Prospects for eHealth in Russia. Prospects for e-health in Russia The concept of creating a unified state information system in the field of healthcare

A single information space in the field of medicine is being formed in our country. After analyzing the trends in the application information technologies in healthcare, TAdviser and the National Informatization Center prepared an infographic and an overview of the prospects for creating a single e-health space and reviewed it from the standpoint of a patient, doctor, and industry regulators.

Problem and solution

The growth in demand for medical services with a simultaneous increase in the requirements for their quality leads to an inevitable increase in the cost medical services. This poses a very serious problem for the state: how to ensure the availability of all types of medical care guaranteed by law?

A simple increase in healthcare costs, as evidenced by both domestic and world experience, cannot overcome this problem. The solution can only be found in the integration of all resources available in the health system, as well as in their optimization and effective planning.

We are talking about improving the quality of management, optimizing patient flows, eliminating unnecessary bureaucratic links, organizing barrier-free interaction between all parts of the healthcare system, and activating the processes of wide and rapid implementation in medical practice. the latest technologies diagnosis and treatment.

To this end, Russia has been creating the Unified State Health Information System (EGISZ) since 2011.

eHealth should cover primary and ambulance, disease prevention and inpatient treatment, drug supply, raising awareness of citizens, training of doctors, scientific activity and industry management.

To ensure connectivity information space, all polyclinics and hospitals in the country should use uniform processing formats in in electronic format medical information and regulations of interaction. These organizations should be equipped with medical information systems (MIS), which, among other things, maintain electronic medical records.

An important element of e-health in the near future should be telemedicine systems, as well as services for remote health monitoring.

The entire system is based on the information and telecommunications infrastructure designed for processing and transmitting data, as well as providing information security and protection of personal data.

As of 2016, a lot of work has been done: in 83 subjects Russian Federation medical information systems were introduced in which electronic medical records of patients are maintained; 57% of automated workplaces of medical personnel are connected to medical information systems; in 83 regions, systems for electronic appointments with a doctor have been implemented; in 66 - implemented automated systems dispatching of sanitary vehicles; in 75 - automated systems of preferential drug provision have been introduced.

How will eHealth help the patient and the doctor?

Information technologies in the field of health care help the patient simplify the procedure and reduce the time for receiving medical care, improve the quality of any type of care, says Alexey Remez, founder and head of the Unim Internet service, which provides patients with the opportunity to get a medical opinion on the results of diagnosing oncological diseases.

The direction of portable medical devices for remote diagnostics of patients' health indicators is actively developing. The doctor has the opportunity to remotely monitor the most important indicators, avoiding critical situations.

Remotely, you can already take about 12 parameters – pressure, ECG, temperature, sugar level, and so on. Their mass use will make it possible to deal more effectively with the most common chronic diseases, with an emphasis on prevention, and to drastically reduce the number of severe complications leading to hospitalization.

According to expert estimates, cited by Alexander Saversky, President of the League of Patient Defenders, the introduction of remote technologies reduces the level of hospitalization and the cost of it by 40%. Practice will show real efficiency. But, obviously, if a person is diagnosed in time, the necessary medicines are selected, and they help to adjust their lifestyle, this will reduce the cost of an ambulance, keeping him in a hospital, sick leave, disability, etc.

“Another important point is that the patient must be sure that the service provided remotely with the help of information technology has the same professional level, quality and legal responsibility as the one provided in person,” notes Alexey Remez.

To do this, it is necessary to legally regulate the provision of remote medical services.

“It’s one thing to simply communicate with a doctor via Skype, when the doctor can’t understand anything and doesn’t have the right to make a diagnosis, as a result of which a face-to-face visit is required, and it’s completely different when the doctor receives an ECG on the tablet, where he sees the patient’s pre-infarction or infarction condition. From a legal point of view and from the point of view of consequences, these are completely different situations that require legislative regulation,” Saversky explains.

Prepared amendments to federal law No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation”, which, among other things, address issues legal support application of telemedicine technologies, may be adopted by the State Duma in the autumn session.

