2020 № 3 Improving the quality of dispensary medical examination of the population in an outpatient clinic based on the use of information technologies
Introduction. A special feature of the adult population’s dispensary medical examination (DME) is the wide range of new tasks for the primary health care system. DME leads to an increase in the number of patients subject to dispensary follow up (DFU), an increase in the load on specialists of outpatient hospitals. Thus, it is necessary to search for and implement new tools in the practice of outpatient hospitals that improve the quality of preventive medicine and ensure that doctors make informed and
timely decisions. Information technologies are offered as such a tool. Material and methods of study. This article uses methods of descriptive statistics and programming. The source material for the development of software modules was the materials of questionnaires and clinical and instrumental examination of patients, statistical reports on DME, DFU of patients in need at the district outpatient hospital from 2013 to 2018. The technical task and development of the algorithm for programming were performed by the authors. Comprehensive monitoring of risk factors for non-communicable diseases among those who have undergone DME was carried out using the program module “Screening of modifiable risk factors for major chronic non-communicable human diseases”, integrated with the MIS (medical information system of the institution). On this basis, the database “Monitoring of risk factors for chronic diseases among the population of the territory covered by the district outpatient hospital” was created. Improving the quality and increasing the coverage of the population with dispensary follow up was carried out using a software module developed for this purpose, integrated with the institution’s MIS. Results and discussion. A continuous comprehensive monitoring of non-communicated diseases risk factors has been organized, and their structure and changes over a 6-year period have been described. The proposed efficiency coefficient indicates positive changes in the work of the medical network to reduce the impact of risk factors on health. It was found that the most modifiable risk factors include “Low physical activity”, “Eating disorders”, and “Hyperglycemia”. DME leads to an increase in the number of patients who need DFU, an increase in the load on the primary health care network. The use of a software module in the practice of the institution to improve the quality and coverage of those in need of DFU contributes to positive changes in this section of work, facilitates the work of healthcare providers. Expanding the range of information technologies used in the work of outpatient hospitals contributes to improving the quality of decisions taken in the prevention of public health disorders by doctors working in conditions of increased workload. Conclusion. DME statistics indicate an increase in the burden on specialists of outpatient hospitals due to the increase in the detection of patients, the need to perform work to eliminate risk factors for non-communicable diseases, and an increase in the number of people subject to dispensary follow up. The work of specialists of outpatient hospitals to eliminate the impact of modifiable risk factors of non-communicable diseases should be carried out on the basis of their comprehensive monitoring. In these conditions, there is a need to expand the range of information technologies used in the preventive work of institutions providing primary health care, aimed at improving the quality of work in this section, creating new working conditions for healthcare providers. These results of using the proposed IT‑tools in integration with the operated MIS allow to improve the quality of preventive work in an outpatient facility, demonstrate the emergence of new tools for doctors that contribute for informed and timely medical decision-making.