Articles from rubric: «Digital healthcare»
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2023 № 12 Regional model for organizing telemedicine consultations in ophthalmology: problems and prospects.
Relevance. In modern healthcare, there is an increasing role of information and telecommunication technologies. Digital transformation of the medical industry makes it possible to ensure continuity of patient monitoring, optimize the diagnostic stage, and improve the quality of medical prevention. Today, teleconsultations are widely implemented in the activities of national medical research centers. This article presents a regional model for organizing and conducting telemedicine consultations in the 3rd level ophthalmological center of the Republic of Tatarstan – State Autonomous Institution «RKOB MZ RT named after Prof. E. V. Adamyuk» for the period 2019–2022, an analysis of problems and prospects for improving interaction Level 3 medical organizations with National Medical Research Center when
carrying out remote consultations (consiliums).
The purpose of the study studying the results of introducing telemedicine consultations (hereinafter referred to as TMC) into the activities of a regional ophthalmological center providing primary specialized health care and specialized (including high-tech medical care), in 2019–2022. and development of proposals to improve the efficiency of the use of telemedicine technologies in the provision of medical care.
Materials and methods. An analysis of the legal regulation of telemedicine technologies in healthcare was carried out, an assessment was made of the number and structure of telemedicine consultations with the National Medical Research Center using information from the unified state information system of the regional ophthalmological center for the period 2019–2022.
Results. When organizing telemedicine in the clinic, local regulatory documents were developed, the main processes of teleconsultations were identified, and responsible persons were appointed. Since the introduction of telemedicine technologies in the State Autonomous Institution “RKOB MZ RT named after Prof. E. V. Adamyuk”, 130 telemedicine consultations with the National Medical Research Center have been carried out. The structure of nosological forms during TMC is dominated by inflammatory diseases of the eye (49,5%), degenerative diseases of the retina (13%), and glaucoma (8,4%). Most often, specialists at the National Medical Research Center for TMC recommended face-to-face consultation or surgical treatment of the patient in the conditions of the National Medical Research Center (46,6%), correction of the ongoing conservative therapy (24,8%).
Conclusions. The work carried out indicates the demand for remote consultations with the National Medical Research Center when providing medical care in the field of ophthalmology. The more active introduction of telecommunication technologies into the activities of regional specialized centers in interaction with medical organizations of the second and first levels is becoming relevant. -
2023 № 12 Using MVP in the development of a software product for an infectious disease monitoring information system.
In world practice, the effectiveness of management decisions taken to organize medical care for the population in the context of the COVID‑19 pandemic is associated with the construction of mathematical models based on statistical data implemented in the software of medical information systems and the development of digital technologies that allow remote observation and interaction with the patient.
As information about COVID‑19 accumulates, the issue of automating the processes of collecting, accumulating, storing, analyzing and visualizing medical data has become relevant for executive authorities in the field of protecting the health of citizens in the Russian Federation.
Purpose of study. To develop and to implement a software module for monitoring infectious diseases to automate basic business processes related to the provision of medical care to patients with COVID‑19.
Methods. The basis for the development of MVP was the e-document flow system (EDF) «Bureaucrat». The main tool was the CUBA platform, and the following technologies were used: Spring, Groovy, YARG, HL7, SOAP, REST API, Tomcat, Vaadin, Activiti.
Results. At the first five stages of creating an MVP information system for monitoring infectious diseases, the “Questionnaire” and “Observation Sheet” forms were introduced, and also integration with the Federal Register of COVID‑19 Patients was carried out, functionality for creating emergency notifications about infectious diseases was introduced, and integration with the regional information system was partially implemented. The sixth and seventh stages provided for the separation of MVP based on the Bureaucrat EDF into an independent software product with expanded functionality.
Conclusions. As a result of the work, a software product was obtained, first as a module within the Bureaucrat EDF, and then as an independent information system “Infections.Net”, which was able to quickly act as an addition to RMIS in the Tyumen region and automate all necessary business processes at the regional level related to work on COVID‑19 patients in a short time frame. -
2023 № 12 Online training for doctors of non-oncology specialties on the prevention and early diagnosis of malignant skin tumors.
