System to monitor government-financed high-tech medical assistance

Transcription

1 System to monitor government-financed high-tech medical assistance

2 Customer profile The Ministry of Health of the Russian Federation is the federal executive body responsible for drafting and implementing government policy and legal regulation in the area of healthcare; mandatory health insurance; distribution of pharmaceuticals for medical use, including disease prevention measures (such as AIDS and other infections); medical treatment; rehabilitation and appraisals (excluding medical-social and military medical appraisals); pharmaceutical activities, such as ensuring the quality, efficacy, and safety of pharmaceuticals for medical use; the distribution of medical products; the sanitary and epidemiologic welfare of the population; medical and sanitary support for people employed in industries with dangerous working conditions; the medical-biological assessment of the health hazards associated with hazardous physical or chemical factors; the resort and recreation industry; the management of state property and provision of state services related to healthcare, such as medical services; the introduction of modern medical technology; new disease prevention methods; diagnostics; treatment and rehabilitation methods; forensic tests and psychiatric appraisals; organization of associate, university-level, postgraduate, and additional medical and pharmaceutical education; and resort and rehabilitation services. 2

3 Description Crucial to the effective implementation of state health policy is access to consolidated, complete, and reliable data about the level of healthcare, the condition of healthcare providers, and the financing of the healthcare sector. The development of a system to monitor the implementation of the government assignment for the provision of high-tech medical assistance (HTMA) financed from federal funds was the next step in streamlining the information and analytical support of the ministry s activities. The system facilitates government control over the provision of high-tech medical care to citizens. The development and deployment of the system was primarily caused by the need to gather and process large amounts of data. The traditional paper-based workflow to collect and process data related to the implementation, cost, oversight, and co-financing of HTMA significantly slowed down the capabilities for data search and reporting. The inability to generate electronic reports within short time frames and control the implementation of HTMA according to Order No. 242n of the Ministry of Health and Social Development of Russia (April 16, 2010) became the reason for the development of the system. Scope The system is comprised of the following functional modules: The data collection and storage module enables users to collect and store data entered by regional and federal users. Data are collected by the following key topics and system subsections: Data input. This section helps to gather data on provision of HTMA, staffing and equipment levels, and HTMA requirements. Information is collected by HTMA types, evaluation, methods employed, requests for HTMA, and HTMA requirements. Billing. This section enables users to enter HTMA billing data in the Data Input subsection. Patients. This section gathers patient data and the status of HTMA ticket review in subsections such as Health Record, HTMA Ticket, and Waiting List. Information. The Information section gathers contact data of healthcare organizations providing HTMA. On the whole, this module collects and stores personal data of patients who applied for HTMA and the status of review and approval of their patient tickets. The module supports storage of data about HTMA requirements, requests, and bills. Data about HTMA delivery is provided by a variety of slices. For the convenience of users, the module accumulates data about staffing, bed capacity, and equipment of healthcare organizations that deliver HTMA. Contact information of healthcare organizations specializing in HTMA delivery is provided as well. Information is stored on the server where the Oracle database is installed. Sensitive data are exchanged with the server via HTTPS protocol. A distinguishing feature of the module is the support of integrated data collection, where data accessible to users of different levels are updated online. 3

4 Scope The HTMA provision government assignment planning module is designed to plan and monitor the volume of HTMA provided across Russia s regions. It is closely integrated with the data collection and storage module, and it supports automated HTMA planning and monitoring based on data contained in the system. By comparing and analyzing planned values versus actual outcomes, users can control volumes of HTMA provided online in the course of implementation but not on completion of planned HTMA, which helps to prevent possible delays in the implementation of the plan and enables the users to adjust the plan as necessary. The HTMA provision government assignment planning module performs the following key tasks: Develop a nationwide HTMA provision plan for regions broken down by healthcare providers and areas of HTMA based on the following data sets: HTMA satisfaction of regions for prior periods Requests for HTMA submitted by healthcare providers Requests for HTMA submitted by regions Monitor the implementation of the plan, and monitor the current satisfaction of regions in terms of volumes of HTMA provided 4

