What should be the digitalization of medicine in Russia - Part Three

Let’s start in order, I’ll speak from a hospital employee. Login and registration of patients “Registration”

Problems – All right, all patients must go through the stage of identification, signing consent to the processing of personal data, consent to medical examination and manipulation, determining the payment system. The flow of patients who arrived at the same time by self-treatment and emergency medical care is 20-25 per hour.

– the stages of entering the hospital are –

1) Put on shoe covers

2) Find the right registry

3) Get a passport, policy, SNILS.

4) Dictate information about yourself, place of registration, place of residence (very important), place of work (for sick leave), cell phone number (also important)

5) You will be given at least 2 consents for manual filling – it is not possible to fill in or sign electronically.

6) Describe your problem to the registrar and put in the queue

Solution example.

Moscow metro – payment by biometrics. This system is so coolly debugged that it determines who you are with an accuracy of up to 100% by your face and can deduct money from your secure account for travel. Such a system can also be applied at the entrance to the hospital, everyone who comes in to be scanned by biometrics and data from the GOUSSERVICES + Insurance Company is loaded into the registry. In your personal account, you can make a point for signing consents to the processing of personal data and medical manipulations using the GOS-KEY application (EDS)

In total, without having time to put on shoe covers, the hospital knows who you arewhere you live, your personal data including phone number and knows how you can pay for medical services

I’m going to the doctor

Problem: very often, before visiting a doctor, you need to complete or go through a series of checklists: donating blood, urine, other body fluids, passing an ECG and other studies.

We do not touch upon changes in the layout of the hospital and very often laboratories and functional diagnostics are located in different parts of the hospital and even floors.

Solution: As soon as you entered the hospital, the AI identified you, it remains to identify your complaint, such a complaint can be made using your phone in the form of text, voice (or the ambulance team will report for you (in serious condition))

1. Data entry – in central clinics, patients can be in different languages of groups – and systems such as “speech recognition” (speech-to-text – STT) have already been implemented by the (domestic) Yandex Cloud apu speech-to-text company. The system will help to recognize the text, translate the text and send it for processing. Even the correct dialogues are not important for us, the main thing for us is to catch on to some anchors (fracture, abdominal pain, trauma, fever, cough, runny nose, earache, sore throat, poisoning)

2. Data processing. All data collected with complaints, taking into account the patient’s history loaded, should ideally be processed by a single digital platform – which is closely linked to many national guidelines that describe diagnostic and treatment algorithms.

3. Output check sheet – the program gives a printout in the form of a check where it will be written where to donate blood, urine, etc. Are painted on the floor and should give the queue number.

The queue should also be sorted by severity. For each disease or complaint, you can come up with a point system – an example: Rise in pressure – 10 points, runny nose – 1 point.

In the specialist’s office

Problem: due to the huge flow of patients – very little time for questioning and collecting anamnesis and complaints. It is very difficult to listen to speeches “2 years ago, I had a hernia removed (specially singled out, many patients do not even understand how much surgery was performed), now my legs are numb, etc.

Solution: EDS (Electronic Digital Platform, hereinafter referred to as EDS) should identify the patient at the entrance to the door and give out all the key moments of a person’s life.

1. Name

2. Chronic diseases – highlight with colors (green those that are in remission or specialist supervision, red those that the patient did not bother to start treating)

3. Operations

4. Allergic reactions

5. A note about various infectious diseases.

Further, the points should be built depending on the specialist, for example, the doctor of the Audiologist (the doctor deals with the pathology of hearing) should come out with a schedule of measurements of “audiometry” (measurement of hearing acuity, determination of auditory sensitivity to sound waves of various frequencies.)

ProblemA: There are two outcomes of visiting a doctor in an emergency hospital – home or stay. Two problems come out of this: If the patient is sent home, then you need to write, examine, make a diagnosis, make or enter all concomitant diagnoses (there may be more than 10), set the correct recommendations for calculating the dosage of drugs. Explain what is wrong with the patient.

Solution: Based on the clinical recommendations and the loaded patient card, automatically after the diagnosis is established, prescribe all recommendations suitable for this patient, taking into account age, gender, position, allergic reactions, weight, and also take into account the current medications and their compatibility. For example, if a patient needs antibiotic therapy, then the system should take into account the courses of antibiotics already completed, the tank of cultures for the resistance of microorganisms to antibiotics, allergies, and simply write out a prescription for the desired drug. The certificate should also contain all the accompanying diagnoses – and their recommendations by other doctors.

As a result, the patient will receive a complete algorithm for research and treatment. In the best case, add a memo about the disease to the certificate, where, as a child, his illness and its solution are described.

Problem 2: The patient is sent to the hospital.