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Information technologies for the Physician 2017 #3
Published: 2017-05-10
1736
CONTENT OF THE ISSUE
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Digital public health. Necessity and background
There are a number of ongoing state programs and projects in digital health, moreover an ad hoc federal law No. 242-FZ “On Amendments to Certain Legislative Acts of the Russian Federation on the Application of Informa- tion Technologies in the Sphere of Health Protection” was recently adopted. Authors consider the background for such activity of government bodies, its maintenance by market forces. The article demonstrates priority and necessity of the only conceptual core for public health digital transformation as well as the economy at the whole. Project approach benefits to the new law implementation are pointed out
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Reengineering of public health system, based on a person-centered model, hybrid project management approaches and methods of artificial intelligence
The paper considers new approaches of public health emerging on the platform of the technological revolution of information systems. The authors describe the key methods of managerial, technological and mathe- matical interaction with the collective information infrastructure of the healthcare system that will bring qualitative changes in the near future and will form the basis of a digital society, digital economy and public health of a new type. The methods are considered from the point of view of their influence on the formation of new approaches in the process of the economic and social transformation of waves of innovation. The model of the person-centered health care system and the forecast of its impact on the subject area are presented, the advantages of the new model are summarized and the agile project management approaches to its implementation in the current stage of development are presented.
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Application of a software package for the certification of trauma centers and quality control of treatment of patients affected by road traffic accidents in the Moscow Region
Within the framework of the Unified Medical Information and Analytical System of Moscow Region («EMIAS») there was developed a software package for the certification of trauma centers, which allows to perform statistical and economic analysis for the financial modeling of trauma centers to ensure high quality of treatment and to prevent economic losses of the society and reduce the lethality of the victims after a car accident
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Online method medical-economic control of prescriptions for preferential drug provision
There is a high probability of making mistakes (intentional and unintentional) while filling the electronic form of the recipe for preferential drug provision, that may lead to violations in the prescription of drugs. Expert detection of prescription form filling errors after the drugs had been released to the patient in pharmacy can’t prevent the negative impact on patient’s health. The purpose of the study is to improve the effectiveness of organizing and performing the medical control of drugs prescribing, to simplify procedures for providing citizens with preferential medicines, applying the developed methods and algorithms for real-time verification of the selected recipes. The paper represents the method and the development of decision making support algorithm to be used while performing the medical expertise, also called medical -economic control. The opportunities of unified information system for prescribing and releasing of preferential recipes in the Krasnodar Region are observed in the paper in the frame of implementation of the “electronic prescription” technology and medical expertise of preferential drugs prescribing in real time. The prospects of medical expertise performing for detecting cases of polypharmacy in advance are established in cases of multiple drugs prescription (more than five). The importance of performing medical expertise was defined for all kinds of prescription, not only for preferential drugs, consequently the suggested method and developed algorithm should be applied to medical expertise of all kinds of electronic prescription in real-time
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Functional requirements for healthcare quality information system
One of the main objectives of the adoption of the Law of the Russian Federation of 29.11.10, No. 326-FZ «About compulsory medical insurance in the Russian Federation» is a significant improvement of the quality of medical care for Russian citizens. In accordance with the norm of Article 4 of the Law, the main principle of compulsory health insurance is to «...create conditions for ensuring the accessibility and quality of medical care provided under compulsory health insurance programs». Healthcare quality assessment can be implemented using the following methods:
- medical standards compliance inspections;
- pharmacotherapy effectiveness inspections;
- medical and economical quality control;
- questioning the quality of medical care, medical institutions rating, and medical staff rating.
