFNICFNI

CARECCAREC

PANAFTOSAPANAFTOSA

BIREMEBIREME

CLAPCLAP

CEPISCEPIS

INCAPINCAP

PRESENCE OF PAHO IN THE REGIONPRESENCE OF PAHO IN THE REGION


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PAHO MEMBERSTATESPAHO MEMBERSTATES

Antigua and Barbuda

Argentina

Bahamas

BarbadosBelize

Bolivia

Brazil

Canada

Chile

Colombia

Costa Rica

Cuba

DominicaDominican Republic

Ecuador

El Salvador

Grenada

Guatemala

Antigua and Barbuda

Argentina

Bahamas

BarbadosBelize

Bolivia

Brazil

Canada

Chile

Colombia

Costa Rica

Cuba

DominicaDominican Republic

Ecuador

El Salvador

Grenada

Guatemala

Guyana

Haiti

Honduras

JamaicaMexico

Nicaragua

Panama

Paraguay

PeruSaint Kitts and Nevis

Saint Lucia

Saint Vincent and

the Grenadines

Suriname

Trinidad and Tobago

United States

Uruguay

Venezuela

Participating States

France

Kingdom of the

NetherlandsUnited Kingdom of Great

Britain and Northern

Ireland

Associate Member

Puerto Rico

Observer States

SpainPortugal


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PAHO - Specialized Agency on HealthPAHO - Specialized Agency on Health

Organization of American

States

Specialized Agency

Inter American

Systems

United Nations

SystemPAHOPAHO

Regional Office of the

World Health Organization


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Risk ManagementRisk Management

Risk Management is a Process to Make Decision

that will Eliminate or Minimize the Consequences

of a Accidental Losses

The Process: Objective

Efficient

Pragmatic

Risk Management is a Process to Make Decision

that will Eliminate or Minimize the Consequences

of a Accidental Losses

The Process: Objective

Efficient

Pragmatic


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Risk Management Program PurposeRisk Management Program Purpose

Protect the Organization/Institution Against Loss

Property Loss

Net Income Loss Liability Loss

Personnel Losses

Protect the Organization/Institution Against Loss

Property Loss

Net Income Loss Liability Loss

Personnel Losses


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Risk Management Program ComponentsRisk Management Program Components

Risk Identification

Risk Analysis

Loss Prevention

Claims Management Disaster Preparedness

Risk Identification

Risk Analysis

Loss Prevention

Claims Management Disaster Preparedness

HEALTH TECHNOLOGIES


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HEALTH TECHNOLOGIES

People's Health Environmental Health

Community Health Services Individual Health Services

Protection

Technologies

Clinical

Technologies

MedicalEquipmentand Devices

ClinicalProcedures

Organization

Information

Infrastructure

and Equipment

Prevention

Technologies

Promotion

Technologies

Support

Technologies

Pharmaceuticaland OtherProducts

TELEMEDICINETELEMEDICINE

Electronic Medical Record

Epidemiological Information Clinical Information

Health Information System

ee--HealthHealthTeleTele--HealthHealth --

Source: Developing Health Technology Assessment in Latin America and the Caribbean - PAHO/WHO


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Health TechnologiesHealth Technologies

Assessment

Safe, and Cost-effective Interventions ...

Regulation

Efficacy, Safety and Quality Devices

Management

Planning, Acquisition, Use, Maintenance, Evaluation &Discharge

Technical Support Service

Training, Information, Maintenance

Assessment

Safe, and Cost-effective Interventions ...

Regulation

Efficacy, Safety and Quality Devices

Management

Planning, Acquisition, Use, Maintenance, Evaluation &

Discharge

Technical Support Service

Training, Information, Maintenance


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Health TechnologiesHealth Technologies

Convergence

Moving to Uniformity

Integration

Process of Incorporated as Equals

Development

Accelerated

Interoperability

Exchange Information Among Them

Convergence

Moving to Uniformity

Integration

Process of Incorporated as Equals

Development

Accelerated

Interoperability

Exchange Information Among Them


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HEALTH SERVICES PHYSICAL AND

MEDICAL DEVICES REGULATION

PLANT OPERATION

MAINTENANCE SERVICES

CLINICAL HOSPITAL

DEVICES

ENGINEERING ENGINEERING

TECHNOLOGICAL INFRASTRUCTURE

INDUSTRIALMEDICAL EQUIPMENT TECHNOLOGY MANAGEMENT

HEALTHCARE FACILITY DEVELOPMENT

MAINTENANCE

ARCHITECTURE AND ENGINEERING

E-HealthTele-Health

Telemedicine

HEALTHCARE TECHNOLOGY ASSESSMENT

TH S/EV -A H H

1

ENERGYMANAGEMENT

MAINTENANCEMANAGEM ENT

SAFETYANDBIO-SAFETY

ENVIRONMENTALMANA GEMENT

DISASTER PREPAREDNESS

HEALTHCARE FACILITIESHEALTH CARE FACILITIES

ENGINEERING PROGRAMSENGINEERING PROGRAMS

TH S/EV -A H H

HEALTH CARE FACILITYDEVELOPMENTHEALTHCAREFACILITYDEVELOPMENT

FUNCTIONALPROGRAMMING

DESIGN

CONSTRUCTION

INSTALLATION

ACEPTANCE TEST

OPERATION ANDMAINTENANCE

PLANNING

EQUIPMENT

THS /EV-AHH

EQUIPMENT TECHNOLOGYMANAGEMENEQUIPMENTTECHNOLOGYMANAGEME

PLANNINGPLANNING

PROCUREMENTPROCUREMENT

MANAGEMENTMANAGEMENT

ASSESSMENTASSESSMENT

DISPOSALDISPOSAL

REPLACEMENTREPLACEMENT

MEDICAL DEVICE REGULATION PROGRAMMEDICAL DEVICE REGULATIONPROGRAM

Define &Classify"MEDICALDEVICE"Define &Classify"MEDICAL DEVICE"

