Service of Pneumology. Hospital Doce de Octubre
Interviews/ Dr. Carlos Melero

Dr. Carlos Melero Moreno
Service of Pneumology
Hospital Doce de Octubre

How do you think the information technologies (Internet, cell phones, personal electronic agendas) have influenced the professional practice of doctors?

Without a doubt the greatest impact is represented by the use of Internet in the information technology, and in particular in its application to the area of Health Sciences. The facility and immediacy of the diffusion of the contents have made Internet an indispensable tool for the research field and the practice of medicine.

The systems for bibliographic searches, for scientific articles, the possibilities offered by the on-line publications, the search for clinical cases, images, inter-personal communications or between Scientific Societies, and the virtual communications make up a brief example and their perspectives for development seem to be limitless. The cell phone and the personal electronic agendas constitute incorporations of a technological advancement with the obtaining, handling and storage of data and information which perhaps finds its greatest form of expression in the development of Tele-medicine, to furnish “remote” medical services, using computers and electronic and telecommunication media.

All of these circumstances directly influence the every day clinical practice, from the formative point of view, to the elements or tests that can be used in the areas of diagnosis, therapeutics and the making of medical decisions. In addition to the information which is furnished to the user and which constitutes a fundamental element in daily medical practice.

What parameters or methodologies exist for evaluating the quality of the information for the professional which is found on the Internet?

The main purpose of the information would be to improve the knowledge one possesses.  In the case of Internet and its relationship to health, the results should be evaluated in terms of an improvement in the making of decisions and the health care given, but despite the massive use of this tool, there is a notable lack of evidence which has duly evaluated this data.

On Internet, the information can be widely dispersed and there is no standard of quality, for there is an exaggerated collection of resources. There are organizations and different institutions which have developed criteria for guiding and evaluating the Health-related web pages, such as Health on the Net Foundation (HON), Food and Drug Administration (FDA), American Medical Association, Internet HealthCare Coalition, Hi-Ethics, and MedCertain, but these criteria have not been systematically applied to the health-related web pages, either at the time of their creation or for their evaluation. Don Fallis and Martin Frické identified three measures of security in terms of the quality of the information: that it features the HONcode logotype stamp, that it belongs to an organization and that it has a copyright.

The health professional must follow the most basic rules: consult the most prestigious data bases and review the information furnished by Universities, Scientific Societies and International Health Organizations.

What has been the influence of Internet on the disclosure of the Medicine Based on Evidence among the Health professionals?

I think that it has contributed greatly to its diffusion, but it has not been duly quantified and its influence on clinical practice is a slow process which requires time and a great formative effort. We should not forget that the MBE furnishes a new conceptual framework for the resolution of the clinical problems, and it tries to approximate the data resulting from clinical research and investigation to medical practice. The line of the process involves a systematic search, critical evaluation and application of the research findings to the making of clinical decisions.

The MBE helps to resolve the challenges raised by today’s medicine, especially when there is an enormous amount of scientific information available, the maximum quality care is required and the heath resources are limited. The MBE can be applied to the practice of any type of health interventions, whether they be diagnostic, therapeutic or preventive.

4. In your opinion, where would you situate the information technologies in the future of medical practice?

It is very basic. The tendency is towards the extension, and the evolution towards the mobility of doctors and patients, exploiting the full capacity of Internet and the application of the new technologies (state of the art mobile phones, personal networks, etc.), which make the mobility of the health professionals possible. This would enable them to have access to their clinical histories, records and data anywhere and at any time and it would also be possible to monitor and control patients. In fact, some of this is already a reality in cardiac and respiratory pathologies.

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