Unified medical information and analytical system EMIAS

Moscow is a smart city

Main article: Moscow Smart city

Why EMIAS is needed

EMIAS, Unified Medical Information and Analytical System is a state unified medical information and analytical system of the city of Moscow, which is created in order to improve the quality and availability of medical services of state health care institutions.

What is EMIAS - Presentation, March 2013

The project was developed and implemented by the Department of Information Technologies of the city of Moscow within the framework of the Information City program, on the basis of the Decree of the Government of Moscow dated April 7, 2011 No. 114-PP "On the Program for the Modernization of Health Care of the City of Moscow for 2011-2012" (as amended by the Decree of the Government of Moscow dated 27.10.2011 No. 513-PP)

The system functionality shall include:

• managing patient flows;
• Integrated Health Information System (IMI);
• consolidated management accounting;
• personalized record of medical care;
• management of medical registers.

In addition to integrating services among themselves, as well as with medical information systems of medical institutions, EMIAS will have to integrate with the software of the federal fragment "EGIS-Zdrav" and electronic government systems, including public services portals.

As of October 2012, EMIAS consists of a set of services with web access, a subsystem for the formation of user interfaces and an integration bus, which should model business processes when providing medical care, linking services to each other.

Scheme of EMIAS in infographics

Unified Radiological Information Service (ERIS)

Main article: Unified Radiological Information Service (ERIS)

A single radiological information service (ERIS) was created within the framework of the informatization project. health care Moscow ERIS is an information system that combines high-tech medical equipment, radiologists' workplaces and a single archive of diagnostic images. Among this IT solution are magnetic resonance, digital devices of classical X-ray, devices for fluorography and computer. tomographs The creation of ERIS solved the problem of storage and availability of the resulting images, descriptions and conclusions. Thanks to the launch of ERIS, high-tech diagnostic studies have become more accessible to Moscow patients and their waiting time has been reduced.

Financing

health care Moscow In 2012, 8 billion rubles were allocated for informatization.

System Usage Indicators

2021: Almost all maternity hospitals and perinatal centers in Moscow connected to EMIAS

On August 11, 2021, it became known that almost all maternity hospitals and perinatal centers in Moscow connected to the unified digital platform EMIAS. Thanks to the implementation of this project, as reported on the website of the mayor of the capital, the quality of medical care for patients during pregnancy, childbirth and in the postpartum period is improving, as well as improving interaction with the outpatient clinic.

In the near future, we will complete the process of connecting maternity hospitals and perinatal centers of the capital to a single digital platform, today 95% of these institutions are already connected. To do this, we have updated the network and server infrastructure and trained staff to work in the system, "said Anastasia Rakova, Deputy Mayor of Moscow for Social Development, whose words were on August 11, 2021.

Connecting to the EMIAS allows doctors to access the electronic medical record of patients and take into account their health data when providing the necessary medical care. Integration of the system with clinical diagnostic laboratories enables the doctor to have access to laboratory data. In addition, the doctor is exempted from paperwork: all primary medical documentation is fully maintained in the system, and information about patients is entered into the electronic history of childbirth.

As part of the project, a number of important medical documents for the obstetric hospital were transferred to electronic form. Among them are birth protocols, partograms, discharge epicrises of maternity patients, neonatal epicrises of newborns and other documents.

To parents, this ensures that the child's medical history is maintained digitally from birth, which means that transparency and the ability to always have the newborn's medical documentation in quick access is guaranteed. Now all primary medical documentation is fully maintained in the system. The discharge epicrisis of the maternity hospital and the neonatal epicrisis of the newborn will be automatically loaded into the electronic medical record, - added Anastasia Rakova.[1]EMIAS

2018

Implementation of the subsystem "Duty Doctor" in 368 polyclinics in Moscow

On October 09, 2018, CROC stated that the Subsystem of the Unified Medical Information and Analytical System of Moscow (EMIAS) "Doctor on Duty" would reduce the waiting time for an appointment with a doctor on duty. Patients who came to the clinic without an electronic appointment and are counting on an appointment on the day of appeal have an electronic queue and comfortable waiting areas, and doctors have the opportunity to control the flow of patients and take measures to optimize queues.

A citizen who needs medical assistance on the day of appeal receives a ticket with a number in the electronic queue at the information desk or in the information room and is sent to the waiting area. Previously, patients were forced to be located next to the office so as not to miss the appointment, and waiting in the "live queue" caused a lot of inconvenience. The "Duty Doctor" component also allows the chief physician and heads of departments of the clinic to track the load of doctors and instantly connect other specialists to speed up the reception of citizens and reduce the queue.

The introduction of the subsystem in 368 adults and children's city polyclinics in Moscow was implemented by CROC.

As of October 9, 2018, 376 employees of the organizational and methodological departments of polyclinics, 2306 employees of information racks, 563 heads of departments use the "doctor on duty." The tasks of the CROC included methodological preparation and implementation of software, including the configuration of the subsystem, personal briefing and advisory support for all participants in working with the electronic queue.

