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P. Roberto, et al.: Informatização de uma Consulta de Dor Crónica. Um Sistema de Utilização Livre em Português

Abstract
Introduction and objectives: In the last years in Portugal, chronic pain recognition has evolved and now
multidisciplinary, specialized, and organized medical care is freely provided to patients by the national
health service.
To improve chronic pain management, besides health policies and clinical excellence, an adequate digital
platform for data management is essential. Pain units in Portugal have for a long time sought suitable
software that meets present scientific demands and practical restraints.
Digital clinical systems can improve quality of service; reduce errors, risks, and costs; help the clinical
decision; maintain clear records; and are valuable tools for scientific research.
In spite of these advantages, it is common for hospitals to keep paper records and professional adherence
to digital technologies is negatively affected when their needs and expectations are not met. The cost of
acquiring new software or modifying the existent is a limiting factor in the present economic situation.
The authors wanted to develop an upgradeable electronic application, specifically designed to be used in
chronic pain units.
Methods: This tool was entirely developed by anesthesiologists, with no costs to the hospital. The authors
®
used MS Excel and its Visual Basic Editor (VBE). It is compatible with any computer installed with MS
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Excel 1997 to 2013.
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Results and Discussion: The system is currently available for use in the authors’ central hospital and the
newest completed version is freely available for download. The interface is accessed by username and
password; the main page integrates information from four different tabs: 1. clinical history, 2. body diagram
and pain details, 3. complementary investigations and diagnosis, and 4. therapy and follow-up. The last tab
allows access to records from previous appointments and is linked to nine sub-forms with questionnaires
regularly used in chronic pain (i.e. BPI, DN4, SF-36). Information is entered in text boxes and multiple
choice fields, and algorithms use this to perform calculations. All the data is categorized and saved in a
digital database the authors created. The information collected can be printed and attached to the clinical
file or exported as a PDF report that can be uploaded for the patient’s electronic record. Additionally, it
is possible to print a handout for the patient with his prescription and recommendations. The authors
developed a button that sums up the clinical record and this can be pasted in other programs as
unformatted text.
This system was adapted to the department’s needs and has replaced the previous record keeping system.
Conclusion: Electronic tools developed by physicians can be better adapted to their preferences as users
and the ability to freely and easily update them improves the adherence to new technologies.
The authors hope to contribute to the widespread conversion of health records to digital by sharing this
application, which is available at: http://www.anestesia.pt. (Dor. 2014;22(1):34-40)
Corresponding author: Paulo Roberto, pauloroberto.xpta@gmail.com

Key words: Chronic pain. Clinical software. Data management.

Introdução e objetivos estar ligado em rede. Esta informatização dos
registos permitirá o livre acesso da informação
Nos últimos anos, o conhecimento sobre dor aos profissionais em todos os pontos do país de
crónica em Portugal tem evoluído de forma po- forma uniformizada, prática e eficaz.
sitiva e muito se tem conquistado. Esta nova A tendência para substituir os processos clí-
atitude tem permitido oferecer aos doentes com nicos em papel por sistemas digitais é gene-
dor crónica uma abordagem em equipas espe- ralizada nos países desenvolvidos, e as plata-
1
cializadas, multidisciplinares e de forma gratuita. formas gratuitas e open-source parecem ser o
Sabe-se que para melhorar o controlo da dor futuro. Várias vantagens são advogadas: a dimi-
em Portugal, além da política de saúde e da nuição do espaço de arquivo e dos custos as-
existência de profissionais de elevado nível, é sociados; a maior acessibilidade à informação;
essencial melhorar o registo e processamento a maior capacidade de análise dos dados sem
de dados. necessidade de mudança de suporte e, natural-
Há muito tempo que as diferentes unidades mente, o fim dos problemas de interpretação da
2
de dor em Portugal procuram uma plataforma de caligrafia .
registo adequada à realidade da dor crónica. A utilização de algoritmos informáticos para
Entende-se como crucial a criação de um sis- computar parâmetros clínicos, cálculos de do- DOR
tema informático simples, eficaz e com padrões ses ou simples cálculos aritméticos obtidos da
de uniformização definidos de forma a poder resposta a questionários demonstrou ser mais 35