One of the reasons for the late diagnosis of malignant skin neoplasms (hereinafter referred to as MNS) is the insufficient knowledge of doctors in non-oncology specialties [1], [2]. The sensitivity for recognizing cutaneous melanoma (hereinafter referred to as MNS) during a visual examination by primary care physicians is 40,2% [3]. The sensitivity of recognizing MNS for an inexperienced dermatologist is 69%, compared to the sensitivity of diagnosing MNS by an experienced dermatologist is 92% [4].
Also, the reason for the late diagnosis of MNS is an insufficiently complete examination of patients. Evidence suggests that doctors do not routinely offer full body mole screening. Up to 63% of patients diagnosed with MK visited their GP in the year before diagnosis. Only 30% of dermatologists perform a full body skin examination on all of their patients [5].
Thus, an important method is the education of doctors of non-oncology specialties in the form of training programs in the principles of early diagnosis of cancer, which in turn can help improve the oncological epidemiological situation [9].
The purpose of this study is to study the effectiveness of organizing an 8-hour online training aimed at raising the awareness of nononcology doctors on the prevention and early diagnosis of cancer.
Material and methods. An 8-hour online course «Early diagnosis of skin tumors» was conducted for doctors, created by a group of authors on the platform «Personal Account of a Doctor at the Volga Research Medical University.» The training course included the following issues: risk factors for MK and other cancers, a description of the diagnostic algorithm using the ABCDE method with an illustration of each sign on photographic images, differential diagnosis of skin tumors, prevention with an emphasis on protection from ultraviolet radiation. The course used 82 photographs of MNS. The illustrated material consisted of 30 images of MK, 25 images of basal cell skin cancer (BCSC), 15 images of seborrheic keratoma of the skin, 12 images of skin hemangiomas.
Conclusion. As a result of online training, one can note an improvement in the level of knowledge of doctors after completing an online course aimed at the prevention and early diagnosis of cervical cancer.
Increasing the specificity of diagnosing nevi (0,846, 0,953) before and after, respectively, can help reduce costs in the “secondary level” of healthcare. The topic of prevention presented in the course also contributes to conducting preventive conversations with patients and correct patient routing.
Thus, conducting online training has a number of advantages and shows good learning results. The diagnostic methods discussed in the course, aimed at clarifying the diagnosis of cancer, especially in the early stages of the disease, predetermine the choice of optimal treatment tactics and are the key to ensuring the best prognosis of the disease. -
2023 № 11 Digital evolution in Healthcare: Trends and legal regulation of Digitalization of primary Health Care in the Russian Federation (analytical review).
Relevance. Digital evolution in the field of healthcare brings significant changes to the provision of primary health care in the Russian Federation. This process requires a comprehensive analysis and adequate legal regulation in order to ensure the effective implementation of innovative technologies, protection of the rights of patients and medical workers.
The purpose of the study: is to analyze the current trends in the digitalization of primary health care in the Russian Federation and the existing legal regulation of the digitalization process in the field of primary health care in the Russian Federation.
Materials and methods: the review is based on publications on the selected topic in the PubMed and eLibrary databases (n = 56), consideration of Russian regulatory legal acts related to digitalization in healthcare, including PHC, as well as the study of domestic and international experience in this field.
Results. The study revealed the main trends and prospects for the development of digitalization of primary health care in the Russian Federation. The analysis of publicly available publications made it possible to identify the main regulatory legal acts that regulate the process of digital transformation in the Russian Federation, including the PHC area. The technologies and services actively implemented in the state healthcare system were studied, and it was revealed that the active dissemination of information via the Internet creates the need to improve the mechanisms for protecting the confidentiality of patients’ medical data. It was also found that in the context of the rapid development of digital technologies in healthcare, various aspects of legal regulation need to be reviewed, including organization, liability
measures, guarantees and control. These conclusions emphasize the need for further analysis and improvement of legal regulation in this area to ensure effective and secure digital transformation in the field of primary health care in Russia.
Conclusion. Digital transformation of healthcare is an integral part of the modernization of the Russian healthcare system and requires a comprehensive and balanced approach, taking into account all possible risks and benefits. It is worth emphasizing the need to work out effective legal regulation mechanisms to minimize possible risks and ensure maximum safety and efficiency of the digital transformation process in the Russian healthcare sector.
The scope of the results. The results of the study can be used to improve legislation in the Russian Federation in the field of digitalization of healthcare, including primary health care, as well as to develop strategies and mechanisms for effective implementation of digital technologies in this area. -
2023 № 11 Digital information support of patients in medical organizations.
