New innovative technologies in medicine presentation. Presentation on the topic "IT in medicine". Use of IT in medicine

The goal of the strategy is the development of medical science, aimed at creating high-tech innovative products that, based on the transfer of innovative technologies into practical healthcare, ensure the preservation and strengthening of public health; implementation public policy in the healthcare sector, improving the quality and accessibility of medical care to the population Russian Federation, including the development of innovative products, the development of critical technologies and the development of competencies.

Strategy objectives 1. development of medical science and innovation in the healthcare sector; 2. development of the medical research and development sector to the world level and integration of Russian medical science into the global scientific space; 3. increasing the effectiveness of fundamental and applied scientific research, strengthening human scientific potential; 4. development of a system of examination (informed selection) of promising and priority areas, assessment of the quality and effectiveness of scientific research;

Strategy objectives 5. creating conditions for sustainable demand for innovative products and their implementation in practical healthcare; 6. increasing the efficiency of medical science management based on the development of a strategic and project management system, the introduction of a program-targeted method of financing and institutional reforms; 7. improvement of mechanisms for motivating researchers; 8. further development international cooperation; 9. development of translational medicine.

Implementation of the strategy Participants scientific and scientific-pedagogical teams, scientific and educational organizations implementing scientific activity in the field of medicine Executors are the main managers of budget funds, state corporations and other organizations carrying out scientific medical research Coordinator Ministry of Health of the Russian Federation

Strategy Creating conditions for effective interaction between scientific and scientific-pedagogical personnel, experts in specialized fields, representatives of investment companies and departmental structures, integration of youth into the field of science and education in healthcare

Objectives of the scientific platform Conducting research: to create innovative products with the prospect of commercialization in the field of medicine and healthcare for the competitive development of biomedical science at the global level, focused on practical problems of medicine and healthcare

Requirements for the head of the scientific platform The head of the department is a doctor or candidate of sciences The total citation index for the last 5 years is at least 35 The threshold value of the Hirsch index is at least 7 The number of articles in journals with an impact factor of at least 2 (according to Web of Science) for the last 5 years - at least 5 Threshold quantity scientifically - research work completed on a competitive basis over the last 5 years - at least 2 Threshold number of patents received by the project manager - 1

Requirements for participants in the scientific platform The share of researchers under the age of 39 is at least 27% Threshold value of the degree - candidate of medical sciences Total citation index for the last 5 years - at least 12 Threshold value of the Hirsch index - at least 3 Number of articles in journals with impact - a factor of at least 2 (according to Web of Science) for the last 5 years - at least 2

Cumulative citation index for the last 5 years Number of articles in journals per Number of patents received per year

Activities aimed at implementing the scientific platform Heart failure of various origins Ischemic stroke Hip dysplasia Obstructive uropathy Controlled reprogramming of macrophages in various pathologies Conducting research in the field of molecular diagnostics of socially significant human diseases

Direction 1: new methods for diagnosing heart failure of various origins Study of the content of: pro-inflammatory cytokines (IL-6, IL-8, IL-12, TNF α and its soluble receptor sTNF-R), biomarkers of the inflammatory process (C-reactive protein), biochemical indicators heart failure (Nauretic peptide) hemodynamic parameters in patients with alcoholic cardiomyopathy and coronary heart disease 3-5 functional classes according to the NYHA classification

Direction 2 new methods for diagnosing and predicting the course of ischemic stroke study of the dynamics of the content of apoptosis markers: sTNF-α, sTNF-α R1, Fas(CD95), soluble Fas receptor (sFas) soluble Fas ligand (sFasL) in the blood of patients who have suffered an ischemic stroke determination correlation of their levels with the severity of neurological manifestations

Direction 3 new methods for diagnosing the severity and assessing the effectiveness of treatment for hip dysplasia in children A study was conducted: metabolic products of hyaline cartilage of the hip joint (type II collagen, aggrecan, hyaluronate) subchondral bone (osteocalcin), growth stimulating factors (FGF, VEGF)

The main results of the implementation: the intensity of alterative-destructive processes in hyaline cartilage reflects changes in the content of type II collagen in the urine, aggrecan and hyaluronate in the blood serum in children with DTBS, the severity of DTBS in children correlates with an increase in the serum level of fibroblast growth factor (FGF), a factor angiogenesis (VEGF)

Direction 4 new methods for diagnosing and predicting the course of the inflammatory and sclerotic process in children with obstructive uropathy Study of acute phase proteins C - reactive protein CRP U-hs (highly sensitive DiaSys Diagnostics Systems GmbH) Ceruloplasmin (Sentinel Diagnostics)

