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
Autor para correspondencia
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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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 7 | 6 | 13 |
| 2024 Octubre | 68 | 52 | 120 |
| 2024 Septiembre | 56 | 27 | 83 |
| 2024 Agosto | 85 | 52 | 137 |
| 2024 Julio | 79 | 47 | 126 |
| 2024 Junio | 64 | 51 | 115 |
| 2024 Mayo | 46 | 46 | 92 |
| 2024 Abril | 52 | 27 | 79 |
| 2024 Marzo | 58 | 41 | 99 |
| 2024 Febrero | 49 | 39 | 88 |
| 2024 Enero | 45 | 47 | 92 |
| 2023 Diciembre | 41 | 48 | 89 |
| 2023 Noviembre | 46 | 44 | 90 |
| 2023 Octubre | 48 | 34 | 82 |
| 2023 Septiembre | 46 | 40 | 86 |
| 2023 Agosto | 26 | 19 | 45 |
| 2023 Julio | 37 | 510 | 547 |
| 2023 Junio | 43 | 43 | 86 |
| 2023 Mayo | 35 | 49 | 84 |
| 2023 Abril | 38 | 27 | 65 |
| 2023 Marzo | 29 | 24 | 53 |
| 2023 Febrero | 20 | 17 | 37 |
| 2023 Enero | 38 | 41 | 79 |
| 2022 Diciembre | 33 | 35 | 68 |
| 2022 Noviembre | 19 | 41 | 60 |
| 2022 Octubre | 21 | 24 | 45 |
| 2022 Septiembre | 14 | 40 | 54 |
| 2022 Agosto | 16 | 34 | 50 |
| 2022 Julio | 16 | 35 | 51 |
| 2022 Junio | 16 | 25 | 41 |
| 2022 Mayo | 27 | 61 | 88 |
| 2022 Abril | 35 | 36 | 71 |
| 2022 Marzo | 35 | 55 | 90 |
| 2022 Febrero | 24 | 58 | 82 |
| 2022 Enero | 19 | 55 | 74 |
| 2021 Diciembre | 26 | 37 | 63 |
| 2021 Noviembre | 20 | 48 | 68 |
| 2021 Octubre | 25 | 103 | 128 |
| 2021 Septiembre | 34 | 56 | 90 |
| 2021 Agosto | 20 | 66 | 86 |
| 2021 Julio | 34 | 42 | 76 |
| 2021 Junio | 29 | 49 | 78 |
| 2021 Mayo | 26 | 21 | 47 |
| 2021 Abril | 54 | 95 | 149 |
| 2021 Marzo | 35 | 27 | 62 |
| 2021 Febrero | 34 | 29 | 63 |
| 2021 Enero | 15 | 27 | 42 |
| 2020 Diciembre | 28 | 17 | 45 |
| 2020 Noviembre | 25 | 14 | 39 |
| 2020 Octubre | 22 | 13 | 35 |
| 2020 Septiembre | 25 | 19 | 44 |
| 2020 Agosto | 33 | 26 | 59 |
| 2020 Julio | 12 | 13 | 25 |
| 2020 Junio | 30 | 18 | 48 |
| 2020 Mayo | 33 | 22 | 55 |
| 2020 Abril | 23 | 16 | 39 |
| 2020 Marzo | 22 | 24 | 46 |
| 2020 Febrero | 3 | 3 | 6 |
| 2020 Enero | 0 | 10 | 10 |
| 2019 Diciembre | 0 | 10 | 10 |
| 2019 Noviembre | 0 | 5 | 5 |
| 2019 Septiembre | 0 | 6 | 6 |
| 2019 Agosto | 0 | 7 | 7 |
| 2019 Julio | 0 | 13 | 13 |
