Valoración de la historia clínica electrónica por los profesionales de organizaciones sanitarias y sociales / Evaluation of the electronic medical record by professionals in helath and social organizations

Objetivo: Evaluar diferencias en el grado de satisfacción de los profesionales que participan en la asistencia sanitaria y en la gestión de las organizaciones de salud en relación a la historia clínica electrónica (HCE) implantada en sus organizaciones. Métodos: Se incluyen profesionales asistenciales, gestores y profesionales de Sistemas de Información que trabajan con la HCE de cualquier organización sanitaria o social en Cataluña. De 312 usuarios contactados, se obtuvo una tasa de participación del 60,25%. Las variables explicativas fueron el sexo, la edad, nivel de estudios, tipo de organización y categoría profesional. Como variables dependientes se incluyeron: el grado de satisfacción global con el sistema actual, la valoración de la posibilidad de cambio de la aplicación de la HCE y la valoración de su uso para mejorar la atención sanitaria. Resultados: Se observa un menor grado de satisfacción en los centros analizados respecto a atención primaria (ORa=0,11; IC 95% = (0,02-0,52)), en los profesionales con Grado/Licenciatura (ORa=0,12; IC 95%=(0,01-1,26)) y de Máster/Doctorado (ORa=0,10; IC 95%=(0,01-1,17) respecto a estudios secundarios, y en los profesionales considerados respecto a los de gerencia/dirección (Médica/o: ORa=0,18; IC 95%=(0,06-0,54) y Enfermera/o: ORa=0,36; IC 95%=(0,13 - 1,03)). Conclusiones: Las diferencias observadas entre los profesionales en su percepción del uso de la HCE deberían conllevar una mejora de estas herramientas para la asistencia de los pacientes

Objective: To evaluate differences in the degree of satisfaction among professionals who participate in health care and in the management of health organizations in relation to the electronic medical record (EMR) used in their organizations. Methods: We surveyed healthcare professionals, managers and information technology professionals who work with an EMR in any health or social organization in Catalonia. Among 312 contacted professionals, the participation rate was 60.25%. Explanatory (independent) variables were sex, age, education, type of organization and professional category. Dependent variables included the degree of overall satisfaction with the current system, an assessment of possibly changing the EMR system s and an assessment of the use of an EMR to improve health care. Results: There was a lower degree of satisfaction in primary care centers (sociosanitary, assisted residence and other work centers: ORa = 0.11, 95% CI = (0.02-0.52)), among those with a professional or bachelor’s degree (ORa = 0.12, 95% CI = (0.01-1.26)) and those with graduate studies (ORa = 0.10, 95% CI = (0.01-1.17) as compared to respondents with secondary studies, and among healthcare professionals as compared to managers (physicians: ORa = 0.18, 95% CI = (0.06-0.54) and nurses: ORa = 0, 36; 95% CI = (0.13 - 1.03)). Conclusions: The differences observed among the professionals with respect to their perception of the use of the EMR should lead to improvements in the use of these tools for patient care

[Evaluation of the electronic medical record by professionals in health and social organizations]. / Valoración de la historia clínica electrónica por los profesionales de organizaciones sanitarias y sociales.

OBJECTIVE: To evaluate differences in the degree of satisfaction among professionals who participate in health care and in the management of health organizations in relation to the electronic medical record (EMR) used in their organizations. METHODS: We surveyed healthcare professionals, managers and information technology professionals who work with an EMR in any health or social organization in Catalonia. Among 312 contacted professionals, the participation rate was 60.25%. Explanatory (independent) variables were sex, age, education, type of organization and professional category. Dependent variables included the degree of overall satisfaction with the current system, an assessment of possibly changing the EMR system s and an assessment of the use of an EMR to improve health care. RESULTS: There was a lower degree of satisfaction in primary care centers (sociosanitary, assisted residence and other work centers: ORa= 0.11, 95% CI = (0.02-0.52)), among those with a professional or bachelor's degree (ORa = 0.12, 95% CI = (0.01-1.26)) and those with graduate studies (ORa = 0.10, 95% CI = (0.01-1.17) as compared to respondents with secondary studies, and among healthcare professionals as compared to managers (physicians: ORa = 0.18, 95% CI = (0.06-0.54) and nurses: ORa = 0, 36; 95% CI = (0.13 - 1.03)). CONCLUSIONS: The differences observed among the professionals with respect to their perception of the use of the EMR should lead to improvements in the use of these tools for patient care.

