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19Short Communication
J Health Dev 2018;2 (27):28-31
THE ROLE OF DIGITALIZATION OF HEALTH IN THE SYSTEM OF MANDATORY SOCIAL MEDICAL INSURANCE OF THE REPUBLIC OF KAZAKHSTAN
Zarina Keldibayeva1, Zarina Keruyenova2
1Expert of the department for monitoring the quality of medical services Branch of the NAE "Fund for Social Health Care" in Astana, Kazakhstan 2Leading Specialist of Monitoring and Analysis Department, RSE on JEM "Republican Center for Electronic Health" of the Ministry of Health of the Republic of Kazakhstan
Abstract
Thanks to the introduction of e-health, it is possible to increase the availability of medical services for the population, to ensure the promptness and accuracy of diagnosis and treatment of patients, to shorten the time for filling out papers that will allow it to be used directly for patient care. In the framework of compulsory social health insurance, a modernized approach to the provision of medical care using modern technologies is needed. Thus, the e-health environment based on the person-centered approach implies efficiently organized access to any set of patient medical records. This will make it possible to simplify and ensure a full account of the characteristics in the state of people's health, their individual risks, timely detection of borderline conditions and diseases, and simultaneously dramatically improve the efficiency and efficiency of medical organizations.
Keywords: health care, insurance, information systems, modernization.
Казахстан Республикасыныц MiHdemmi элеуметтш медициналыц сацтандыру саласындагы денсаульщ сацтауды цифрландырудьщ рвлi
Келдiбаева З.Р., Керуенова З.И.
"Медициналын сантандыру норы" КЕАЦ Астана паласы бойынша филиалы, медициналын нызметтщ сапасын банылау бвлiмiнiц сарапшысы, Астана, Казахстан ЦР ДСМ «Республикалын электрондын денсаулын сантау орталыгы» ШЖЦ РМК, Банылау мен талдау бвлiмiнiц жетекшi маманы, Астана, Цазацстан
Тушндеме
Электронды денсаулын сантауды енгiзудih| арнасында халы; медициналын цызметтщ нолжетiмдiлiгiн арттыру MYмкiндiгi бар, наунастарды емдеу жане диагностикалау дэлдiгi мен жеделдiктi намтамасыз ету, нужаттарды толтыруга жумсалган уанытты ныснарту наунастарга сапалы нызмет етуге MYмкiндiк бередi. Мiндеттi алеуметтiк сантандыру аясында замануи технологияларды нолдану арнылы медициналын нызмет кврсетуге жацартылган таслдеме нажет. Осылайша, дербестендiрiлген таслдеме негiзiнде электронды денсаулын сантау ортасы наунастыц кез-келген жинанталган медициналын жазбаларына уйымдастырылган тиiмдi цолжетiмдiлiктi намтамасыз етедi. Бул адамдардыц денсаулын жагдайындагы ерекшелiктердi, олардыц жеке цауiп-цатерлерiн толыннанды тiркеудi намтамасыз ету мен жецтдетуге, вз уанытында ауруды анынтауга жане медициналын уйымдар нызметтершц натижелiгi мен жеделд^н б'1р уанытта ку:рт жогарылатуга MYмкiндiк бередi.
Туйн свздер: денсаулын сантау, сантандыру, анпараттын ЖYйелер, жацгырту.
Роль цифровизации здравоохранения в системе обязательного социального медицинского страхования Республики Казахстан
Кельдибаева З.Р., Керуенова З.И.
Филиал НАО «Фонд социального медицинского здравоохранения» г. Астана, эксперт отдела мониторинга качества медицинских услуг, Астана, Казахстан РГП на ПХВ «Республиканский центр электронного здравоохранения» МЗ РК, ведущий специалист отдела мониторинга и анализа, Астана, Казахстан
Резюме
Благодаря внедрению электронного здравоохранения, имеется возможность повысить доступность медицинских
услуг для населения, обеспечить оперативность и точность диагностики и лечения пациентов, сократить время на заполнение бумаг, что позволит использовать его непосредственно для обслуживания пациентов. В рамках обязательного социального медицинского страхования необходим модернизированный подход к оказанию медицинской помощи с использованием современных технологий. Так, среда электронного здравоохранения на базе персонцентрированного подхода подразумевает эффективно организованный доступ к любой совокупности медицинских записей пациента. Это позволит упростить и обеспечить полноценный учет особенностей в состоянии здоровья людей, их индивидуальные риски, своевременное выявление пограничных состояний и заболеваний и одновременно резко повысить эффективность и оперативность деятельности медицинских организаций.
Ключевые слова: здравоохранение, страхование, информационные системы, модернизация.
УДК 61:002
Corresponding author: Zarina Keruyenova, Leading Specialist of Monitoring and Analysis Department, RSE on JEM "Republican Center for Electronic Health" of the Ministry of Health of the Republic of Kazakhstan Postal code: 010000
Address: Kazakhstan, Astana city., Amangeldy Imanova Str, 13
Phone: +7 (7172) 700 960, 1011
E-mail: [email protected], [email protected].
Recieved: 02-05-2018 Accepted: 14-05-2018
Introduction
In the age of the development of information technologies, one of the priority and most important areas of the «Information Kazakhstan 2020» program is the promotion of the problem of e-health development, which will lead to a new level of quality of medical care [1]. The prospect of universal digitalization of health is the creation of an electronic health passport that will provide both the doctor and the patient with operational information, presenting a logical framework for storing and exchanging data on human health.