Today, digital transformation in the communication of an organization with its customers is more a necessity than a trend. It has penetrated into all spheres of life of modern society, including medical.
However, only a small proportion of medical organizations (MO) understand this and are ready to switch their organizational systems and processes of communicating with patients to «digital».
Based on the low level of awareness about digital information support tools and the willingness to allocate the organization’s budget for this, it is advisable at the beginning to focus on optimizing those tools that the Ministry already has and can improve. Thus, an effectively implemented strategy of using digital communication tools will allow the Ministry of Health to attract the attention of potential patients and significantly reduce the cost of existing tools, as well as increasing the effect of it.
T h e p u r p o s e o f t h e s t u d y : to study the use of modern digital technologies for patient information support and develop proposals for their implementation and improvement in medical organizations
M e t h o d s . The study used a descriptive method, questionnaire, analysis, comparison. Based on the results of the survey, a SWOT analysis was compiled.
R e s u l t s . A survey was conducted among 100 patients of two medical organizations, which showed that digital information support for patients is poorly developed. Attention should be paid to the development and improvement of existing tools such as the website, messengers, social networks and chatbots of medical organizations.
C o n c l u s i o n s . The introduction by medical organizations of new and improvement of old tools for digital information support of patients has a positive effect on the exchange of information with them. However, there is a clear link between the patient’s age and his desire to use digital means of communication. Based on this, the heads of the Ministry of Health should regularly conduct research on the quantitative and qualitative composition of their patients and, based on them, develop the necessary tools for digital information support. -
2023 № 10 Assessment of the impact of the implementation of telemedicine in the sphere of health care.
It has been revealed that telemedicine significantly improves the availability of medical care, especially in remote and sparsely populated regions. It has been determined that the integration of telemedicine can improve the quality of medical care due to prompt consultation of specialists and reduction of time for diagnosis. A direct relationship has been found between the use of telemedicine and patient satisfaction. The key factors influencing the effectiveness of telemedicine are identified: the quality of the Internet connection, the training of medical personnel, and the level of patient awareness. It has been established that the use of the DEMATEL method allows one to deeply
penetrate the structure of relationships in the telemedicine system and identify potential growth points.
Purpose of the study is to determine the complex relationships and interactions within the telemedicine system in the context of healthcare.
Materials and methods. The study is based on the application of the DEMATEL method for analyzing cause-and-effect relationships in a telemedicine system. This method allows you to penetrate deeply into the structure of relationships, identify key factors, and highlight causes and consequences.
Results. The study results confirm that the integration of telemedicine improves the availability and quality of medical care. The main cause-and-effect relationships influencing the effectiveness of telemedicine in the healthcare context were identified. It has been revealed that telemedicine significantly improves the availability of medical care, especially in remote and sparsely populated regions. It has been determined that the integration of telemedicine can improve the quality of medical care due to prompt consultation of specialists and reduction of time for diagnosis. A direct relationship has been found between the use of telemedicine and patient satisfaction. The key factors influencing the effectiveness of telemedicine are identified: the quality of the Internet connection, the training of medical personnel,
and the level of patient awareness. It has been established that the use of the DEMATEL method allows one to deeply penetrate the structure of relationships in the telemedicine system and identify potential growth points.
Findings. The importance of using analytical methods such as DEMATEL in the healthcare system has been confirmed. The use of such methods may be the key to optimization and further development of telemedicine in the digital economy. -
2023 № 10 Chatgpt as one of the elements of digital health literacy: the transformation of healthcare and primary health care.
Artificial intelligence (AI) plays an important role in digital healthcare, including primary health care, and large language models make a significant contribution to this progress. ChatGPT, the newest language model, has aroused interest in the global community, including in the healthcare sector, and attracted attention to the study of large language models in terms of their usefulness and safety of practical use. This article explores the role of ChatGPT as a tool for improving digital health literacy, assessing its benefits and potential risks in the context of modern healthcare and primary health care.
Purpose of the study is to еvaluate the potential benefits and challenges of integrating ChatGPT into the healthcare system, including primary health care, as an element of digital health literacy.
Materials and methods. A systematic search was conducted in PubMed/MEDLINE and Google Scholar.
Results. In the course of this study, concerns were found about the use of ChatGPT. These concerns include ethical issues, transparency and legal aspects, the risk of bias, misquotes, and information security.
