[Teleconsultation: finding its place in primary care]. / Teleconsulta: encontrando su lugar en Atención Primaria.

Teleconsultation is a remote health consultation using information and communication technologies. There are different modalities and specific practical and communication skills are required. Notwithstanding its prominence in Spain, there is little evidence on teleconsultation. This article explores the applicability, barriers, facilitators and future challenges of teleconsultation. While it has the potential to improve access to healthcare, as well as save time and costs for both patients and healthcare professionals, it faces a number of challenges such as the digital divide and resistance to change. To address new challenges and overcome obstacles, it is crucial to gain the trust of patients and professionals. Improving training in the skills required to optimize their use is also essential. Future research should aim to provide robust evidence regarding safety and cost-effectiveness to ensure successful implementation.

Análisis de las interrupciones generadas por el uso de los smartphones entre los profesionales sanitarios de Atención Primaria / Analysis of the interruptions generated by the use of smartphones among Primary Care Health professionals

Objetivo: Analizar el uso particular de los smartphones entre los profesionales sanitarios de Atención Primaria durante el acto asistencial y sus consecuencias. Diseño: Estudio multicéntrico, transversal en un entorno de atención primaria, realizado en 3 fases: encuesta a profesionales, checklist de profesionales y encuesta a pacientes. Participantes: Profesionales sanitarios de atención primaria de la Gerencia Territorial de Atención Primaria de Barcelona (encuesta online) y profesionales sanitarios (checklist) y pacientes (encuesta a los pacientes) de 2equipos de Atención Primaria de Barcelona ciudad. Mediciones principales: Análisis descriptivo bivariado de las variables de las distintas encuestas. Utilización del teléfono móvil en la consulta, tiempo, motivo, tipo de uso y percepción de adecuación. Características de las interrupciones. Resultados: En relación con los pacientes, un 31% considera que el profesional sanitario solo debe consultar el teléfono móvil si es para resolver algún aspecto de su motivo de consulta y un 10% lo considera una falta de respeto. El 18% de los pacientes describen interrupciones, siendo la mayoría de entre 10 y 30 s de duración y considerándolas en su mayoría evitables. En relación con los profesionales, la mayoría (96%) afirma tener el teléfono móvil en la consulta y de manera silenciada (77%), y reconociendo solo el 2% su uso en presencia del paciente, lo que contrasta con lo descrito por los pacientes. Además, el 80% de los profesionales afirman pedir permiso para utilizarlo, contrastando con lo que refieren los pacientes (50%). El 85% de los profesionales consideran su uso como adecuado...(AU)

Objective: To analyze the particular use of smartphones among Primary Care Health professionals during the care act and its consequences. Design: Multicenter, cross-sectional study in a primary care setting, carried out in 3phases: survey of professionals, checklist of professionals and survey of patients. Participants: Primary Care Health professionals from the Territorial Primary Care Management of Barcelona (online survey) and health professionals (checklist) and patients (patient survey) from 2primary care teams in Barcelona city. Main measurements: Bivariate descriptive analysis of the variables from the different surveys. Use of the mobile phone in the consultation, time, reason, type of use and perception of appropriateness. Characteristics of interruptions. Results: In relation to patients, 31% consider that the health professional should only consult the mobile phone if it is to resolve some aspect of their reason for consultation and 10% consider it a lack of respect. Eighteen percent of patients describe interruptions, the majority lasting between 10 and 30s and considering them mostly avoidable. In relation to professionals, the majority (96%) claim to have their mobile phone in the consultation and on mute (77%), with only 2% recognizing its use in the presence of the patient, which is in line with what the patients describe. Furthermore, 80% of professionals say they ask permission to use it, contrasting with what patients report (50%). Eighty-five percent of professionals consider its use appropriate. Conclusions: The use of mobile phones is perceived by patients as an interruption that can affect the care act, generating dissatisfaction, which must be taken into account by health professionals. Healthcare organizations should establish recommendations regarding the use of mobile phones in consultations.

[Digital literacy as a key element in the digital transformation of health organizations]. / La alfabetización digital como elemento clave en la transformación digital de las organizaciones en salud.

In the last years, the digital transformation, has become a reality influencing organizational processes and advancing services for users. This transformation must align with WHO guidelines, addressing the needs of individuals globally and acknowledging Social Determinants of Health and emerging Digital Determinants of Health and the digital divide thas has been created. To accomplish this, the appropriate legislation and infrastructures are required. Correspondingly technology enables enhanced self-care and increased participation in decision-making across various levels, consequently, addressing the digital divide must not be an exception, and needs to include citizens, communities, entities, and professionals to work on how to diminish it and solve it. As a result of this national and supranational campaigns should formulate unified plans and strategies, that include training requirements and establishing programs for both professionals and users, highlighting the significance of incorporating digital knowledge on both groups.

