РОЗРОБКА МЕДИЧНОЇ ІНФОРМАЦІЙНОЇ СИСТЕМИ ДЛЯ МЕДИЧНИХ ЗАКЛАДІВ ПЕРВИННОЇ ЛАНКИ

Purpose. Development of a web application with a functional module for conducting prescriptions according to the ICPC2 standard for primary care facilities.Methodology. The C # 8.0 language and the ASP.Net Core 5.0 framework were chosen to implement a server application with the RESTful architecture. The MySql database is selected as the database. HTML5 SASS, JavaScript, React and Redux were used to develop the client part.Findings. Theoretical bases and business processes of medical information systems are investigated. The basic principles of building a modern information system are studied. A medical information system with a high rate of reliability and speed has been designed and implemented. Developed a web application with a client-server architectureOriginality. Features of modern applied medical information systems are revealed. Possibilities of medical information as the main means of medical data storage are considered. The process of conducting medical reception according to the ICPC2 standard for primary care facilities has been worked out. Theoretical bases of construction of software information system for polyclinic and outpatient clinic are investigated.Practical value. A medical information system with a high level of reliability and speed, an interface understandable for all age groups of users has been designed and implemented. Developed a web application with client-server architecture.

ANALYSIS OF THE DEVELOPMENT OF A MEDICAL INFORMATION SYSTEM

Охрана здоровья граждан – одна из ключевых тем развития государства. О необходимости выстроить систему здравоохранения на новой технологической базе заявил в Послании Федеральному Собранию 21.04.2021 Президент РФ Владимир Путин. Здравоохранение представляет собой достаточно сложную и динамическую систему, которая требует постоянной оценки ситуации и быстрого принятия решений. Непрерывная оценка эпидемиологической ситуации и мониторинг здоровья конкретного гражданина невозможен без качественно организованного обмена информацией и единой системы данных, внедренных в повседневную работу медицинских учреждений. На данный момент существует большое количество медицинских информационных систем (МИС), однако, многие из них содержат избыточный функционал и специфичный формат хранения данных. Адаптировать существующие МИС под нужды конкретных регионов довольно проблематично как в трудо- и времязатратах, так и финансовом плане. Была поставлена задача разработать медицинскую информационную систему Астрал.Мед, направленную на решение актуальных задач в сфере оказания первичной медико-санитарной помощи. Одной из задач разработки является возможность передачи и приема различной медицинской информации в уже существующие МИС с целью, в конечном итоге, отправки этих данных в Единую государственную информационную систему в сфере здравоохранения. В данном случае должно реализовываться единое хранилище всех данных пациентов внезависимости от медицинского учреждения, в котором они обслуживаются, и от информационной системы в данном учреждении. Реализация системы Астрал.Мед состоит из: разработки модуля интерфейсной части; разработки базы данных и способа взаимодействия с ней; модуля обработки запросов от специалистов медицинского учреждения и модуля интеграции со сторонними МИС (что является одной из самых основных и сложных задач из-за возможной несовместимости форматов хранения данных в различных информационных системах). Protection of the health of citizens is one of the key topics in the development of the state. The need to build a health care system on a new technological base was announced by the President of the Russian Federation Vladimir Putin in his Address to the Federal Assembly on April 21, 2021. Health care is a rather complex and dynamic system that requires constant assessment of the situation and quick decision-making. A continuous assessment of the epidemiological situation and monitoring of the health of a particular citizen is impossible without a well-organized exchange of information and a unified data system introduced into the daily work of medical institutions. At the moment, there are a large number of medical information systems (MIS), however, many of them contain redundant functionality and a specific data storage format. It is quite problematic to adapt existing IIAs to the needs of specific regions, both in terms of labor and time costs, and financially. The task was to develop a medical information system Astral.Med, aimed at solving urgent problems in the field of primary health care. One of the development tasks is the possibility of transferring and receiving various medical information to the already existing MIS with the aim, ultimately, of sending this data to the Unified State Information System in the field of health care. In this case, a single repository of all patient data should be implemented, regardless of the medical institution in which they are served and the information system in this institution. Implementation of the Ast-Ral.Med system consists of: development of the interface module; developing a database and a way to interact with it; a module for processing requests from specialists of a medical institution and a module for integration with third-party MIS (which is one of the most basic and complex tasks due to the possible incompatibility of data storage formats in various information systems).

