CC BY
5TECHNICAL SCIENCES
AN AUTOMATED SYSTEM FOR ORGANIZING THE OPERATION OF EMERGENCY MEDICAL
SERVICE
Abdullayeva G.,
Institute of Control Systems Nagizade G.
Institute of Mathematics and Mechanics Azerbaijan, Baku DOI: 10.5281/zenodo.7467673
Abstract
The paper addresses the problem of organizing paperless technology in healthcare, in particular, in the work of emergency medical services throughout the country. For this purpose, unified protocol forms are developed. The important issues of the patient-medical institution relationship are taken into account, in which it is necessary to comply with such legal standards as confidentiality and security of information. A crucial point in ambulance calls is the formation of the medical team, which implies its competence with minimal or incomplete information about the patient.
Keywords: emergency medical care, protocol, paperless technology, screens.
Introduction. There is and can be no doubt that improvement of healthcare is a pressing problem for any country, because it is not just a medical issue. It is about providing quality medical service that guarantees proper care for the population. Medicine must be at its best even in situations like Covid-19. The pandemic has revealed various kinds of problems, including those common to almost all countries, regardless of the standard of living and information technology, as well as those related to underdevelopment and poverty. When we speak of a civilized society, we naturally mean a society that provides state guarantees of quality, that is, proper medical care to the population on the basis of effective strategic planning, human resources, medical, technical and information policy [1].
A special place in the healthcare organization is given to emergency medical services. The introduction
of information technology has increased the importance of electronic data sharing, which in turn enables the development of paperless document management. Today, we can say that electronic information is becoming dominant in many areas of public activity, and its priority is the development of paperless technology. Proceeding from this "postulate" of the 21st century, we propose developing paperless technology for the operation of the Emergency Medical Care Station of the city of Baku. As a whole, the development of such system implies continuous transfer of information in the network of substations, their connection with the center and, importantly, the station's connection with poly-clinics, clinics, city hospitals, carrying out information exchange. In principle, the functions of emergency medical care can be generally represented as shown in Fig. 1.
Call
Apparently healthy
Aid has been provided
False call
Refusal of ambulance service
Call has been cancelled
Lethal outcome before the arrival of the ambulance
Fig. 1. General structure of the results of ambulance calls
Calls to the ambulance station can come from a variety of sources: street/highway, an apartment, an institution, swimming pools, industrial facilities, etc. Accidents are also grouped into respective classes. For example, coma, shock, cardiac arrest, burns, falls from a height, explosions, poisonings, etc.
When comparing the operation of emergency medical services in different countries, one can see dis-
tinctive features that characterize both their functionality and its execution. For example, in Austria (especially in Tyrol), there is a form of organization of an emergency medical care group consisting of highly qualified doctors in the private sector. This group is not part of the emergency medical services and, depending on the situation, can operate autonomously, although there are cases in which they fulfill the orders of the center. There is a similar situation in Switzerland. In
Germany, 12 million ambulance calls were recorded in 2012-2013 alone. In special cases, these services are backed up by emergency response personnel. In the United States, the famous 911 call works nationwide. It is universal, that is, there is one number and many call centers. This number is essentially Public Safety Answering Points (PSAP). The universality of PSAP is that with one call, after explaining the reason for the call and the location (today location is mostly a non-issue for landlines, but PSAP is not always able to locate a call coming from a mobile phone), you are connected to the appropriate PSAP substation, which solves your problem (fire department in case of a fire, ambulance in case of a heart attack, police in case of a shooting, etc.). As of April 26, 2022, there are over 8,000 PSAPs in the United States. A person can call 911 from anywhere and ask about the condition of a family member at the same time. The complex network of PSAPs will respond to your request [2].
Problem statement. The increasing role of information and communication technology (ICT) could not but affect this area of healthcare. Its introduction into healthcare can significantly remove fiscal constraints on the provision of medical services, on the one hand. On the other hand, digital ICT enables remote consultations, can make routine tests and information transfer much easier for patients, and, very importantly, rid medical professionals of paperwork. In addition, a new trend has emerged: telemedicine with the capability of organizing telemonitoring. In this regard, the work of a group of scientists from England [3] is interesting. Catherine Pope et al. believe that quality results in the organization of emergency medical services at a high level will be achieved with the full compatibility of doctors and ICT specialists, i.e., collective action is required, with a special emphasis on cognitive participation with the financial support of the relevant agencies. The aim of this work is to identify the shortcomings of the existing electronic system in the emergency medical services on the basis of a study of the whole cycle, the reanalysis of the workflow, the examination of the needs of society as a whole and the development of a new electronic solution by assessing the possibility of maximum adoption of information technology in the modern era.
The task of organizing a comprehensive emergency medical service in the Republic was addressed by us with the help of a group that included specialists
from the Azerbaijan National Academy of Sciences, doctors from the Ministry of Health and the Ministry of Labor and Social Protection of Azerbaijan. For the development of the first version of the system, we chose the city of Baku with its suburbs. In the system, the city is divided into the following districts: Absheron, Bina-gadi, Khatai, Khazar, Garadagh, Narimanov, Nasimi, Nizami, Pirallahi, Sabunchi, Sabayil, Surakhani and Yasamal. Successful implementation of the transition to paperless technology requires solving a fairly large number of subtasks.
Solution. To this end, we have developed more than 40 forms of tables for different purposes. The main subtasks are the following:
✓ Conducting a proper preliminary analysis to analyze the process and form requirements;
✓ Preparation of a functional document based on the formed requirements (terms of reference);
✓ Technical development of the software database;
✓ Development of the design of the corresponding screens;
✓ Development of internal and external part of the registration department (4 screens for internal part and 4 screens for external part);
✓ Finalization of the first phase of the software and preparation of the temporary login screen;
✓ Testing the early phase of the software and recording the results for the software;
✓ Presentation of the software to management;
✓ Presentation of the software at the Ambulance Service Station and production in the first test environment;
✓ Writing the binary part of the main screens of the KIS and ADMIN sections (4 screens), etc.
Some of these are: types of accidents; severe cases; call receipt points, etc., etc.
A functional analysis of the developed system involves complete resolving such issues as satisfying the needs of the relevant classes of users, where a guarantee security system, identification of the type, etc., are required for each class. On this basis, a list of functions is prepared to meet the needs of each user. After identifying the highest and lowest level of needs, we can move on to the preparation of scenarios for the behavior of the system. Fig. 2 shows a combined diagram of functional requirements.
Fig.2. The structure of functional requirements
In this work we propose a new electronic solution that involves the FIN code, compulsory digitalization of the paperwork of on-call medical teams, and implementation of this activity in appropriate software on a
tablet (all emergency medical services are equipped with tablets) (Fig. 3).
Fig.3. A fragment of the work of the ambulance team (registration card No. 2)
Doctors have to deal with many different complex problems every day. Some of these problems are extraordinary, such as a difficult diagnosis, a rare disease, etc.
Setting up the operation of the hospital admission department based on the transfer of information collected by the ambulance teams on the tablets, displayed on the screen reserved for that department (Fig.4).
Fig.4. A fragment of the registration card for hospital admission
Conclusions. The development of paperless technology in healthcare is an integral part of telemedicine. From this point of view, the developed system can be considered the foundation for remote transfer of information and at the same time its secure storage, where all ethical norms and legal rights of both the doctor and the patient will be respected. It should be added that the proposed technology offers the possibility of control over doctor's work during the call. Additional tools and built-in software modules can provide a summary assessment of the doctor's professional qualifications.
References
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