Further, it will be necessary to work out the issues of payment for telemedicine services by the compulsory health insurance system, determine the rules for remote interaction between medical workers, a medical worker and a patient, and develop a list of medical services that can be provided remotely.

One of the most important elements of a unified healthcare system, from the point of view of both the doctor and the patient, is an electronic medical record. As of September 2016, in the constituent entities of the Russian Federation, they were introduced to 46 million Russian citizens. Filling the electronic card with medical information will allow the patient to consult a doctor in any region of the country, having a medical history at hand in online access.

“An electronic medical record is very important, it provides more reliable storage of information and more convenient use,” says Alexander Saversky. “One of the most important questions here is how much information will be protected in electronic medical records, from the point of view of medical secrecy, what will be its legal significance.”

It is these goals that the development of the central component of the Uniform State Health Information System, an integrated electronic medical record, meets. Filling it with data from regional medical information systems will ensure the continuity of the process of providing medical care, and the use by doctors of enhanced qualified electronic signature will ensure the legal significance of the information contained in it.

"Next important step- launch in early 2017 on the Unified Portal of Public Services of the personal account "My Health", - says Elena Boyko, Director of the IT Department of the Ministry of Health.

The patient's personal account should become a convenient tool for the provision of electronic services in the field of health care, in compliance with the principles of a "single window", the security of personal data and an equal level of quality, regardless of the place of residence of citizens.

“Filling the patient's personal account with electronic services will take place in stages,” says Boyko. - First, from your personal account, you can check the number compulsory medical insurance policy, information about attaching to a polyclinic, call a doctor at home, and next year the functionality will be supplemented by services for checking information about the medical care provided, the cost of services, access to medical data from an electronic medical record, and others.

The Ministry of Health as the operator of the Unified State Health Information System and the Ministry of Communications and Mass Communications as the operator of the EGISZ infrastructure are responsible for the implementation of the patient's personal account, but in fact the success of the implementation will depend on the readiness of regional medical information systems to transfer the necessary information about the schedule of doctors, as well as data in the required format from medical information systems to the Unified State Health Information System.

“Thus, it can be said that Personal Area patient "My Health" is the quintessence of all the previously done work on the introduction of information technologies in the healthcare sector of the constituent entities of the Russian Federation, ”says Elena Boyko.

In the future, the medical data of patients stored in a single system, subject to their depersonalization, can be used to create Russian medical decision support systems and knowledge bases.

“These systems will be based on methods of analysis big data, which can be used when making a diagnosis, choosing a treatment method, prescribing and monitoring medications, ”says Konstantin Solodukhin, CEO National Center informatization.

If we talk about medical information systems, they already now have all the necessary functionality, as close as possible to the daily processes of a doctor.

“The main task of a doctor is to treat. It is also important for him to meet short admission standards, comply with the requirements of treatment standards and medical documentation. Therefore, doctors most often demand that the information system works quickly and stably, without freezes and downtime, and its interface is intuitive and minimizes information entry errors,” notes Elena Shtykova, director of the Medicine business center of the BARS Group company. ".

Another task in terms of the development of HIS is to increase the number of mobile automated workstations (AWPs) for medical personnel.

“If today tablets with automated workplaces are mainly provided for emergency doctors, then in the future they should be supplied to district doctors, hospital doctors, nurses and heads of medical organizations,” Shtykova is sure.

Technologies for industry management

The technological basis of the e-health system, through which the interaction of all its participants is carried out, is the Unified State Information System in the field of healthcare. Medical information systems of the regions are integrated with it.

Information from medical organizations goes to the regional segment, and from there to the federal segment. By aggregating medical information, information about patient flows, staffing needs and other information, the Ministry of Health has the ability to generate statistics and make informed management decisions.

The first level of healthcare management is the chief doctors of medical organizations. They rarely work in medical information systems, but they understand that MIS is a tool for operational monitoring of the state of work of a medical organization.

