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Information technologies for the Physician 2020 #2
Published: 2020-07-03
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CONTENT OF THE ISSUE
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Evaluation of innovations for healthcare
Actuality : evaluation system for healthsaving technologies innovation level development is defined by need of innovative healthcare development strategy implementation and insufficient definition of innovative healthcare technologies criteria. Implementation of new healthcare technologies into systemic healthsaving requires managerial decision making support for innovations integration.
Goal: healthsaving technologies innovation level multicriteria evaluation scientific approval and development.
Materials and methods: program includes systemic and content analysis, expert evaluation, analytical and statistical methods. Working with Public Health experts focus group three steps algorithm was used. Excel based data processing was performed with indicative indicators and indicative space calculation.
Results: healthsaving technologies innovative level multicriteria analysis method was designed. Method novelty consists of first time introduced for healthcare innovative level criteria, expert card and evaluation algorithm. Healthsaving technologies final evaluation indicative indicators and space were calculated as a base for managerial decision choice support for their integration.
Conclusion presented evaluation scale allows medical technologies ranging according to needs of solutions for certain tasks. -
Informatization in public health: from standards to expert systems
According to the updated requirements of the Ministry of Health of Russia, the main document regulating the treatment and diagnostic process are clinical recommendations. The guidelines for clinical recommendations, based on the results of randomized trials, determine the doctor’s actions when making a diagnosis, and choosing a rational treatment. However, the rudimentary format for the placement of information on paper significantly limits their operation. The capabilities of IT technologies allow integrating clinical recommendations into the structure of expert systems. On the example of the expert system “Treatment of chronic heart failure” the possibilities and prospects of informatization of the diagnostic process are presented.
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Multimodal data analysis, “Human” and “Machine” approaches difference, social problematics of biomedical data collection and turnover
Artificial intelligence technologies based physicians decision support systems is an important step of healthcare digital transformation. Despite of neuronet algorithms implementation into analytical systems benefits there are questions that have to be solved for digital healthcare successful launch. In addition to knowledge expert level for systems development and privacy warranties work with professional medical society and general public is essential for psychological and social barriers overcoming during transmission to digital economics.
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Personal telemedicine. Prospects for implementation
This article is devoted to the introduction of one of the most promising areas of telemedicine – personal telemedicine. A number of definitions are given, and some aspects of implementation are briefly considered. Based on the analysis of foreign experience and the current situation in Russian healthcare, the necessary steps are considered for the implementation of this direction.
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Legal problems of telemedicine technologies application in the context of fighting the spread of COVID-19 coronavirus
The purpose of the research is to analyze the legal problems of using telemedicine technologies, taking into account the experience of other countries; to assess the limitations of using telemedicine technologies in preventing the spread of COVID-19 coronavirus; to develop approaches to overcome existing restrictions in this area.
The authors consider the system of legal relations that arise between various participants in the provision of telemedicine services, focusing on international experience in this field.
On the example of the Russian Federation, the analysis of legal restrictions for the development of telemedicine technologies, which are typical for other countries, is carried out. A number of common problems of implementing telemedicine technologies are identified, as well as the specifics of legal regulation of telemedicine services in the Russian Federation.
Measures are proposed to overcome a number of legal restrictions in the use of telemedicine services related to licensing, labor legislation, etc. -
Telemedicine and COVID-19: quality of patient-initiated teleconsultations in case of acute respiratory disease
There is a global increase in demand for direct-to-patient telemedicine consultations due to COVID-19 pandemic. We made a quality assessment of the patient-initiated consultations in case of acute respiratory viral infection symptoms (COVID-19). There are 20 teleconsultations of 2 simulated patients in 10 the most popular telehealth services. An incomplete history of the disease was recorded in 50.0% of cases, incomplete allergy anamnesis – in 60.0%, and epidemiology anamnesis – in 35.0%. Information on chronic illnesses (critical for COVID-19 suspected situations) is fully collected only in 50.0% of cases. Due to defects in the history taking the target diagnostic concept was achieved in 30.0% of teleconsultations, target actions were recommended in only 35.0%. Telemedicine services did not provide continuity of medical care. In 60.0% of cases, medications were prescribed, including injectable antibacterial agents, which completely contradicts not only the legislation, but also the accepted international methods and practices of distance counseling. The quality of the direct-to-patient telemedicine services remains unsatisfactory. There is no effective quality control and quality assurance systems.
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Personnel education for digital healthcare and professional standards analysis
Most important task of healthcare is medical service continuous improving through implementation of new technologies. Modern technologies development is largely based on big biological data analysis. Ability to fully utilize modern technologies requires as new level of training for medical personnel, so reconsidering of professional standards with paying more attention to scientific and technical development.
Materials and methods: Physicians going through professional skills improvement process were questioned, professional standards, legislation for medical services and education were investigated.
