The creation of artificial skin is an innovative technological development that has the potential to revolutionize the education and learning process. It is a tool with a new and exciting approach that makes it possible to create realistic and authentic products that imitate the feel of human skin. This is particularly important in health education where students need to have a deep understanding of the functioning of the human body.

This project is an initiative of the health benefits division, with a view to ensuring the comprehensive health care of Social Security Institute of Guatemala (Instituto Guatemalteco de Seguridad Social – IGSS) employees.

The project aims to remove the stigma surrounding mental health and to address the main psychosocial risks among IGSS employees through the provision of ongoing training on topics related to mental health and psychosocial stress factors. It provides spaces for reflection and analysis on experiences and interpersonal relationships in the workplace.

The National Registry of Social Security Organizations (Registro Nacional de Obras Sociales – RNOS) and the National Registry of Health Insurance Funds (Registro Nacional de Entidades de Medicina Prepaga – RNEMP) of Argentina’s Superintendency of Health Services (Superintendencia de Servicios de Salud – SSSalud) are responsible for receiving, analysing and ensuring compliance with all regulatory requirements in force for the registration, modification and update of social security organizations and health insurance funds in Argentina, and for keeping their documen

Panama’s Social Insurance Fund (Caja de Seguro Social – CSS) has launched a course on “Social security for all” and has made it available to the entire population of Panama.

The “Social security for all” (Seguridad social para todos) course is aimed at the institution’s employees and is in fact part of the induction process for new employees. However, everyone should understand social security because social security is a human right. Consequently, the institution’s challenge is to provide everyone with this knowledge.

The Single Reimbursement System (Sistema Único de Reintegros – SUR) was created in 2012 with the introduction of Resolution 1200/201. It aimed to handle requests from health-related social security organizations efficiently and in a timely manner, partially compensating the payment of benefits with high economic impact or that cover chronic diseases.

Members of the Social Security Institute of Guatemala (Instituto Guatemalteco de Seguridad Social – IGSS) who are entitled to benefits under the Sickness, Maternity and Accident Programme (Programa de Enfermedad, Maternidad y Accidentes) and on leave from work due to COVID-19 receive a subsidy payment to substitute the salary they would otherwise receive, proportional to the measures outlined in the corresponding regulations.

People with disabilities are one of society’s most excluded groups and usually have the most difficulties in accessing health, education, employment, and social security. Current policies are either not inclusive, or are still in the initial stages, and thus do not protect the rights of this group. We need rules and regulations that support us in taking action to better protect their rights. Even more importantly, we need to properly understand their needs in order to provide quality care.

Panama’s Social Insurance Fund (Caja de Seguro Social de Panamá – CSS) has put in place operational models that use and develop new communication technologies through mobile devices to offer high-quality care to members. This is part of its vision to be a leading guarantor of social security in Panama and to ensure efficient, agile and timely management, for the benefit of Panamanian people.

Thanks to the use of the Single Digital Health Record (Expediente Digital Único en Salud – EDUS) in health facilities, the Social Insurance Fund of Costa Rica (Caja Costarricense de Seguro Social – CCSS) has managed to gather a wealth of highly relevant data. Using data science and data mining, this data can be transformed into information that gives valuable input for decision-making. We can use it to assess potential disease incidence, based on a reliable and timely process, which helps to identify how public budgets can be best used.

Safe and healthy work environments (Entornos laborales seguros y saludables – ELSSA) is a free, voluntary and non-punitive programme from the Mexican Social Security Institute (Instituto Mexicano del Seguro Social – IMSS) that aims to foster three-way coordination and participation between companies, workers and the IMSS. It looks to implement strategies and actions to improve the health, safety and wellbeing of workers in workplaces, while at the same time promoting productivity and quality.

The good clinical practice of Hospital II Lima Norte Callao Luis Negreiros Vega – part of the Sabogal service network of Peru’s EsSalud - Social Health Insurance Institute (EsSalud - Seguro Social de Salud) – aimed to prevent respiratory and gastrointestinal diseases in hospitalized newborns.

To this end, we established an innovative model of care that disrupted the traditional neonatal-care model. Health professionals working in the neonatal unit were trained to promote exclusive breastfeeding and to ensure that colostrum was expressed within an hour of childbirth.