“The chief doctor as a manager needs a lot of reports with prompt and reliable information. In addition, MIS for him should be an effective tool for managing the key performance indicators of a medical organization - the availability and quality of medical care, the fulfillment of government orders, the optimization of the bed fund and the use of medicines, ”says Elena Shtykova from BARS Group.

In the context of the transition to per capita financing, the chief physician has new goals: increasing the attractiveness of a medical organization for patients and the efficiency of using its resources, and these tasks are difficult to solve without the use of information technology, the expert adds.

The next level of government is regional. The MIS of the subject level provides services for electronic appointments, collection of medical information from electronic patient records, formation of registers of medical organizations, doctors and patients, and a register of medicines.

In the future, according to Elena Shtykova, regional systems will be equipped with planning and forecasting tools, due to the fact that the development of regional services is expected to provide information support for medical decision-making.

The tasks of increasing the availability of medical care will be addressed through the development of telemedicine - regional services for the interaction of citizens with medical workers and providing prompt access to data about their health.

Of great importance are integration projects between e-health participants - the Ministry of Health, the Compulsory Medical Insurance Fund, the Social Insurance Fund, both at the federal and regional levels.

“This allows you to create a single space for the exchange of patient medical data at all stages of providing medical care and providing social services to citizens - when applying for medical care, during treatment, when issuing a certificate of incapacity for work, issuing an electronic prescription, organizing rehabilitation. Our goal is to optimize processes through the use of information technologies, increase the efficiency of medical care and reduce the number of citizens' requests for various certificates or documents,” says Elena Boyko.

At the level of the federal segment, according to the director of the IT Department of the Ministry of Health, a whole range of measures is being developed to improve the efficiency of management activities, including the introduction of legally significant electronic medical document management and the creation of a telemedicine subsystem.

Medical workers and health management staff must be prepared to use the opportunities provided by informatization. For greater effectiveness of healthcare informatization measures, it is necessary to introduce medical information into educational programs. educational institutions special courses, where future doctors and healthcare management specialists should be explained how information technologies are integrated with medical and management processes.

May 07, 2018 on the portal legal information Decree of the Government of the Russian Federation of 05.05.2018 No. 555 “On a unified state information system in the field of healthcare” (hereinafter - RF PP No. 555, Regulations on the Uniform State Health Information System) was published (entered into force on 15.05.2018).

The regulation on the Uniform State Health Information System is aimed at a more detailed regulation of the functioning of the unified state information system in the field of healthcare (hereinafter referred to as the Unified State Health Information System), including the issues of the structure of the Unified State Health Information System, the procedure for accessing the information contained in it, the procedure and terms for providing information to the Unified State Health Information System, the procedure for exchanging information using the Unified State Health Information System, the requirements for software and hardware of the Unified State Health Information System and the procedure for protecting information in EGISZ. At the same time, the basic norms on the Uniform State Health Information System were enshrined in the Federal Law of July 29, 2017 No. 242-FZ “On Amendments to Certain Legislative Acts of the Russian Federation on the Application of Information Technologies in the Field of Health Protection”.

We recall once again that according to Art. 91.1 of the Federal Law of November 21, 2011 No. 323-FZ "On the Fundamentals of Protecting the Health of Citizens in the Russian Federation" (hereinafter - Federal Law No. 323) in order to ensure citizens' access to healthcare services in electronic form, as well as the interaction of information systems in the healthcare sector with the Ministry of Health of Russia a unified state information system in the healthcare sector is being created, developed and operated.

And although this act has been expected for a long time, there is no reason to be particularly happy yet, since many of the norms on the Uniform State Health Information System are tied to an additional regulatory framework that has not yet been adopted. Moreover, the PP RF No. 555 itself leaves much to be desired in terms of certain standards.

PS: Please note that in accordance with paragraph 4 of the RF PP No. 555, the Regulations on the Uniform State Health Health Information System in terms of submitting information to the Uniform State Health Health Information System do not apply to medical organizations of the private healthcare system until 01/01/2019, if such medical organizations have not previously decided to submit information to the specified system.

