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энергией, газом и паром, кондиционировании воздуха - 103,2%.
3. Основная часть доходов федерального бюджета (99,2%) сформирована за счет поступлений двух видов налогов: налога на добычу полезных ископаемых и налога на добавленную стоимость.
4. Реальная заработная плата в УФО по итогам двух месяцев текущего года сократилась, Среднемесячная номинальная заработная плата по итогам 2016 года составила 39,7 тыс.рублей, или 104,2% к уровню АППГ.
5. Уровень регистрируемой безработицы составил 1,4% от численности экономически активного населения, что выше среднероссийского показателя (1,2%).
Использованные источники:
1. Игрунова О.М. Современные подходы к анализу и развитию сферы услуг в регионах: учебное пособие. Москва; Берлин: Директ-Медиа, 2016. 210 с.
2. Курнышев В.В. Региональная экономика. Основы теории и методы исследования: учебное пособие. Москва: КНОРУС, 2016. 279 с.
3. Официальный сайт Уральского Федерального округа Режим доступа: http://uralfo.gov.ru/district/economics/
4. Официальный сайт Федеральной службы государственной статистики Режим доступа: http://www.gks.ru/
УДК 004.386
Сакиев Т. Р. старший преподаватель кафедра «Программная инженерия»
Набиева С. С. студент Самаркандский филиал Ташкентский университет информационных технологий им.
Мухаммада Аль Хорезмия Республика Узбекистан, г. Самарканд Аннотация. В статье рассмотрены вопросы построения медицинских информационных систем (МИС), проведен обзор и оценена эффективность внедрения информационных систем различной функциональности для лечебно-профилактических учреждений (ЛПУ), объединенных по территориальному ведомству. Выявлены отрицательные и положительные стороны существующих систем, приведены данные, отражающие улучшение показателей деятельности врачей амбулаторного звена при вводе и обработке информации посредством МИС.
Ключивые слова: Преимущества, недостатки, использование, информационные системы, МИС, ЛПУ.
Sakiyev T.R.
Samarkand branch of the Tashkent University of Information
Technologies named after Muhammad Al Khorezmiy, Senior teacher of the
Department "Software Engineering"
Nabiyeva S.S.
Student
Republic of Uzbekistan, the city of Samarkand ARCHITECTURE OF THE MEDICAL INFORMATION SYSTEM
Annotation: The paper reviewed the construction of medical information systems (MIS) and evaluated the effectiveness of the implementation of information systems with various functionality for medical care institutions (MCI), united by a territorial authority. In addition, the paper identified the negative and positive aspects of existing systems, and presented data showing improved performance of doctor's outpatient when entering and processing of information by the MIS.
Keywords: Advantages, disadvantages, using, information systems, MIS,
MCI.
Introduction.
Most traditional medical organizations and agencies gather, accumulate, storage and process huge volumes of information on paper in the form of cards, bulletins, procedural reports, documents for accounting of patients, medications, etc. This kind of approach in today's information society associates with many problems, the most important of which may be impossibility or duration of extensive data collection, which provides information about the patient, about his illnesses, about intolerance of drugs as a whole. The situation becomes more compounded if the person not attached to a particular clinic near place of residence, and this information is scattered on hospitals, which he once visited. In an emergency, the ability to quickly access to necessary information can play a decisive role in the struggle for the patient's life [1, 2].
In addition, the effective use of information by physicians, managers and governments provide the quality of medical care, overall living standard of the population, country's level of development as a whole and each of its territorial subject in particular. Therefore, the need to use large, and still ever-increasing volumes of information for solving diagnostic, therapeutic, statistical, administrative and other tasks, indicates that there is a need to designing information systems for health care agency [4].
Medical information system (MIS) can be divided into three groups by purposes:
1. data and information accumulating systems;
2. diagnostic and advising system;
3. Systems that provide health care.
Doctors every day are dealing with need to accumulate large volumes of professionally valuable information. The computer comes out as a tool for securely store of professional knowledge, providing accessible and quick search of
necessary information. In addition, the computer memory may store information, classified by the object feature (material - technical base, medicines), by type of information (economic, scientific, legal and regulatory), or by its nature (primary, secondary, operational, surveillance and analytical, expert, predictive). The storage, handling and use of information is the basis for creation information environment.
