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Sistemas de información de medicamentos

by System Administrator - Friday, 5 September 2014, 10:30 PM
 

Panorama de los sistemas de información de medicamentos: ¿qué se necesita?

Paul Bonnet, director general de Vidal Vademecum Internacional, aporta una reflexión sobre los errores en la administración de medicamentos y repasa cuáles son las herramientas disponibles para consultar información farmacológica.

Cada año se producen errores en la prescripción de medicamentos con consecuencias fatales para la salud, que además suponen unos elevadísimos costes para los organismos sanitarios.

Uno de estos fallos derivó, en cierta ocasión en la ciudad de Denver, en el fallecimiento de un recién nacido que recibió, por vía intravenosa, la administración de un medicamento con una dosis 10 veces superior a la que había sido prescrita.

En tal caso, el error se produjo por una serie de fallos: administración de un medicamento innecesario, prescripción médica ilegible, falta de verificación de la orden médica por parte del farmacéutico, mal etiquetado de la especialidad farmacéutica, e inexperiencia del personal de farmacia y de enfermería en el manejo del medicamento en cuestión; es decir, una cadena de errores que se podrían haber evitado.

En la prescripción de medicamentos, estos errores no sólo tienen consecuencias en la salud de los pacientes sino, que además, derivan en unos costes para los sistemas de salud realmente importantes.

En concreto, y según datos del Centro para el Control y Prevención de Enfermedades de Estados Unidos (CDC USA, por sus siglas en inglés), al año se producen en Estados Unidos 700.000 ingresos en urgencias por interacciones de medicamentos, de los que 120.000 requieren ingreso hospitalario, ocasionando un coste estimado de unos 3.500 millones de dólares.

Sin embargo, otros datos de otras regiones no son más optimistas. Por ejemplo, un estudio realizado por el National Health Service (NHS) de Reino Unido calculó que aproximadamente una media de 60 pacientes mueren cada día debido a un error adverso a la medicación prescrita; y en Nueva Zelanda, el Ministerio de Salud estima que cada año cerca de 5.000 pacientes están sujetos a errores en su medicación. De estos pacientes, cerca de 150 fallecen y más de 400 sufren una discapacidad permanente.

En la misma línea y volviendo a apuntar a Europa, en España, según un estudio del Ministerio de Sanidad sobre eventos adversos de la medicación, el 9,3% de las estancias hospitalarias se deben a efectos adversos graves, siendo los errores asociados con la medicación los más abundantes -con más del 30% del total-.

Diferentes organismos han puesto en marcha una serie de protocolos para evitar errores en la prescripción de medicamentos. El Consejo de Salubridad General de México, por ejemplo, recomienda que, para una correcta farmacovigilancia, se debe cumplir el estándar M.M.U 5.1. de la Joint Commision para México DF, referente al Manejo y Uso de Medicamentos -Medication Management and Use (MMU)-.

Este proceso incluye la evaluación de: 

a) idoneidad del fármaco, dosis, frecuencia y vía de administración 

b) duplicación terapéutica 

c) alergias o sensibilidades

d) interacciones reales o potenciales entre medicamentos o alimentos

e) variación con respecto al criterio del uso del medicamento en el hospital 

f) peso del paciente, información fisiológica 

g) otras contraindicaciones. 

Herramientas disponibles

En la actualidad acudimos, en primer lugar, a las fuentes oficiales a la hora de consultar información farmacológica. En México, la aplicación del Cuadro Básico de Medicamentos (CBM) y Catálogo de Insumos en la Administración Pública Federal ha permitido contar con un sistema único de clasificación y codificación de insumos para la salud, lo cual ha contribuido a homogeneizar las políticas de adquisición de las instituciones públicas federales del Sistema Nacional de Salud. 

Pero además de las fuentes oficiales, existen otras formas de acceder a información clínica y farmacológica de referencia, tanto en diferentes websites como mediante bases de datos farmacológicas que pueden estar integradas en los sistemas informáticos. 

El problema aquí es que son escasos los actores globales que se dedican a indexar y conectar información sanitaria/farmacológica, y menos aún los que están disponibles en idioma español y con farmacopeas “non FDA”.

Y es que para garantizar prescripciones de fármacos seguras, que eviten errores o reacciones adversas de medicamentos, se hace necesario contar con bases de datos que contengan, al tiempo, información clínica así como información oficial local, todo ello en un entorno normalizado, con la información indexada, codificada y actualizada y que sean herramientas que puedan estar interconectadas.

