Integrated Electronic Health Record J.Vinarova, N.Tzacheva Sofia, Bulgaria

Transcription

1 Integrated Electronic Health Record J.Vinarova, N.Tzacheva Sofia, Bulgaria In the abstract of this article, we have described a real working in Occupational Health Services INTEGRAL ELECTRONIC HEALTH RECORD (IEHR), designed for specialized processing of health and medical information there. This article is devoted on a concrete development, ordered by a Private Health - insurance Company, which maintains Occupational Health Services (OHSs) for insured persons. The functions, described in this Ordinance are used in the elaborated Medical Information System (MIS). There are main screen for work, which is structured by activity types : for patients - at left and for experts, working in Occupational Health Services (OHSs) - at right area; Passport professional data screen constant administrative-passport data and professional characteristics; Health Condition screen - current health and medical information; Information inquire and health indicators; Also there is a screen for Work of OHS specialists and their connection with GP. Every entry is connected with the system date, administrative-passport data of employed and system identifier. Information is a very expensive product, which serves for financial reports and analyses at the Health Insurance Fund - iit s used by many users in dialog regime. Page 1 of 8

2 Introduction The aims and purposes we had to perform for development of a working model for Occupational Health Services are listed below : The model should mirror the practice of OHS physician and his/her information contacts with the health provided worker and his GP. To observe and pay attention of the documental medical economy, to describe all examined medical and auxiliary parameters and their standardized characteristics. Performing this quite new indexes in the electronic version is facilitated, because of the fact, that this is a very new practice and still there are no traditions for applying their paper version. To enforce the automated document turnover through ELECTRONIC HEALTH RECORD (EHR), as a first step of MIS integration on national level. In this way, it would be possible to be made all kind of health risk analysis at the working place, distinct health providing and control on the employer. EHR should be the basis on routine report analysis of workers health condition, as well allow for substitution of mainly one-dimensional with multi-dimensional statistical examinations. EHR should combine the center-oriented with decentralized method of approach of examine group health conditions of employees, considering International Disease Classificatory (ICD)/ EHR and Information System, destined for, should both allow multi-access of the specialized Database for the purposes of national responsible institutions mainly for Center of Hygiene, Medical Ecology and Nutrition and National Register of Occupational Morbidity in Sofia, Bulgaria ; Stage enlargement of the section Inquiries (Statistics) should also be considered as various algorytmic processing of the collected through work time information. The summarized examined characteristics should be based on the relative contingent of illness in all necessary sections by sex, by age, by profession, by production work and etc, accounting for selected case-effect relationships and correlations. This will optimize management of socially significant diseases in the relevant professional categories. Such information approach will help promotion initiatives directed to workplaces with health risk, work expertises and socio-medical behavior. Page 2 of 8

3 Presentation This article is devoted on a concrete development, ordered by a Private Health- insurance Company, which maintains Occupational Health Services (OHSs) for insured persons in Sofia, Gabrovo and Bourgas. At this moment, another two OHSs work successfully with EHR in Sofia. MIS and EHR are designed in a way to be a first step in the integration at National level. The compatibility of computer electronic files for processing information, connected with Occupational Health Services (OHSs) is a significant part of the aims, which are pursued by the reorganizing national health care. By trying to co-ordinate the specified requirements ad conforming with relatively limited information technology use in this specialized area that is searching for its place among the new forms of health care, we are introducing some basic screens of the working EHR : This is the main screen for work, which is structured by activity types : for patients - at left and for experts, working in Occupational Health Services (OHSs) - at right area. Then there is an entry screen for each health insured individual, passing the medical examination. The basic primary information for creation of an electronic record has the following sources : Page 3 of 8

4 1). Passport professional data constant administrative-passport data and professional characteristics, through which is created a reference information in the enterprise s department Human Resources and for health-insurance fund : 2). Section Health Condition - current health and medical information performed medical examinations by type, decisions of medical commissions and other medical documentation : Page 4 of 8

5 3.) Information inquire and health indicators: Page 5 of 8

6 4.) Work of OHS specialists and their connection with GP: Every entry is connected with the system date, which allows future references and with the administrative-passport data of employed his/her national identifier. Besides, MIS performs entrance Auto-number function, which gives the employed his/her system identifier. Searching function could be made by one of this three modes. The Card for preliminary medical check up, that is performed once before each employment at a new job is unique for each patient. It is provided with standardized attributes according to the chosen graphical design of the fields. The number of prophylactic check ups are unlimited after complaining or after OHS s initiative. Page 6 of 8

7 Conclusion From big importance for the realization of this project was the accent to the pragmatic aspects of specialized medical and health information and it s management use. This information is a very expensive product, which serves for financial reports and analyses at the Health Insurance Fund. It s used by many users in dialog regime. In future there are intentions about packet, epidemiological processing and terminals. This INTEGRAL ELECTRONIC HEALTH RECORD is a stage model of Occupational Health Services functions. It s in process of optimization the best vision of it s formalized structure is still not found, because there isn t any paper version to consider with. The graphical design of EHR is realized on the base of the present, modern medical electronic documents and it would develop in the practice. Key words: INTEGRAL ELECTRONIC HEALTH RECORD (IEHR), Occupational Health Services, Medical Information System (MIS), OHS specialists. Page 7 of 8

8 References, Lectures and Publications 1. Вариант на професионално здравно досие предназначен за компютърна обработка, Ж.Винарова, А.Желязкова, списание Асклепий (Asklepios), ISNN , 2001, том XIV, стр Лекционни курсове CST 381 Медицински Компютърни Системи и CST 470 Моделиране на болестни състояния и процеси, в НБУ, Програма Компютърни технологии в медицината за бакалаври, Лектор доц. д-р Ж. Винарова, д.м. - (Vinarova J. - Lectures, CST 381, Medical Information Systems and CST 470 Modeling of disease states and processes, New Bulgarian University, Bachelor Program Computer technologies in medicine ) 3. -Лекционен курс MED 128 Компютърни модели в системата на публичното здраве, в НБУ, Програма Мениджмънт на здравеопазването за магистри, Лектор доц. д-р Ж. Винарова, д.м. - (Vinarova J. - Lectures, MED 128, Computer models in the public health system, New Bulgarian University, Master Program Health care management ) 4.Сборник Cyberculture, издание НБУ, автор-съставител и научна редакция Ж.Винарова, ISBN , София, Речник и учебник по Телемедицина издание НБУ, автори на учебника и превод от английски език на European Telemedicine Glossary, Glossary of standards, concepts, technologies and users, edited by DG INFSO, May 2001, editor d-r Luciano Beolchi, Ж.Винарова и М.Вуков, ISBN , София, Tzacheva N. Practical methodology for analysis and assessment of the health state of insured employees. Sofia, 2002, Фирмена документация на НЗОК Медина,АД 8. Наредба 14/7 Август/1998 за Службите по трудова медицина Page 8 of 8