Thus, it turns out that from January 1, 2019, medical organizations of the private health care system are required to join the Unified State Health Health Information System without fail.

Tasks and functions of the Uniform State Health Information System

Before proceeding to a brief analysis of RF PP No. 555, we note that the entire range of tasks (5) and functions (16) of the Unified State Health Information System is reflected in paragraphs 2-3 of the Regulations on the Unified State Health Information System. In our opinion, the most interesting of them are the following:

• processing and storage, depersonalization of information about persons who are provided with medical care, as well as about persons in respect of whom medical examinations, medical examinations and medical examinations are carried out ( the adoption of the depersonalization procedure is entrusted to the Russian Ministry of Health together with Roskomnadzor);
• processing and storage of information about persons who participate in the implementation of medical activities, including the maintenance of the federal register;
• maintaining a register of medical organizations ( the requirements for maintaining the register must be approved by the Ministry of Health of Russia);
• maintenance of regulatory and reference information in the field of healthcare ( the list, the procedure for maintaining and using this information must also be approved by the Ministry of Health of Russia);
• ensuring the provision of medical care in medical organizations, including the issuance of referrals for diagnostic tests and medical examinations (consultations);
• organization of statistical observation in the field of healthcare and the formation of consolidated analytical information on the implementation of medical activities and the provision of medical care;
• other functions.

What is included in the structure of the EGISZ

The structure of the Unified State Health Information System, as previously assumed, included the following subsystems:

• federal register of medical workers;
• federal register of medical organizations;
• federal electronic registry;
• federal integrated electronic medical record;
• federal register of electronic medical documents;
• a subsystem for maintaining specialized registers of patients for certain nosologies and categories of citizens (hereinafter referred to as specialized registers of patients), monitoring the organization of the provision of high-tech medical care and sanatorium and resort treatment;
• information - analytical subsystem of monitoring and control in the field of procurement of medicines to meet state and municipal needs;
• a subsystem for automated collection of information on health system indicators from various sources and reporting;
• federal register of normative - reference information in the field of healthcare;
• subsystem of depersonalization of personal data;
• geoinformation subsystem;
• secure network for the transfer of personal data;
• integration systems.

Please note that specialized patient registries are presented in the form of a federal register of people infected with HIV, a federal register of people with tuberculosis, a federal register of people suffering from orphan diseases, a federal register of people with hemophilia, cystic fibrosis, pituitary dwarfism, Gaucher disease, malignant neoplasms of lymphoid, hematopoietic and related tissues, multiple sclerosis, persons after organ and (or) tissue transplantation, National Radiation Epidemiological Register.

We emphasize that many subsystems of the Unified State Health Information System have been functioning for a long time, but this happened outside the legal framework. And even the adopted RF PP No. 555 did not solve the legislative problem, because, firstly, this act does not contain any requirements for the functioning of the Uniform State Health Information System subsystems, and secondly, the establishment of such requirements is entrusted to the Ministry of Health of Russia (clause 31 of the Regulation on the Uniform State Health Information System).

Currently, there are several subsystems of the Unified State Health Information System, which are regulated by the following acts:

• Order of the Ministry of Health of Russia dated December 31, 2013 No. 1159n (by virtue of clause 1 of the Procedure determines the rules for maintaining personalized records in the implementation of medical activities of persons involved in the provision of medical services through the maintenance of the federal register of medical workers. Thus, this wording can be interpreted in such a way that personalized accounting is part of the Uniform State Health Information System);
• RF GD No. 426 dated 08.04.2017 (regulates the rules for the management of RF of persons infected with HIV and persons with tuberculosis);
• RF GD dated April 26, 2012 No. 403 (regulates the procedure for managing the RF of persons suffering from orphan diseases);
• RF GD dated April 26, 2012 No. 404 (regulates the rules for managing the RF of persons with hemophilia, cystic fibrosis ... ..);
• RF GD dated July 23, 2013 No. 625 (regulates the rules for maintaining the National Radiation Epidemiological Register);
• Order of the Ministry of Health and Social Development of Russia dated February 28, 2011 No. 158n (regulates the rules for maintaining the register of medical organizations operating in the field of compulsory medical insurance). ( Attention! The regulator has not established requirements for the rules for maintaining a register of all medical organizations of the state, municipal and private healthcare system).