Organization of medical care in FMBA institutions of the siberian federal district during the pandemic of new coronavirus infection (COVID-19): challenges and solutions

Introduction. The experience of organization of medical activity in the medical institutions subordinate to the FMBA of Russia in the Siberian Federal District during the I-III epidemic waves of COVID-19, the procedure for making and implementing organization and managerial decisions on building the health care system; the analysis of the experience gained in the formation and operation of consolidated mobile emergency response teams was made.Materials and methods. The study was performed on the basis of the statistical data, regulations on the organization of medical care for patients diagnosed with COVID-19, including medical care provision in the extreme conditions.Results and Discussion. The rational distribution of infectious diseases hospitals, human resources and equipment made it possible to create bed capacity reserve, as a result of which, even during the peak episodes of the pandemic process, the average occupancy of beds in the serviced area was no more than 92-93% and there was always the possibility to receive new patients in hospitals; the capacity of the laboratory was gradually increased 25 times: from 200 tests per day in the pre-pandemic period to 5,000 tests per day. Thanks to the introduction of the new management solutions, digitalization of medical processes has been ensured: accounting of results in the medical information system, transmission of results directly to medical institutions within 12-14 hours, which is 4 times faster than the standard time. The legal regulations of interaction with the rescue centres of the Ministry of Emergency Situations of Russia, the Ministry of Defense and other power structures, the improvement of the material and technical equipment of basic mobile hospitals and emergency medical teams were proposed for discussion.Conclusion. A scheme has been worked out for the involvement of the MOF of the Federal Medical and Biological Agency of Russia in the timely organizational measures for mobilization of forces and means in order to ensure the re-profiling of medical activities to work on providing medical care in the COVID-19 pandemic conditions.

Information system for monitoring of hypopituitarism in childhood and adolescence

The article is devoted to the development of a medical information system (MIS) designed to monitor and predict hypopituitarism in children and teenagers. MIS combines the medical information storage and management system with an intellectual system of medical decision-making support. The information system is based on a database with information obtained from impersonal medical discharge papers of children and adolescents of the Altai Territory diagnosed with hypopituitarism. Medical discharge papers provide information about the patient’s health status while in the hospital, the results of examinations and treatment. Discharges form a complete medical history of the patient, and the information system allows assessing the disease in dynamics. The purpose of the intelligent information system is to predict the patient's growth in order to select the optimal treatment strategy. The intelligent decision support system is based on a machine-learning model trained on data from a database. The model was trained in the Python programming language. The MIS interface is developed using the C # programming language. The use of MIS in medical institutions will allow doctors to carry out a personalized approach to the monitoring and predicting the growth for patients, and to choose the optimal trajectory of treatment.

Clinical and Patient-Related Outcome After Stabilization of Dorsal Pelvic Ring Fractures: A Retrospective Study Comparing Transiliac Fixator (TIFI) and Spinopelvic Fixation (SPF)

Purpose: Aim of this retrospective cohort study was the comparison of the transiliac fixator (TIFI) and spinopelvic fixation (SPF) for fixation of dorsal pelvic ring fractures in terms of clinical outcome, complications, and quality of life.Methods: Thirty-eight patients (23 men, 15 women; mean age 47 ± 19 years) with dorsal pelvic ring fractures (type-C-injuries after AO/OTA) that have been stabilized by either TIFI (group TIFI, n = 22) or SPF (group SPF, n = 16) between May 2015 and December 2018 were retrospectively reviewed. Outcome measurements included demographic data, perioperative parameters, and complications and were obtained from the medical information system. Quality of life was assessed using the German version of the short form 36 (SF-36) and short muskuloskeletal function assessment (SMFA-D). Clinical results were assessed using Merle d'Aubigné-Score, Iowa Pelvic Score, and Majeed Pelvic Score.Results: Both groups show relatively good post-operative results, which has previously been reported. Quality of life was comparable in both groups. Group TIFI was slightly superior regarding complication rates, cutting/suture time, and fluoroscopy time. Group SPF seemed to be superior regarding pain and pelvic scores.Conclusion: None of the methods could demonstrate significant superiority over the other. Management of pelvic injuries remains a highly individual challenge adapted to the individual patients' condition. Nevertheless, if fractures allow for stabilization with TIFI, the use of this method should be taken into consideration as a less invasive and more tissue-conserving approach.