The medical record system is a solution that has allowed the Mexican Social Security Institute (Instituto Mexicano del Seguro Social – IMSS) to move from having isolated information models at the three levels of care to having an integrated automated model. This makes it easier for doctors to access a patient’s medical record during a consultation, regardless of the practice, medical unit, care level or city in which the patient received previous medical care.

Uruguay’s Social Insurance Bank (Banco de Previsión Social – BPS) manages the National System of Labour Certification, (Sistema Nacional de Certificación Laboral – SNCL), which centralizes the register of medical leave certificates for active workers for social security purposes.

It is necessary to strengthen HIV prevention measures through the use of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). Since the year 2021, the use of PrEP has been initiated nationwide in Mexican Social Security Institute (Instituto Mexicano del Seguro Social ‒ IMSS), being the first institutional initiative in our country. At the last cut-off, there were 2130 people in treatment with Emtricitabine/Tenofovir distributed throughout the national territory, although most of them are in Mexico City and suburban areas.

The Institutional Digital Medical Imaging Network (Red Digital Institucional de Imágenes Médicas – REDIMED) project consists of providing the Social Insurance Fund of Costa Rica (Caja Costarricense de Seguro Social – CCSS) with a comprehensive digital imaging solution that offers institutional coverage and will improve response time, diagnosis and quality of patient care. We also look to add value to the Single Digital Health Record (Expediente Digital Único en Salud – EDUS) by integrating the two solutions.

The body’s poor assimilation of food leads to a pathological state known as malnutrition, which can take varying degrees of severity and have different clinical manifestations. It is considered a disease with high morbidity and mortality rates.

The good clinical practice implemented at the Edgardo Rebagliati Martins National Hospital (Hospital Nacional Edgardo Rebagliati Martins – HNERM), part of Peru’s EsSalud - Social Health Insurance Institute (EsSalud - Seguro Social de Salud), looked to prevent complications of infections in paediatric patients with onco-haematological diseases and febrile neutropenia.

As a result of the COVID-19 pandemic, Peru’s EsSalud - Social Health Insurance Institute (EsSalud - Seguro Social de Salud) was not able to provide patients with a single diagnosis of arterial hypertension with adequate check-ups due to the suspension of some services and the health regulations in place at the time. This led to an increase in hypertensive patients with diabetes mellitus (in 2020, there were 15 per cent more hypertensive patients with diabetes mellitus).

The Medical Directorate of Mexico’s State Employees’ Social Security and Social Services Institute (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado – ISSSTE), through its National Office of Mental Health (Jefatura Nacional de Salud Mental), prioritizes the implementation of the guidelines set out in the Comprehensive Mental Health Programme (Programa Integral de Salud Mental), as approved by the Board of Directors on 25 March 2021, in order to strengthen the holistic, biopsychosocial care of its users.

The need to care for older patients with chronic illnesses in a more human-centred and effective way inspired this good clinical practice at the Almanzor Aguinaga Asenjo National Hospital (Hospital Nacional Almanzor Aguinaga Asenjo), which is part of the Lambayeque Health Care Network (Red Prestacional Lambayeque) and Peru’s EsSalud - Social Health Insurance Institute (EsSalud - Seguro Social de Salud).

The Superintendency of Health Services (Superintendencia de Servicios de Salud – SSSalud) has designed a tool to try and reduce late payments and arrears in Argentina and better manage the difficulties faced by health-care establishments in obtaining payment for services delivered.

Good practice in health – service quality.

As health-care systems have evolved to become more complex and due to the resultant increase in patients coming to harm in health care settings, patient safety has emerged as a health-care discipline.

Panama’s Social Insurance Fund (Caja de Seguro Social – CSS) has put in place operational models that use and develop new technologies to offer high-quality care to members. This is part of its vision to be a leading guarantor of social security in Panama and to ensure efficient, agile and timely management, for the benefit of Panamanian people.