However, we note that the above acts also require changes, since they were adopted long before the release of the basic act on the Uniform State Health Information System (PP RF No. 555). In addition, many of them do not directly establish requirements for the functioning of the Unified State Health Information System subsystems (for example, order No. 1159n).

Participants of information interaction

In accordance with the Regulations on the Uniform State Health Information Health Information System, the participants of the Uniform State Health Information System are divided into 3 categories: the operator of the Uniform State Health Information System (which is the Ministry of Health of Russia), information providers (their list is established by clause 40 of the Regulations on the Uniform State Health Information Health Information System, including medical organizations of the state, municipal and private health care systems), as well as users of information (the list is established by clause 42 of the Regulations on the Uniform State Health Information System).

Recall that the conditions for the interaction of other information systems, including the IS of medical organizations, with the Uniform State Health Information System, as well as the requirements for software, hardware and linguistic means of such organizations, are established by the Government of the Russian Federation of April 12, 2018 No. 447.

On the procedure and terms for posting information in the Uniform State Health Information System

The main "trend" of the Regulations on the Uniform State Health Information System should be considered the composition of information and the timing of its placement in this system (its subsystems) (Appendix No. 1 to the Regulations on the Uniform State Health Information System). The information itself in Appendix No. 1 is divided depending on the structural unit (subsystem) of the Uniform State Health Information System.

At the same time, the submission of information to the Uniform State Health Information System is carried out using the following information systems: IS in the field of compulsory medical insurance, automated IS of the Federal Tax Service of Russia, FSIS "Federal Register of Disabled Persons", FSIS "Unified Integrated Information System" Social Insurance "of the FSS of the Russian Federation", medical IS of medical organizations of state, municipal and private healthcare systems and others. A complete exhaustive list of such information systems is presented in paragraph 51 of the Regulations on the Uniform State Health Information System.

The term for providing information to the Unified State Health Information System, depending on its content, varies from 1 to 5 working days.

However, it is worth noting that RF GD No. 555 does not contain provisions on the consequences of violating the established deadlines, including for failure to provide information, as well as providing information outside the established deadline.

On conflicts in the rules on the composition of information posted in the Uniform State Health Information System

It is impossible to ignore the information that suppliers are required to provide to the Uniform State Health Information System.

So, in the federal register of medical workers (based on Order No. 1159n, it is tied to personalized records in relation to persons providing MP) in accordance with Appendix No. organization, structural subdivision of the Ministry of Defense, position, type of position, rate, date of commencement of employment, date of termination of employment, reason for termination). However, this provision is contrary to Art. 93 of the Federal Law No. 323, which does not provide information on the type of position held by a medical worker, rate, start and end dates of employment, termination grounds (the established list is exhaustive). Moreover, Order No. 1159n does not contain such information.

The situation is similar with information about persons who receive medical care in the subsystem "Federal Integrated Electronic Medical Record". So, under Art. 94 FZ No. 323 additional information o prescribing and use of medicinal products indicating the means of identification of medicinal products (except for retail sale) ... (clause 22 of Appendix No. 1 to the Regulations on the Uniform State Health Information System).

Also, one of the types of information provided to the Uniform State Health Information System "Federal Electronic Registry" is the protocol of telemedicine consultation. However, in our opinion, here the legislator made a slight inaccuracy in the terminology, since according to the Procedure for organizing and providing medical care using telemedicine technologies, approved by Order of the Ministry of Health of Russia dated November 30, 2017 No. the consultant draws up a medical report (minutes of the consultation of doctors). And it is these documents that are drawn up in electronic form when providing medical care using telemedicine technologies, but not the protocol of telemedicine technologies.

