Novelties in dermatology
Electronic Medical History: Experience in a Dermatology Department
Historia Clínica en Soporte Electrónico: Experiencia de un Servicio de Dermatología
J.L. López-Estebaranza,
, V. Castilla-Castellanob
Corresponding author
jllopez@fhalcorcon.es
Correspondence: Servicio de Dermatología. Fundación Hospital Alcorcón, C/ Budapest, 1, 28922 Alcorcón, Madrid, Spain.
Correspondence: Servicio de Dermatología. Fundación Hospital Alcorcón, C/ Budapest, 1, 28922 Alcorcón, Madrid, Spain.
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"apellidos" => "López-Estebaranz" "email" => array:1 [ 0 => "jllopez@fhalcorcon.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "V." "apellidos" => "Castilla-Castellano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Fundación Hospital Alcorcón, Alcorcón, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna, Fundación Hospital Alcorcón, Alcorcón, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondence: Servicio de Dermatología. Fundación Hospital Alcorcón, C/ Budapest, 1, 28922 Alcorcón, Madrid, Spain." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Historia Clínica en Soporte Electrónico: Experiencia de un Servicio de Dermatología" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaAceptado" => "2008-09-16" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec84473" "palabras" => array:2 [ 0 => "electronic health records" 1 => "information technology in medicine" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec84474" "palabras" => array:2 [ 0 => "historia clínica electrónica" 1 => "tecnología de la información en medicina" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Computerization, with a change from paper to electronic format, represents an alternative to traditional information management. This model offers advantages in legibility, uniformity, accessibility, and use of the data. However, it is not easy to apply this process to clinical practice as it requires a suitable network, continuous application development, an implementation strategy, and the cooperation of all staff involved. We have reviewed our experience in the development and introduction of electronic health records and their adaptation to a pioneer dermatology department in Spain. Since our hospital was opened 1998, the model used is that of a single, centralized electronic health record, with supplementary departmental attributes. The electronic health record is conceived as an interactive database designed around the patient, with a procedure-based structure, and that obviates the need for hardcopies (paper or films) in practically all situations; it must comply with legal requirements. The system is installed on central servers maintained by the information technology department. The potential is unlimited; particularly important possibilities include clinical guideline-directed care, remote connection for general practitioners, and online activity, stock, and quality management. With the aim of realizing this potential, a technological change was started in 2003, moving towards what was to become the chosen system in the Community of Madrid to cope with the workload arising from new hospitals.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">La informatización consiste básicamente en una alternativa a la gestión clásica de la información, pasando del soporte en papel al electrónico. Este modelo aporta ventajas en la legibilidad, uniformidad, accesibilidad y explotación de los datos. Sin embargo, no es sencillo aplicar este proceso a la práctica clínica, pues requiere un adecuado soporte de equipos en red, el desarrollo continuo de las aplicaciones, una estrategia de implantación y la colaboración de todo el personal implicado. Revisamos nuestra experiencia en el desarrollo e implantación de una historia clínica (HC) en formato electrónico y su adaptación a un Servicio de Dermatología pionero en España. El modelo elegido en nuestro hospital desde su apertura en 1998 fue el de historia única centralizada electrónica de uso común (HCE) que se complementa con aplicaciones departamentales. La HCE se concibe como una base de datos relacional, centrada en el paciente y estructurada por procesos, que cumple los requisitos legales y permite prescindir del soporte físico (papel o placa) en la práctica totalidad de las situaciones. El sistema funciona en los servidores centrales bajo el mantenimiento del departamento de sistemas de información. Las potencialidades son ilimitadas, destacando: asistencia por guías de actuación clínica, conexión remota con Atención Primaria, gestión on-line de actividad, consumos y estándares de calidad. Buscando alcanzar estas potencialidades en 2003 se inició un cambio tecnológico hacia lo que después sería el sistema elegido en la Comunidad de Madrid para soportar el trabajo de los nuevos hospitales.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:24 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La informatización del trabajo clínico asistencial: análisis crítico desde la experiencia de un centro hospitalario de nueva creación" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "V. Castilla" 1 => "F. Ojeda" 2 => "A. Checa" 3 => "R. González" 4 => "A. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 0 | 2 |
