Atencion primaria
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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.
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Family doctors see a wide range of patients, with a wide range of complexity, in a short time and with few diagnostic resources. This situation makes primary care professionals more vulnerable to diagnostic errors. For this reason, an adequate clinical reasoning process is the most powerful tool family doctors have to safely guide the patient care process. ⋯ The review includes, among other aspects, identifying cognitive biases, analysing the ways in which work is organised in primary care teams, and situations in the care context that may contribute to such errors. In this article we describe the most frequent diagnostic errors and their causal factors in primary care, the impact of cognitive process failures, situations of overdiagnosis and the diagnostic and therapeutic cascades associated with them. Finally, we propose a set of tools to improve decision-making in the diagnostic process in primary care.
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To analyze the perceptions, motives and reasons that influence the election of Family and Community Medicine (FCM) speciality, thus exploring possible proposals for change in the health system model and university training. ⋯ The FCM specialty will not be attractive in a hospital-centric health and training system that does not bet on PC organizationally or economically.