Direction 4 Collection of material: before treatment intraoperatively 6 months after treatment Liquid level tetramethylbenzidine streptavidin peroxidase Second antibodies conjugated with biotin Cytokine First sorbed antibodies Well of the tablet Cytokine Biomarkers: Inflammation (MCP-1) Fibrogenesis (TGF- β 1); Damage to the main elements of the nephron (α -GST, π -GST, type IV collagen); Angiogenesis (VEGF) Study of cytokines IL-1β, 6, 8, TNF-α, 4 "Vector - Best" (Russia, Novosibirsk) IL 10 "Bender Medsystems" (Austria) Study of intercellular adhesion molecules sE - celestine "Bender Medsystems" ( Austria)

Main results of implementation 1. The standard complex of clinical, laboratory, microbiological and auxiliary studies is effective only for diagnosing exacerbation of the inflammatory process in the urinary tract. 2. The phase of latent inflammation of COP is characterized by an increase in the content of CRP, pro- (IL 6.8) and anti-inflammatory (IL 4.10) cytokines. There is a pronounced relationship between shifts in the cytokine profile in urine and biopsy samples and pathomorphological changes in the tissues of the kidneys and urinary tract 3. In the phase of active inflammation of COP, there is an imbalance between pro- and anti-inflammatory cytokines

Main results of implementation 4. Determination of CRP in blood serum, IL 6, 8 in urine has high sensitivity for diagnosis, assessment of the nature of the course and prevalence of the inflammatory process in the urinary tract and the effectiveness of treatment. 5. The initial level of the inflammatory activity index in urine allows us to predict the possibility of exacerbation of COP in the early postoperative period. 6. In children at risk of exacerbation of COP in the early postoperative period, it is advisable to use immunocorrective drugs and probiotics.

Main results of implementation The standard complex of clinical, laboratory and instrumental research methods is not very informative for diagnosing early damage to the renal parenchyma in patients with PMR. Prognostically unfavorable criteria characteristic of early kidney damage against the background of PMR are a pronounced increase in the content of VEGF, type IV collagen and π-GST in the urine. Calculation of the IRP allows us to objectify the diagnosis and monitor the process of renal scarring in children with VUR.

Direction 5 1. Study of the phenotypic plasticity of peritoneal macrophages and macrophages of the urinary tract 2. Elucidation of the receptor and signaling pathways of reprogramming for known factors 3. Detection of other, as yet unknown reprogramming factors 4. Determination of the systemic effect on the body of local reprogramming of macrophages Controlled reprogramming of macrophages – new possibilities for regulating the course of various pathologies

Research Institute of Molecular Medicine Department of Cardiovascular Surgery and Invasive Cardiology Federal State Budgetary Institution Scientific Center for Diagnostics of the Russian Academy of Medical Sciences Department of Pediatric Surgery, Urology and Andrology Integration Department of Pathophysiology Research Institute mental health Department of Obstetrics and Gynecology

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The role of informatization in the healthcare system

2 The basis of a monitoring system for the state of population health and demographic indicators The basis for promptly making adequate treatment and diagnostic decisions The basis for making adequate management decisions State Specialist Manager/owner Sokos “Olimpic Garden”, March 26, 2009

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Prospects for healthcare informatization

3 Approval of standards in the field of “Informatization of health” Creation of a “State information system for personalized accounting of the provision of medical care to citizens of the Russian Federation” Protection of personal data of a citizen of the Russian Federation processed in the MIS Development of federal and territorial medical information systems Adoption of new legal acts regulating the use of information systems in healthcare.

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Accepted national standards

Sokos “Olimpic Garden”, March 26, 2009 4 GOST R 52636-2006 “Electronic medical history. General provisions" GOST R ISO/TS 18308-2008 "Informatization of health. Requirements for architecture electronic records in healthcare"

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Concept for the development of the healthcare system until 2020

5 Sokos “Olimpic Garden”, March 26, 2009 Personalization of medical services based on an electronic health passport (EHR) Development of ICT infrastructure of the healthcare system, incl. creation of regional data processing centers Organization of electronic exchange of medical data Creation of national registers, reference books and classifiers, a national electronic medical library Integration of all state information systems in the field of healthcare, social development and labor Directions of work on informatization, main tasks: Ministry of Health and Social Development ©, O.V. Simakov

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Expected results of healthcare informatization in the Russian Federation