Findings. ChatGPT is a valuable tool for improving digital health literacy and its implementation can lead to drastic changes in medical education, research and practical healthcare, but its use should be carried out with caution: the cooperation of regulatory authorities of all countries of the world is required. This approach will make it possible to develop legal norms regulating the code of ethics, which will become the basis for the «responsible» use of ChatGPT and other AI-based models in the field of medical education, scientific research and practical healthcare. -
2023 № 9 Digital transformation in primary health care and data-driven management.
In the contemporary healthcare context, there exists a necessity to optimize the organization and management of patient diagnosis, routing, and treatment, especially within the primary care sector. Within this scope, digital transformation assumes a pivotal role, offering novel avenues for enhancing the quality of medical assistance.
Research Objective: This study aims to identify the fundamental issues pertaining to the organization and management of patient diagnosis, routing, and treatment within the primary care sector. Furthermore, the study seeks to formulate recommendations for addressing these challenges through the avenue of digital transformation.
Materials and methods. The study was conducted through the utilization of comparative analysis employing synthesis, analysis, modeling, and specialization methodologies. Data were acquired through a specially developed questionnaire encompassing inquiries regarding healthcare process organization and management.
Discussion and results. The outcomes of the investigation elucidate notable disparities between the organization and management of healthcare processes within the primary care sector and the inpatient setting. Notably, the application of digital technologies is underscored for its capacity to enhance patient-physician communication, reduce transactional overheads, and facilitate the effective collection and analysis of health-related data.
Conclusion. The significance of digital transformation is underscored in enhancing patient satisfaction with medical care, optimizing processes, and elevating the quality of medical assistance within the primary care domain. -
2023 № 9 Digital transformation in primary health care and data-driven management.
In the contemporary healthcare context, there exists a necessity to optimize the organization and management of patient diagnosis, routing, and treatment, especially within the primary care sector. Within this scope, digital transformation assumes a pivotal role, offering novel avenues for enhancing the quality of medical assistance.
Research Objective: This study aims to identify the fundamental issues pertaining to the organization and management of patient diagnosis, routing, and treatment within the primary care sector. Furthermore, the study seeks to formulate recommendations for addressing these challenges through the avenue of digital transformation.
Materials and methods. The study was conducted through the utilization of comparative analysis employing synthesis, analysis, modeling, and specialization methodologies. Data were acquired through a specially developed questionnaire encompassing inquiries regarding healthcare process organization and management.
Discussion and results. The outcomes of the investigation elucidate notable disparities between the organization and management of healthcare processes within the primary care sector and the inpatient setting. Notably, the application of digital technologies is underscored for its capacity to enhance patient-physician communication, reduce transactional overheads, and facilitate the effective collection and analysis of health-related data.
Conclusion. The significance of digital transformation is underscored in enhancing patient satisfaction with medical care, optimizing processes, and elevating the quality of medical assistance within the primary care domain. -
2022 № 6 Experience and prospects of digital twins application in public healthcare
Digitalization of healthcare opens up opportunities for applying new approaches to the organization of medical care, improving its quality, optimizing the use of healthcare resources. Digital twin is one of the new approaches, a virtual model of a physical object with dynamic bidirectional connections between a physical object and its corresponding twin in a digital environment.
Digital twins allow to study, create and test new hypotheses, conduct experiments and research in silico. T h e a i m o f t h e s t u d y is to describe the existing Russian and foreign experience in the practical application of digital twins in the field of healthcare.
M a t e r i a l s a n d m e t h o d s . The literature review was conducted in Pubmed and Elibrary databases. Publications describing ethical and regulatory aspects, industrial, engineering or logistics applications were excluded. The articles have passed two rounds of peer review. R e s u l t s . Digital twins are used in clinical medicine to test new methods of treatment and the body’s response to them, to simulate the work of organs and tissues. The application of the technology for the development of precision therapy in cardiology, oncology, endocrinology, gastroenterology, orthodontic treatment, rehabilitation, intensive care is described. The digital twin can be used by health authorities to model patient behavior, predict the spread of the infectious process, the work of a medical institution and its structural units in order to optimize resources. C o n c l u s i o n s . The article provides an overview of technology and the main areas of application of digital twins for personalized medicine, public health and smart healthy cities. The prospects for using digital twins lie in the field of creating smart “healthy” cities and regions.