Atencion Primaria Practica最新文献

We present the case of a young adult patient who consulted for odynophagia fever and arthralgias, accompanied by non-pruritic rash, on physical examination adenomegaly and hepatomegaly were found, laboratories were requested with elevated ferritin, leukocytosis and neutrophilia and negative antibodies, using Yamaguchi's criteria the diagnosis was made and management with corticotherapy, NSAIDs and methotrexate was given with subsequent clinical improvement.

The case of a patient with urinary urinary incontinence due to hemiplegia who comes to the consultation for fever and general malaise is presented, it is striking that he brings a collection bag of purple coloration, urinary tract infection is identified and with antibiotic management resolves purple coloration of the bag, a semiological finding is described by a chemical reaction that involves urine, plastic and certain enzymes of some bacteria that produce sulfatases and phosphatases.

To gain the maximum effectiveness from telemedicine, it is very important to redefine care processes with the participation of healthcare professionals to achieve a mixed model of care that will facilitate their work and patient accessibility. Telemedicine must be appropriately included in corporate information systems and provide primary care with systems that help in clinical decision-making and predictive models of care that can signal potential disease progression. Not everything that is technically possible is necessary or will add value to the organisation and we must analyse real needs. At present we have insufficient evidence on the clinical benefits of telemedicine in the management of chronic disease. We need more investment in information systems, new professional profiles, and changes in care processes to take advantage of the benefits of Big Data and artificial intelligence.

Asynchronous telemedicine consultations between providers are an emerging mode of communication between hospital care and primary care. The territory of Central Catalonia has been characterized by the implementation of asynchronous telemedicine programs since 2007, always guaranteeing patient autonomy, professional secrecy and data protection. These asynchronous telemedicine programs (teledermatology, teleaudiometry, teleulcers, teleeyelids, among others) have not been understood as a replacement for face-to-face visits, but as a complement, improving accessibility (especially in rural areas) and favoring the longitudinality that is so characteristic of primary care. Over the last 15 years, a «telemedicine culture» has been created in Central Catalonia that will make it much easier to adapt to the technological changes that will inexorably take place in the not too distant future.

Telemedicine should support the patient's entire journey through the health system, from the moment they notice a symptom, usually in their home, to the use of home monitoring systems. Telephone consultations work best when the patient knows the healthcare professional.

Taking the perspective of the patient into account in the design, implementation and evaluation of telemedicine systems will increase satisfaction in using the system and help improve their health status. There are no technological barriers for people, as they are quick to learn how the mobile devices work that they can use at home to monitor their disease and communicate with doctors.

Issues such as the use of data from vital sign monitoring in the patient's home, and the accessibility and usability of teleconsultation platforms are key to the success of telemedicine programs for patients.