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Use new technologies to ensure the correct medication for the patient in different settings, whether in the hospital, when he is at home, through a 24-hour pharmacy service with which he can contact whenever he has doubts; or taking medications home when necessary. This is the philosophy of the comprehensive pharmaceutical telecare project of the Hospital Gregorio Marañón Pharmacy Service. A way of working that has gained special relevance with the Covid-19 crisis and that this year has deserved the ABC Salud award for the best initiative in Pharmacy.
The first steps in this project were taken ten years ago. «The Gregorio Marañón is a large hospital, with a high volume of healthcare activity and a great deal of complexity for patients.
We needed tools that would help us to be close, to provide pharmaceutical care in conditions and to facilitate two-way contact with the pharmacy service ”, recalls María Sanjurjo, head of the Hospital Pharmacy Service of that center.
The first step for digitization was to establish an internal system that would help clinical decision-making, focused on patient safety and efficiency in the use of drugs. He started Higea (Intelligent Adverse Effects Management Tool), which connected the electronic prescription of hospital doctors with diagnostic analysis units, so that every time there was a patient safety problem, an alert was launched to prevent contraindications.
The next step was to develop a application platform with the aim of continuing to care for the patient beyond the hospital. «The problem arises when you go home and start with all kinds of Medication-related questions», Explains María Sanjurjo.
They started in 2016 with cancer patients who, thanks to the appearance of oral drugs, can continue treatment at home. «Our first app, OncoSalud, achieved great results in terms of safety, efficiency and satisfaction. Patients tell us that it is very reassuring for them to have pharmacists on the other side of the app and to be able to contact them when they have questions, ”says Sanjurjo. Attention is 24 hours every day of the year. Given the good results, the project continued to grow. They expanded the platform with e-MidCare, an app for patients with immunity-mediated inflammatory diseases (rheumatoid arthritis, spondyloarthropathies, psoriasis, psoriatic arthritis, Crohn’s disease and ulcerative colitis) and this year they have developed FarMcuida, for complex chronic patients. Internally, they also continue to expand Higea, with which they are working to connect with Radiology and Pathology.
Telefarmacia
The pandemic was a real challenge for the health system, but at Gregorio Marañón, digitization made things easier. “With Covid, patients had great difficulty in contacting the health system. Having the app implemented was super useful. It gives them a lot of tranquility and confidence ”, affirms Vicente Escudero, the person in charge of the project. Most of the consultations through the app are for interactions with other medications or for adverse effects that usually appear a week following starting treatment, before the next appointment scheduled by the doctor. «We identify an adverse effect early, which allows us to anticipate and decide if it is an emergency. The patient who has the app goes to the emergency room less and has less income than the one who does not have it, “he says. Those who cannot use the app for whatever reason are provided with a 24-hour contact telephone number.
To avoid unnecessary travel, at the beginning of the pandemic a telepharmacy service was launched with home delivery of medication for the most vulnerable. «It is a service highly valued by patients. At the end of 2021 we had more than 10,000 deliveries of medication “, explains Carmen Rodríguez, pharmacist and head of the project, who points out that the profile of the beneficiary is that of a patient” with a lot of dependency, comorbidities, with mobility problems and who depends on some caregiver ».
The objective of all these initiatives is that the patient “does not feel helpless”, says the head of the Pharmacy Service. The team wants applications to be available in the future for all types of serious and chronic pathologies whose treatment is complex. “We have to advance the digital transformation of healthcare. Our work does not end with the discharge of the patient, we have to continue to improve communication and listen to his voice even more », concludes Sanjurjo.
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