In addition, as information in subsystem ... monitoring the organization of high-tech medical care... such a document as "referral for hospitalization for the provision of high-tech medical care" is presented. Meanwhile, according to the Procedure for organizing the provision of high-tech medical care using a specialized information system, approved by Order of the Ministry of Health of Russia dated December 29, 2014 No. 930n, such a document is issued manually or in printed form without the use of a specialized information system, that is, it is not an electronic document that can be placed in a specialized information system. While a voucher for the provision of high medical care is issued using this system ( however, it is a separate document and also appears in Appendix No. 1 to the Regulations on the Uniform State Health Information System). Requirements for the electronic form of referral for HCW hospitalization are not established by other acts regulating legal relations for the provision of HCW. Thus, the question arises: how will the direction be entered into the Uniform State Health Information System if the electronic form of the document is not provided for by the legislation of the Russian Federation? Maybe the legislator had in mind the information reflected in the referral for hospitalization for the provision of HTMC?

It seems doubtful the requirement of RF PP No. 555 to confirm the accuracy of the information provided to the Uniform State Health Information System in electronic form, citizens through the use of an enhanced qualified electronic signature or a simple electronic signature through the use of a unified system of identification and authentication(clause "b" clause 35 of the Regulations on the Uniform State Health Information System). The Faculty of Medical Law has repeatedly written in its notes and articles that with the establishment of such requirements, a significant stratum of patients who are not registered in the unified system of identification and authentication are cut off from participation in the Unified State Health Information System, despite the fact that the only information provided in the Unified State Health Information System citizens is "an appointment for a patient appointment or a call to a doctor at home" in the "Federal Electronic Registry" subsystem.

"Porridge" on statistical reporting in the Uniform State Health Information System subsystem

The question of the operation of the Uniform State Health Information System subsystem remains unclear."Subsystem for automated collection of information on health system indicators from various sources and reporting».

Thus, this subsystem includes information about the indicators of the health care system, including medical and demographic indicators of the health of the population. The providers of this information are, among other things, medical organizations of all health care systems.

From the concept of the specified subsystem of the Uniform State Health Information System (clause 21 of the Regulations on the Uniform State Health Information System), it follows that it is a subsystem of the Uniform State Health Information System, designed to optimize and simplify procedures collection of statistical and other reporting information on indicators in the field of healthcare from organizations subordinate to the Ministry of Health of Russia, federal executive authorities in accordance with their authority, healthcare authorities of the constituent entities of the Russian Federation, medical organizations of the state, municipal and private healthcare systems, as well as to reduce the time spent on preparing consolidated reporting on data, collected and processed in the Uniform State Health Information System subsystems.

It is known that in the Russian Federation there are 3 types of statistical observations: federal, sectoral and regional.

However, if everything is clear with the collection of primary data (federal surveillance) in the form of an electronic document ( similar provisions are provided for by the Government of the Russian Federation of August 18, 2008 No. 620, the Order of Rosstat of October 27, 2010 No. 370), then with regard to sectoral statistical observation, here we should talk about a deep legal hole, since the Ministry of Health of Russia has not yet developed normative document on the procedure for conducting sectoral statistical observation in the field of healthcare, not to mention the fact that the collection of such data can also be carried out in electronic format. As for regional monitoring, here, too, the norms of the subjects of the Russian Federation do not clearly spell out the provisions on the provision of reports in electronic form. For example, in accordance with the Regulations on the automated information system of Moscow "EMIAS", approved by the Moscow GD dated January 20, 2015 No. 16-PP, only formation and maintenance of medical reporting of medical organizations the state healthcare system of the city of Moscow, medical organizations that are not members of state system health care of the city of Moscow and performing medical activities on the territory of the city of Moscow (clause 1.6.7 of the Regulations).

On access to information contained in the Uniform State Health Information System

As for access to information from the Unified State Health Information System, according to clause 46 of the Regulations on the Unified State Health Information System, such access is received by registered users. At the same time, the registration of users of the Uniform State Health Information System is established in accordance with the requirements of the Ministry of Health of Russia ( currently not accepted).