Data mining technologies in a distributed medical information system

Proposed a method for solving the problem of identifying hidden relationships in hard-to-structure data that have an implicit character is considered using information mining. Proposed decision trees, the effectiveness of which is illustrated by a specific example. The use of OLAP analysis systems on data presented using in the form of a real or virtual hypercube’s information is an effective tool for the effectiveness of the management for medical monitoring

DESIGN OF MEDICAL INFORMATION SYSTEMS USER INTERFACE

The publication considers the relevance and purpose of medical information systems, as well as the tasks that should be solved by medical workers with their help. Functional capabilities and main modules of medical information systems were inspected. A list of the most powerful information systems is given, according to the recommendations of the Ministry of Health of Ukraine, for use in medical institutions. Since each medical information system has different modules with a unique interface, this requires certain skills to work with the system, understand the properties and principles of designing the user interface. The concept of the user interface is investigated, and its properties are specified. The main principles of the user interface design and quantitative methods of assessing its usability are described. Based on the result of the analysis, the strengths and weaknesses of methods for assessing the convenience of the user interface were identified. In particular, the complexity analysis method gives the possibility to investigate the actions and use of the system from the user's point of view, as well as the parameters that are responsible for the functionality of the system. It has been found that increasing the complexity of the interface leads to an increase in the number of operations that can be carried out in the medical information system. In turn, the use of the GOMS method makes it possible to evaluate the performance of the information system and step by step investigate its effectiveness, predicting the usability of the interface. On the one hand, a correct assessment of the interface complexity will make it possible to rationally adjust the process of the development of medical information systems on the basis of the user’s previous skills. On the other hand, knowledge of the principles of designing the user interface and its properties will make it possible to effectively and fully use their functional capabilities in professional activities.

Application of an Automatic Medical Information System to Implement Bundle Care for the Prevention of Ventilator-Associated Pneumonia

Ventilator-associated pneumonia is a common hospital-acquired infection. It causes patients to stay longer in the hospital and increases medical costs. This study explores the effect of applying an automatic medical information system to implement five-item prevention care bundles on the prevention of ventilator-related pneumonia. This study was a retrospective cohort study. This study was conducted from October 2017 to February 2018 and collected data from the intensive care unit of a medical center in southern Taiwan from January 2013 to May 2016. The control group (enrolled from January 2013 to June 2014) received oral hygiene. The experimental group (enrolled from July 2014 to December 2015) received five-item ventilator-associated pneumonia prevention care bundles, which consisted of (1) elevation of the head of the bed to 30–45°; (2) daily oral care with 0.12−0.2% chlorhexidine twice daily; (3) daily assessment of readiness to extubate; (4) daily sedative interruption; and (5) emptying water from the respirator tube. Results showed the incidence of ventilator-associated pneumonia in the bundle group was significantly less than the oral hygiene group (p = 0.029). The factors that significantly affected the incidence of ventilator-associated pneumonia were ventilator-associated pneumonia care bundle, ventilator-days, and intensive care unit length of stay. A significant reduction in ventilator-associated pneumonia rate in the bundle group compared to the oral hygiene group (OR = 0.366, 95% CI = 0.159–0.840) was observed, with 63.4% effectiveness. Application of an automatic medical information system to implement bundle care can significantly reduce the incidence of ventilator-associated pneumonia.

Organization of research activity in a polyclinic using medical information system

Introduction. The article considers an approach to organization of research activity using medical information system. Materials and methods. Authors carried out retrospective analytical cohort study of adults with temporary incapacity to work based on the data from the State Medical Institution Galichskaya District Hospital (Kostroma Region of the Russian Federation) for a period 2014–2019. Sampling was done using the medical information system. Results. As the medical information system has been operating for many years and is designed in the way that the key information gaps should be filled, we consider the results of our study on research activity in a polyclinic using medical information system successful. Discussion. The organization of research activity is discussed using results of an epidemiological study aimed at identifying the correlation between the incidence of acute respiratory diseases and further development of circulatory system diseases carried out in Galichskaya District Hospital.