Link: http://www.ehealthreporter.com

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Sistemas de Información de Salud

by System Administrator - Tuesday, 29 August 2017, 4:58 PM
 

Sistemas de Información de Salud: Una Mirada al Pasado, Presente y Futuro

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Six Phrases to Avoid When Talking with Patients

by System Administrator - Friday, 22 August 2014, 4:46 PM
 

Six Phrases to Avoid When Talking with Patients

By Aubrey Westgate

Robin Diamond, chief patient safety officer at medical malpractice insurer The Doctors Company, identifies six common communication missteps physicians make.

Please view the slides on the attached whitepaper.

Link: http://www.physicianspractice.com

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SOA in the CLOUD age

by System Administrator - Monday, 4 August 2014, 8:19 PM
 

FAQ: THE BASICS OF THE CLOUD AND SOA

Some people may think SOA is irrelevant because of the cloud, while others assert the cloud and SOA go hand in hand.

by: Maxine Giza

Some people don't think SOA is relevant in the cloud age, but that isn't what industry insiders say. Coupling the cloud and SOA can translate into major cost-saving benefits for enterprises due to improved agility and flexibility. Read on to learn about the cloud, SOA and how they can be a powerful resource when combined.

Continue reading on the site http://losnuevosguerreros.org

 

 

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Software Defined Storage

by System Administrator - Thursday, 18 June 2015, 6:53 PM
 

Reduce Costs and Increase Performance with Software Defined Storage

The rise of e-commerce, social media and the Internet of Things has contributed to an explosion in data—800% growth is expected over the next five years alone. Data is an organization's most valuable commodity, but provisioning for intensive data growth can strain the budgets of IT departments, especially ones with a traditional, infrastructure-centric mindset.

A transition is underway from standard data center infrastructures to cloud-enabled, software-defined ones that permit resources to be scaled in response to evolving business needs. And with IT managers under pressure to trim expenses, there's a new openness to flexible system architectures that sidestep vendor lock-in. Virtualization created the first step in this direction by providing software tools to maximize computing hardware resources. And now Software Defined Storage (SDS) extends those same benefits to storage infrastructure.

SDS enables a modular approach that abstracts the software layer from hardware while adding management and automation capabilities. As with virtualization in the compute realm, heterogeneous storage resources are presented as a combined pool. The SDS software then enables features including provisioning, replication, deduplication and compression—all of which are removed from the physical storage where they invariably increase latency and decrease overall performance by taking up processing resources.

A 2015 survey by Research and Markets (www.researchandmarkets.com) projected a compound annual growth rate of 34.6% from 2014 to 2019 for SDS. At this point, major players in the SDS market include a growing list of small companies and startups, as well as major storage manufacturers including EMC, IBM, NetApp, Dell and HP.

Please read the attached whitepaper.

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Speech Solution into Mobile EHR

by System Administrator - Thursday, 23 October 2014, 8:09 PM
 

Nuance Embeds Speech Solution into eClinicalWorks Mobile EHR

Nuance today announced it has partnered with eClinicalWorks to embed Nuance cloud-based medical speech recognition technology into eClinicalTouch for the iPad and eClinicalMobile for iOS and Android, enabling clinicians working in outpatient settings to enter patient notes into the Electronic Health Record (EHR) using tablets and smartphones through a fully connected and consistent experience.

“This is a major win for clinicians practicing in the ambulatory setting using our Dragon Medical solution and they are excited about the opportunity to leverage the same front-end speech recognition they know and trust to support a more efficient workflow using mobile devices,” says Jonathon Dreyer, director of mobile and cloud solutions, Nuance Communications. “We are seeing an intersection between consumer technology and health IT, and the ease-of-use that comes from these developments will help offset some of the challenges physicians are currently facing. The goal is to remove as much administrative burden from them as possible,” he adds. 

Overhauling EHR Usability

Recently, the American Medical Association (AMA) called for a design overhaul of EHRs to make them easier for physicians to use in clinical settings, outlining eight priorities to improve usability.To ensure a consistent physician experience and flexible workflow with minimal disruption, eClinicalWorks has embedded Nuance speech solutions in its mobile clinical documentation apps, empowering physicians to document patient care in their own words and in the same way on eClinicalTouch and eClinicalMobile platforms.