Sokos “Olimpic Garden”, March 26, 2009 6 Improving the quality of services by increasing the time per patient; increasing the availability of medical information and educational resources for citizens; reducing errors by medical personnel associated with prescribing medications and choosing a course of treatment (up to 15%); reducing temporary disability of citizens by reducing the number of errors when making a diagnosis (up to 20%); reducing mortality by 5% and a corresponding increase in the average life expectancy of the population Reducing financial costs due to the number of additional consultations, examinations and tests prescribed by various specialists in the absence of information about previously performed procedures (up to 14%); overexpenditure of medical Supplies and medications (up to 11%); the number of re-hospitalizations after treatment (up to 20%), the number of visits by patients to medical institutions (up to 5%); the number of incorrect financial transactions in the health insurance system Reducing time costs by automating the search for necessary information (up to 60%); automation of current documentation (up to 20%); increasing the efficiency of consultations, collecting anamnesis and making a diagnosis (up to 25%), Reducing the labor costs of medical personnel by automating the search and processing of reference and documentary information, access to personal medical information about the patient, preparation of documents (reports, conclusions, prescriptions, etc. ) access of doctors to information on the latest methods treatment and innovations in the field of medicines of the Ministry of Health and Social Development ©, O.V. Simakov

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Infrastructure of proposed solutions for 2009–2011.

7 Reserve State information system for personalized accounting of the provision of medical care to citizens of the Russian Federation (System) Internet Secure communication channels (intranet) Crypto routers FSB certification Regional data processing and analysis center (RDC) Standard PTC Standard form of accounting for medical provision. assistance Regional Data Processing and Analysis Center (RDC) Standard PTC Standard form for recording the provision of medical services. assistance Standard PTC Standard form for recording the provision of medical services. assistance Standard PTC Standard form for recording the provision of medical services. help Internet Federal Center for Data Processing and Analysis (FDAC) Main Unified integrated system of personalized accounting of medical care provided to insured citizens by the Compulsory Medical Insurance Fund Unified information system of the pension fund Unified integrated information system of the Federal Social Insurance Fund of Russia ... ... Total 86 RCDCs Total ≈ 13.2 thousand health care facilities 83 constituent entities of the Russian Federation + Baikonur + 1 additional in Moscow and the Moscow region Integration with existing (under development) Sokos systems “Olimpic Garden”, March 26, 2009 Ministry of Health and Social Development ©, O.V. Simakov

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Problems of healthcare informatization

8 Lack of a national concept for building information medical systems based on a person-centered approach (using generally accepted standards) Lack of a unified system for identifying patients from birth throughout life Difficulties in harmonizing the principles of information exchange in integrated systems Low rates of development of the telecommunications infrastructure of the healthcare system Lack of legal and software and hardware for the confidentiality of personal medical data 8 Sokos “Olimpic Garden”, March 26, 2009

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Organization of automated processing of personal data in medical institutions

9 Person-centered paradigm - maintaining a MIS database with all-Russian citizen identifiers - the basis for the integration of medical information within the framework of a single medical information space Sokos “Olimpic Garden”, March 26, 2009

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Organization of automated processing of personal data in medical institutions.

10 Regulatory framework: Law “On Personal Data”, No. 152-FZ dated July 27, 2006. On approval of the Regulations on ensuring the security of personal data during their processing in personal data information systems, Decree of the Government of the Russian Federation dated November 17, 2007 No. 781 By January 1, 2010, all personal data information systems must be brought into compliance with the requirements of the Law “On Personal Data” Sokos “Olimpic Garden”, March 26, 2009

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11 PROBLEMS: The regulatory framework for the implementation of the laws “On Personal Data”, as well as “Fundamentals of Legislation... on Health Protection...”, “On Medical Insurance...” has not been fully developed in terms of maintaining databases and using ICT in healthcare (after changes in 2006/7) There are no uniform standards for identifying objects, coding and exchanging medical data. The legal acts of the Russian Federation do not explicitly include norms and requirements for the conduct of medical documents and the automated processing of personal data of the patient (except for the Law “On Personal Data”, Article 10) Sokos “Olimpic Garden” ", March 26, 2009

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12 Documented consent of the patient to the processing and transfer of his personal data Informing the patient about the purposes, methods of processing his personal data, about persons who have access to them, as well as about their receipt from third parties PROBLEMS: Procedures and forms are not regulated: Sokos “Olimpic Garden” ", March 26, 2009

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13 Introduction of Electronic Digital Signature (EDS) Example of St. Petersburg: Certification Center (CA) with federal cross certification One CA for IOGV and the subordinate network of a constituent entity of the Russian Federation Issued and installed more than 600 electronic digital signatures: Head of a health care institution Deputy head of a health care institution Areas of application of digital signature in 2008 Creation and signing of an application for inclusion of a citizen in the register of regional beneficiaries Submission of applications for the inclusion/exclusion of doctors from the Sokos health care directory “Olimpic Garden”, March 26, 2009

