scope of medical information management at the regional level in russia

Scope of Medical Scope of Medical Information Management Information Management at the Regional Level in at the Regional Level in

RussiaRussia

Alexander ShoshminAlexander Shoshmin, , Yanina Yanina BesstrashnovaBesstrashnova

Department of Information Technologies for Disability Problems,Department of Information Technologies for Disability Problems,

Federal State Institute “Saint Petersburg Scientific and Practical Center of Medical and Social Federal State Institute “Saint Petersburg Scientific and Practical Center of Medical and Social Expertise, Prosthetics and Rehabilitation of the Disabled named after G.A. Albrecht of Federal Expertise, Prosthetics and Rehabilitation of the Disabled named after G.A. Albrecht of Federal

Medical-Biological Agency”Medical-Biological Agency”

ContentsContents

Need for Medical Information Need for Medical Information ManagementManagement System (MIMS)System (MIMS)

Difficulties in MIMS development Difficulties in MIMS development and implementationand implementation

SolutionsSolutions Capabilities of MIMSCapabilities of MIMS Perspectives for MIMSPerspectives for MIMS

Need for MIMSNeed for MIMS

People are lost, sometimes by reason of People are lost, sometimes by reason of medical errorsmedical errors..

Expensive treatment is not always Expensive treatment is not always justifiedjustified. .

Evaluation of treatment effectiveness is Evaluation of treatment effectiveness is complicatedcomplicated..

There is lack of data about citizens There is lack of data about citizens needs for medical care (and so about needs for medical care (and so about resources).resources).

There are no There are no certain certain datadata for health care for health care managementmanagement..

Difficulties in MIMS Difficulties in MIMS development and development and implementationimplementation

Information technologies evolve Information technologies evolve quickly. It seems they can fulfill quickly. It seems they can fulfill almost all things. How to use them?almost all things. How to use them?

Low effectiveness of MIMS Low effectiveness of MIMS implementation is the result of rare implementation is the result of rare using of integrated solutions which using of integrated solutions which coordinate citizens health, modern coordinate citizens health, modern technologies and knowledge, technologies and knowledge, economics and management.economics and management.

Main reasons for Main reasons for decreasing MIMS decreasing MIMS

effectivenesseffectiveness No measurable target indicators No measurable target indicators

((both during MIMS development as a both during MIMS development as a whole and during implementation at a whole and during implementation at a working place)working place);;

Low administrative competence of Low administrative competence of persons responsible for persons responsible for implementationimplementation;;

Implementation periodImplementation period MIMS MIMS modulesmodules depend on each other depend on each other

as usualas usual. . In the long implementation In the long implementation period they irritate users because of period they irritate users because of limited (unavailable) functionalitieslimited (unavailable) functionalities;;

MIMS itself, ITMIMS itself, IT and medicine are in and medicine are in progress. The latest subsystems may progress. The latest subsystems may be incompatible tobe incompatible to ones in useones in use;;


effectivenesseffectiveness

Fear to lose one’s work Fear to lose one’s work ((not to meet not to meet new requirements, changed processes new requirements, changed processes may result in decreasing number of may result in decreasing number of employeesemployees));;

Unwillingness by managers to Unwillingness by managers to change business processeschange business processes ((statistics statistics is close to managers’ point of view)is close to managers’ point of view);;

Underestimation of required Underestimation of required investments…investments…


effectivenesseffectiveness

How do these reasons act at How do these reasons act at the regional level in Russia?the regional level in Russia?

DisadvantagesDisadvantages Low automation level as a whole Low automation level as a whole

and in hospitals as usualand in hospitals as usual;; No integrated programmes for No integrated programmes for

health care IT implementationhealth care IT implementation;; Misunderstanding the fact:Misunderstanding the fact:

IT implementation means changes in IT implementation means changes in ALL processes rather than ALL processes rather than automation of some functionsautomation of some functions!!

Enthusiasts attain spontaneous Enthusiasts attain spontaneous financing and start implementation financing and start implementation of whatever software of whatever software (without (without experience in implementation it is experience in implementation it is difficult to estimate differences in difficult to estimate differences in suggested solutions);suggested solutions);

Integrated automation programmes Integrated automation programmes for health care are approved rarely for health care are approved rarely in the regions of Russiain the regions of Russia..

How do these reasons act at How do these reasons act at the regional level in Russia?the regional level in Russia?

DisadvantagesDisadvantages

There are no old information systems There are no old information systems with patients data almost at allwith patients data almost at all;;

An opportunity to implement MIMS An opportunity to implement MIMS which meets certain requirements which meets certain requirements existsexists ((to implement a standardto implement a standard));;

It is possible to develop a common It is possible to develop a common electronic health recordelectronic health record;;

Those who started implementation Those who started implementation and failedand failed (80% (80% according to statisticsaccording to statistics)) know how need not to doknow how need not to do;;

How do these reasons act at the How do these reasons act at the regional level in Russia?regional level in Russia?

