The main objective of epidemiological surveillance systems is to detect epidemics early, collecting and analyzing information that allows political decision-makers and health professionals to design the corresponding control and monitoring strategies.
The current epidemiological situation worldwide represents a great challenge for the health systems of the main countries, not only in terms of the enormous health structure deployed, but also highlights the need for timely and quality information to make better decisions. Currently, this information is partial, fragmented, and with delays, which generates dilations in its consolidation and analysis, often not being timely to identify or monitor epidemics in time.
Epidemiological Surveillance 4.0 is a platform that gathers all this information in one place, organizing it and allowing it to be consulted in real time. Doctors report cases in the app, biochemists upload test results, epidemiologists, and senior managers interact on the platform to manage this information. It also makes it possible to record the traceability of the close contacts of each case and for health personnel to follow up on positive cases at home through teleconsultation. It also incorporates as a distinctive fact the participation of the citizen, who can report compatible symptoms through the app, upload their close contacts and receive the results of their tests. The possibility of registering the vaccination status for COVID19 of the person and thus monitoring the vaccination coverage of the population is also added.
It has a dashboard with the main statistics and maps with cases for panoramic analysis.
To date, 67,940 citizens (15% of San Luis inhabitants) downloaded the app and 16% used it to report symptoms to the Health System. Of these, 57% were classified as suspect for COVID and the corresponding follow-up began.
The platform has managed 91,211 case reports, of which 15,965 were positive per laboratory for COVID and more than 20,000 close contacts were identified and followed up.

https://agentessanitarios.sanluis.gob.ar/

• San Luis province, Argentina

• Youth
• Older persons
• Women
• Indigenous and nomadic peoples
• People with disabilities
• The unemployed
• The poor
• Migrants
• Refugees and internally displaced people
• Remote and rural communities
• Adolescent
• Adult
• Children between 5 and 12
• Children under 5
• Elderly
• New born
• Pregnant women
• all citizens of the Province of San Luis

In this first stage, VE 4.0 allows the registration and monitoring of three events that, due to the current epidemiological situation, represent a risk to the health of the population in Argentina, because they are events with epidemic behavior: COVID 19, Dengue and Measles. The system is scalable and in the future it could monitor more than 80 mandatory notification pathologies that by law 15,465 of the Argentine Republic must be notified to the health system.
VE 4.0 can be used by any institution of both public and private health and can be replicated by any state that needs to strengthen its surveillance system. The system meets the notification standards for diseases under epidemiological surveillance at both the local and national levels and meets the requirements of the International Health Regulations. In addition, due to its characteristics, it is interoperable with other health notification and surveillance systems such as; laboratory management systems, digital medical records, vaccine reporting systems, etc., it also links to the Argentine Health Information System (SISA).
Regarding the number of users, it is also replicable since in the particular case of patients with COVID-19, the number of users in the system will vary as the magnitude of the epidemic increases.

The sustainability of a system is fundamentally given by factors external to it, mainly by the political decision focused on the need to have intelligent information systems, commonly called health intelligence systems. The emergency of Covid-19 accelerated the digitization processes that were partially and incipiently implemented in health systems. Telemedicine, applications, digital prescription and artificial intelligence, gained strength and found fertile ground for expansion. In San Luis technological development and digital inclusion have been central policies for decades. Connectivity, devices, and training support innovative developments that enable their expansion in different fields. Our fiber optic network provides high-speed connectivity in all hospitals, carries out a process of implementation of digital Clinical Records that allows breaking with the traditional organizational culture of the use of the role and administrative bureaucracy. In the case of epidemiological surveillance, the lack of feedback from the system is due to the under-notification of the events by doctors and their respective laboratory result, which must be notified in a timely manner to confirm or rule out cases and quickly define control measures. Epidemiological Surveillance 4.0 largely solves this problem, providing the doctor with a tool to report a case directly from his phone or device in an agile and simple way, being able to follow the entire track of the patient through the laboratory result, the traceability of your close contacts, their hospitalization, discharge or death. It incorporates the citizen into the system through a symptom notification app, optimizes the loading of laboratory results and their subsequent return to the doctor and the patient through the system, allows the monitoring of close contacts, provides information related to the occupation of beds intensive therapy, facilitates mortality analysis and provides decision makers with real-time information on the development of the epidemic.

VE 4.0 allows the creation, consultation, use and sharing of information and knowledge among health professionals, decision-makers and citizens. All the inhabitants of the Province have the opportunity to participate in the surveillance of COVID 19 by reporting key information to the system such as; the presence of symptoms, their close contacts, and receive the results of their tests directly on their mobile devices as well as official statistics and alerts. It empowers the citizen, actively participating in surveillance and control actions, generating citizenship and social responsibility for the health care of the entire population, it also provides one more tool to communicate with the health system. VE 4.0 can reduce many traditional obstacles especially time and distance. Through its tele-triage profile (online questionnaire to alert about compatible symptoms of COVID 19) and its teleconsultation module for monitoring cases at home, it offers citizens, especially from rural or distant areas, one more channel of access to care medical care without the need for unnecessary transfers, reducing risks, costs and disorders such as uprooting for him and his family. VE 4.0 offers young students of medicine and biochemistry the possibility of taking full advantage of the possibilities offered by ICTs in the field of health, since, as a result of the current situation, this human resource has been added to health teams to collaborate with monitoring and testing tasks. This government-university articulation is essential to enhance development and growth processes for the benefit of the entire society. VE 4.0 incorporates the private sector in epidemiological surveillance, resulting in this fundamental synergy to reduce the fragmentation of notification systems. The platform complies with all information security requirements and is designed to interoperate with other health surveillance systems at the national level. This feature allows cooperation between different components at both the local and central levels.