A positive aspect of the introduction of information systems is the example of reducing queues in medical offices at the polyclinic level, patients have broad alternatives when choosing a doctor, and can also plan the time of a visit to it. Thanks to the introduction of e-health, the state has the opportunity to increase the availability of medical services for the population, to ensure the promptness and accuracy of patient diagnosis and treatment, to shorten the time for filling out the papers and, accordingly, to use it directly for patient care. So, within the framework of the Strategic Development Plan of the Ministry of Health, target indicators for the digitization of health have been identified: by 2020, the share of health organizations that will be connected to a single network will be 100%; the proportion of the population provided with electronic medical records will also be 100%; will fully integrate information systems of health organizations with a single integration platform [2].
Electronic health in international practice
As international experience shows, information technologies in the health system are gradually becoming not just a passive tool for providing accumulated data, but also a mechanism for preventing medical errors and a platform for teaching and disseminating new clinical knowledge, best practices and experience. To date, the world practice has collected significant experience in the use of information and communication technologies (ICT) in the health sector. National health informatization programs have been carried out for more than five years in several European countries, the United States and Canada [3].
So, now in the UK there is a program called NHS Connecting for Health [4]. Similar programs are being implemented in all countries of the Organization for Economic Cooperation and Development. In the countries of the European Union, a single e-health program is now being implemented [5]. The primary objectives of this program include the following: the processing of medical data about a patient using information technology tools, regardless of the location of the patient should be provided with insurance coverage.
Today, Canada is developing a unified information system in the healthcare industry. Within the framework of this program it is planned to develop a segment of the information system in the healthcare sector within the framework of the Electronic Government. Priority directions
«Digitalization is not a panacea, it's only part of the industrial revolution» N. Nazarbayev
of the work within the framework of the program are: the electronic health passport (EHR), the national information infrastructure for the healthcare sphere, the regional centers of medical information (RHIOs), the electronic exchange of medical information [6].
The example of the neighboring state is closest to our state. So, since 1992, Russia has been developing and implementing health information programs. To date, in the development of health informatization, ICT elements have been created in the country, as well as processes for introducing ICT in the health sector. In Russia, automated information systems of compulsory medical insurance funds and insurance medical organizations, as well as specialized information and analytical centers, have been created. As is known, information systems have a narrow specialization directions, which are focused on providing private functions and tasks. The lack of a common approach to their development in the process of exploitation led to serious problems. As a result, existing information systems are a complex of disparate workstations, rather than a single information environment.
Implementation of a single integration platform
Informatization of the health care system has a direct impact on the progress of the system, both in the direction of the development of the service itself, and in monitoring the health of patients. Modern information systems change the principles of the work of medical services of various profiles and raise it to a new level, including the introduction of differentiated methods of forecasting, detection, diagnosis, treatment and numerous diseases into medical practice. For a full-fledged transition to paperless management of medical records, the authorized health authority creates a secure, unified healthcare network that allows, where necessary, to organize teleconferences, consultations and consultations with the industry's leading experts. This will allow people living in remote settlements to receive advice from leading experts «without leaving home». Achievement of all indicators is planned through the introduction of a unified integration platform and the connection to it of all information systems and databases of medical organizations and health organizations that store all the necessary information about the activities of institutions, specialists, schedules for patients, providing access to medical databases through the network Internet or mobile telephony, as well as the introduction of health monitoring devices for patients transmitting data in real time to the patient's electronic card and to the attending physician by means of a secure electronic card of the patient containing information on visits, medical examinations, diagnostic examinations, outpatient and inpatient treatment, with the possibility of operative access via the Internet.
The use of information systems will affect a wide range of medical care, so it is planned to introduce a database of scientific and medical information that will include publications, reports, studies, information on epidemics and foci of diseases, information on diseases, their prevention
and treatment; creation of a common unified database of medicines registered in the Republic of Kazakhstan and their availability in pharmacy chains; the creation of a system of electronic medical prescriptions and prescriptions that allow you to quickly access the archive of patient appointments; introduction of telemedicine bracelets monitoring the health status of elderly and single citizens (over 60 years); full automation of ambulance services.
Mandatory medical insurance
The last decade in Kazakhstan there has been an improvement in the socio-economic level of life of the population. The overall economic stability of the state certainly affects the pace of development of health care [7]. The dynamics of the main economic indicators of health care indicate an annual increase in the budget allocated for financing the guaranteed volume of free medical care. Examination of the quality of medical care ensures the right of the patient to receive appropriate medical care within the framework of the state volume of free medical care.
The accumulated international experience shows the multidimensionality of the problems of quality management of medical services. The introduction of new payment principles for inpatient care and the real transformation of the health care financing system in the Republic of Kazakhstan require constant monitoring and evaluation of ongoing processes aimed at providing quality and qualified assistance, including using modernized approaches to the examination of the volume and quality of medical services. It is important to note the need for a qualitative examination of the provision of medical services, which will result in the providers of medical services being able to ensure the patient's safety in the provision of medical care in a timely manner.
In the framework of compulsory social health insurance, a modernized approach to the provision of medical care using modern technologies is needed. Providing a personal approach, digitalization will have the possibility of
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Up to date, the share of digitalization in healthcare organizations is 76.4%. By January 1, 2019, it is planned to bring this figure to 100%. The equipment of doctors and nurses with computer equipment is 82.8%. By the end of 2021 it is planned to bring the indicator to 100%. 51.0% of health organizations have Internet access. By the end of 2021, it is also planned to bring the indicator to 100% [2]. One of the tools for implementing effective management of the medical care process is information technology for expert evaluation of services.
Conclusion
Thus, the digitalization of the health care system is one of the important aspects in the development of this branch of the country. The development of the information component in the activities of medical organizations is one of the key tasks of increasing competitiveness. A new vision of the functional architecture is determined by the needs of the stakeholders, both in the information and in the automation of processes, as well as the overall goals of the health system reflected in the program documents.
It is important to conclude that the widespread use of advanced technologies is the key to the development of digitalization in the overall health system.
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