Despite this, one of the conditions for accessing information from the Unified State Health Information System in accordance with the RF PP No. 555 is the passage of identification and authentication using the identification and authentication system.

In addition, the regulator has determined the composition of the information that is provided to users of the Unified State Health Information System and the persons to whom it is provided, depending on the subsystem of the Unified State Health Information System (Appendix No. 2 to the RF PP No. 555).

One of the users of the Uniform State Health Information System, as noted in the RF PP No. 555, are citizens. In accordance with Annex No. 2, they have the right to access the following information:

• Making an appointment with patients or calling a doctor at home (in the subsystem "Federal Electronic Registry");
• Information about medical records and information about the medical organization in which the medical records are created and stored ("Federal Register of Electronic Medical Documents").

However, as we see from Appendix No. 2 to the RF PP No. 555, remote acquaintance of the patient with medical documentation in electronic form is not provided. Thus, it is not clear how the patient's right to familiarize himself with medical documentation in the form electronic documents, provided h. 5 Article. 22 FZ No. 323.

And finally

In addition to the above, RF PP No. 555 established requirements for software and hardware tools of the Uniform State Health Information System, the procedure for exchanging information using the Uniform State Health Information System, as well as some provisions on the protection of information contained in the Uniform State Health Information System. Despite the adoption of such an advanced regulation on the main health information system, many questions remain open. So, for example, from the Regulations on the Uniform State Health Information System, it is not clear how the Uniform State Health Information System will work with those medical organizations that are located in settlements where the Internet speed is 1 Mb? At the expense of what financial resources will access to the Uniform State Health Information System be provided to medical organizations and patients located and living in small settlements? Etc.

Medical Information System– a set of methodological, programmatic, technical, informational, legal and organizational funds supporting the functioning processes of an informatized organization (LPU)

UIS in the field of healthcare and social development is an automated system aimed at information support for the implementation of the functions of the Ministry of Health and Social Development of the Russian Federation, federal services, agencies, etc.

The UIS provides the functions of collecting, storing, processing, transmitting and using information in the areas of healthcare, social development, labor and employment in the Russian Federation and is designed to solve the following problems:

information support for the adoption of managerial decisions in ensuring the effective operation of the Ministry of Health and Social Development of the Russian Federation, its subordinate agencies, etc.

improving the efficiency of servicing citizens and organizations.

ensuring information transparency of the activities of the Ministry of Health and Social Development of the Russian Federation, etc.

improving the efficiency of interdepartmental relations.

36. The concept of telemedicine. Strategic tasks of using information technologies in medicine.

Telemedicine- a direction of medicine based on the use of computer and telecommunication technologies for the exchange of medical information between specialists in order to improve the quality of diagnosis and treatment of specific patients.

"Telemedicine is a comprehensive concept for systems, services and activities in the field of health, which can be remotely transmitted by means of information and telecommunications technologies, for the development of world health, disease control, and education, management and research in the field of medicine.

Tasks of telemedicine:

Preventive maintenance of the population.

Reducing the cost of medical services.

Maintenance of remote subjects, removal of isolation.

Increasing the level of service.

With the current level of development of information technology, it becomes possible to exchange electronic versions of medical records, pictures, video images, communicate using the Internet, and arrange video conferences.

37. Modeling as a method of knowledge. Definition of the model, its properties and characteristics. Classification of models.

Modeling is a method of understanding the surrounding world, consisting in the creation and study of models. Different sciences investigate objects and processes under different angles vision and build different types models. In physics, the processes of interaction and change of objects are studied, in chemistry - their chemical composition, in biology - the structure and behavior of living organisms, etc.

Mathematics as a cognitive device is inseparable from the development of knowledge. In essence, mathematics, as a form of reflection of reality, was born in antiquity simultaneously with the emergence of scientific knowledge. However, in a distinct form (although without using the term itself), M. begins to be widely used in the Renaissance

Model- a new object that reflects the essential features of the object, phenomenon or process under study. One and the same object can have many models, and different objects can be described by one model.

