The Digital Circuit Is Not Only Information Technology And Software

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The Digital Circuit Is Not Only Information Technology And Software
The Digital Circuit Is Not Only Information Technology And Software

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The digital circuit is not only information technology and software

In Russia, conditions must be created for full-fledged interaction within the Unified State Health Information System - a unified state information system in the field of health care. It is assumed that this will improve the efficiency of management, the accuracy of statistics and the quality of medical care. The "digital transformation" of the industry was discussed at the International Forum on Digital Medicine.

"The digital circuit is not only information technology and software"
"The digital circuit is not only information technology and software"

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In Russia, conditions must be created for full-fledged interaction within the Unified State Health Information System - a unified state information system in the field of healthcare. 177 billion rubles have been allocated for the creation of a global infrastructure digital single circuit. It is assumed that this will improve the efficiency of management, the accuracy of statistics and the quality of medical care. The "digital transformation" of the industry was discussed at the International Forum on Digital Medicine held at Sechenov University.

Medical inequality

As a member of the Federation Council of the Russian Federation Ildus Akhmetzyanov noted at the opening of the Forum, Russia has accumulated the intellectual potential necessary for the transition to digital medicine. “It is important that telemedicine, as a method of remote data exchange in real time, is adequately integrated into the system of practical health care, medical science, and education,” he said.

According to Herman Klimenko, Chairman of the Council of the Digital Economy Development Fund, Co-Chairman of the Council of the Russian Chamber of Commerce and Industry for the Development of Information Technologies and Digital Economy, we live in an era of medical inequality: there are no more than 7,000 specialists per 150 thousand settlements. The resource of doctors today is limited, the annual number of graduates of medical universities remains constant, while the standard of living and its duration are growing, the expert noted. Consequently, the quality of diagnostics should grow and this, first of all, is the importance of digital technologies.

According to him, there are many domestic projects in the field of digital medicine, but all of them are faced with problems associated with the imperfection of the current legislation in this area. On the other hand, as Vladimir Maslov, Director of the Department of Digital Development of the RF CCI, noted in his speech, only the scaling of unique solutions will make it possible to change the legislative base faster, and such solutions already exist - there was an opportunity to get acquainted with them within the framework of the exhibition timed to the Forum.

Single digital circuit

Organization of interaction within the framework of the Unified State Health Insurance System between medical organizations, pharmacies, institutions of medical and social expertise, medical workers and patients is one of the instructions for the implementation of the President's Address to the Federal Assembly dated February 20, 2019. According to the plans of the Ministry of Health, by 2021, electronic prescriptions and a single electronic medical record should be introduced in all regions. By the end of 2023, all regions must complete the creation of centralized systems, which will make central archives of medical images and unified laboratory systems available to all medical institutions. In addition, National Medical Research Centers will appear in the country, which will become the main specialized organizations responsible in each region for the medical information infrastructure.

“The digital circuit is not only information technology and software. To a greater extent, this is a regulation of business processes for effective interaction between participants in both healthcare and other industries. Modern information systems are at the intersection of industries. Medical certificates are needed everywhere: to get a driver's license, go to the pool, go to the camp, "Deputy Minister of Health for Digitalization Elena Boyko explained the task previously facing the department. In addition, according to her, the Uniform State Health Information System will allow for more effective management of preferential drug supply, monitoring compliance with clinical recommendations, the quality of patient routing.

Iceland was the first country in the world to allow citizens to obtain their medical data via the Internet two years ago. Users of the special application receive detailed information about their vaccinations, treatment received, allergies, medical prescriptions, prescribed medications and upcoming doctor visits. It also accumulates information from wearable devices. If desired, the patient can provide his medical data to the insurance company. Today, similar services are becoming available in Russia.

Digital freedom

The maintenance of the Uniform State Health Information System is provided for by the law on telemedicine, which entered into force on January 1, 2018, and the foundations of its functioning and interaction with other systems are also determined there. At the same time, the law itself is based on the EGIS, which should link all medical institutions and health authorities. And from January 1, 2019, all medical information systems of clinics (MIS), regardless of the form of ownership, are ordered to transfer data to the Unified State Health Information System.

We are talking, in particular, about an electronic registry, an integrated electronic medical record, registers of medical workers, organizations and electronic documents, doctor's appointments, statistical and financial reporting, subsystems for maintaining specialized patient registers and other subsystems. For example, up-to-date information on the schedule of doctors' appointments and the possibility of registering patients with them should be transmitted to the Unified State Health Information System within one working day, information on the expenses and income of the institution - within five days.

Experts assess the prospects of the Uniform State Health Information System very highly - patients will definitely benefit in the speed and quality of medical care. According to the head of the National Technical Committee for Standardization TK-468 "Health Informatization" on the basis of the Central Research Institute of Health of the Ministry of Health of Russia, Director of the Institute of Digital Medicine of Sechenov University Georgy Lebedev, the patient will be protected from incorrect treatment due to incomplete information provided to the doctor by himself. If the patient has chronic diseases, contraindications, the doctor will be able to see this information in any other clinic.

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The unified information environment will also greatly simplify the provision of medical services remotely. According to Georgy Lebedev, for the development and organization of remote monitoring of the health of patients, the Institute of Digital Medicine, by order of the Ministry of Health of the Russian Federation, is carrying out a research project "Creation of an applied digital platform for remote monitoring of health." In particular, he is developing a regulatory framework that will approve the procedure for interaction between clinics and telemedicine projects.

The patient's right to telemedicine observation is actively promoted in the expert community. So, according to the president of the National Agency for Patient Safety and Independent Medical Expertise, Alexey Starchenko, it is necessary, for example, to create an information system for monitoring pregnancy in the countryside. Another vulnerable category is the elderly, for whom automatic programs for monitoring the function of the heart muscle, respiration and other parameters are needed.

Towards a single standard

Today, all organizations licensed to provide medical care can transfer data about patients to the Unified State Health Information System and receive it from there. But integrating Russian IIAs with federal services is far from an easy task. Thus, the structuring of medical data is a huge problem: the lack of uniform standards in the fields of medicine makes it difficult to exchange data between different programs.

As a result, the transfer of information from even the simplest devices, such as an electrocardiograph or an automatic blood pressure monitor, to the medical information system of a medical institution becomes a difficult task, says the head. Department of Medical and Biological Cybernetics, Siberian State Medical University, university - participant of the project "5-100", Konstantin Brazovsky. And the main condition for combining into a single digital circuit, as well as for the development of telemedicine as a whole, is the approval of a single standard for information storage formats and exchange protocols within information systems, as well as protocols for connecting digital medical devices to medical information systems.

Moreover, in other countries the situation practically does not differ from the Russian one. More than ten large organizations are engaged in international standardization in the field of digital medicine. According to Georgy Lebedev, the International Organization for Standardization (ISO) has established a Technical Committee (ISO TC 215) “Health Informatization” for the development of international standards, which has already published 185 standards, another 59 international standards are under consideration.

For these purposes in Russia in 2005 the National Technical Committee for Standardization TK-468 "Health Informatization" was created on the basis of the Federal State Budgetary Institution "TsNIIOIZ of the Ministry of Health of Russia". In 2017, the committee was modernized, as a result, Subcommittee No. 3 "Semantic content in medical information, analytical, intelligent, robotic and telemedicine systems, the use of Internet resources in healthcare" was created on the basis of Sechenov University. The committee carries out standardization in ten areas, including "Information on the state of health and medical care", "Terminological resources and presentation of medical knowledge", "Requirements for electronic medical history", "Harmonization of health informatization standards and profiles", etc.

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