OBJETIVO: Evaluar diferencias en el grado de satisfacción de los profesionales que participan en la asistencia sanitaria y en la gestión de las organizaciones de salud en relación a la historia clínica electrónica (HCE) implantada en sus organizaciones. MÉTODOS: Se incluyen profesionales asistenciales, gestores y profesionales de Sistemas de Información que trabajan con la HCE de cualquier organización sanitaria o social en Cataluña. De 312 usuarios contactados, se obtuvo una tasa de participación del 60,25%. Las variables explicativas fueron el sexo, la edad, nivel de estudios, tipo de organización y categoría profesional. Como variables dependientes se incluyeron: el grado de satisfacción global con el sistema actual, la valoración de la posibilidad de cambio de la aplicación de la HCE y la valoración de su uso para mejorar la atención sanitaria. RESULTADOS: Se observa un menor grado de satisfacción en los centros analizados respecto a atención primaria (ORa=0,11; IC 95% = (0,02-0,52)), en los profesionales con Grado/Licenciatura (ORa=0,12; IC 95%=(0,01-1,26)) y de Máster/Doctorado (ORa=0,10; IC 95%=(0,01-1,17) respecto a estudios secundarios, y en los profesionales considerados respecto a los de gerencia/dirección (Médica/o: ORa=0,18; IC 95%=(0,06-0,54) y Enfermera/o: ORa=0,36; IC 95%=(0,13 ­ 1,03)). CONCLUSIONES: Las diferencias observadas entre los profesionales en su percepción del uso de la HCE deberían conllevar una mejora de estas herramientas para la asistencia de los pacientes.

Los registros de salud personal: el caso de la Carpeta Personal de Salud de Cataluña / Personal health records: the case of the Personal Health Folder of Catalonia (Spain)

Este trabajo explora las posibilidades de la Carpeta Personal de Salud e identifica la brecha entre el potencial de esta herramienta y las aplicaciones que ofrece a través de Internet. Se presenta la Carpeta Personal de Salud, un proyecto vinculado a la Historia Clínica Compartida de Cataluña, que ofrece un punto de acceso a la información sobre la propia salud que es seguro, personalizado y soportado por las tecnologías de la información y la comunicación. La experiencia, realizada íntegramente por la Consejería de Salud de la Generalitat de Cataluña, escogió una metodología mediante encuesta anónima. Los resultados han sido de gran relevancia para obtener información sobre la idoneidad de los datos publicados y las expectativas de una herramienta dirigida a la población en general (AU)

The aims ofthis studywere to explore the possibilities ofthe Personal Health Folder and to identify the gapbetween the potential applications ofthis tool andwhatit offers through the Internet. The Personal HealthFolder is presented, a project linked to the Shared Medical Record of Catalonia (Spain), which providescitizens with an access point to information about their health insurance, customized and supported byinformation and communication technologies. The project was carried out by the Ministry of Health ofthe Government of Catalonia (Generalitat de Catalunya) and data were gathered through an anonymoussurvey. The results were critical to obtain information on the suitability of the published data and on theexpectations of a tool aimed at the general population (AU)

[Personal health records: the case of the Personal Health Folder of Catalonia (Spain)]. / Los registros de salud personal: el caso de la Carpeta Personal de Salud de Cataluña.