As part of the efforts to modernize processes, measures must be put in place to analyse and respond to the needs of the Social Security Institute of Guatemala (Instituto Guatemalteco de Seguridad Social – IGSS), supported by objective procedures. In order to update the Institutional Medicines Register, health technology assessments have been used as a methodology to ensure informed decision-making. These assessments bring together demographic, scientific and financial variables that together are used to make objective decisions around health care coverage.

In view of the declaration of the coronavirus pandemic by the World Health Organization (WHO) and the national emergency declared by Peru, the EsSalud - Social Health Insurance Institute (EsSalud - Seguro Social de Salud) proposed rapid responses to tackle the challenge of insufficient hospital infrastructure in order to protect lives and offer healthcare services during a health emergency.

The EsSalud - Social Health Insurance Institute (EsSalud - Seguro Social de Salud) of Peru is a critical actor with regard to the COVID-19 pandemic, as it watches over the well-being of nearly 12 million insured persons. The information produced by the recently created Business Intelligence and Data Analytics Unit (Unidad de Inteligencia y Análisis de Datos – UIAD) has underpinned the strategic, tactical and operational decisions of EsSalud’s senior management and other entities, as well as other aspects of the institutional response to the health emergency.

The quality of health services is an urgent necessity in order to deal with the COVID-19 pandemic. Although it is estimated that up to 80 per cent of the people who become infected only exhibit mild symptoms, the primary challenge facing health systems is in dealing with moderate or severe manifestations that require hospital care.

In March 2020, the Social Insurance Fund of Costa Rica (Caja Costarricense de Seguro Social – CCSS) consolidated an innovative automated tool for tracking the spread of the COVID-19 pandemic among the population and the relevant care provided in the CCSS’s health establishments.

Intelligent health analytics solutions were developed for the clinical and administrative management of services, with timely, high-quality information in means accessible by decision-makers, thereby boosting the effectiveness of the management of the pandemic and other pathologies.

The Virtual Medical Consultation (Teleconsultation) offered by the Ecuadorian Social Security Institute (Instituto Ecuatoriano de Seguridad Social – IESS) is a system which uses information and communication technology to provide health care led by specialist health professionals, as well as to exchange medical information electronically in order to help patients who are not able to attend a consultation in person.

As a result of the SARS-CoV-2 health crisis, the Mexican Social Security Institute (Instituto Mexicano del Seguro Social – IMSS) introduced an initiative to provide training for and consolidate know-how among nursing staff caring for patients diagnosed with COVID-19.

The COVID-19 pandemic has posed an enormous challenge for health systems, particularly with regard to the expansion of healthcare capacity, with a focus on beds in intensive care units (ICUs) and the mechanical ventilators required to equip them.

To cope with this problem, the Mutual for Safety CChC and the TECCAP-TPI Engineering Consortium formed an alliance to develop emergency mechanical ventilators designed, manufactured and validated at the national level.

According to the World Health Organisation (WHO), the laryngoscope is an essential instrument within clinical practice for the intubation or insertion of endotracheal tubes, including in patients with COVID-19.

When the COVID-19 pandemic was declared by the World Health Organization (WHO), in El Salvador the Directorate General of the Salvadoran Social Security Institute (Instituto Salvadoreño del Seguro Social – ISSS) put forward a new form of care. This was authorized by the ISSS board in agreement No. 2020-0651 ABR. This made it possible to implement virtual care through telemedicine, known as Dr. ISSS en línea (Dr. ISSS online).

The Social Insurance Bank (Sociale Verzekeringsbank – SIB) of Curaçao is determined to collect healthcare treatment outcome data in a structured way. This will amongst others be achieved by embedding mandatory feedback reporting to the General Practitioner (GP) as part of the medical billing process. In tandem, referral providers can optionally appraise the quality of the referral notes from the GP’s. In doing so, the SIB will be able to interpret and analyze heterogeneous treatment outcome data on an unprecedented large scale.

Social security will remain subject to continuous change owing to the economic, political, social and demographic circumstances which not only impact its environment and development but also constitute management challenges.

By taking up this challenge, the current administration of the Social Insurance Fund (Caja de Seguro Social – CSS) of Panama, through its strategic planning and objectives, has created an opportunity to optimize the ongoing quality, efficiency and sustainability of health services.

