HOPES EXPerience Dra. Nagore Fernández

HOPES EXPerience Dra. Nagore Fernández
0 20 April, 2017

HOPES EXPerience: Dr Nagore Fernández

We had been thinking about organising a series of interviews for a long time. The result is HOPES EXPerience and the idea is to raise the profile and provide a platform for the medical professionals who work with us day after day. After all, our users are also our greatest allies along the road to instilling an innovation-based management culture in the healthcare system. Besides creating a community, we think this blog format is a great way of sharing HOPES user experiences. To start the project, we are highly honoured to interview Dr Nagore Fernández-Llanio, deputy head of the Rheumatology Department at Arnau de Vilanova Hospital in Valencia, Spain. Rheumatology is Dr Fernández-Llanio’s vocation and profession. After finishing her medical studies at Navarre University and completing her specialist training at Marqués de Valdecilla Hospital in Santander, she did not hesitate to pack her bags and move to Valencia with her one-year-old daughter at the request of Dr José Andrés Roman Ivorra, then Head of the Rheumatology Department at Peset Hospital.

Good morning Dr Fernández-Llanio, thank you for making time for us in your busy schedule. Tell us a little about your career.

My pleasure. I studied medicine at Navarre University and then did my specialist training at Marqués de Valdecilla Hospital in Santander. After my MIR (medical resident internship) training I worked as a stand-in at Navarre Hospital for two and a half months, and then did short, one-day stand-ins. Work was not very regular so when Dr Román called to see if I would like to work with him in Valencia I didn’t give it a second thought and accepted his offer.

Do you remember more or less how long you worked as an assistant at Peset Hospital?

I was an assistant doctor in rheumatology at Peset Hospital for nearly eight years until I passed the state exam of 2011 and was offered a job. I started work at Arnau de Vilanova Hospital because no jobs were available at Peset Hospital.

If you don’t mind us asking, why rheumatology?

Well, it’s not very usual because rheumatology is an unknown field, even for students. No one starts learning medicine to become a rheumatologist and normally no rheumatologists teach rheumatology so it’s almost off the radar. Connective tissue disorders? They sounded strange and we never really understood them because no one explained them well. In the third year of my degree, which is when you start your training in hospitals, we had a draw and I got rheumatology – I hadn’t asked for that area.

So it was a bit by chance?

Yes because most people wanted to be in the usual areas: cardiology, pediatrics, etc. I was assigned to rheumatology and at first I was very upset. But then I realised that that was what I wanted to do, so in fact I was very lucky. What I liked best was the practitioner-patient relationship that emerges. There are systemic, chronically ill patients, admissions, technical cases, etc. It’s a very broad speciality that made other specialities feel rather unfulfilling.

Very interesting. On a different subject now, are you involved in any research at the moment?

Yes. I’ve been taking part in more basic research since my internship, and during my time at Peset Hospital quite a few clinical trials were carried out. At the moment I am working on research about lupus being conducted in the Region of Valencia in collaboration with the regional authorities and the UPV (Polytechnic University of Valencia). We are studying the economic impact of lupus and its impact on the quality of life of patients and society.

Taking a closer look at every day activities, what are the challenges for rheumatologist specialists today in hospital surgeries?

The biggest challenge is undoubtedly the lack of time to deal with patients. You have to get the best information you can from patients in order to take good decisions about their treatment.

In this respect, with regard to HOPES, do you think that new technologies are a fast track to this efficiency?

I can’t deny that new technologies are a hindrance at first because you always need time to adapt and learn. You have to get used to working with them and they can distract you from what matters most: dealing with patients. But it’s also true that once you get used to them and stop having to pay more attention to the IT platform than to patients, then new technologies do help because they make it possible to do things faster: they file information, it’s always available and you can analyse it. HOPES lets me know exactly what I’m doing because although you have an impression, there comes a time when this sort of support is essential.

So would you say that new technologies help you in your everyday activities?

Yes, I think they are helpful because they let me know what I am doing and let me monitor it, and this is a very effective way of seeing it, but I must admit that an effort is needed at first and we find it hard. This is normal, I deal with about 900 patients in my surgery and I can’t remember all their details, but computer systems put the information at my fingertips.

Generally speaking, do you think that today’s rheumatologists can access all of a patient’s data easily?

Yes, as time goes by we have more information about specific things although I think that a thorough assessment by each specialist is always advisable. It is always best to create a medical record for each patient in order to evaluate each one well and avoid cut-and-paste files. Whatever happens, the practitioner-patient interview is essential.

I always use HOPES when I prescribe biological treatment”

On the subject of HOPES again, how long have you been using it? You talk about getting used to it, did it take you a long time?

Well, I’ve been using it for more than a year and I must say that it wasn’t difficult, it’s all quite intuitive.

Would you say you use it every day?

I always use it when I start a biological treatment and also to fill out the MAISE documents obligatory in the Region of Valencia. I have to fill them out anyway because it is compulsory, so I enter the data in HOPES and in passing I record all the information about what I am doing: how many and which biological treatments I prescribe, the doses, etc. I also use it when I change biological treatments. Then, if a patient doesn’t respond to this sort of treatment, it’s much quicker to change the treatment because the patient is already in the platform and you can see all the information. It’s all there: serological tests, vaccines and patient data. In other words, it speeds matters up considerably and provides feedback about what I am doing.

What about how data are entered into HOPES. Do you do it in real-time whilst talking to the patient or later?

I always do it in real time. I try not to put anything off for later because I might forget something. If I left it for later it would be a burden and extra work. In addition, I take the opportunity to print out the documents that the patient has to sign for the MAISE, so I have to do it immediately.

We’ve almost finished. Do you think this platform has the right approach?

Yes, very much so, although I know that it’s possible to make greater use of it. Having said this, the approach is fine for what I need and it makes my job a lot easier. The platform is obviously very good and very comprehensive for anyone who wants to prepare papers for conferences, and it can be used to obtain lots of findings because you can look ahead and start gathering very valuable data. For the time being I am totally immersed in clinical practice – which is more than enough! (laughter).

Many thanks once again Dr Fernández-Llanio. It’s been a pleasure starting the HOPES EXPerience series with you.


Valencia, 25 February 2016

HOPES _Dept. Marketing and Communication

Posted in MEDiadd EXPerience by quatresoft