CONTENT OF THE ISSUE
Prospects for the further development of the medical statistics service through the transition to management based on data
In the article the problems of the system of collection of state statistical reporting existing in Russia and the consequences to which they result are analyzed. A review of literature and publications in the media and the blogosphere is provided, which reveal the existing shortcomings of medical statistics.
The gradual development of health management based on data with the refusal to use statistical reports is proposed. The key idea is a gradual refusal to apply the existing forms of state statistical reporting. Instead, it is necessary to create and consistently develop a system of support for management decisionmaking in the health sector, presented as one of the federal components of the EGIS. Ultimately, such a system should completely replace state statistical reporting approved by the orders of Rosstat, Ministry of Health, FFOMS and other executive authorities, including regional government bodies, as well as numerous disparate “monitoring”, “registers” and other federal management systems available in present time. The established single federal service EGISP should accumulate in itself all the formalized primary data, primarily depersonalized, from other components of the EGISP, such as medical information systems of medical organizations (MIS MO), regional services and EHISM systems, information systems of the TFOMS and etc.
Relevance of use of technology blockchain in questions of provision of medicines of citizens
The paper identifies the requirements that will be presented to the information systems involved in the process of issuing and dispensing of medicines. Proved the efficiency of using blockchain technology for the successful implementation of these operations and the possibility of solving the main tasks on the basis of this technology
Decision Support System for Choosing Correction Tactics of Internal Carotid Arteries Stenosis
Along with the medical systems development there is an important task on creation of medical decision support systems (DSS), in particular, capable of predicting the probability of postoperative complications. Computer methods of data analysis make it possible to successfully use both classical methods of applied statistics and modern heuristic procedures for identifying latent (hidden) knowledge in patients’ databases with subsequent construction of predictive models. The article describes the DSS, which automates the prediction of complications probability in the surgical treatment of internal carotid arteries stenoses by carotid endarterectomy and angiostentiation methods basing on the clinical parameters of the patient’s condition before treatment and the technological parameters of the operative intervention. The DSS is based on such classification methods as classification trees and neural networks, the training sample for the classification is the database of patients, who have been treated, with the information of complications presence or absence availiable. Studies, preceding the DSS development were implemented in the STATISTICA package environment. The entrance into program is automated. At the user’s require, the patient data, needed for the calculation is imported into the prediction program module of complications probability from the Excel table. Also, at the user’s request, the prediction results can be saved in the source table.
«Cross-reporting» as a way for sub-speciality teleradiology
There is an original telemedicinebased approach for a subspeciality reporting of a radiology examinations at primary level facilities. This approach allows to increase quality of «neuroradiology» reporting at children. The level of discrepancies decreased from 42,0% to 20,0%.
Reduction of the features space when processing multiple drug resistance of mycobacteria in patients with pulmonary tuberculosis
Early detection of the presence of multiple drug resistance of mycobacteria to essential antituberculosis drugs is relevant in the diagnosis and treatment of pulmonary tuberculosis. Mathematical methods and information technologies can help solving this medical problem by excluding those not informative features from the set of features (indicators of the patient’s health status). The Kulbak method is used for assessment of informative features of the multiple drug resistance. The selection of features is made by the sorted (by informativeness) list of features through evaluating the quality of classification performed by ROC analysis. The performed researches showed that 6 features selected from the suggested method (out of 26 considered) allow to select patients with high probability of not having multiple drug resistance, which creates conditions for their adequate treatment.
Simulation of the admission department of the city hospital: building a digital model and optimizing the activity
The possibility of optimizing the activity of the admission department of the city hospital is shown on the basis of the results of simulation modeling. The use of FlexSim Healthcare software allows obtaining characteristics of medical care that are inaccessible to other methods of analysis. The digital model of activity of the medical organization allows to localize «bottlenecks», leading to the formation of queues. The problems of obtaining the data necessary for constructing models are considered. Virtual experiments help to find options for optimizing activities, while replacing longrunning and costly management experiments using real resources. The detailed description of the processes of medical care with the timing of its individual stages will help to obtain more accurate results of simulation. Simulation of medical care can be one of the stages of the introduction of «lean manufacturing» in health practice.
Model of the patient with liver failure for use in meta-analysis, focused on selection of adequate therapy
The features of classification of liver failure in various regions of the world are analyzed. Methods for constructing mathematical models of patients and diseases have been studied. A settheoretical model of the complex clinical presentation of a patient with hepatic insufficiency, used in the process of metaanalysis, is proposed. The model takes into account the etiology and features of the disease course, as well as regional variants of classification of hepatic insufficiency in Russia, Europe, America and Asia. An example of conducting a metaanalysis according to specified criteria is given
Medical information systems
Blockchain in Healthcare
Decision support systems