To help meet the protection needs of chronic patients and older adults of the Social Insurance Fund of Costa Rica (Caja Costarricense de Seguro Social – CCSS) in the COVID-19 context and to avoid them having to travel to the health establishment to ensure their adherence to treatment, the following strategies were promoted:

As of 2022, the Salvadoran Social Security Institute (Instituto Salvadoreño del Seguro Social – ISSS) in El Salvador has 12 palliative care home support teams nationwide, four of which deal with the most complex cases. The teams are distributed across a variety of care networks.

Mexico’s State Employees’ Social Security and Social Services Institute (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado – ISSSTE) has a large proportion of beneficiaries over the age of 70 – nearly 3 million out of a total of 13.5 million. There is a need, therefore, for a specific strategy to provide care for them and offer them the best possible protection in combating the COVID-19 epidemic.

The epidemic caused by coronavirus (COVID-19) in other countries at the start of 2020 highlighted the need to prepare an institutional response to face this threat, aggravated by a lack of information and uncertainty surrounding the extent of the risk posed to beneficiaries.

With the aim of providing the medical staff of Mexico’s State Employees’ Social Security and Social Services Institute (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado – ISSSTE) with relevant information to help them tackle the SARS-CoV-2 (COVID-19) epidemic, a decision was made to draft operational prevention and care guides for patients infected with the virus and for other activities relating to care for beneficiaries in this context.

The project “Implementing the “Active Breaks” programme in the Human Talent Management Unit at the San Juan de Dios Hospital” of Costa Rica is being presented to the International Social Security Association (ISSA), as the results obtained have shown that the integral health of staff is key to their performance and fosters an ideal state of well-being, given that the correct balance was struck between physical, emotional, biological, work and social factors.

Chapter II of Law No.

Argentina’s Superintendency of Health Services (Superintendencia de Servicios de Salud – SSSalud) ensures that citizens can freely exercise their right to switch between social security organizations. This system has been in place since 1998.

The “Oxygen at Home” (Oxígeno en Casa) system of Mexico’s State Employees’ Social Security and Social Services Institute (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado – ISSSTE) is a technological tool that manages the prescription of home oxygen to eligible patients. It also provides monthly monitoring of how the service is being delivered in all medical units with a view to strengthening this health insurance service that protects, promotes and restores health, thereby improving patients’ quality of life.

The Mexican Social Security Institute (Instituto Mexicano del Seguro Social – IMSS) developed the online education platform “IMSS Massive Online Courses” (Cursos en Línea Masivos del IMSS - CLIMSS) to promote health education to its beneficiaries and the general public. The aim was to disseminate knowledge that would improve the health of the population.

Pressure sores are a major public health issue. They have personal consequences, as they diminish the quality of life of those subjected to healing, the administration of antibiotics, prolongation of hospital stays and socioeconomic repercussions in general.

The users of San Juan de Dios Hospital of the Social Insurance Fund of Costa Rica (Caja Costarricense de Seguro Social – CCSS) come from rural and urban areas, and include the indigenous population. The total population is 1,152,539 persons.

The telephone assistance programme established by the Mexican State Employees’ Social Security and Social Services Institute (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado – ISSSTE) provides prompt and timely care to its beneficiaries regarding the epidemic caused by the SARS-CoV-2 virus (COVID-19).

In the light of the experiences of countries in Asia and Europe, brought on by the COVID-19 pandemic, the need arose to establish strategies to address social security systems, aimed at maximising the available resource provisions, in the face of a demand that collapses health systems, thereby increasing the number of deaths.

The Medical Directorate of Mexico’s State Employees’ Social Security and Social Services Institute (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado – ISSSTE) has recently implemented a robotic therapist mental health programme. The programme is delivered with the help of “LaLuchy Robotina”, the humanoid robot, and provides care to hospitalized patients, their families and health-care staff.

The project Escuta (escuta means “to listen” in Portuguese) of the National Institute of Social Security (Instituto Nacional do Seguro Social – INSS) was conceived and developed by a team from the southern region of Brazil, the Health and Quality of Life at Work team, to meet the needs of employees who, in the context of COVID-19 pandemic, have to observe social distancing to perform their professional activities.

