Manager Zdravoochranenia 2022 #11
CONTENT OF THE ISSUE
HIS as a buisiness platform of the digital ecosystem of medical care
The article examines the concept of an ecosystem in the provision of medical services, formulates the features of the construction and application of ecosystems in healthcare. The article describes an approach to creating an ecosystem based on HIS. The study compares the views on the ecosystem of heads of medical organizations and software developers, determines the properties of the system-forming MIS and the requirements for its architecture.
The purpose of the study is to consider the concept of an ecosystem in relation to healthcare, to analyze its role and opportunities for improving the quality and accessibility of medical care. Determine the components necessary to build such an ecosystem and their characteristics.
Materials and methods. The relations between consumers and providers of medical care in the conditions of the changed paradigm of medical care are analyzed. A retrospective of the concept of an ecosystem was conducted and the proposals of business platforms in the IT services market at the present time were analyzed, the features of medical care ecosystems were highlighted. To determine the requirements for building ecosystems in healthcare, the experience of using IT in medicine and related fields, the experience of organizing a unified information space for healthcare subjects was analyzed.
Results. The properties of business ecosystems are also inherent in medical care ecosystems with some features of the latter. The basis of such an ecosystem should be an IIA that has the following properties: support for cooperation, integrativity, adaptability, platform, complexity or completeness of functionality, the ability to work on different software and hardware platforms, openness. The architecture of a system-forming MIS should support three levels: the level of infrastructure, the level of transformation and the level of interaction.
Findings. Service in the ecosystem of medical care for citizens means the ability to solve the whole range of health management tasks. For health care providers, participation in the ecosystem means creating prerequisites for generating sustainable income. The transition to ecosystems will create a new, future-oriented framework for medical care and scientific research. The transition to medical ecosystems will lead to the fact that the term “digital community” can be applied to healthcare in the near future.
A service management strategy in the Hospital information system
To determine the strategy of service management in medical institutions, the article discusses the basic concepts associated with services, gives goal-setting, defines the roles, properties and attributes of medical services, gives recommendations for managing services through the HIS.
Service management is considered on the example of HIS Interin PROMIS Alpha (Interin Technologies, Moscow).
P u r p o s e . Develop a strategy for managing medical services, define goals and objectives for managing services. Analyze the role of information technology in the implementation of medical services in the free market.
M a t e r i a l s a n d m e t h o d s . Models for maintaining a catalog of medical services are analyzed. The experience of service management in medical institutions based on the existing regulatory framework has been studied. The characteristics of medical services that determine the features of their economic accounting are analyzed. The role of MIS in providing analytical and control tools, as well as mechanisms for configuring business processes is determined.
R e s u l t s . The methodology and stages of transition to a centralized model of maintaining a catalog of medical services have been developed. The tools for managing the production of medical services are described.
F i n d i n g s . The most effective production management strategy in the MO is a centralized (organizational and methodological) model based on a single catalog of medical services, the ability to perform which is evidence of the maturity of the organization.
Implementation Of The Material Incentives Mechanism In A Healthcare Organization With The Use Of HIS.
The article notes the importance of the financial incentive mechanism for a healthcare organization. The mechanism should be both effective, delicate, objective, fair, transparent, stimulating professional and personal growth. The principles are proposed and the mechanism of material incentives, built at the V. A. Nasonova Research Institute of Rheumatology. The features of the implementation of the subsystem “Incentive payments” in HIS Interin PROMIS are briefly presented. In conclusion, the main results of the implementation and operation of the subsystem “Incentive payments” of HIS in the medical organization are listed.
Hospital information system and quality control of treatment.
The article presents an approach to quality control of treatment at the present stage. A trend of today – the use of a medical information system for quality control of the medical and diagnostic process (with special attention paid not to reporting to higher authorities, but to the organization of internal control in a medical organization). Possible tools and benefits are considered.
P u r p o s e . Determining the capabilities of Hospital Information System for quality control of medical care.
M a t e r i a l s a n d m e t h o d s . We analyzed the requirements of regulatory acts for the control of medical care, as well as the real needs of HIS users. An experiment on the formation of a set of tools for quality control of treatment was carried out using the example of Hospital Information System Interin PROMIS Alpha. We considered the prospects taking into account the results of the research of Ailamazyan Program Systems Institute of RAS in the field of working with clinical data banks.
R e s u l t s . General requirements for internal quality control include 5 levels of control. The use of HIS is most in demand in the following areas: compliance with medical care standards, internal control tools (analysis of compliance with clinical recommendations, expert assessment of the quality of treatment, quality and safety of medical activities, format and logic control, etc.) and ensuring patient safety.
The use cases of the HIS in these areas are illustrated by the example of the Hospital Information System Interin PROMIS Alpha. The prospects of the development of the direction consisting in transferring the main load from a person to an HIS and in attracting AI technologies and neural networks are considered.
F i n d i n g s . The main problems of quality control are the need for the participation of highly qualified specialists and the high complexity of the process. These problems can be solved by shifting the control regulations from «after the fact» to «proactive» and «in real time» by using HIS, as well as involving knowledge-intensive technologies in this process with the involvement of artificial intelligence and neural networks.
Development of patient-centered services in medical organizations
The development of patient-oriented means of interaction between citizens and organizations of the participants of the modern “digital interaction” system is a current trend in the field of medical information technology. The formed principles of digital transformation of healthcare, which are carried out within the framework of the federal project “Creation of a unified digital contour in healthcare based on the unified state health information system (UGISZ) ”. National Project “Health Care”, provide ample opportunities for designing and developing new applied solutions in terms of requests from medical organizations for modern domestic IT tools for “communication” with patients.
The aim of the article is to analyze and describe the current level of development of patient-oriented software products and methods of their development.
As a result, the software “Personal account of the patient “Interin LC”, developed on the basis of research and running on a stack of freely distributed software, is described.
Digital ecosystem of a medical organization
Quality of medical care