Model properties:

Finiteness: the model reflects the original only in a finite number of its relations and, in addition, the modeling resources are finite;

Simplicity: the model displays only the essential aspects of the object;

Approximation: reality is represented roughly or approximately by the model;

Adequacy: how well the model describes the modeled system;

Informativity: the model must contain sufficient information about the system - within the framework of the hypotheses adopted in the construction of the model;

Potentiality: predictability of the model and its properties;

Complexity: ease of use;

Completeness: all necessary properties are taken into account;

Adaptability.

According to the form of presentation of figurative-sign models, the following groups can be distinguished among them:

Geometric models that reflect the appearance of the original (picture, pictogram, drawing, plan, map, three-dimensional image);

Structural models that reflect the structure of objects and the relationship of their parameters (table, graph, diagram, diagram);

Verbal models fixed (described) by means of natural language;

Algorithmic models describing the sequence of actions.

Iconic models can be divided into the following groups:

Mathematical models, represented by mathematical formulas that display the relationship of various parameters of an object, system or process;

Special models presented in special languages ​​(notes, chemical formulas, etc.);

Algorithmic models representing the process in the form of a program written in a special language.

"

1. In order to ensure access of citizens to services in the field of healthcare in electronic form, as well as the interaction of information systems in the field of healthcare, the authorized federal executive body creates, develops and operates a unified state information system in the field of healthcare (hereinafter referred to as the unified system).

2. Regulations on a unified system, including the procedure for access to information contained in it, the procedure and terms for submitting information to single system, the procedure for exchanging information using a unified system, is approved by the Government of the Russian Federation.

3. A single system includes:

1) information contained in federal information systems in the field of health care, federal databases and federal registers in the field of health care, which are maintained by the authorized federal executive body using a unified system;

2) information about medical organizations, with the exception of medical organizations subordinate to federal executive bodies, in which federal laws provide for military service or service equivalent to it;

3) specified in Article 93 of this federal law information about persons who participate in the implementation of medical activities;

4) specified in Article 94 of this Federal Law and depersonalized in the manner established by the authorized federal executive body in agreement with the federal executive body exercising the functions of control and supervision in the field of mass media, information about the persons who are provided with medical care, and also about persons in respect of whom medical examinations, medical examinations and medical examinations are carried out;

5) information about medical documentation, the composition of which makes it impossible to determine the state of health of a citizen, and information about the medical organization in which the medical documentation was created and stored;

6) information of statistical observation in the field of healthcare, as well as summary analytical information on the implementation of medical activities and the provision of medical care;

7) information on the organization of the provision of high-tech medical care;

8) information necessary for monitoring and control in the field of procurement of medicines to meet state and municipal needs;

9) information on the organization of providing citizens with medicines for medical use, medical devices (medical products) and specialized medical food products in accordance with Article 6.2 of the Federal Law of July 17, 1999 N 178-FZ "On State social assistance", Clauses 19 and 20 of Part 1 of Article 14, Article 44 and Clause 5 of Part 2 of Article 81 of this Federal Law;

10) classifiers, reference books and other regulatory and reference information in the field of health care, the list, the procedure for maintaining and using which are determined by the authorized federal executive body.

4. The unified system ensures the maintenance of the federal registers provided for by Part 2.1 of Article 43, Parts 4, 8 of Article 44 of this Federal Law, Article 24.1 of the Law of the Russian Federation of May 15, 1991 N 1244-1 "On social protection citizens exposed to radiation as a result of the disaster at the Chernobyl nuclear power plant.

5. The unified system provides the possibility of providing citizens with services in the field of healthcare in electronic form through a single portal of state and municipal services, the list of which is approved by the Government of the Russian Federation.

6. Providers of information in a single system are:

1) an authorized federal executive body;

2) federal executive authorities in the field of health protection and other federal executive authorities in accordance with the powers established by the legislation of the Russian Federation;