The pandemic, which began in 2019 with the spread of the infectious disease caused by the coronavirus (COVID-19) has proved a challenge for all the social security institutions in the world. The pandemic has required the establishment of social protection mechanisms for the whole population, particularly the most vulnerable groups – older adults, people with chronic diseases, etc.

Panama’s Social Insurance Fund (Caja de Seguro Social de Panamá – CSS) has put in place operational models that use and develop new technologies to offer high-quality care to members. This is part of its vision to be a leading guarantor of social security in Panama and to ensure efficient, agile and timely management, for the benefit of Panamanian people.

Argentina’s Mutual Association for the Protection of the Family (Asociación Mutual de Protección Familiar – AMPF) forms, through its 65 branch offices nationwide, a network of primary health-care (PHC) services (servicios de atención primaria de la salud – APS).

The service, which focuses on prevention, looks at patients within their family and social contexts, delivering care through interdisciplinary teams coordinated by family doctors, psychologists and social workers.

The Mexican Social Security Institute (Instituto Mexicano del Seguro Social – IMSS) has a systematic overview of materials and all kinds of supplies and services such as: medical equipment, diagnostic tools, surgical and curative material, sanitary products and all types of goods and supplies necessary to face the health emergency caused by COVID-19.

The Social Insurance Fund (Caja de Seguro Social – CSS) of Panama, with a set of actions contained in the Strategic Plan, is managing to integrate technological platforms with the modernization of IT systems. This also allows access to the new services offered via the website through the use of this new technology to broaden solutions to insured persons.

The most widely used processes for the technological tools are the following:

In March 2020, Peru declared a health emergency owing to the COVID-19 global pandemic and the Ministry of Health recommended suspending external consultations and diagnostic tests to avoid exposing the population to infection by the new coronavirus.

With the declaration of the novel coronavirus SARS-CoV-2 as a pandemic in March 2020, the Mexican Social Security Institute (Instituto Mexicano del Seguro Social – IMSS) set up two new digital services for its beneficiaries which are available 24/7:

On 16 March 2020, a state of emergency was declared in Peru due to COVID-19 which also impacted the services for patients with chronic diseases, including diabetic and hypertensive patients.

Health is a fundamental right in Colombia. However, there are certain segments of the population that because they live in geographically remote regions, have difficulties accessing health services in areas such as prevention, treatment and sourcing quality medicines. In general, the country’s health and medicine-dispensation services are located in the municipal capitals, which can be hard for rural dwellers to reach.

In response to the growth in the population of elderly beneficiaries of Mexico’s State Employees’ Social Security and Social Services Institute (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado ‒ ISSSTE), and given the high incidence in this population of chronic degenerative diseases and identified health phenomena, such as the abandonment of treatments and the identification of specific healthcare and treatment needs, a need arose to create the Gerontological Modules Programme, which aims to provide elderly people with integrated and appropriate healthca

Silicosis is an incurable lung disease caused by inhaling dust containing free crystalline silica. Silica is a chemical compound found in crystalline and amorphous (non-crystalline) forms.

The Occupational Exposure to Silica in Chile (Situación de Exposición Laboral a Sílice en Chile) report (Ministry of Health, 2015) estimated that 5.4 per cent of the workforce is at high risk of exposure to silica.

El Instituto Ecuatoriano de Seguridad Social viene arrastrando durante varios años una desmejorada percepción en los servicios que brinda a afiliados, pensionistas y jubilados.

The proper disposal of syringes and insulin needles is a matter that should be given thought in the field of public health. Among other reasons, it prevents the reuse of such materials, avoiding accidental pricks for family members and waste collection workers and helping to protect the environment.

Needles can cause injury. In addition, they carry bodily fluids.

Used needles can transmit infections and the human immunodeficiency virus (HIV), as well as Hepatitis B and C.

Sharps must be collected in waterproof, rigid and puncture-proof containers.

One of Mexico’s commitments to the Sustainable Development Goals (SDGs), in Target 3.3 and in line with the approach of accelerating action to end the AIDS epidemic by 2030, is to attain 95-95-95: that 95 per cent of those who live with HIV know their serological status; that 95 per cent of them receive treatment; and that 95 per cent have an undetectable viral load.