5 Scope The scheduled reporting module enables users to generate scheduled reports using up-to-date data at any time. The system includes the following main reports tailored to fit the Ministry s needs Requirement of HTMA provided by healthcare providers in a Russian region under the regional program on state guarantees HTMA delivery by types Volumes by healthcare providers, which supplies data on planned versus actual HTMA provision HTMA request implementation report Report on delayed tickets Report on readmission of patients Report on spending for HTMA Reports designed to track HTMA approval and delivery Forms to be reported to the Ministry of Health according to the ministry s orders Generated reports are exportable to DOC or XLS formats. The ad-hoc reporting (OLAP) module enables users to generate ad-hoc report forms for the specific needs of the Ministry of Health and its subordinate authorities. Users can develop report forms as needed and present data in charts and maps. Reports are also exportable to DOC or XLS formats. The module provides flexible customization options for each report form. For example, in tables, users can add totals either in rows or columns; in charts, they can choose the type of chart and format the chart and its legend. Reports with maps have settings for map lettering and formatting as well as customizable legends and color schemes depending on the amount of data 5

6 Scope in the report. Custom reports can be saved as drafts for future use. The ad-hoc reporting module supports the analysis of data about treated patients based on such parameters as period, benefits, region of residence, profiles, sex and age, healthcare provider, and social status. The notification module enables users to exchange messages within the information system. This module supports the automatic distribution of notifications on the occurrence of events specified by the developer. Messages between users in the module are exchanged similarly to Each message contains data on the sender; the user can specify the subject line, attach a file, send the message to several users, and so on. After fourteen days from receipt, incoming messages are automatically archived, so that the Incoming section contains current messages only. Notifications are sent automatically to relevant users upon the occurrence of the following events: Documents are attached to the patient s health record or ticket The patient is assigned to healthcare provider Results of the patient ticket review by the medical board of the healthcare provider or regional healthcare authority are added to the system Operation results are entered into the system Comments are added to ticket The Open Portal was developed for patients to track the current status of their HTMA tickets. The portal can be tested using the demo ticket number At the portal, any patient waiting for a decision on HTMA provision can get information throughout all stages of the ticket review. The portal displays the creation date of the ticket, the status of the ticket, the scheduled date of the medical procedure, the healthcare provider where HTMA is scheduled to be provided, the type of HTMA, and so on. The patient also receives access to the contact information of the regional healthcare authority and the healthcare provider delivering HTMA. 6

7 Scope Key features The implementation of the original project started in 2008 and ended in May Currently, the system is being updated to accommodate changes in the legal framework for HTMA provision. The system continuously evolves as Russian laws and the Ministry of Health s policies change. In the future, the ministry plans to enhance the analytical functionality of the system by adding such functionality as planning, forecasting, and assessing the efficiency of HTMA. OLAP module provides flexibility in analyzing data for any period and creating ad-hoc reports based on the results of analysis. The system is integrated and mobile: Once information is uploaded, it is made available to any user anywhere in the world, provided that the user has appropriate access privileges. For convenience, data and report forms are exportable to external applications such as Microsoft Word, Microsoft Excel, and so on. Data can be analyzed using maps and charts. Additionally, Prognoz made the following suggestions for improvements and new features: Computerize ticket data entry into the system using bar code scanning Develop the OLAP analysis section Develop the notification system Supplement the system with a user forum Results of the implementation of the system The system provides fully automated data collection, significantly reduced the need for paper-based workflow, and greatly increased the speed at which users can find relevant information. Scheduled and ad-hoc reports can be generated online on an automated basis. Reporting data are now available for any time period; prior to system implementation, reporting for past years was challenging, as it required the review and processing of large numbers of documents. An advantage of the system is its mobility and accessibility from anywhere in the world, originally because of Web server architecture, where system databases and business logic are located on database servers and Web servers, respectively. User access to system data is granted via the Internet using HTTP and HTTPS protocols. 7

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