Dos años de historia clínica electrónica. Experiencia en un hospital comarcal / Two years experience of computerised medical records in a regional hospital

La implantación de dicho programa fue precedida de un curso acelerado de formación a todos los trabajadores del centro. En el momento de su inicio se decidió que la aplicación informática entraría en funcionamiento en todo el ámbito hospitalario relegando el papel de la historia escrita a mano. Se vivieron días de dificultades durante su desarrollo pero de forma progresiva la historia clínica electrónica ha sido bien aceptada por la mayor parte de los trabajadores del centro. Tras le etapa inicial de acostumbramiento se comenzaron a ver los problemas de diseño de la aplicación así como sus posibles soluciones. En el día de hoy el uso del programa SELENE permite una asistencia sanitaria fluida dentro del hospital aunque existen problemas que precisan de una solución que pasa por una financiación adecuada. La implantación de la historia clínica electrónica en los hospitales públicos es sin duda uno de los grandes cambios experimentados en la asistencia a los pacientes en estos últimos años. Se trata de un proceso progresivo y no exento de dificultades pero que sin duda marcará un hito en la forma de manejar la información en la sanidad. Siguiendo esta estela en noviembre de 2008 se adquirió en el centro donde desarrollamos nuestra actividad quirúrgica el programa informático SELENE perteneciente a la empresa multinacional Siemens (AU)

The introduction of computerised medical records in public hospitals is, without a doubt, one of the biggest changes made in patient health care in the last few years. It is a gradual process and is not exempt from difficulties, but it will surely set a challenge in the way information is handled in health care. Taking this path, in November 2008, the computer program SELENE, from the multinational company Siemens, was purchased in the centre were we carry out our surgical activities. The introduction of this program was preceded by an intensive training course for all the workers in the hospital. At the start, it was decided that the computer application would come into operation throughout the entire hospital, replacing the handwritten records. There were difficult days during its gradual introduction, but the computerised medical record has been well accepted by the great majority of the workers at the centre. After the initial stage of becoming accustomed, design problems started to be seen in the application, as well as their possible solutions. Currently, the use of the SELENE program has led to fluid health care within the hospital, although there are problems which can be resolved with adequate funding (AU)

[Two years experience of computerised medical records in a regional hospital]. / Dos años de historia clínica electrónica. Experiencia en un hospital comarcal.

The introduction of computerised medical records in public hospitals is, without a doubt, one of the biggest changes made in patient health care in the last few years. It is a gradual process and is not exempt from difficulties, but it will surely set a challenge in the way information is handled in health care. Taking this path, in November 2008, the computer program SELENE, from the multinational company Siemens, was purchased in the centre were we carry out our surgical activities. The introduction of this program was preceded by an intensive training course for all the workers in the hospital. At the start, it was decided that the computer application would come into operation throughout the entire hospital, replacing the handwritten records. There were difficult days during its gradual introduction, but the computerised medical record has been well accepted by the great majority of the workers at the centre. After the initial stage of becoming accustomed, design problems started to be seen in the application, as well as their possible solutions. Currently, the use of the SELENE program has led to fluid health care within the hospital, although there are problems which can be resolved with adequate funding.

[Surgical training with simulators in training centers]. / Formación quirúrgica con simuladores en centros de entrenamiento.

The development of new endoscopic procedures and minimally-invasive surgical interventions has led the methodology used to date to be questioned. Greater demand for safety by patients, the growth of the health budget and the reduced time available for training have led to the proliferation of centers with accredited personnel in which the knowledge and surgical skills necessary for the controlled incorporation of these techniques can be acquired. Simulators are available for the learning of both digestive endoscopy and laparoscopic techniques. These simulators are more or less dynamic, virtual, with viscera or mixed; even live animals can be used. Thus, the various techniques can be incorporated into clinical practice safely and effectively and at a reasonable cost. Simulators also allow evaluation and follow-up of the skills acquired.

Formación quirúrgica con simuladores en centros de entrenamiento / Surgical training with simulators in training centers

El desarrollo de nuevos procedimientos endoscópicos e intervenciones quirúrgicas mínimamente invasivas cuestiona los medios y la metodología utilizada hasta el momento. Las mayores exigencias de seguridad por parte del paciente, el crecimiento del gasto sanitario y la reducción del tiempo disponible para la formación justifican la proliferación de centros con personal acreditado en los que se puedan adquirir los conocimientos y las habilidades quirúrgicas necesarias para la incorporación controlada de estas técnicas. Tanto para el aprendizaje de la endoscopia digestiva como para las técnicas con abordaje laparoscópico hay disponibles en el mercado modelos de simuladores más o menos dinámicos, virtuales, con vísceras, mixtos e incluso se puede recurrir a animales vivos. Así se consigue incorporar a la actividad clínica las diferentes técnicas con eficacia, seguridad y coste razonable, además de permitir una evaluación y un seguimiento de las capacidades adquiridas (AU)

The development of new endoscopic procedures and minimally-invasive surgical interventions has led the methodology used to date to be questioned. Greater demand for safety by patients, the growth of the health budget and the reduced time available for training have led to the proliferation of centers with accredited personnel in which the knowledge and surgical skills necessary for the controlled incorporation of these techniques can be acquired. Simulators are available for the learning of both digestive endoscopy and laparoscopic techniques. These simulators are more or less dynamic, virtual, with viscera or mixed; even live animals can be used. Thus, the various techniques can be incorporated into clinical practice safely and effectively and at a reasonable cost. Simulators also allow evaluation and follow-up of the skills acquired (AU)