This programme, “Supervision and medical auditing”, is based on the principle of putting the beneficiary at the centre of our work. It is carried out by a new administrative unit set up to implement and strengthen supervision and guarantee the service quality levels offered by the State Employees’ Social Security and Social Services Institute (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado – ISSSTE) in Mexico.

The Business Intelligence and Data Analytics Unit (Unidad de Inteligencia y Análisis de Datos – UIAD) is a functional body created by the EsSalud - Social Health Insurance Institute (EsSalud - Seguro Social de Salud) of Peru to generate critical information to underpin the decisions taken by the institution’s senior management and departments.

The Greet, Listen, Respond (Saludar, Escuchar, Responder – SER IMSS) Programme was jointly implemented in 2016 by the Mexican Social Security Institute (Instituto Mexicano del Seguro Social – IMSS) and the Mexican National Union of Social Security Workers (Sindicato Nacional de Trabajadores del Seguro Social – SNTSS) to transform the culture of service, improve the working environment and enhance treatment in the user service provided to beneficiaries. In 2017 it obtained a Certificate of Merit from the International Social Security Association (ISSA).

With a view to improving risk management at the strategic and operational level, the Social Insurance Fund of Costa Rica (Caja Costarricense de Seguro Social – CCSS) has encouraged the evolution of its risk culture, from an approach based on simple regulatory compliance to a standardized framework that generates useful, effective information for decision-making.

Arterial hypertension has been identified as a major risk factor for cardiovascular disease.

Pharmacotherapeutic monitoring is the professional practice where the pharmacist is responsible for meeting the patient’s medicine-related needs.

The impact of the pharmacotherapeutic monitoring programme was measured via a sample comparison using Student’s t-test. Blood pressure values were compared as well as adherence to treatment for the patients in the study, before and after receiving the programme.

For the first time, the Social Insurance Fund of Costa Rica (Caja Costarricense de Seguro Social – CCSS) implemented a multicentre high-dimensional study, in association with the International Agency for Research on Cancer (IARC) of the World Health Organization (WHO), for the early detection of cervical cancer. A decision was taken to conduct the study in the region of the country with the highest mortality rate for this form of cancer, and it was launched with the challenge of implementing it without adding any human resources to the staff already present in each health area.

In an effort to contain the spread of COVID-19, the Mexican Social Security Institute (Instituto Mexicano del Seguro Social − IMSS) is using technology and online platforms to keep people informed about the condition of family members hospitalised with the disease.

To prevent family members from having to leave home, the IMSS has set up a phone line they can call to receive information on the health of their loved ones. Information can also be provided by email.

Chile’s Mutual for Safety CChC (Mutual de Seguridad CChC) has formed a multidisciplinary team to develop and implement a care model for its patients with sequelae. Tailored to the needs of chronically ill patients, the model allows appropriate monitoring of related risks with a view to preventing bio-psychosocial complications that can affect how such patients maintain their residual capacity in the long term.

The use of QR codes in patient education arose from the need for the pharmacy service to reach different groups of patients in an innovative way, in order to provide education on the proper use of medicines for better treatment adherence, as well as education about their diseases.

The World Health Organization (WHO) defines health education as learning opportunities created consciously that involve a form of communication intended to improve health literacy.

The use of QR codes in user education is broad and depends on the health professional who wants to use it.

The good clinical practice implemented at the Guillermo Almenara Irigoyen National Hospital (Hospital Nacional Guillermo Almenara Irigoyen – HNGAI), which is part of Peru’s EsSalud - Social Health Insurance Institute (EsSalud - Seguro Social de Salud), looked to improve the difficult experiences of patients with rheumatoid arthritis.

In all health systems, the incorrect identification of patients leads to errors in medication, procedures being carried out on the wrong person, and new-born babies being handed over to the wrong families. Between November 2003 and July 2005, the National Patient Safety Agency in the United Kingdom reported 236 incidents and near losses related to the loss of bracelets or bracelets with incorrect information.

Improving the quality of services is an ongoing task that involves multiple dimensions such as listening to and evaluating the participants, transparency, excellence and investment in training as the main focus.