Automation of diagnostic-advising functions realize with decision-making systems. The attraction of electronic expert system contributes the most complete analysis of complex and controversial situations. For example, an expert technician can simultaneously think about seven hypotheses, and machine-to-expert allows us to consider all emerged options.
In providing health care to the population, enough common is the use of modern computing facilities. Electronic devices and software help to detect important physiological functions, such as cardiac index, liver density, volume and location of the cyst and others. These devices include echocardiography, a gamma camera. Possible error measurement (calculation) of these functions - about 15% of the data obtained using any of the computer monitoring system.
All computer systems in medicine and health care, regardless of their destination may be represented by the following levels of difficulty:
Level 1 - automated data processing systems and / or automated information processing systems (ASCD and ASIP) help to implement computational work that is carried out arithmetic operations, converting the original data / information (payroll, reports in accounting, etc...).
Level 2 - automated information and information - Reference System (AIS and ARS) intended for processing, storage and retrieval of documents, document information, certain facts and information.
Level 3 - Automated Control Systems (ACS) pre-process part of information on the computing devices by given programs and use processed information to perform variety of control functions such as planning, analysis, forecasts, operational management of health institutions.
Level 4 - Expert Systems (ES) for preparation of options and choice solution.
Approaches to build health information systems.
Creating MIS involves phasing of introduction in medioprophilactic institutions (MPI). In the first stage the system run services such as the emergency department, medical statistics etc.. The next step is connected to clinical services and research work. To implement these steps, there are different approaches to data management, among which the most common relational and object approaches.
The advantages of relational approach are the dominance of relative table data structure in most organizations, support of parallel processing, reliability, fault tolerance, efficiency, security, integrity, completeness, decrease of cost, online backup and restoration. Among the shortcomings, we can select impossibility of implementing the relational model of multimedia data, including
images, documents, video, audio, composite objects.
Object management advantages are copying familiar paper forms, the effective management of complex objects and relationships, object-oriented approach to modeling, flexibility, productivity and modularity. The high cost of the software is one of the main barriers to widespread of object-oriented systems.
Based on advantages and disadvantages of these approaches and specifics of medical information system, it is logically to conclude about reasonability of synthesis of two types technologies.
At that, the necessity to separate information gathering and processing in the MIS as follows is obviously. The process of collecting information is preferred to give to document-oriented environment as well as electronic documents the most faithfully replicate paper counterparts which familiar to the medical staff and this does not require changes in the structure of document. The process of information processing is carried out better on relational basis, because relational model focused on organization of data in the form of two-dimensional arrays allows use this structure when creating reports that require obtaining statistical data, various samples, etc.
Thus, successfully Implemented object-relational approach is the most promising solution, which takes into account the specificity of subject area and, at the same time, integrating all advantages of the first two solutions.
Advantages and disadvantages of using MIS.
MIS realize complex automation of medical institutions activities, that allows to choose modules which conform complete to current requirements of the institution and implement gradual build-up of MIS. Such systems allow to provide the following advantages.
For administrators:
• obtaining operating information about status of medical diagnostics, state of bed's number and state of patient's health;
• analysis of causes of failure of medical prescription and monitoring of treatment process progress;
• monitoring of treatment progress and compliance of selected individual treatment scheme to established medical standards;
• exclusion of duplication and unnecessary procedures of diagnostic tests and medical prescription by several medical specialists;
• control of medical documentations, analysis and registration of treatment process defects;
• control of patients' motion (translations, discharges, hospitalization, etc.);
• operational accounting and statistical reporting;
• monitoring and analysis of the quality of care;
• the ability to improve the quality of treatment process by analyzing profiles of medical staff and patients;
For staff:
• obtaining of operating information about results of diagnostics and laboratory tests, rehabilitation treatment, obtaining information about the patient;
• information support on treatment schemes (adopted and developed by the Ministry of Health of Uzbekistan), including diagnostic, therapeutic and medical prescriptions;
• routing requests for diagnostic tests and medical prescriptions;
• ability to influence on the quality of treatment process by participating in the survey;
• monitoring of Implementation of prescriptions made by midrange and paramedical personnel, analysis of causes of failure.
