Dr María Teresa García-Baquero Merino, Head of Madrid Regional Palliative Care Office, Spain, and a UK-trained Palliative Medicine Consultant, introduces Madrid’s electronic palliative care records system. The post relates to a longer article in the January/February edition of the European Journal of Palliative Care.
Madrid, capital of Spain, has a population of 6.3 million within metropolitan, urban and rural areas. From 2005, the regional government has sought to offer an integrated palliative care model to provide universal access from all levels of care. One of the challenges has been to optimise resource distribution and allocation.
Why did we do the project?
We were driven by the commitment to offer those with palliative care needs truly holistic, seamless end of life care and support. To achieve this, you need the commitment of professionals from different palliative care teams and all levels of care to work together. Exquisite coordination is an imperative. Twenty-first century technology can make important contributions and fill the gaps in human communication and geographical distance – an idea behind the inspiration for our venture.
Who was involved?
We consulted all professional stakeholders involved. Be it generalists from primary care, specialists from secondary care, every single one of our region’s palliative care teams; everyone wanted to develop a common tool. They required it to be standardised and homogenous to achieve integral assessment of each patient’s needs from all dimensions, central to Dame Cicely Saunders’ concept of Total Pain, and to offer up-to-date clinical data easily accessible from every point of care in real time. infoPAL offers just this.
Is it useful and functional?
“The arrival of infoPAL has meant a forward move in our work environments. Centralised Electronic Medical Records (EPCRS), accurate in their palliative care detail, fully electronic and open to all of us professionals caring for those with life threatening illnesses are today a reality. Communication – a key element of good palliative care – has been reinforced and enriched, enabling us to offer timely, better quality palliative care”, says Alfredo Dominguez, a Hospital Support Team Nurse Palliative Care Expert in Getafe Hospital.
He illustrates the relevance of the system with a real-life scenario: “Imagine a patient supported by a hospital palliative care team, discharged home under the care of the primary care and community palliative care teams; his clinical plan clearly outlined. Both palliative care teams arrange the first home visit, relying on infoPAL; the multiprofessional domiciliary team use their laptop (connected to a safe server) to update the EPCRS in the patient’s own home. The patient’s primary care team also accesses EPCRS to consult the latest development from their own health centre as required. In fact, as the central end of life coordinating tool, infoPAL can be consulted by any healthcare professional involved in that patient’s end of life process.”
Madrid’s out of hours service is assured by PAL24, based in the 112 Emergency Coordinating Centre. It offers specialist palliative care 24 hours a day, 365 days a year. Should the patient, family or carers need advice or medical help when their regular team is unavailable, the updated EPCRS held in infoPAL ensures appropriate and sensitive responses often avoiding unnecessary hospital admission and visits to the Accident and Emergency department.
These are just two of the advantages infoPAL has brought to our patients. For regional policy makers, it has enabled Madrid to create its Palliative Care Needs-Based Register, underpinning future rigorous strategic planning and showing exactly how many patients are included in the Madrid Regional Programme.
We are delighted to present what is contributing significantly to a truly equalitarian access to palliative care across the region. Thanks to outstanding professional commitment, Madrid’s continuity of care is today a reality.
To find out more…
Read more about Madrid’s integrated palliative care model in the Plan Estratégico de Cuidados Paliativos de la Comunidad de Madrid.
This blog post relates to the longer article, ‘InfoPAL – Madrid’s electronic palliative care records system’ by Teresa García-Baquero Merino, Belén Martínez, Fernando Pinedo, Manuela Monleón-Just and F Javier Hernández, published in the January/February 2014 issue of the European Journal of Palliative Care (vol. 21.1).
If you already have a web-based subscription to the European Journal of Palliative Care you will be able to download this issue, plus all articles in the journal archive. You can also browse the archive and download articles by taking a 10-minute or 30-minute subscription. Members of the EAPC receive discounted subscription rates to the journal – click here to subscribe online.
SPECIAL ANNOUNCEMENT OF NEW AWARD…
Do you know someone who has made a major contribution to palliative care policy development?
The Palliative Care Policy Development Award, launched by the European Journal of Palliative Care (EJPC) in collaboration with the European Association for Palliative Care (EAPC), is aimed at professionals working in palliative care worldwide who have made a substantial contribution to policy development through research, clinical practice or as policy activists. Please nominate the person of your choice using the online form. Deadline for applications: 20 March 2014