Hospitalization is an experience that involves both physical and emotional risks for the patient and family as well as institutional costs. Lowering these is the challenge of this good practice.

June 2015: after taking up the post of Director of Foreign Travel at the Social Health Insurance Institute (Seguro Social de Salud – EsSalud), I had the following experience: a patient had come back from a foreign country after spending a month there and I decided to go with him to his first check-up in Peru. The attending doctor looked at me and asked “What do you want me to do with this patient? He has had a type of treatment that we don’t use in this country and I’m not familiar with it.

The Social Insurance Fund of Costa Rica (Caja Costarricense de Seguro Social ‒ CCSS) launched a free mobile application which gives access to the Single Digital Health Record (Expediente Digital Único en Salud ‒ EDUS). The purpose of this was to increase access to and coverage of health services in Costa Rica so that insured people are more aware of the information in their clinical profile and can access their information in a timely manner using a mobile device.

After implementing the differentiated care service for teenagers and young people at primary care level in 2015, the Catholic Workers’ Circle of the Uruguay Mutual Fund (Círculo Católico de Obreros del Uruguay Mutualista) considered it fundamental to strengthen the service to improve quality of life for people at this stage of their lives and, as a result, throughout their whole lives, reducing risks, chronic disease and costs to society. The approach was always to bear the rights of the young people in mind.

Medical committees issue decisions determining the percentage of disability caused by occupational accidents or diseases. Moreover they intervene in the cases of discrepancies over treatment or advice concerning return to work, and to determine the occupational nature of an accident. The management model used is entirely digital and provides a simple, effective and rapid tool for workers, reducing the time taken to process each step and offering the possibility of providing medical consultations when the application is made by the worker, thereby improving the service.

In the face of the problem posed by the financial deficit of the Sickness and Maternity Insurance in terms of its coverage for affiliates and pensioners, we had to look for methodologies to assess the future trends of revenues and expenses.

To estimate the coverage expense for Medical Expenses for Pensioners (gastos médicos de pensionados (GMP)), in 2013 we developed an actuarial model with which we could estimate the sufficient leveled premium to settle the future expenses based on the results obtained.

The international community discusses the impact of noncommunicable diseases (NCD) such as heart disease, diabetes, obesity, tobacco-related diseases and cancer, among others. NCDs account for 60% of morbidity and mortality rates worldwide. In Argentina, this percentage is even higher, reaching 80%, according to the study published by the World Health Organization (WHO) in 2014: Noncommunicable Diseases (NCD) Country Profiles 2014.

This programme, “Promotion of active aging among the beneficiaries of the State Employees’ Social Security and Social Services Institute” (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado – ISSSTE) in Mexico, encourages the adoption of habits and good practices allowing elderly adults to have a healthy life, based on promoting active aging. With this aim, courses, workshops and awareness-raising sessions are given and recreational activities held for elderly beneficiaries, depending on their needs.

Mexico has the highest mortality due to acute myocardial infarction (AMI) in people over 45 – 27.2 per cent compared to an average of 7.5 per cent (OECD, 2013). For the Mexican Social Security Institute (Instituto Mexicano del Seguro Social – IMSS), cardiovascular diseases have been the main cause of years of healthy life lost due to premature death and disability since 2015. They are also the main cause of emergency department visits and the most common reason for consultations.

This programme improves patient care in the accident and emergency departments of second- and third-level hospitals in the country. It involves identifying dissatisfaction among many beneficiaries, patients and family members with the care they receive in this environment as a result of excess demand in these areas and an inadequate response to the beneficiary’s situation in the accident and emergency unit, regardless of whether the emergency is real or only perceived.

This good practice was introduced in 2014, based on the search for administrative solutions among health providers in Uruguay that guarantee care and coverage for specific vulnerable populations. We identified that these target groups would likely struggle to reach and access care, given that they lived far from the capital, primarily in suburban and rural areas. Moreover, beneficiaries were generally covered by the universal health-care system but worked in the informal sector.

