Russia plans to link regional hospitals and polyclinics into a single information system. This means that institutions will have to almost completely switch to electronic document management, and all patient information will be available to doctors even if a person changes hospitals, clinics, and even regions. The corresponding government decree was adopted in February and will come into force in March. Read more about what the digitalization of regional healthcare organizations means in practice, whether remote medical facilities are ready for this and how it will affect patients in the Izvestia article.
According to the extended program
The decree, which expands the functionality of the Unified State Health Information System (EGISZ), was signed by Prime Minister Mikhail Mishustin. The document was published on the government website in mid-February.
— The system will connect all regional medical organizations. At the same time, most of the documents – extracts, certificates and medical cards must go into electronic form – follows from the accompanying text.
Thanks to this, doctors will have access to necessary documents, such as a medical history, even if a person has moved and changed clinics or hospitalsemphasize in the government.
The expansion of the system should become one of the stages of work on the digitalization of domestic healthcare.
After expansion The updated Uniform State Health Information System will include various federal registries, including databases of medical documents on death and birth, as well as a register of information on the results of medical examinations for the right to own weapons. In addition, the system will provide data on drug provision of citizens.
All information will be collected in one place. So much more convenient. And in an emergency, this can save a person’s life,” Mikhail Mishustin said at a meeting of the Presidium of the Coordinating Council under the government to combat the spread of a new coronavirus infection.
Additionally, within the Uniform State Health Information System there will be a single resource with information on the incidence of coronavirus – The data collected there will be used for analytics and forecasting of new outbreaks of the disease, the document says.
The resolution comes into force in March this year, follows from the document.
In manual mode
The introduction of a unified information system will ensure the introduction of electronic medical document management in medical organizations, electronic medical records in which the doctor sees all the information about the patient – from the medical history to the protocols of instrumental examinationsexplains Andrey Dorofeev, Ph.D.
“Patients will also have access to information from their electronic medical record, in particular, information on examination, laboratory tests and diagnostic tests, information on electronic sick leave sheets,” he lists.
In addition, the system will be integrated with the Gosuslugi portal. So, in the personal account “My Health” on the portal “Gosuslugi” it will be possible to call a doctor at home, sign up for vaccination, an appointment with a doctor or a medical examination.
Now the system of information exchange between medical institutions works in a “manual” mode, says a specialist in medical marketinghead of the federal IT company Rostsayt Vladimir Krivov.
– If you are thinking about moving to another city, first you need to pick up a medical card and the entire package of documents on the state of health from the former institution. The documents must be accompanied by a certificate stating that at the moment the patient is not being served anywhere, he recalls.
After moving, you will need to come to the selected clinic in order to write an application for attachment, providing your passport, medical policy and SNILS data, the expert lists.
“Necessary like air”
The organization of continuity in the provision of medical care at the interregional and federal levels is today one of the main taskssays Valentina Tsyvova, deputy chairman of the Public Chamber’s commission on protecting the health of citizens and developing healthcare.
– The system can already now provide a solution to such key tasks in the field of healthcare as quality control of medical care based on primary data in electronic form, monitoring and management decision-making at the level of both the region and the federation based on objective and reliable operational and statistical information , – lists the interlocutor of the publication.
This, according to her, “extremely important” for the organization of quality medical care in the field.
The digitalization of the medical sector is “needed like air”, thinks Vladimir Krivov. At the same time, the transition to a new format, according to him, will be comparable with the introduction of public services.
“The first couple of years we got used to it, but now most of them pay fines, sign up for a queue through this service,” he recalls.
In the end, same the innovation will make life easier for patients in case of moving or in case of emergency, and will also reduce the budgets for the work of staff who were responsible for archiving and storing medical records on paperthe expert is sure.
Expensive equipment
On the other hand, the expansion of a unified information system will increase the risks associated with the confidentiality of patient data. It will also require the development of digital infrastructure in regional medical facilities, many of which will require additional equipment for this..
However, the risks in this case are not critical, according to information security experts interviewed by Izvestia.
– For the transfer of personal data of this category, secure communication channels are required. Protection is provided both with the help of hardware, special equipment, and software methods. For their application it is required to carry out competitive purchases, and software should be of the Russian production — the lawyer Tatyana Karkhaleva reminds.
But both the necessary hardware and software are already on the market, so it is quite possible to ensure data protection during storage and transmission.but she notes.
Organizational and technical measures to ensure the security of data stored in state information systems (GIS) are defined at the state level and prescribed in the order The Federal Service for Technical and Export Control, which has been operating for nine years, recalls Dmitry Kovalev, head of the information security department at Sissoft.
The requirements stipulated by the order will apply both when expanding one of the existing information systems, and when creating a new GIS. This, according to him, allows “to minimize the risks at the level of the regulator.”
– Fundamental changes in the IT infrastructure of hospitals and clinics are not needed for this, however, according to the order, it will be necessary to carry out a set of measures: install firewalls, antiviruses, provide protection against unauthorized access to certain equipment, then certify the implemented solutions, and so on. Of course, the need to ensure the safety and protection of personal data should not be forgotten by the medical institutions themselves, – he explains.
Additional equipment that will be required by medical institutions is quite expensive, while the rest of the infrastructure must be “made not “on the knee”warns Alexander Vetkol, lead systems engineer at Varonis Systems.
— This is important to take into account when forming requirements for small and remote regional divisions – for example, outside the district centers and with limited accessibility, he emphasizes.
“No one is safe”
In addition to the actual purchase of equipment, medical institutions will need to ensure interaction with the regional health authority and the Ministry of Health using secure communication channels, automate all processes in a medical institution using medical information systems (MIS), and also establish interaction with other medical and other medical institutions – for example, with registry offices, medical and social expertise (ITU), the territorial fund for compulsory medical insurance, Rospotrebnadzor and other organizations, Andrey Dorofeev lists.
Now the creation of a unified information system for medical organizations, according to him, is at various stages of implementation in different regions. Much depends on the existing material and technical base, the degree of implementation of electronic document management and the qualifications of technical and medical personnel..
The greatest concern is the introduction of a data exchange network in remote areas of any subject of the federation, says Roman Tanin, director of the public sector department at T1 Consulting.
– Last year, representatives of the Ministry of Health reported on the results of a 10-year digitalization program for the country’s medical institutions. According to them, all subordinate organizations, including small FAPs, are connected to the Internet; computerized workplaces have been created in them and the introduction of medical information systems has begun,” he recalls. – According to the statistics of the Ministry of Health, as of January 1, 2021, more than 82% of medical organizations already use MISs and support data exchange with the Uniform State Health Information System.
Two-thirds of medical institutions, according to these data, have implemented centralized subsystems approved by the state. However, not all medical institutions can technically become completely paperless today, the expert believes. In addition, the digital health perimeter currently lacks private clinics that also have important patient data.
There have already been examples of data leakage from state information systems in Russia, reminds Vladimir Krivov. However, when introducing new information systems, there are always risks and “no one is immune from them”he believes.
Moreover, in the near future, it will be necessary to carry out work on the education and training of personnel, however, both the risks and the necessary efforts in this case are justified, says the expert. “Of course, there will be errors, data loss, information leakage. But this is normal, of course, and this should be treated with understanding. There is no need to be afraid of the new,” he concludes.
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