2022 № 1 About the ability of the Uniform State Health Information System to solve management problems
The unified state health information system (UHISZ) is becoming a state-significant information system (IS), which is capable of solving any problems of preserving and strengthening the health of citizens.
Purpose of the study is to substantiate the problems of the construction and functioning of the Unified State Health Information System, the solution of which will multiply the capabilities of the Unified State Health Information System to solve the problems of preserving and strengthening the health of citizens and look for new non-traditional ways to improve their health.
Results. I n the article, the authors distinguish three levels of problems to be solved. The first level of problems is problems that can be solved at the highest (legislative) level. The second level of problems is the problems that must be solved at the regional level. The third level of problems is the problems faced by ordinary users of the Uniform State Health Information System – doctors and other medical workers.
The article initially uses the position – “Any information system is a tool for solving management problems.” The authors trace the stages of creating informatization in the Russian Federation from the complex program “Development and implementation of automated consultative systems for diagnosis, prognosis and choice of treatment tactics in emergency conditions”, which substantiated the development of automated systems for the period 1978–1990 until 2018, when Russia was the National Healthcare Project was launched, which includes the Federal project “Creation of a unified digital circuit in health care based on the unified state health information system (Unified State
Health Information System) ”. The article discusses the problem of the privacy of data on the health of a resident of the region and the privacy of knowledge of the factors that determine both the health of a particular resident of the region and those around him. Preserving the complete privacy of a citizen’s “personal space” will lead to the fact that the Unified State Health Information System will have the most general data on the health of a resident of the region. In this case, it will only be possible to solve those problems that characterize the health of the region’s inhabitants, which were solved without any digitalization. The second level of problems is associated with the work of “Uniform State Health Information System” and support programs operating at the level of the regional health care system. The main
regional problems associated with “EGISZ” are: problems of licensing of auxiliary programs; problems of accounting for the quantitative parameters of the development of the Uniform State Health Information System and auxiliary programs; problems of control over the work of auxiliary programs; problems of control over the filling of the Uniform State Health Information System; the problem of “user-friendliness of the interface” (especially for departments with cases of “peak work” – emergency departments).
Separately, it should be noted the issues that are not problems of the functioning of the Uniform State Health Information System, but more characterize the new opportunities that arise in the presence of the Unified State Health Information System, which has a wide range of knowledge about human health. Uniform State Health Information System allows to solve in a different way the traditional tasks of an informational, organizational, medical, economic, scientific and educational nature that exist in the region. The noted fact prompts to look for new problems of assessing the health of residents of the region and ways to solve them, which were previously unavailable due to the lack of systematized data on the treatment and diagnostic process, other aspects of the activities of medical organizations, as well as information on factors affecting the health of residents of the region.
Conclusions. Any information system is a tool for solving management problems. Without eliminating the problems of replenishing the Uniform State Health Information System with data on the factors influencing the health of the inhabitants of the region, it is impossible to effectively solve the problems of preserving and strengthening the health of the citizens of the region. The data, which, in accordance with the Federal Law “On Personal Data”, are included in the list of closed data, are encrypted in the EGIZS. To oblige the regional health authorities to introduce a licensing mechanism for programs interacting with the regional Unified State Health Information System.
The development of regional Uniform State Health Information System will lead to a radical change in the view of the traditional tasks of information, organizational, medical, economic, scientific and educational nature, solved in the region.
2021 № 8 Evolution of information systems
In medical organizations, information systems solve the following tasks: the ability to receive and store information, quick access to it and its transmission, the ability to generate various reports, the availability of specialized workplaces of medical workers, etc. Information systems are gradually evolving, turning from a tool capable of solving the simplest management tasks into a tool capable of solving the entire range of management tasks encountered in the practice of a medical organization at all levels of management. The purpose of the study is to describe the four stages of creating information systems, highlight the characteristic features of the functioning of information systems at each stage, as well as highlight the list of the main management tasks that are being developed at the selected stage and ways to solve them. The main attention was paid to the development of information systems of medical organizations working with the children’s population.
Results. The first stage of the development of information systems began with the use of computer technology in the practice of medical organizations and was reduced to the fact that programmers of both medical and third-party organizations began to develop tasks, the totality of which later became known as “creating an information system” of a medical organization. The goal of the second stage is already the transformation of information systems of medical organizations in order to describe production processes in terms of a process approach and implement them in the form of software modules. The third stage of building information systems is the stage of describing the work of a medical organization based on mathematical models in order to justify the optimal solution of the production tasks available in it. The fourth stage of building information systems is the construction of an “information system that implements the functions of an intelligent management system of a medical organization”. The authors of the article give recommendations on the formalization of information available in a medical organization for the purpose of its
effective use by artificial intelligence.
Findings. Thus, an information system is a tool for solving management problems, its development as a tool for solving management problems requires knowledge of management theory, organization theory, process approach in management, methods of multidimensional statistical analysis and modeling methods, languages and modeling methods based on neural networks.
2021 № 10 MODERN APPROACHES TO SOLVING THE TASKS OF MANAGEMENT OF MEDICAL ORGANIZATIONS
A large amount of data is currently appearing in the information systems of medical organizations, which requires a revision of those industrial relations that exist in the practice of health care institutions.
T h e p u r p o s e o f t h e s t u d y is to study the possibilities of mathematical methods using the concept of “an object with estimates in a certain state” to solve management problems that are in the practice of medical organizations.
R e s u l t s . The authors use the term “production process”, which is not typical for the classical description of the activities of a medical organization. This is due to the fact that the approaches to solving management problems available in a medical organization are valid not only for medical and diagnostic work, but also for other household work. New approaches to solving the existing management problems of a medical organization consist in the fact that the description of the solution to the control problem is made in the form of some algorithm, which can then be implemented in some programming language. The digitization of production processes leads to the need for their formalized description in the language of mathematics, as well as the widespread use of mathematical methods, on the basis of which algorithms for solving control problems are built. Markov chains make it possible to find general patterns in the behavior of control objects within the framework of the problem being solved, which can be used to construct a tree giving a detailed description of the behavior of each control object. Further, the method of oriented
trees with estimates is applied, which provides information for writing job descriptions for employees of the Ministry of Defense, on the basis of which the management problem will be more optimally solved. It is necessary to highlight four features of the method of oriented trees with estimates: it allows to give a detailed analysis of the sequence of transitions of each object for the selected states; in the presence of a large number of analyzed objects, the resulting tree is difficult to analyze; you can rebuild the branches of the tree; in the course of building a tree, it is possible to change a set of states without changing the obtained chronological sequences of states of each control object in the initial data. Oriented trees with estimates can be used to simulate the production process, which is based on the possibility of simultaneously changing both quantitative and qualitative characteristics of the tree.
The article presents two options for modeling using changes in the qualitative characteristics of the tree.
F i n d i n g s . The introduction of digitalization in healthcare requires a different approach to solving management problems, which should be carried out with extensive use of mathematical methods at the stages of analysis and modeling. The work on the use of mathematical methods in solving management problems should be organized by regional medical information and analytical centers.
It is necessary to carry out work on the formalization of production processes, the creation and storage of algorithms for solving control problems. Promising methods that allow solving most of the management problems available in the practice of medical organizations are the methods of Markov chains with estimates, branching processes with estimates and oriented trees with estimates.