Following an analysis of the occupational accident statistics for 2012 from the health institution of the Catholic Workers’ Circle of the Uruguay Mutual Fund (Círculo Católico de Obreros del Uruguay Mutualista), a target was set to reduce the frequency and severity of occupational accidents by at least 15 per cent. To this end, we introduced measures through the Occupational Health and Safety Commission (Comisión de Salud y Seguridad Laboral), which is made up of representatives from both trade unions and institutions.

Implementing the Single Digital Health Record (Expediente Digital Único en Salud – EDUS) has been perhaps the most radical transformation process that the Social Insurance Fund of Costa Rica (Caja Costarricense de Seguro Social – CCSS) has undergone in its years of existence.

This process has involved not only incorporating technologies but also modifying processes, as well as the impact on the persons who in one way or another have been immersed in this change process.

Preventing professional risks requires teamwork and network efforts. Our experience as a Mutual Fund that employs 2,233 officials and provides care services of every sort to approximately 83,000 associates indicates that it is essential to work on the continuous improvement of the promotion, prevention, and health care in the workplace.

For this purpose, line managers have formed multidisciplinary work teams responsible for designing the roadmap for the process, developing and updating procedures that standardise the criteria for the services we provide, and streamlining the procedures in the insurance agencies.

Main Screens:

There are challenges to overcome such as collusion; which could be overcome by considering allocating a key role to consolidated public inter-governmental purchases, in strict compliance with the legal framework to impose sanctions on providers for breach of contract.

The ISSSTE seeks to be involved in the consolidated purchases that the IMSS makes, as part of a strategy and procurement policy for the health sector that should be encouraged to achieve the best contracting conditions for healthcare supplies, such as medication and medical supplies.

These are physical spaces located in the workplace prepared and equipped to provide privacy, hygiene, and comfort to the employee during the breastfeeding stage. There, she can breastfeed the baby and/or express breast milk, to store it and extend its use. Several evidence-based scientific studies show the benefits of breastfeeding in the short, mid and long-term regarding the improvement of the population's health.

Good Practice: Tools for the Innovation of Health Promotion in the Workplace: Programme “Por un Buen Trabajo” (For a Healthy Job).

This programme, developed by the Department of Preventive Health of the Chilean Safety Association (Asociación Chilena de Seguridad (ACHS)), is intended as a specific methodological tool to develop management skills in the area of health promotion in the workplace. Its general objective is to develop effective strategies in health promotion with a long-term perspective.

Scientific research is an activity that requires a high level of expertise. For the Mexican Social Security Institute (Instituto Mexicano del Seguro Social – IMSS), research must have a bearing on medical care capacity and on the generation of new knowledge. Regular evaluation of the CVs of staff who carry out research makes it possible to identify their progress and to guarantee that research is carried out to high quality standards.

The state institute of the ISSSTE in Campeche offers equine therapy as a complementary therapy to traditional techniques in the rehabilitation of a large number of chronic and subacute diseases, including physical disabilities such as cerebral palsy, spinal cord injuries, stroke, multiple sclerosis, as well as psychiatric or psychological disorders such as autism, emotional and cognitive problems, to name but a few.

In amputation cases, besides losing the capacity of performing an activity normally exercised, there is the actual loss of a limb or body part. The use of a prosthesis or orthosis is crucial for the recovery of the work capacity.

The purpose of LOGHOS is to render the inventory administrative procedures for supplies and medication more efficient in order to provide a better service. It seeks to guarantee a maximum percentage of supplies available for the treatment of patients at the national level and thus to improve the quality of care and the satisfaction of our insured members.

The Programme for Paediatric Cardio-vascular Surgery, which includes a Programme for Interventional Catheterization Program and the Treatment of Arrhythmias was established as a response to this problem.

Implementation of this initiative was based on collaboration between Cooperative teams from the United States and the Consortium known as the World Pediatric Project, which has its headquarters in Richmond Virginia.

Associated Universities and Hospitals:

This system, which was coordinated with the National Disability Secretariat (SENADIS), consists of a web form which can be accessed via our web site www.css.gob.pa, which in turn has a direct link with our medical appointments service; the latter was specially set up to respond to this type of request, its objective being to implement good practices which will enable timely treatment for this important group within the Panamanian population.