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Prospects for informatization of healthcare in St. Petersburg

The most important steps to develop the informatization of healthcare in St. Petersburg: Development of a telecommunications environment that allows organizing the work of doctors in a single information space Creation and approval of a regional standard for collective electronic medical records (EMR) and the creation of an EHR repository for maintaining and storing information on the health status of citizens and organizing the provision of medical care to them Creation and development of information systems allowing doctors in St. Petersburg to work in a single information space and directly with the repository electronic medical records when receiving patients Creation of an official information portal healthcare system of St. Petersburg and the city center for processing calls from citizens in order to implement the constitutional right of citizens to information Development of normative documents and regulations for organizing the interaction of medical institutions in St. Petersburg. 14

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Key areas of informatization in the healthcare system of St. Petersburg

15 TELECOMMUNICATION ENVIRONMENT TECHNOLOGICAL INFRASTRUCTURE AND BASIC SERVICES FUNCTIONAL ORIENTED INFORMATION RESOURCES AND SYSTEMS

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Infrastructure

1. The need to manage the cost of maintaining the IT infrastructure of healthcare institutions and the management system as a whole. 2. Solving common problems and issues: Problems of resource integration Solving technical and technological problems Solving issues of distribution of responsibilities State technological organization performing the functions of IT consulting at the level of the Government of St. Petersburg State technological organization performing the functions of IT consulting at the level of the healthcare system of St. Petersburg Sokos “Olimpic Garden” , March 26, 2009 St. Petersburg IAC St. Petersburg MIAC 16

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Infrastructure state centers of St. Petersburg

GOVERNMENT OF ST. PETERSBURG Health Committee Committee on Informatization and Communications Committee on Social Protection St. Petersburg IAC Information and Analytical Center of the State Center for the Accrual and Payment of Pensions and Benefits City Center for the Calculation and Payment of Pensions and Benefits Sokos “Olimpic Garden”, March 26, 2009 St. Petersburg IAC Medical Information and Analytical Center 17

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Infrastructure

Multiservice network of public authorities Unified Multiservice Telecommunication Network IOGV St. Petersburg (EMTS) Data Processing Center for healthcare institutions (DPC) Centralized technical support for healthcare institutions Use of funds cryptographic protection information (EDS) Central server Email healthcare institutions Sokos “Olimpic Garden”, March 26, 2009 Main components of the infrastructure of the healthcare management system in St. Petersburg: 18

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Unified Multiservice Telecommunication Network IOGV St. Petersburg (EMTS)

Fiber optic communication - 900 healthcare points Reserve modem pool - 480 lines Data protection - VipNet EMTS services: MIAC IAC Internet Mail server healthcare Unix mail servers of institutions Information exchange between IS institutions Sokos “Olimpic Garden”, March 26, 2009 19

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Sokos “Olimpic Garden”, March 26, 2009 Performance monitoring Information transparency Standardization of administrative regulations Monitoring Reports Analysis Collection and storage Methodology Support Security Repositories Accessibility Mobility Public service Feedback 20

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Sokos “Olimpic Garden”, March 26, 2009 Efficiency control Monitoring Reports Analysis Collection and storage “Increasing the availability and quality of medical care” Efficiency of government bodies task N task 1 tool 1 tool N Control 21

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Monitoring

State medical statistical observation Monitoring the assessment of the effectiveness of the activities of executive authorities in St. Petersburg Monitoring the interaction of executive authorities in St. Petersburg Monitoring of the National Health Project Monitoring the socio-economic development of St. Petersburg (including districts of St. Petersburg) Monitoring living standards in St. Petersburg Social and hygienic monitoring in St. Petersburg Sokos “Olimpic Garden”, March 26, 2009 Analytical systems of the Business Intelligence class and related methodological developments 22

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Portal technologies

System of information interaction between health care institutions in St. Petersburg Tasks: Organizing interaction with health care institutions and regional government departments Formation and maintenance of a centralized monitoring resource Analysis of information resource materials Generating results in the form of reports Healthcare management project portal Tasks: Document management system Project management in health care of St. Petersburg Citywide calendar healthcare activities Phonebook healthcare systems Information search Sokos “Olimpic Garden”, March 26, 2009 23

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System of information interaction between healthcare institutions in St. Petersburg