AdvantagesAdvantages

SolutionsSolutions

To integrate existing information To integrate existing information systemssystems:: Difficult from the manager’s point of Difficult from the manager’s point of

viewview;; Difficult technicallyDifficult technically;;

To install a common MIMS at once if To install a common MIMS at once if possiblepossible;;

To do nothing To do nothing ((we’ll have spontaneous we’ll have spontaneous MIMS elements in 1-3 years and start to MIMS elements in 1-3 years and start to integrate themintegrate them))..

MIMS structureMIMS structure

multilevel system that integrates multilevel system that integrates information resources including information resources including distributed network of health distributed network of health institutions, regional health care institutions, regional health care authorities, territorial fund of authorities, territorial fund of obligatory medical insurance and obligatory medical insurance and insurance companiesinsurance companies;;

integrationintegration of informationof information from from thesethese institutionsinstitutions in a data base.in a data base.

Диспансеры

Родильные дома

Поликлиники

Больницы (многопрофильные,

специализированные)Госпитали для

ветеранов

Медсанчасти

• Development and support of actual integrated register of insurants in a region;

• Creating an integrated regional register of obligatory medical insurance agreements and policies;

• Holding certification of regional health care institutions and their licenses;

• Forming a common resources register of regional health care;

• Creating a regional programme of state guarantees.

Patients registration and monitoring of:

• provided medical services;

• costs for medical care;

• medicaments and costs for them;

• sickness rate.

ЦБР

MIMS structureMIMS structure

Capabilities of MIMSCapabilities of MIMS

Holding a detailed register of regional and territorial health care institutions including data about service districts;;

Creating a Creating a register of health care institutions with their lists of licenced services;;

Certification of health care institutions ((providing consolidation of providing consolidation of detailed information about every institution detailed information about every institution into an integrated data baseinto an integrated data base));;

Collection of identifiers, bank and tax Collection of identifiers, bank and tax essential information about essential information about health care institutions;;

Determining indicators of institutions Determining indicators of institutions network network (till the level of department)(till the level of department) and and resources;resources;


Statistics gathering and analyzingStatistics gathering and analyzing:: Organizational structures,Organizational structures, staff members listsstaff members lists,, personnel informationpersonnel information,, data about material resources and data about material resources and

equipmentequipment, , location of departmentslocation of departments,, number of bedsnumber of beds;;


• Listing provided medical servicesListing provided medical services ((health care institutions, citizenshealth care institutions, citizens));;

• Determining indicators of sickness Determining indicators of sickness raterate, , volumes of medical carevolumes of medical care ((typetype, , profileprofile, , financingfinancing, , place and time of a place and time of a serviceservice, , groups of patientsgroups of patients…)…)..


• Determining indicators of additional Determining indicators of additional medicaments provision system:medicaments provision system:• personal prescriptionspersonal prescriptions;;

• personal lists of distributed medicamentspersonal lists of distributed medicaments;;• totals and personal statistics oftotals and personal statistics of::

• qualityquality• costscosts


• Reports and references about Reports and references about insurantsinsurants;;

• Monitoring of plans-tasksMonitoring of plans-tasks;;• Analytics about programmes of Analytics about programmes of

regional state guarantees and regional state guarantees and municipal tasksmunicipal tasks;;


• State medical statistical reports, State medical statistical reports, obligatory medical insurance reports obligatory medical insurance reports at the institutional, municipal and at the institutional, municipal and regional level;regional level;

• Budgeting of health care institutions Budgeting of health care institutions according to a regional programme of according to a regional programme of state guaranteesstate guarantees ((providing state guarantees providing state guarantees

in health care forin health care for citizenscitizens)); ;


• Citizens needs in health care in the Citizens needs in health care in the context of institutionscontext of institutions;;

• Data about provided medical servicesData about provided medical services ((health care institutions, groups of health care institutions, groups of citizenscitizens));;

• Data for prices calculations for Data for prices calculations for medical servicesmedical services……


Perspectives for MIMSPerspectives for MIMS

Integration of existing resources Integration of existing resources for more effective health carefor more effective health care!!

Thank you for your Thank you for your attentionattention!!

E-mail: E-mail: [email protected]; ; [email protected]

mailto:[email protected]

mailto:[email protected]

scope of medical information management at the regional level in russia

Documents

mims development

medical care

regional level

health care management

citizens health

usemain reasons

long implementation

practical center of