[Electronic medical record and prescription: risks and benefits detected since its implementation. Safe designing, rollout and use]. / Historia clínica y receta electrónica: riesgos y beneficios detectados desde su implantación. Diseño, despliegue y usos seguros.

New information technologies have transformed the way care is delivered within health services, permeating almost every aspect of health care. As the complexity of the system increases, it becomes more difficult to work optimally without the assistance of new technologies. Although its implementation represents a breakthrough, either because of the advancement involved in the proper use of any technology in health care, or because of the development of specific applications that improve patient safety, other factors such as incorrect design, implementation and poor maintenance, inadequate training, along with overconfidence and dependency, can make technologies compromise patient safety. This article describes the beneficial effects, and those that are not so, of the introduction in our country of the electronic medical record and the electronic prescription on the healthcare quality and safety.

[Impact of overdiagnosis and overtreatment on the patient, the health system and society]. / Impacto del sobrediagnóstico y sobretratamiento en el paciente, el sistema sanitario y la sociedad.

The medical activity displays a set of skills aimed at improving the health status of people. In this way, diagnoses are made, choices of tests and treatments are made, and decisions are made about what to do and what not to do that affect the lives of patients. In this article, we propose a reflection on overdiagnosis and overtreatment in relation to the factors that promote it and the impact they have on society, on the functioning of the health system and also directly on patients. Finally, we make some proposals on how to address this overuse considering that primary care is a privileged place to adapt and minimize the impact of the actions of the health system on the health of citizens and reduce the incidents of patient safety linked to the overdiagnosis and inappropriate use of tests and treatments that do not add value to the health of patients.

Impacto del sobrediagnóstico y sobretratamiento en el paciente, el sistema sanitario y la sociedad / Impact of overdiagnosis and overtreatment on the patient, the health system and society

La actividad médica despliega un conjunto de competencias encaminadas a mejorar el estado de salud de las personas. En este camino se realizan diagnósticos, se hacen elecciones de pruebas y tratamientos y se toman decisiones sobre hacer y no hacer que afectan a la vida de los pacientes. En este artículo, proponemos una reflexión ante el sobrediagnóstico y sobretratamiento en relación con los factores que lo promueven y el impacto que tienen en la sociedad, en el funcionamiento del sistema sanitario y también directamente en los pacientes. Finalmente, realizamos unas propuestas de cómo redirigir este exceso considerando que la atención primaria es un lugar privilegiado para actuar en adecuar y minimizar el impacto de las actuaciones del sistema sanitario en la salud de los ciudadanos y reducir los incidentes de seguridad del paciente ligados al sobrediagnóstico y al uso inadecuado de pruebas y tratamientos que no aportan valor a la salud de los pacientes

The medical activity displays a set of skills aimed at improving the health status of people. In this way, diagnoses are made, choices of tests and treatments are made, and decisions are made about what to do and what not to do that affect the lives of patients. In this article, we propose a reflection on overdiagnosis and overtreatment in relation to the factors that promote it and the impact they have on society, on the functioning of the health system and also directly on patients. Finally, we make some proposals on how to address this overuse considering that primary care is a privileged place to adapt and minimize the impact of the actions of the health system on the health of citizens and reduce the incidents of patient safety linked to the overdiagnosis and inappropriate use of tests and treatments that do not add value to the health of patients

Toxicidad por metotrexato: algo más que recordatorios / Methotrexate toxicity: More than just reminders

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