Desktop of the health care organizer Calendar of events Data collection (questionnaire) Library of copies of orders and orders of the health care organization Virtual office of the Chief specialist of the health care organization in the areas Information system for working with citizens' appeals Information system for recording the needs and planning of equipment purchases Directories and classifiers Catalog/repository of web services (UDDI ) Information service for monitoring the epidemiological situation Node of Preferential Drug Provision Information service for registering mortality Reference services Pharmaceutical reference service Medical reference service Repository of interactive document flow schemes in the healthcare system of St. Petersburg Technical support (Service Desk) of healthcare institutions of St. Petersburg Sokos “Olimpic Garden”, March 26, 2009 24

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Projects for the implementation of EDMS in health care institutions of the city districts 25 Sokos “Olimpic Garden”, March 26, 2009 The introduction of EDMS will ensure increased efficiency of health care institutions and general public health institutions, increased efficiency of interdepartmental interaction and work on receiving letters and appeals from citizens through: Creation of an automated information system providing: automated accounting of IOGV documents; access to documents in accordance with the competence of document flow participants; Providing automated control over the execution of documents and instructions: automated distribution to in electronic format control documents and instructions; automated electronic distribution of notifications about violation of deadlines for the execution of documents and instructions.

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26 Sokos “Olimpic Garden”, March 26, 2009 Project goals: Reducing the time for review and execution of official documents, instructions from managers, letters and oral appeals from citizens; Reducing the time required for approval of draft working and administrative documents. Project activities: To achieve the set goals, it is necessary to solve the following main tasks: ensure accounting and control of the movement of documents; introduce a unified end-to-end technology for document execution control; eliminate the need for repeated, manual entry of primary registration information about documents included in the EDMS when transferring documents between document flow participants; provide information support making management decisions on the basis of prompt access of employees of healthcare institutions and executive bodies to any document within their area of ​​competence; Projects for the implementation of EDMS in health care facilities in city districts

Slide 27

A number of health system management tasks

Sokos “Olimpic Garden”, March 26, 2009 Standardization of administrative regulations Methodology Support Security Repository SOA solution architecture XML data exchange format Project management (PMI PMBOK) Creation of centralized technical support Use of digital signature 27

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SOA solution architecture

28 Physician support Management accounting Statistical accounting Financial accounting Other Medical Information System (MIS) State information systems Citywide information systems Regulatory reference information Health care institution Regulations Regulations Sokos “Olimpic Garden”, March 26, 2009

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Methodology

Sokos “Olimpic Garden”, March 26, 2009 Project management based on the ANSI PMI PMBOK Guide 3rd Edition Standards for the development of information systems and information resources Standards for the implementation of IS and IR and technical support in accordance with ITIL libraries METHODOLOGY REGULATIONS 29

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A number of health system management tasks

Sokos “Olimpic Garden”, March 26, 2009 Information openness Accessibility Mobility Feedback Information openness is the basis of the new image of Russian public administration! thirty

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Organization of a unified information space for making appointments at health care facilities

31 At the reception of a healthcare facility: Infokiosk Call Center Registration via the Internet EMTS AIS “Electronic registration” Sokos “Olimpic Garden”, March 26, 2009

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Information kiosk

EMTS Text Data from the compulsory health insurance system Information about the medical services provided Directory of LSIIMP for health care facilities Information about the availability of drugs in city pharmacies Information about the status of inclusion in registers Management of the queue for appointments in health care facilities Directory of institutions. Search. GIS. Appeal to the hotline of the Health Committee VoIP Sokos “Olimpic Garden”, March 26, 2009 Directory of IOGV St. Petersburg 32

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Call centers

Hotline for working with citizens' requests Pharmaceutical reference service Medical reference service Technical support (Support) High-tech medical assistance 24*7 24*7 24*7 5*8 5*8 03 Service 112 0999 VoIP Sokos “Olimpic Garden”, March 26, 2009 33

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From e-government to mobile government

Obtaining information on the status of inclusion of a citizen in the register of regional beneficiaries Obtaining information on the issuance of a quota for receiving High-tech (expensive) medical care EDS TOUZ ESRN Sokos “Olimpic Garden”, March 26, 2009 34

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Informatization concepts

Sokos “Olimpic Garden”, March 26, 2009 Concept of informatization of the healthcare management system of St. Petersburg for 2009-2011 Concept of informatization of the compulsory health insurance system of St. Petersburg Resolution of the Government of St. Petersburg 35

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36 THANK YOU! [email protected]

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To demonstrate the deplorable state of medicine in Moldova, doctors there created a video in which they allegedly perform an operation on a child using a construction drill and rusty wire cutters. And this is against the backdrop of how in developed countries every day new, even more accurate and and technology. This review is devoted to the ten most interesting of them.

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