Healthcare mobility trends are on the rise, and Nuance has seen anincreased adoption of cloud-based medical speech solutions. With several thousand clinicians using both Dragon Medical 360 and eClinicalWorks in conjunction today, mobile speech is seen as a natural extension and critical component within the clinical workflow to help them produce faster, more accurate patient notes. 

“Nuance cloud-based speech integrated with eClinicalTouch and eClinicalMobile will empower our users to speak right into the iPad, iPhones, and Android phones and convert speech into text, said Girish Navani, CEO and co-founder of eClinicalWorks. “eClinicalWorks Scribe will then take that text and convert it into discrete data that is searchable and reportable.”

Nuance’s medical cloud-based speech solution embedded into the eClinicalWorks mEHRs will be demonstrated at the eClinicalWorks National Users Conference, October 17- 20 in Orlando, Florida. For more information on how Nuance is creating seamless, secure mobile solutions for clinical documentation, visit poweredbynuancehealthcare.com.

Link: http://hitconsultant.net

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Start-Up Practices

by System Administrator - Monday, 29 September 2014, 8:47 PM
 

 

3 things start-up practices must know about healthcare in 2014

2014 is the year when physicians have to make some tough decisions to keep their practices afloat. There are multiple obstacles to endure in order to stay profitable and meet regulatory compliance deadlines.

Did you know?

  • With the rise of high deductible plans, collecting payments from patients will be crucial like never before.
  • This fall, Federal regulators will begin a new round of HIPAA compliance audits.
  • Your practice is likely to face a shortage of human resource by the end of the year that could gravely de-motivate your remaining staff?
  • With July deadline for Meaningful Use already past, eligible physicians who haven't implemented an EHR system at their practices would have to face government penalties in 2015.

This free white paper includes a list of challenges that physicians will face this year accompanied by best practices that will help you during this tough time.

Link: http://www.physicianspractice.com

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Startups de salud digital

by System Administrator - Sunday, 5 October 2014, 8:25 PM
 

Financiamiento para startups de salud digital llegaría a US$ 6.500 millones en 2017

Impulsada por la evolución de las expectativas de los consumidores, el financiamiento de las startups de salud digital, como las especializadas en telesalud y en tecnologías wearable, deberá duplicarse en los EEUU a lo largo de los próximos tres años. De esta manera, crecerá de US$ 3.500 millones en 2014 hasta US$ 6.500 millones hasta fin de 2017, según Accenture.

De acuerdo con la consultora, el financiamiento de las startups de salud digital el año pasado fue estimado en US$ 2.800 millones, lo que representa una tasa de crecimiento anual del 31% desde 2008. Para 2015, la previsión es de US$ 4.300 millones.

Según Dipak Patel, director de iniciativas para el acceso a pacientes de Accenture, la ruptura digital se está desarrollando en el área de salud y cambiará interacciones sociales, alterará las expectativas de los consumidores y mejorará los resultados de la salud. Este movimiento será sustentable si las startups de salud digital aplican recursos para crear una experiencia perfecta para los pacientes y generan economías de costos médicos con mejores resultados. Converge

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States Could Soon Require Random Drug, Alcohol Tests for Docs

by System Administrator - Saturday, 9 August 2014, 1:47 AM
 

States Could Soon Require Random Drug, Alcohol Tests for Docs

By Ericka L. Adler

I recently spoke with a physician seeking guidance concerning a colleague in her office she believed might be impaired by drugs.  She was alarmed at the risk this posed to patients, as well as her practice’s liability, and wanted to report the physician to her superiors. 

In this particular case, we decided together there was insufficient factual knowledge of any wrongful activity to support my client taking action, without further evidence.  As I have discussed before, presenting information to a third party without factual evidence, when such information can be damaging, will open a physician to liability for defamation.

Because physicians are typically afraid to report their suspicions, and can actually face liability for doing so, how should physician drug use in the workplace be addressed?  

Given the subversive habits of drug users, how can practices catch physician drug-users before a patient is harmed, and do so in a manner that can help a provider receive assistance he may require?

The use of drugs and alcohol by physicians is a well-known public health risk.  Statistics indicate that physicians are about as likely as the general public to abuse alcohol or illegal drugs, but five times more likely to misuse prescription drugs, according to the University of Florida’s Center for Addiction Research and Education.  In a profession where clear thinking, decision-making, and a steady hand are all essential tools, physician drug use is a grave concern.