We carried out the introduction of the subsystem in such a way that this did not affect the current operating mode of medical institutions and did not create a collapse in the admission of citizens by a doctor on duty. About 50 consultants, analysts and managers of CROC were involved in the tasks. When implementing the subsystem, we conducted large-scale personal training of polyclinic employees. As of October 2018, the EMIAS as a whole and the "Doctor on Duty," in particular, allow you to structure the work of personnel, control the load, and correctly distribute the flow of patients contacting the doctor without an appointment for urgent circumstances.

Muscovites were prescribed more than 45 million electronic prescriptions in four years

Main article: Electronic recipe

At the beginning of 2018, the capital's doctors issued more than 45 million electronic prescriptions to patients, of which 43 million were preferential, citizens can receive medicines for them free in pharmacies at clinics. Read more here.

Electronic medical records - 6.3 million Muscovites

As the Moscow Department of Health reported in January 2018, more than 6.3 million electronic medical records of Muscovites have already been established in the Unified Medical Information and Analytical System (EMIAS).

The electronic medical record is available to all doctors working in the EMIAS system. It contains information about the patient's diseases, visits to the doctor, prescribed drugs, sick leave.

The total number of patients registered at the EMIAS and at least once made an appointment with a doctor exceeded the mark of 9.7 million people. Most of them have already established an electronic medical card, - said the head of the Moscow Department of Health Alexei Khripun. - The need to view paper medical records for a long time in the past, medical records in electronic form allow doctors to find all the necessary information about the patient, wherever he is, saving time for both the patient and the doctor. In real time, the doctor sees the information needed to make a diagnosis and prescribe treatment, both in the clinic and during an ambulance call, which is extremely important when the patient requires, for example, emergency hospitalization. Moreover, such cards are always available, they cannot be lost, and several protection systems are provided to save data.

2017

Project progress

Three planned phases

The introduction of EMIAS takes health care to the next level. The process must be implemented in several stages:

• provision of self-recording services for patients to the doctor;
• inclusion in the system of doctors who will be able to see the patient's medical history and write electronic prescriptions;
• organization of multifaceted accounting of medical care provided for effective management of medical institutions.

2024

₽260 million allocated for repair of IT equipment used in the work of EMIAS

In October 2024 Department Moscow , according to the competitive policy, he announced a tender for the maintenance of foreign equipment in data processing centers that ensure the operation of the Unified Medical Information and Analytical System () EMIAS of the capital. For these purposes, ₽260 million were allocated.

According to CNews, applications for participation in the competition are accepted until October 28, 2024, and the winner will be announced on November 5, 2024. The contract provides for the performance of work within 700 days on the territory of three Moscow data centers.

₽260 million allocated for repair of IT equipment of EMIAS

The terms of reference include maintenance of 94 types of server hardware, including firewalls, servers, storage, and switches manufactured by Cisco, Dell, and IBM. The work is planned to be carried out in eight stages.

The Moscow EMIAS was created to improve the quality and availability of medical care in state health care institutions. The system provides the ability to remotely record with a doctor, view and manage records, access to an electronic medical record with a history of examinations, tests and appointments.

All manufacturers of equipment requiring maintenance stopped working in Russia in 2022. Cisco Systems Inc. suspended sales and liquidated the Russian representative office in December 2023, destroying ₽2 billion in inventory.

Dell also left the Russian market in August 2022, closing its representative office and laying off employees. At the same time, the Moscow Arbitration Court arrested more than ₽778 million in the accounts of the Russian division of Dell as part of the claim of the system integrator Talmer.

The tender for equipment maintenance reflects the need to maintain the operability of critical urban infrastructure in the context of the departure of foreign manufacturers from the Russian market.^[2]

The service "Digital Resuscitation" has been launched in Moscow hospitals, where all information about the health of patients lying in intensive care units flows

On October 18, 2024, it became known that the Digital Resuscitation service began to function in 23 hospitals in Moscow, providing automation of key processes in intensive care units (ICU). The system allows you to collect and analyze electronically all data on the condition of patients in critical condition. Read more here

An SMS notification service from intensive care has been launched in Moscow hospitals. Relatives receive data on the patient's condition every day

On July 7, 2024, it became known that a new SMS notification service for relatives of patients in intensive care was launched in the capital's medical institutions. The initiative is designed to ensure daily informing of loved ones about the state of health of patients in intensive care units of Moscow hospitals.

The SMS information service was originally introduced on the basis of the Kommunarka Moscow Multidisciplinary Clinical Center. After a successful pilot launch, the project was expanded by connecting 18 more city hospitals operating in the format of a digital hospital.

In Moscow hospitals, an SMS notification service from resuscitation has been introduced. Relatives receive daily patient data

Anastasia Rakova, Deputy Mayor of Moscow for Social Development, emphasized the importance of a new service to reduce the anxiety of relatives of patients in critical condition.