| 2019 Junio | 0 | 5 | 5 |
| 2019 Mayo | 0 | 50 | 50 |
| 2019 Abril | 0 | 15 | 15 |
| 2019 Marzo | 0 | 6 | 6 |
| 2019 Febrero | 0 | 5 | 5 |
| 2019 Enero | 0 | 4 | 4 |
| 2018 Junio | 0 | 5 | 5 |
| 2018 Mayo | 0 | 7 | 7 |
| 2018 Abril | 0 | 2 | 2 |
| 2018 Marzo | 1 | 1 | 2 |
| 2018 Febrero | 24 | 1 | 25 |
| 2018 Enero | 17 | 5 | 22 |
| 2017 Diciembre | 30 | 9 | 39 |
| 2017 Noviembre | 14 | 2 | 16 |
| 2017 Octubre | 18 | 9 | 27 |
| 2017 Septiembre | 24 | 5 | 29 |
| 2017 Agosto | 38 | 9 | 47 |
| 2017 Julio | 28 | 4 | 32 |
| 2017 Junio | 19 | 10 | 29 |
| 2017 Mayo | 14 | 9 | 23 |
| 2017 Abril | 17 | 11 | 28 |
| 2017 Marzo | 16 | 13 | 29 |
| 2017 Febrero | 21 | 12 | 33 |
| 2017 Enero | 18 | 5 | 23 |
| 2016 Diciembre | 48 | 12 | 60 |
| 2016 Noviembre | 29 | 9 | 38 |
| 2016 Octubre | 26 | 16 | 42 |
| 2016 Septiembre | 33 | 3 | 36 |
| 2016 Agosto | 23 | 5 | 28 |
| 2016 Julio | 21 | 0 | 21 |
| 2016 Junio | 7 | 6 | 13 |
| 2016 Mayo | 11 | 6 | 17 |
| 2016 Abril | 8 | 0 | 8 |
| 2016 Marzo | 2 | 0 | 2 |
| 2016 Febrero | 6 | 1 | 7 |
| 2016 Enero | 5 | 0 | 5 |
| 2015 Diciembre | 13 | 0 | 13 |
| 2015 Noviembre | 5 | 2 | 7 |
| 2015 Octubre | 7 | 1 | 8 |
| 2015 Septiembre | 11 | 8 | 19 |
| 2015 Agosto | 13 | 3 | 16 |
| 2015 Julio | 24 | 14 | 38 |
| 2015 Junio | 31 | 4 | 35 |
| 2015 Mayo | 75 | 18 | 93 |
| 2015 Abril | 59 | 4 | 63 |
| 2015 Marzo | 50 | 12 | 62 |
| 2015 Febrero | 38 | 6 | 44 |
| 2015 Enero | 30 | 6 | 36 |
| 2014 Diciembre | 38 | 6 | 44 |
| 2014 Noviembre | 22 | 8 | 30 |
| 2014 Octubre | 35 | 6 | 41 |
| 2014 Septiembre | 34 | 9 | 43 |
| 2014 Agosto | 32 | 15 | 47 |
| 2014 Julio | 39 | 20 | 59 |
| 2014 Junio | 53 | 8 | 61 |
| 2014 Mayo | 61 | 12 | 73 |
| 2014 Abril | 58 | 14 | 72 |
| 2014 Marzo | 56 | 19 | 75 |
| 2014 Febrero | 36 | 21 | 57 |
| 2014 Enero | 37 | 26 | 63 |
| 2013 Diciembre | 45 | 19 | 64 |
| 2013 Noviembre | 35 | 30 | 65 |
| 2013 Octubre | 38 | 31 | 69 |
| 2013 Septiembre | 42 | 52 | 94 |
| 2013 Agosto | 31 | 91 | 122 |
| 2013 Julio | 39 | 78 | 117 |
| 2013 Junio | 43 | 66 | 109 |
| 2013 Mayo | 47 | 76 | 123 |
| 2013 Abril | 40 | 68 | 108 |
| 2013 Marzo | 37 | 22 | 59 |
| 2013 Febrero | 30 | 9 | 39 |
| 2013 Enero | 8 | 3 | 11 |
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