Results: conclusions made on physicians readiness for work at digital healthcare system and on concordance of existing pro
fessional standards to healthcare development trends.
Conclus ion: scientific and technical aspects of physicians education have to be enforced, education time for physicians working at high-tech healthcare segment should be increased, research activity should be included into professional standards for some specialties.
Modern healthcare develops towards neuronet based big data analysis digital technologies implementation. Healthcare becomes more technologized and scientifically capacious. Information volume increase requires more teaching of skills for obtained within personalized digital medicine development data mining and interpreting; professional standards widening for personnel providing medical service at this field. -
Prediction of time of transurethral holmium lithotripsy in urolitiaz’s treatment
Introduction. Rational planning of use of the operating room and the high-tech equipment used at treatment of urolithiasis requires knowledge of time spent for ablation of uric concrements which in turn consists of time interval actually of stone breaking and time spent for additional actions: survey of the place of fragmentation, movement of laser fiber to the displaced stone, changes of caliber of an ureteroscop and so forth. Now there are no methods of calculation or prediction of these intervals of time.
Purpose: to develop a way of prediction of time of fragmentation of uric stones taking into account additional expenses of
time when using a contact lithotripsy the holmium laser that on the basis of knowledge of time of operation it is rational to plan loading of the operational room and the high-tech equipment.
Materials and methods. Own results of measurements of in Vivo of the intervals of time spent for actually destruction of a uric
stone and for the auxiliary actions necessary at carrying out operation of a lithotripsy and also the general time of final fragmentation of a concrement are given in work. Fragmentation of concrements was carried out by means of rigidny and flexible urethroscop in a ureter and cup pelvis to a system. Additional irrigation of operational area by means of a needle was applied. Methods of statistical data processing and a Statistics and Machine Learning Toolbox package of the Matlab system for prediction of duration of the procedure of fragmentation of concrements a holmium lithotripter of Triple (Medoptotekh) are used.
Results. The linear regression model is offered for prediction of the general time on ablation of urinary stone which the general
time is presented in the form of the sum of time ablation for actually process of breaking, and time of additional costs of performance of auxiliary manipulations. Treat auxiliary actions: washing of field of crushing, a movement of optical fiber because of the shift of its retropulsion of a stone and a respiratory excursion, need of change of caliber of an urethroscop, repeated pass through a urethra and a ureter and so forth. Time of direct breaking of a stone is defined on the basis of the mass of a stone calculated on by the holmium laser measured at KT the volume and density, specific speed of loss of mass of a stone when breaking, energy and frequencies of impulses of a laser lithotripter. Time of additional expenses is presented in the form of the work of time of direct breaking of a stone for coefficient of additional expenses. By measurements in vivo and statistical data processing average and maximum allowed values of coefficients of additional expenses when ablations in various parts of a urinary system are received. Average values of these coefficients are 5.44±2.42 when breaking stones in cup pelvis a system a rigid ureteroscop; 3.86±1.95 when using flexible ureteroscop; 8.92±3.13 when breaking stones in various part of a ureter and 1.36±0.62 when using for additional washing of field of breaking by means of a needle.
Conclusion. The obtained data of pilot studies of during of crushing of uric concrements and intervals of time of additional costs of carrying out the auxiliary manipulations which are carried out along with the procedure actually of crushing of stones and also the way of additional washing of a cavity of crushing allowing to reduce time of additional expenses when crushing by 4 times is offered. The mathematical model for calculation of duration of the total costs of crushing allowing to predict more precisely duration of operation of a contact lithotripsy the holmium laser in general is developed. -
Artificial intelligence technologies in medicine and healthcare: Russia’s position on the global patent and publication landscape
An overview of public policy measures aimed at the development of artificial intelligence (AI) technologies in the world and in Russia is presented. In order to evaluate the competitiveness of domestic developments created for the use of AI technologies in medicine and healthcare, a scientometric and patent analysis of the direction for the period 2010–2019 was performed. Based on the analysis of research fronts using the Essential science indicators methodology, the most promising research strategies have been identified. It is shown that on the global publishing landscape, Russia occupies the 27th position in the world by the number of publications devoted to the use of AI in healthcare: Russian researchers account for less than 1% of publications indexed in the Web of science. To enter the top 5 countries in terms of publication activity in this thematic cluster, Russia needs to increase the number of publications by more than 6 times. Of the 16 companies in whose publications the participation of Russian authors are indicated, 13 are foreign. In General, only 14% of publications in the thematic category “Computer science, artificial intelligence” were made in collaboration with the industrial sector. In the landscape formed by patent documents that protect technical solutions in the field of AI in medicine, Russia takes positions that do not confirm its intention to fight for promising markets for goods and services created on the basis of these technologies. In the field of medical AI developments, the number of Russian patents issued to non-residents of the country significantly exceeds the number of holders of domestic patents. Only 12 patents of Russian developers оn AI technologies for healthcare issued by foreign patent offices were found.