These methods allow to formulate the functional requirements for a healthcare quality information system. In practical implementation, such a system should contain a knowledge base on the basis of which it is possible to develop a formal scheme for the process of solving the tasks, as well as the implementation of the proposed knowledge representation model and the decision-making procedure -
Portrait method as technology for development of decision making systems for diagnostics and differential diagnostics in clinical practice
Among the various technologies for the development of expert systems, the portrait method, originally pro- posed by E.V. Gubler. The authors have long used a portrait method for formalizing medical information when creating expert systems for diagnosis and differential diagnosis of diseases. When forming the knowledge base, the clinico-log- ical, expert and clinical-expert approach in the formation of a portrait of the disease is used. This article is enlightened on the description of the methodology for applying the portrait method in the development of expert systems. The features of forming the knowledge base and the algorithm of the solver work are considered
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Analysis and forecasting of socially dangerous acts committed by psychiatric patients by dint of modern mathematical methods
The article considers the possibility of analyzing and forecasting socially dangerous acts committed by psychiatric patients by dint of modern mathematical methods. The review of modern methods of analysis and forecasting of time series is presented. An algorithm for forecasting socially dangerous acts committed by psychiatric patients according to the data of the regional forensic psychiatric expert service of the Tyumen region for the last 16 years has been developed with a total of 17967 examinations and an example of its program implementation is presented. Considered eight times of the series, the optimal model of which is selected from 188 in no less than 30 seconds. To assess the adequacy of the forecast, the model data obtained on the basis of the 15-year time series with the actual ones for 2016 were compared. All the mathematical models obtained confirmed the absence of significant differences in the Mann-Whitney U-test at significance level p = 0,05. Examples of interpretation of possible forecasts and examples of scientifically grounded management decisions are given.
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De-identification of Personal data in Health care
The methods of de-identification: anonymization and pseudonymization of personal data in information systems in health care. Lists the key normative documents and standards defining the requirements for the protection of personal data and their depersonalization. Described embodiments and examples of the use of technology pseudonymization in health care. Formulated proposals for the introduction of methods of pseudonymization in health care
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Prospects for neural networks and deep machine learning in creating health solutions
The paper gives an overview of the prospects of using neural networks and deep machine learning in the creation of artificial intelligence systems for healthcare. The definition and explanations on the technologies of machine learning and neural networks are given. The review of already implemented artificial intelligence projects is presented, as well as the forecast of the most promising directions of development in the near future
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From PACS to teleradiology
This article is about the current situation of the distribution and exchange of medical images. Today PACS is familiar to medical facilities and it is widely used system in radiology departments, but the “teleradiology” term still has difficulties with interpretation. When digital medical images are printing on a film and then transfer to other specialists, this way of exchange becomes more and more expensive and inefficient. That’s why the problem of acquisition, dis- tribution and getting access to the results of the diagnostic studies still actual. Another problem is the lack of qualified radiologists in the regions of Russia, due to the uneven population density; competent specialists are concentrated in regional centers. Therefore performing of urgent remote consultation is an actual problem too. In this article have been defined perspectives of advancement of the teleradiological systems, that began to appear due to PACS implementa- tion in radiology departments. The purpose of this scientific research is to develop the methods of teleradiology systems organization for consultations using PACS and telemedicine networks created in the regions. Factors influencing the quality of teleradiology consultations were discussed in article. Prerequisites for the development and implementation of such socially important systems, as a regional teleradiology system were defined
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Organizational telemedicine
Scientific bases of organizational telemedicine as a new direction of application of information and telecom- munication technologies in the system of citizens’ health protection are developed. The terminology, principles and role of telemedicine in the field of organization of public health and public health are defined. The advantages of using organizational telemedicine for improving the organization of medical care in the system of national and departmental health of the Russian Federation are shown. A new view of telemedicine as a tool for maneuvering health resources is proposed for the rapid change in the volume and level of medical care in the interests of a broad contingent of the population. The integrative role of organizational telemedicine in the integrated application of various information technologies in health care is shown
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Information guidance for the development of targeted training of medical specialists
The problems of information support of continuing medical education and the accreditation of medical specialists are considered. Results of studies of the Medical Academy for continuing professional education (Department of Medical Statistic and Informatics) on these issues are considered and the prospects of the development of the organizational, educational and information initiatives are evaluated