For patients:
• improving the quality of services by information exchange between doctors and professionals involved in the treatment;
• the ability to influence on the quality of treatment process by participating in survey;
• financial savings by eliminating the duplication of costly research or unreasonable prescriptions.
To identify disadvantages of using MIS specialists conducted research, result of which resulted is determined that the computerization in some cases leads to increase the average working time of medical personnel.
Thus, in the study [6] researchers defined figures for the main activities of doctors and working with documents.
Workflow Integration
Data integration is oriented to create the "virtual" data center to manage the entire distributed clinical data, while function integration is oriented to provide common functionalities for systems in healthcare institutions. None of them focus on the workflow, which is a technology that manages and monitors processes and allows the flow of work between individuals and/or departments to be defined and tracked. It is usually implemented by the data relationship of the database in the client-server model. But in a distributed environment such as a healthcare institution, the implementation will be more complicated. Middleware technologies such as Web Service could be used to implement the digital workflow by tackling with distributed database environment just like one database in client-server model. But it has no expandability in terms of adding new system into the architecture especially when the data structures are unknown. Standard messages such as DICOM and HL7 have already been applied in many systems to implement the workflow between different systems, but a complete integration is still difficult if there is no framework or model to guide the system to exchange the correct message in correct time.
IHE is an initiative designed to stimulate the integration of information systems that support modern healthcare institutions. Using a common framework, IHE employs existing protocols like DICOM and HL7 to connect devices, terminals and information systems in a hospital so as to fulfill the digital workflow. Up to now, it contains 12 integration profiles for radiology technical framework each of which specifies the model of one clinical application environment. The Scheduled Workflow Integration Profile establishes the
continuity and integrity of basic departmental imaging data acquired in an environment where examinations are being ordered. It specifies a number of transactions that maintain the consistency of patient and ordering information as well as defining the scheduling and imaging acquisition procedure steps. There are actually four different systems involved, HIS corresponds to ADT and Order Placer actors, RIS corresponds to DSS/Order Filler and Performed Procedure Step Management actors, PACS corresponds to Image Manager, Image Archive, Image Display and Evidence Creator actors, Modality corresponds to Acquisition Modality actor. By implementing each system with the standard transactions, we could easily achieve the workflow integration.
If we talk about introduction MIS in practice of doctors, then there is a need to allocate indicators for subsystems of different levels of detailing, performing different functional tasks. For example, some medical organizations when the doctor is forced to work with MIS and part or all of this work to duplicate on paper then doctor increases time of patient's reception and deteriorates the quality of medical care, which directly contradicts the main purposes for which "informatization" is done . Duplicate data entry is not the only reason. Let's note factors such as high cost of entering data into computer than writing their on paper ("usability" of MIS and problems of developing the effective computer interfaces for doctors), a large number and complexity of medical documentations, etc.
Conlusion
Based on above reasons it can be concluded that, despite all the adverse factors, medical institutions need to apply MIS, and thus it is necessary to take into account the following important criteria:
1. Any implementation of MIS should begin by automation of registry and the front desk, making and verification of passport data, information on benefits, etc., medical cards and coupons of reception, part of which should fill by medical registrars.
2. Revision of accounting documentations of doctor in order to introducing electronic forms, most of which are filled automatically (patient data, the name of drugs, diagnoses, prescriptions) allows to doctor does not print all of data manually, and use certain standards, to carry out the reduction of relevant documents, not only by volume but also by complexity.
3. Consideration of reducing of doctor's duty by transferring some of his functions subject to automation to midrange medical staff. For example, for medical documentations the complexity and amount of which cannot be cut, it is necessary to provide the possibility of its conduct and formation in electronic view by midrange medical staff.
4. When computerization of medical activities it is necessary to provide short-term training of doctors and nurses to computer literacy and thus, the main training time should be devoted to effective use of introduced MIS.
Conclusion. Informatization is the key to improving the quality of care and increase the efficiency of the health care system [4] (the entire system, not just the management). But we must bear in mind that improper informatization can make
difficulty for work or even damage it. How is necessary to analyze and take proper steps in reducing the problem.
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