| 2024 October | 68 | 52 | 120 |
| 2024 September | 56 | 27 | 83 |
| 2024 August | 85 | 52 | 137 |
| 2024 July | 79 | 47 | 126 |
| 2024 June | 64 | 51 | 115 |
| 2024 May | 46 | 46 | 92 |
| 2024 April | 52 | 27 | 79 |
| 2024 March | 58 | 41 | 99 |
| 2024 February | 49 | 39 | 88 |
| 2024 January | 45 | 47 | 92 |
| 2023 December | 41 | 48 | 89 |
| 2023 November | 46 | 44 | 90 |
| 2023 October | 48 | 34 | 82 |
| 2023 September | 46 | 40 | 86 |
| 2023 August | 26 | 19 | 45 |
| 2023 July | 37 | 510 | 547 |
| 2023 June | 43 | 43 | 86 |
| 2023 May | 35 | 49 | 84 |
| 2023 April | 38 | 27 | 65 |
| 2023 March | 29 | 24 | 53 |
| 2023 February | 20 | 17 | 37 |
| 2023 January | 38 | 41 | 79 |
| 2022 December | 33 | 35 | 68 |
| 2022 November | 19 | 41 | 60 |
| 2022 October | 21 | 24 | 45 |
| 2022 September | 14 | 40 | 54 |
| 2022 August | 16 | 34 | 50 |
| 2022 July | 16 | 35 | 51 |
| 2022 June | 16 | 25 | 41 |
| 2022 May | 27 | 61 | 88 |
| 2022 April | 35 | 36 | 71 |
| 2022 March | 35 | 55 | 90 |
| 2022 February | 24 | 58 | 82 |
| 2022 January | 19 | 55 | 74 |
| 2021 December | 26 | 37 | 63 |
| 2021 November | 20 | 48 | 68 |
| 2021 October | 25 | 103 | 128 |
| 2021 September | 34 | 56 | 90 |
| 2021 August | 20 | 66 | 86 |
| 2021 July | 34 | 42 | 76 |
| 2021 June | 29 | 49 | 78 |
| 2021 May | 26 | 21 | 47 |
| 2021 April | 54 | 95 | 149 |
| 2021 March | 35 | 27 | 62 |
| 2021 February | 34 | 29 | 63 |
| 2021 January | 15 | 27 | 42 |
| 2020 December | 28 | 17 | 45 |
| 2020 November | 25 | 14 | 39 |
| 2020 October | 22 | 13 | 35 |
| 2020 September | 25 | 19 | 44 |
| 2020 August | 33 | 26 | 59 |
| 2020 July | 12 | 13 | 25 |
| 2020 June | 30 | 18 | 48 |
| 2020 May | 33 | 22 | 55 |
| 2020 April | 23 | 16 | 39 |
| 2020 March | 22 | 24 | 46 |
| 2020 February | 3 | 3 | 6 |
| 2020 January | 0 | 10 | 10 |
| 2019 December | 0 | 10 | 10 |
| 2019 November | 0 | 5 | 5 |
| 2019 September | 0 | 6 | 6 |
| 2019 August | 0 | 7 | 7 |
| 2019 July | 0 | 13 | 13 |
| 2019 June | 0 | 5 | 5 |
| 2019 May | 0 | 50 | 50 |
| 2019 April | 0 | 15 | 15 |
| 2019 March | 0 | 6 | 6 |
| 2019 February | 0 | 5 | 5 |
| 2019 January | 0 | 4 | 4 |
| 2018 June | 0 | 5 | 5 |
| 2018 May | 0 | 7 | 7 |
| 2018 April | 0 | 2 | 2 |
| 2018 March | 1 | 1 | 2 |
| 2018 February | 24 | 1 | 25 |
| 2018 January | 17 | 5 | 22 |
| 2017 December | 30 | 9 | 39 |
| 2017 November | 14 | 2 | 16 |
| 2017 October | 18 | 9 | 27 |
| 2017 September | 24 | 5 | 29 |
| 2017 August | 38 | 9 | 47 |
| 2017 July | 28 | 4 | 32 |
| 2017 June | 19 | 10 | 29 |
| 2017 May | 14 | 9 | 23 |
| 2017 April | 17 | 11 | 28 |
| 2017 March | 16 | 13 | 29 |
| 2017 February | 21 | 12 | 33 |
| 2017 January | 18 | 5 | 23 |
| 2016 December | 48 | 12 | 60 |
| 2016 November | 29 | 9 | 38 |
| 2016 October | 26 | 16 | 42 |
| 2016 September | 33 | 3 | 36 |
| 2016 August | 23 | 5 | 28 |
| 2016 July | 21 | 0 | 21 |
| 2016 June | 7 | 6 | 13 |
| 2016 May | 11 | 6 | 17 |
| 2016 April | 8 | 0 | 8 |
| 2016 March | 2 | 0 | 2 |
| 2016 February | 6 | 1 | 7 |
| 2016 January | 5 | 0 | 5 |
| 2015 December | 13 | 0 | 13 |
| 2015 November | 5 | 2 | 7 |
| 2015 October | 7 | 1 | 8 |
| 2015 September | 11 | 8 | 19 |
| 2015 August | 13 | 3 | 16 |
| 2015 July | 24 | 14 | 38 |
| 2015 June | 31 | 4 | 35 |
| 2015 May | 75 | 18 | 93 |
| 2015 April | 59 | 4 | 63 |
| 2015 March | 50 | 12 | 62 |
| 2015 February | 38 | 6 | 44 |
| 2015 January | 30 | 6 | 36 |
| 2014 December | 38 | 6 | 44 |
| 2014 November | 22 | 8 | 30 |
| 2014 October | 35 | 6 | 41 |
| 2014 September | 34 | 9 | 43 |
| 2014 August | 32 | 15 | 47 |
| 2014 July | 39 | 20 | 59 |
| 2014 June | 53 | 8 | 61 |
| 2014 May | 61 | 12 | 73 |
| 2014 April | 58 | 14 | 72 |
| 2014 March | 56 | 19 | 75 |
| 2014 February | 36 | 21 | 57 |
| 2014 January | 37 | 26 | 63 |
| 2013 December | 45 | 19 | 64 |
| 2013 November | 35 | 30 | 65 |
| 2013 October | 38 | 31 | 69 |
| 2013 September | 42 | 52 | 94 |
| 2013 August | 31 | 91 | 122 |
| 2013 July | 39 | 78 | 117 |
| 2013 June | 43 | 66 | 109 |
| 2013 May | 47 | 76 | 123 |
| 2013 April | 40 | 68 | 108 |
| 2013 March | 37 | 22 | 59 |
| 2013 February | 30 | 9 | 39 |
| 2013 January | 8 | 3 | 11 |
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