[Analysis of the interruptions generated by the use of smartphones among Primary Care Health professionals]. / Análisis de las interrupciones generadas por el uso de los smartphones entre los profesionales sanitarios de Atención Primaria.

OBJECTIVE: To analyze the particular use of smartphones among Primary Care Health professionals during the care act and its consequences. DESIGN: Multicenter, cross-sectional study in a primary care setting, carried out in 3phases: survey of professionals, checklist of professionals and survey of patients. PARTICIPANTS: Primary Care Health professionals from the Territorial Primary Care Management of Barcelona (online survey) and health professionals (checklist) and patients (patient survey) from 2primary care teams in Barcelona city. MAIN MEASUREMENTS: Bivariate descriptive analysis of the variables from the different surveys. Use of the mobile phone in the consultation, time, reason, type of use and perception of appropriateness. Characteristics of interruptions. RESULTS: In relation to patients, 31% consider that the health professional should only consult the mobile phone if it is to resolve some aspect of their reason for consultation and 10% consider it a lack of respect. Eighteen percent of patients describe interruptions, the majority lasting between 10 and 30s and considering them mostly avoidable. In relation to professionals, the majority (96%) claim to have their mobile phone in the consultation and on mute (77%), with only 2% recognizing its use in the presence of the patient, which is in line with what the patients describe. Furthermore, 80% of professionals say they ask permission to use it, contrasting with what patients report (50%). Eighty-five percent of professionals consider its use appropriate. CONCLUSIONS: The use of mobile phones is perceived by patients as an interruption that can affect the care act, generating dissatisfaction, which must be taken into account by health professionals. Healthcare organizations should establish recommendations regarding the use of mobile phones in consultations.

[Blockchain in health: Transforming security and clinical data management]. / Blockchain en salud: transformando la seguridad y la gestión de datos clínicos.

INTRODUCTION: Technological advances continue to transform society, including the health sector. The decentralized and verifiable nature of blockchain technology presents great potential for addressing current challenges in healthcare data management. DISCUSSION: This article reports on how the generalized adoption of blockchain faces important challenges and barriers that must be addressed, such as the lack of regulation, technical complexity, safeguarding privacy, and economic and technological costs. Collaboration between medical professionals, technologists and legislators is essential to establish a solid regulatory framework and adequate training. CONCLUSION: Blockchain technology has the potential to revolutionize data management in the healthcare sector, improving the quality of medical care, empowering users, and promoting the secure sharing of data, but an important cultural change is needed, along with more evidence, to reveal its advantages in front of the existing technological alternative.

Abordaje de la transformación digital en salud para reducir la brecha digital / Approach to digital transformation in healthcare to reduce the digital divide

La transformación digital implica la integración de tecnología en todas las áreas de una organización y un cambio en la forma de operar y de proporcionar valor. En el sector de la salud, la transformación digital debe centrarse en mejorar la salud para todos, acelerando el desarrollo y la adopción de soluciones digitales. La OMS considera la salud digital como un factor clave para garantizar la cobertura sanitaria universal, la protección frente a emergencias sanitarias y un mejor bienestar para mil millones de personas en todo el mundo. La transformación digital en salud debe incluir los determinantes digitales en salud como nuevos factores de desigualdad junto a los determinantes sociales clásicos. Abordar los determinantes digitales de la salud y la brecha digital es esencial para garantizar que todas las personas tengan acceso a los beneficios de la tecnología digital para su salud y su bienestar.(AU)

Digital transformation involves the integration of technology into all areas of an organization and a change in the way of operating and providing value. In the healthcare sector, digital transformation should focus on improving health for all by accelerating the development and adoption of digital solutions. The WHO considers digital health as a key factor in ensuring universal health coverage, protection against health emergencies, and better well-being for one billion people worldwide. Digital transformation in healthcare should include digital determinants of health as new factors of inequality alongside classic social determinants. Addressing digital determinants of health and the digital divide is essential to ensure that all people have access to the benefits of digital technology for their health and well-being.(AU)

[Approach to digital transformation in healthcare to reduce the digital divide]. / Abordaje de la transformación digital en salud para reducir la brecha digital.

Digital transformation involves the integration of technology into all areas of an organization and a change in the way of operating and providing value. In the healthcare sector, digital transformation should focus on improving health for all by accelerating the development and adoption of digital solutions. The WHO considers digital health as a key factor in ensuring universal health coverage, protection against health emergencies, and better well-being for one billion people worldwide. Digital transformation in healthcare should include digital determinants of health as new factors of inequality alongside classic social determinants. Addressing digital determinants of health and the digital divide is essential to ensure that all people have access to the benefits of digital technology for their health and well-being.