PrePre --MarketApprovalMarketApproval

PostPost--MarketVigilanceMarketVigilance

AuditManufacturer &DistributorAuditManufacturer &Distributor

ApplyPreApply Pre -- MarketAssessmentControlsMarketAssessmentControls

HarmonizeRegulatoryRequirementsHarmonizeRegulatoryRequirements


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Paradigm Shift in HealthcareParadigm Shift in Healthcare

Old Paradigm : Service-Centered CarePrimary Health Care (Alma Ata)

Hospital without Walls

Reaching the Community

New Paradigm: Patient-Centered Care

Point-of-Care TechnologiesPersonal Monitoring Devices

Telemedicine

Old Paradigm : Service-Centered CarePrimary Health Care (Alma Ata)

Hospital without Walls

Reaching the Community

New Paradigm: Patient-Centered Care

Point-of-Care TechnologiesPersonal Monitoring Devices

Telemedicine

PAHO T h i l C tiPAHO Technical Cooperation on


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PAHO Technical Cooperation on

Health Services

Physical Infrastructure & Technology

PAHO Technical Cooperation on

Health Services

Physical Infrastructure & Technology

To Collaborate with the Member States in

National Development

and

Institutional Capacity Building

on

Healthcare Technology

To Collaborate with the Member States in

National Development

and

Institutional Capacity Building

on

Healthcare Technology

Ch ll i LA&CCh ll i LA&C


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Challenges in LA&CChallenges in LA&C

Technology Dependant Countries

Lack of National Policy for Science & Technology in Health

Few Medical Device Regulatory Programs

Limited use of Evidence-Based Information for Decision-Making

Limited or No Use of Norms, Standards and Codes

Average 50% of Equipment Out of Service or Not in Use

Obsolete Buildings and Highly Deteriorated (50%)

Shortage of Professional and Technical Staff

Few Universities & Technical School with Programs on BE, CE,

Lack of Physical Infrastructure Planning Programs

Deficient Maintenance Programs & After Sale Support Service

Low Budget Allocation for Maintenance

Lack of Equipment Inventories and Control Systems

Continuous Acquisition of Technology

Technology Dependant Countries

Lack of National Policy for Science & Technology in Health

Few Medical Device Regulatory Programs

Limited use of Evidence-Based Information for Decision-Making

Limited or No Use of Norms, Standards and CodesLimited or No Use of Norms, Standards and Codes

Average 50% of Equipment Out of Service or Not in Use

Obsolete Buildings and Highly Deteriorated (50%)

Shortage of Professional and Technical Staff

Few Universities & Technical School with Programs on BE, CE,

Lack of Physical Infrastructure Planning Programs

Deficient Maintenance Programs & After Sale Support Service

Low Budget Allocation for Maintenance

Lack of Equipment Inventories and Control Systems

Continuous Acquisition of Technology


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OpportunitiesOpportunities

National Strategic Alliances (Public-Private)

Coordination with Academic Sector

Interaction with Scientific and Professional Societies

Work with PAHO/WHO Collaborating Centers

Institutional Capacity Building on Technology Management

Networks of9 Experts

9 Institutions

Links to Global Initiatives9 International Standards for Healthcare Technology (OMS/ISO/IEC/ITU)9 Health Technology Assessment (HTAi)

9 Medical Devices Regulation (GHTF/PAHO)

9 Global Alliance for Patient Safety (WHO)

9 e-Health/Telemedicine (PAHO/WHO)

9 Integrating Healthcare Enterprise (IHE)- Patient Care Domain (HIMSS/ACCE)

National Strategic Alliances (Public-Private)

Coordination with Academic Sector

Interaction with Scientific and Professional Societies

Work with PAHO/WHO Collaborating Centers

Institutional Capacity Building on Technology Management

Networks of9 Experts

9 Institutions

Links to Global Initiatives9 International Standards for Healthcare Technology (OMS/ISO/IEC/ITU)9 Health Technology Assessment (HTAi)

9 Medical Devices Regulation (GHTF/PAHO)

9 Global Alliance for Patient Safety (WHO)

9 e-Health/Telemedicine (PAHO/WHO)

9 Integrating Healthcare Enterprise (IHE)- Patient Care Domain (HIMSS/ACCE)


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Risk Management Program is a EnablerFactor for Quality, Safety, Equity and

Cost-Effectiveness on

Health Services Delivery

Risk Management Program is a EnablerFactor for Quality, Safety, Equity and

Cost-Effectiveness on

Health Services Delivery

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9.30h - Antonio Hernandez