The aims of this study were to explore the possibilities of the Personal Health Folder and to identify the gap between the potential applications of this tool and what it offers through the Internet. The Personal Health Folder is presented, a project linked to the Shared Medical Record of Catalonia (Spain), which provides citizens with an access point to information about their health insurance, customized and supported by information and communication technologies. The project was carried out by the Ministry of Health of the Government of Catalonia (Generalitat de Catalunya) and data were gathered through an anonymous survey. The results were critical to obtain information on the suitability of the published data and on the expectations of a tool aimed at the general population.

Plan de encuestas de satisfacción del CatSalut-PLAENSA ©. Estrategias para incorporar la percepción de la calidad de servicio de los ciudadanos en las políticas de salud / Satisfaction survey of CatSalut-PLAENSA ©. Strategies to incorporate citizens’ perception of the quality of the service in health policies

El objetivo de este artículo es presentar las estrategias, actividades y resultados del Plan de encuestas de satisfacción del CatSalut-PLAENSA© 2003-2010, que están facilitando avanzar en la mejora de la calidad de los servicios sanitarios. Desde 2003 se dispone del Plan de encuestas de satisfacción PLAENSA©, una herramienta de evaluación y de propuesta de mejora de los servicios que presta la aseguradora pública a través de las entidades proveedoras contratadas siguiendo 3 estrategias clave: medir sistemática y objetivamente la satisfacción de los asegurados con los servicios recibidos; elaborar propuestas de mejora acorde con un modelo sistematizado y normalizado con actividades de seguimiento, y fomentar la equidad mediante la diseminación en los centros sanitarios y territorios. Actualmente se dispone de la valoración de los asegurados de la mayor parte de servicios sanitarios, con más de 2.500 proyectos de mejora en funcionamiento en los distintos proveedores de las 7 regiones sanitarias de Cataluña (AU)

The aim of this work is to present the strategies, activities and results of satisfaction surveys Plan CatSalutPLAENSA© 2003-2010 that are making progress in improving the quality of health services. Since 2003, CatSalut has at its disposal the plan known as PLAENSA© Satisfaction Surveys, a tool for assessment and improvement proposals addressed to the insurance services provided by contracted public entities. The plan follows 3 key strategies: systematic and objective policyholders’ satisfaction measurement, related to the services received; release of improvement proposals according to a standardized model, including standardized monitoring, and promotion of equity through propagation among health centres and territories. Current assessment provided by the insured about most health services has been already collected, leading to more tan 2,500 projects of improvement which are being developed by the providers of the 7 health regions of Catalonia (AU)

[Satisfaction survey of CatSalut-PLAENSA(©). Strategies to incorporate citizens' perception of the quality of the service in health policies]. / Plan de encuestas de satisfacción del CatSalut-PLAENSA(©). Estrategias para incorporar la percepción de la calidad de servicio de los ciudadanos en las políticas de salud.

The aim of this work is to present the strategies, activities and results of satisfaction surveys Plan CatSalut- PLAENSA(©) 2003-2010 that are making progress in improving the quality of health services. Since 2003, CatSalut has at its disposal the plan known as PLAENSA(©) Satisfaction Surveys, a tool for assessment and improvement proposals addressed to the insurance services provided by contracted public entities. The plan follows 3 key strategies: systematic and objective policyholders' satisfaction measurement, related to the services received; release of improvement proposals according to a standardized model, including standardized monitoring, and promotion of equity through propagation among health centres and territories. Current assessment provided by the insured about most health services has been already collected, leading to more tan 2,500 projects of improvement which are being developed by the providers of the 7 health regions of Catalonia.

La organización sanitaria y la implantación de las tecnologías de la información y la comunicación (TIC) / The sanitary organization and the implantation of the technologies of the information and the communication (TIC)

Cada vez más, los servicios asistenciales están orientando su actividad al ciudadano-paciente y su proceso, identificando nuevas prioridades y tendencias, interaccionando las diferentes áreas y disciplinas que intervienen en el proceso, operando dentro del espacio continuo, intercambiando y compartiendo el conocimiento multidisciplinar, gracias a la aportación de las TIC, y muy especialmente, la práctica telemática (AU)

Increasingly, the welfare services are orientating his activity to the citizen - patient and his process, identifying new priorities and trends, interdriving the different areas and disciplines that intervene in the process, operating inside the constant space, exchanging and sharing the multidisciplinary knowledge, thanks to the contribution of the TIC, and very specially, the telematic practice (AU)

[Personal health folder]. / Carpeta Personal de Salud.

