2021 № 1 Identification of patients as a safety in providing medical care (practical experience)
Patient safety is one of the priorities in medical care. The leading place in it is occupied by “correct patient
identification”. According to research by experts from the World Health Organization (WHO), “misidentification of a patient is the cause of many errors.” The purpose of this work is to assess the implementation of a patient identification system using bracelets in a multidisciplinary hospital. The main idea of the project is based on the use of personal identifiers, made in the form of a disposable white bracelet worn on the patient’s arm, as well as the use of color-coded bracelets (red, yellow, red-yellow), which allows identifying patients at risk of developing life-threatening conditions: high risk falling of the patient and the presence of an allergological history. The introduction of identification bracelets with patient data and a barcode on them increased the percentage of identification performance increased from 67% to 89%. After the introduction of the system of prevention of falls and color identification by bracelets, the number of falls of patients decreased by more than 4 times. Successful integration of the automatic identification system into the workflow of a multidisciplinary hospital significantly reduces the influence of the human factor on the number of medical errors and related preventable consequences for patient health.
2020 № 7 Modern approaches to the construction of an effective model of preventive work with children
The approaches to the analysis of the information of the medical information system about the child population
attached to the medical organization (22,950 children) are described to identify homogeneous groups in order to build a
preventive work plan with each. The team of experts of the medical organization has developed an electronic work plan for
4,745 options for monitoring a child, which is implemented as a computer program that allows you to automatically rearrange
the plan. It is considered as a sequence of standard operating procedures. The program automatically “restructures”
the calendar plan of work with the child, allowing you to complete the missed work in an acceptable time for the child
and the performer. The use of such planning is especially necessary for work in the conditions of prevention of COVID‑19.
2017 № 8 Assessment principles of informatization level of medical organization
The article is about assessment principles of informatization level of the regional segment of The Unified State Health System. This approach is based on an assessment of informatization level of the healthcare organizations. Scale building is based on the calculation of indicators, combined into functional segments, which form an integral evaluation for the medical organization. In 2016, the developed scale in the questionnaire form was presented to experts of regional Medical Information and Analytical Centers of eight Russian constituent entities, the experts took a favourable view of 90% indicators. There was implemented a test survey of medical organizations of three pilot regions
2023 № 4 Evaluation of the effectiveness of using remote monitoring of blood pressure in the dispensary observation of patients with arterial hypertension
Arterial hypertension (AH) is by far the most important risk factor for cardiovascular disease. An effective method of dealing with high blood pressure (BP) is dispensary observation. Of particular relevance is the search for new tools to improve the dispensary observation of patients with hypertension, one of which may be remote monitoring of blood pressure, as an option for providing medical care using telemedicine technologies.
Purpose of study – Analysis of the effectiveness of using remote monitoring of blood pressure in the dispensary observation of patients with hypertension.
Methods. A non-randomised, open-label, generalized, single-centre, retrospective, longitudinal, parallel, applied study included 78 patients who completed a remote blood pressure monitoring program who were subsequently divided into 2 groups depending on the degree of achievement of target values of blood pressure (<135/85 mm Hg).
Results. During the observation period, all patients (n=78) experienced a decrease in SBP by 8.2 mmHg, DBP at 3.8 mmHg. Group 1 consisted of 35 patients who reached target levels of blood pressure, group 2 included 43 patients who did not reach target levels of blood pressure. Initially, the groups did not differ in sex and age, while in the second group, the initial values of SBP and DBP were higher. The study found that the degree of achievement of target levels of blood pressure is influenced by the following factors: the level of SBP and DBP at the beginning of observation, the proportion of extraordinary measurements with blood pressure levels above 135/85 mmHg during the observation period, the proportion of missed blood pressure measurements during the observation period, as well as the duration of remote monitoring.
Conclusions. Remote monitoring of blood pressure is an effective tool for improving the dispensary observation of patients with arterial hypertension and can improve the availability and quality of medical care.
2020 № 6 On the issue of the feasibility of the im- munization informatization in penitentiary medicine
The article highlights the use of information systems in immunization as one of the important problems of the pen- itentiary and civil healthcare sectors. It analyzes the existed software systems for automated immunization management and helpes to make conclusion that the implementation of such software products into the practice of penitentiary health care should be carried out taking into account all the specifics of the organization of medical activity in the penitentiary system.
2020 № 6 Application of the method of analysis of “oriented trees with assessments” to identify regional features of forming the pathology of dairy teeth in children
In order to identify regional features of the sequence of lesions of primary teeth in children, the data of the medical in- formation system of a children’s hospital using the method of “oriented trees with estimates” were used. The data of 3,405 children under the age of 6 years who contacted a dentist about diseases of deciduous teeth during 2015–2018 were analyzed. They had 17,462 appeals. It was found that in 516 children the first diseased milk tooth was 51, with an average age of 2.72 years. The second is either 61 (237 patients, with an average age of 2.91 years), or 52 (224 patients, with an average age of 2.58 years). In 113 patients, a sequence of newly diagnosed affected primary teeth 51–52–61 was observed. Only one tooth was observed in 59.9% of patients, in 13.1% of two and in 27% of three or more teeth. It is calculated that if premolar is the first diseased milk tooth, then with a probability of 0.619 the next will be the same as the premolar. Application of the method made it possible to es- tablish regional features of the sequence of lesions of primary teeth in children and to develop approaches to individual prevention.
2022 № 11 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.