To address this growing problem, experts around the country have argued that it’s time physicians, like others who have roles affecting public safety, be randomly drug and alcohol tested.  After all, why are physicians treated differently than pilots or bus drivers when they all have jobs that can hurt innocent victims?

California is taking a stab at addressing the problem of physician drug use, and will present its residents with the issue of random physician drug testing on a ballot this November, known as “Proposition 46.”   Apparently many in the medical industry don’t like Proposition 46, and The New York Times reports that the medical industry, including doctors, hospitals, and medical insurance companies, have already raised more than $35 million to defeat it. 

The problem with Proposition 46, in particular, is that the motivation for the measure appears to be driven by lawyers.  In fact, the proposed law would mainly impact the malpractice industry, increasing the ceiling for pain and suffering awards in medical negligence suits from $250,000 (set by the State legislature in 1975) to $1.1 million to reflect inflation. 

Under this new law, results of random drug tests on doctors would also be reported to the California Medical Board and hospitals would be required to report the names of doctors suspected of abusing drugs or alcohol.

It’s important to note that those who oppose Proposition 46 do not necessarily believe that drug testing of physicians is inappropriate, just that it should not be applied in the manner developed by California state trial lawyers.  Instead, it should be focused on helping impaired physicians and protecting patients in a manner that physicians and others in the industry can support. This requires some thoughtfulness in developing an acceptable approach, which many believe Proposition 46 lacks.

There is no doubt that an issue of drug and alcohol abuse in the medical profession exists.  The vote in California will be important in how it impacts other state laws around the country. 

Link: http://www.physicianspractice.com

 

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Stop the Conflict in Your Medical Practice

by System Administrator - Friday, 19 June 2015, 1:36 PM
 

Stop the Conflict in Your Medical Practice

By Carol Stryker

Squabbling among staff members is common in medical practices. It is more than just an aggravation for the physician. Patients are aware of the ill will and hate it. The squabbling leads some patients to trust certain staff members and insist on dealing with only them, which both decreases productivity and increases staff animosity. Dissension increases risk for the practice because staff members are not wholeheartedly supporting each other. It is a bad situation all around.

Stopping the fighting is simple. It requires only focus and consistent behavior from whoever is in charge. (I didn't say it was easy.) The necessary behaviors of the leader are these:

1. Ask about the desired outcome. When an employee complains to you about a coworker, ask, "What do you want me to do with that information?" This will let you know the complainer's motive. If the objective is legitimate and for the good of the practice, she will be able to tell you exactly what she'd like to see done. If not, stop the conversation because it cannot lead to anything good.

2. Bring both parties together. Don't allow one employee to complain about another employee without including both of them in a conversation. If you allow an employee to complain to you privately without facing the object of the complaint, you make all employees suspicious that you participate in gossip and have favorites among your staff. Effective leadership is impossible in that environment.

3. Make sure roles and responsibilities are clearly defined. Lots of dissension results from staff members interfering with one another's work. Maybe they have different standards for a particular task. Make it clear what your standard is, as well as the fact that you are the one who sets the standard.

4. Hold people accountable. A major source of discord in any environment is subpar performance. Staff members who are allowed to complete work half-heartedly can cause ill will. Hardworking, conscientious staff members have to pick up the slack for these folks. If the good employees don't quit, they will grumble and complain as a way to deal with their frustration.

5. Praise in public, criticize in private. The behavior you reward is reinforced. If staff members come to you with a disagreement or problem and are able to resolve it effectively, praise them. The rest of the office will get the message.

If a staff member is sniping or two of them are squabbling, publicly make an appointment to meet with them privately. Criticize the behavior and move quickly to developing a resolution. It will be a teachable moment for the rest of the staff, too, because you will have demonstrated that arguing will not be tolerated6. Terminate any employee who insists on contributing to dissension.It is actually rare, but there are people who are not willing or able to maintain a positive and supportive attitude. If you are certain that you have been faithful in creating a constructive environment by consistently exhibiting the first five behaviors, get rid of them. One bad apple really can ruin the whole barrel. Just be sure you know which employee is actually the rotten apple.The bottom line is that no one but the actual leader can create and sustain a positive environment. In a medical practice, that has to be the physician. It is one of the few roles that the physician cannot delegate. 

Link: http://www.physicianspractice.com


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