Personal Health Records shared between patients and their health team can improve the capacity of the patients to become active partners in the care of their own health. PHR can offer the patients access to their medical information, services, such as resources programming, or communication between the members of the health team and the patient. They could also allow patients themselves to directly register certain data, be picked up from home monitoring devices, thus becoming a very useful tool in the management of chronic disease and for the prevention and promotion of health. The Government of Catalonia is developing the Personal Health Folder, a space where the Health Department will give the people of Catalonia secure and confidential access to their health information. The Personal Health Folder is within the framework of the Catalonian Shared Clinical History project, which is based on a index system of medical records shared between different personnel, using interoperability tools and is in accordance with the legislation applicable in Catalonia and within its healthcare system. Within the framework of this project and these principles, the Personal Health Folder has the aim to give people responsibility for their own health, allowing them to take part in the management of the preventive actions and care, and to improve the quality of care, and coordination between the different health areas and professionals.

Carpeta Personal de Salud / Personal Health Folder

La creación de Registros Personales de Salud compartida entre pacientes y su equipo de atención de salud puede mejorar la capacidad de los pacientes a convertirse en socios activos en el cuidado de su propia salud. Pueden ofrecer a los pacientes acceso a su información médica, servicios como la programación de citas, o comunicación entre los miembros del equipo de atención de salud y el paciente/ciudadano. También podrían permitir al propio paciente registrar determinados datos escribiéndolos directamente o recogidos desde aparatos de vigilancia y monitorización domésticos, constituyendo por tanto un instrumento de gran utilidad para la gestión de la enfermedad crónica y para la prevención y promoción de la salud. El Gobierno de Catalunya está desarrollando la Carpeta Personal de Salud, un espacio donde el Departament de Salut pondrá a disposición de cada uno de los ciudadanos de Catalunya datos referentes a su salud de forma segura y garantizando su confidencialidad. La Carpeta Personal de Salud se sitúa en el marco del proyecto de Historia Clínica Compartida de Cataluña, proyecto basado en un sistema índice de historia clínica compartida entre diversidad de agentes de salud, obtenido mediante instrumentos de interoperabilidad y conforme a la legislación aplicable en Catalunya y a su sistema sanitario. Bajo el marco de este proyecto y de estos principios, la Carpeta Personal de Salud tiene el objetivo de favorecer la responsabilización del ciudadano de su propia salud, facilitando su participación en la gestión de las actuaciones preventivas y de su cuidado, para mejorar la calidad de la asistencia, la coordinación entre las diferentes líneas asistenciales y entre los profesionales (AU)

Personal Health Records shared between patients and their health team can improve the capacity of the patients to become active partners in the care of their own health. PHR can offer the patients access to their medical information, services, such as resources programming, or communication between the members of the health team and the patient. They could also allow patients themselves to directly register certain data, be picked up from home monitoring devices, thus becoming a very useful tool in the management of chronic disease and for the prevention and promotion of health. The Government of Catalonia is developing the Personal Health Folder, a space where the Health Department will give the people of Catalonia secure and confidential access to their health information. The Personal Health Folder is within the framework of the Catalonian Shared Clinical History project, which is based on a index system of medical records shared between different personnel, using interoperability tools and is in accordance with the legislation applicable in Catalonia and within its healthcare system. Within the framework of this project and these principles, the Personal Health Folder has the aim to give people responsibility for their own health, allowing them to take part in the management of the preventive actions and care, and to improve the quality of care, and coordination between the different health areas and professionals (AU)