HOPES EXPerience: Dra. Amparo Ybañez

HOPES EXPerience: Dra. Amparo Ybañez
0 12 July, 2016

HOPES EXPerience: Dr Amparo Ybañez

A few weeks ago we had the opportunity to talk to Dr Amparo Ybañez Garcia, assistant rheumatologist at the Doctor Peset hospital in Valencia. Dr Ybañez studied medicine at Valencia University and specialised at the San Juan de Dios Hiospital (now called Valencia el Mar Hospital) whilst Dr Daniel Montaner Agusti was head of the department.

Good morning Dr Ybañez and many thanks for allowing us to interview you in your surgery. After finishing your medical studies you did your specialisation training along a different route from the MIR medical resident intern, didn’t you?

Yes, that’s right. I didn’t do MIR training because according to Speciality Law RD 127/1984 then in force, 5% of graduates with a certain type of training could become certified specialists by passing an exam – a different procedure from the one in force now.

How long have you been the assistant doctor here at Doctor Peset Hospital?

I have been the assistant rheumatology doctor at Doctor Peset Hospital since July 2011. Previously, I had been at La Fe Hospital since 2007. Since finishing my studies, I practiced my speciality in private clinics.

What made you choose

It all started at the old San Juan de Dios Hospital after I finished university. They used to hold an annual course about rheumatic diseases, and would invite all the rheumatologists in the Region of Valencia and one or two nationwide eminences. It was the only course of its kind because at that time there were not many rheumatology departments, and this specialty was not well known amongst patients or medical students. I signed up with a friend who is now a dermatologist, and I loved it. Then Dr Montaner persuaded me to carry on. Plenty of colleagues who spent time there obtained this qualification after their finals and although that was no longer possible, the specialities law I mentioned earlier made it possible to get the qualification I received a few years later.

At that time very few MIR placements were available, even though only 500 of the 2,500 who started the degree in just the School of Medicine at Valencia University actually graduated. The truth is that there were 25,000 graduates competing for 1,200 MIR placements. I gave it some thought and decided that I didn’t want to spend all year studying and then have only a remote change of choosing the speciality I wanted. At first, above all, I wanted to find out about clinical medicine and everyday dealings with patients: something they don’t teach you at university.

What is your daily routine here in the surgery? Does the number of patients cause much pressure?

Pressure from dealing with lots of patients is quite normal. Our basic work is mainly dealing with patients. We try to slot everything into our agenda, healthcare, teaching, admin tasks, etc but there are always emergencies, and we have to solve problems that crop up every day, so we never have enough time. Even so there are several research projects and clinical trials with new and established drugs under way in the department.

What about new technologies? What do you think about how they are used in everyday activities?

In my opinion they make my work easier, providing it’s easy to input data and access them all for later use. I think that all the developments in the new technologies available today are excellent. The problem is always the time we can spend on each patient – it’s never long enough – because so many patients are assigned to us.

Here at Peset Hospital, for example, you have been using HOPES for about 2 years, but not in the practitioner-patient relationship.

No, usually we don’t have time. We always use it in the biological treatment committee with the pharmacy department. That’s when we enter the patient’s details, diagnosis and the medicine prescribed. Then we use the system again to fill out the MAISE form. It makes it much easier to comply with this mandatory procedure for prescribing biological drugs.

In other words, you think that the platform as a whole allows a great deal of data to be entered although at the moment you only input key data to be able to monitor areas related to biological treatments.

Yes. I think it’s a very useful platform because once you enter the data, you can decide later what you want to know about one of your patients or even about all the patients in the department. In other words, at any given time, we can see the healthcare outcomes of our patients.

What about the user experience? What do you think about access and the interfaces, if the environment is user friendly, and the quantity and quality of the input data? Does the software run smoothly? Would you suggest any improvements? Why do you use HOPES?

It is easy to access the platform and the user interface and environment are straightforward. As regards the quantity and quality of the data, this depends on the users who input the data.

In general this software runs smoothly but, like everything, could be improved. The advantage is that it can be tailored to suit our needs. When you use it, you see the areas where some things are missing and other areas that are unnecessary. Like everything, certain things need to be refined at some point and it must flexible enough to cater for changing needs.

I use this platform because it really does give me access to data and information about patients. This is very important for me when taking decisions because otherwise I would have to search for them by hand.

As regards the clinical experience, what is the balance between the information provided by the practitioner and the data feedback received? In other words, does working with HOPES make you take different treatment decisions and if so, does this lead to different health outcomes?

The balance is, of course, always positive. If you enter data and use them, you can check your results. You might have an impression about what’s happening, but when you have objective evidence, it’s like, “Ok, now we’re talking.” This really is evidence-based medicine instead of just my clinical impression of the patient. This lets me take decisions about the different drugs I use and the health outcomes I achieve. For example, it facilitates the task of searching for specific profiles of patients with the best outcomes depending on the drug being used; comparing our results with those of other researchers; and assessing the cost effectiveness of our treatments, etc.

As regards patients’ treatment, how important are financial considerations? Do you bear them in mind when taking decisions?

Yes, of course I take them into account because we have limited resources and we have to make them available to as many patients as possible, but what matters even more are the symptoms observed in each patient. We also, of course, take into account patients’ preferences, psychological profiles, and their personal and professional circumstances.

HOPES is working on solutions for all of this.

Great. This is why it is such a useful platform but the problem or obstacle at the moment is finding the time to enter data and make the very most of the platform.

Thank you once again Dr Ybañez. It has been a pleasure talking to you.

 You’re welcome.

Interview on 6 April 2016 in Valencia, Spain.

HOPES_Dept of Marketing and Communication

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