The procedure for connecting to the SMS information service is quite simple. A relative must contact the attending physician of the department, who will make an appropriate mark in the Unified Medical Information and Analytical System (EMIAS). After that, the daily distribution of messages with information about the patient's condition will begin.

SMS notifications contain key indicators of the patient's condition, including temperature, pulse, blood pressure, saturation, heart rate and breathing. In addition, it is indicated whether the patient is conscious and connected to a ventilator. Relatives also receive an opinion on the dynamics of the patient's condition - positive, negative or unchanged.

Among the medical institutions where the new service has been introduced are the S.S. Yudin City Clinical Hospital, the N.V. Sklifosovsky Emergency Research Institute, the S.P. Botkin City Clinical Hospital and other large metropolitan hospitals. In the future, it is planned to expand the service to intensive care units of other hospitals in Moscow.^[3]

Moscow Mayor's Office buys 54.7 thousand licenses for Kaspersky Lab software for 86.2 million rubles to protect EMIAS

In early May 2024, the Moscow mayor's office announced that it plans to purchase Kaspersky Lab antivirus software to protect the digital systems of health authorities in the Moscow region. The mayor's office is ready to spend 86.2 million rubles on the purchase of 54.7 thousand licenses to ensure the security of the Unified Medical Information and Analytical System of the Moscow Region (EMIAS) under the Digital Moscow Region program.

This program, which is being deployed in 2023-2030, was approved by the government of the Moscow Region and is aimed at additional equipping hospitals and other health authorities with digital equipment and software that can be used to provide telecommunications and other network services. The purchased antivirus software will be used as part of the EMIAS system, which is certified for compliance with information protection requirements.

Moscow Mayor's Office announced that it plans to purchase Kaspersky Lab antivirus software to protect the digital systems of health authorities in the Moscow region

Within the framework of state contracts, in the period from 2019 to 2023, the health authorities of the Moscow Region formed a software base in the field of ensuring the security and automation of the work of medical institutions, including antivirus software. According to the requirements, special software for ensuring the security of digital systems must be installed on automated workplaces and servers of EMIAS, one of the components of which is Kaspersky Total Security.

In addition, the Kaspersky Security Center (KSC) security server is used to track and control the protection of information at the end user level, which provides a centralized update of software and databases. It is known that the customer does not consider antivirus software from other suppliers and purchases only Kaspersky Total Security.^[4]

Moscow and St. Petersburg agreed to cooperate on the implementation of IT systems in medical organizations

At the end of February 2024, Moscow Mayor Sergei Sobyanin and St. Petersburg Governor Alexander Beglov signed an agreement on the digitalization of healthcare in the Northern capital. One of the directions of this partnership involves the introduction of the Moscow Unified Medical Information and Analytical System (EMIAS) in St. Petersburg medical institutions.

The terms of the contract provide for the introduction of the Clinical Information System subsystem of the Unified Medical Information and Analytical System of Moscow (KIS EMIAS) in 35 hospitals in St. Petersburg, as well as in maternity hospitals and the I. I. Janelidze Research Institute of Emergency Medicine. These processes are planned to be implemented in 2024-2025.

Moscow Mayor Sergei Sobyanin and Governor of St. Petersburg Alexander Beglov

It is assumed that Moscow will ensure the integration of the EMIAS CIS with the medical IT systems of St. Petersburg, finalize the subsystem at the separate requests of the St. Petersburg government, and provide server equipment for free use to medical organizations during the implementation of the subsystem in them.

Moscow will also provide technical support to users until June 30, 2026 and will conduct initial training for representatives of the regional technical support service of St. Petersburg and the regional competence center of St. Petersburg. The necessary methodological and training materials for users of the EMIAS CIS will be provided.

It is necessary to create a single medical card for each resident of our country. So we take the first step, unite Moscow and St. Petersburg, creating a single medical card so that residents of our cities, and in the future and the whole country, can come to absolutely any subject of the Russian Federation, and they do not need to present a passport or something else, - said Alexander Beglov and separately thanked Sobyanin for the fact that Moscow shared the developments for free.[5]

2023

Moscow allocated 3.94 billion rubles for the development of EMIAS

In early November 2023, information appeared that the Moscow Department for Competitive Policy announced a number of tenders for the creation of the Unified Medical Information and Analytical System (EMIAS) - a regional GIS in the healthcare sector. The total amount of work is estimated at 3.94 billion rubles.

The largest tender - for 950 million rubles - was announced on October 30, 2023. The contractor will have to deal with the modernization of user and software interfaces. It is, in particular, about the development of a tool for creating documents in the integrated electronic medical records of a patient (iEHR) by nurses. For example, the possibility of a nurse and a functional diagnostic doctor in iEHR should be provided. Financing of the work is carried out at the expense of the budget of the city of Moscow.

Two more tenders involve the development of the subsystem of operational control of the internal activities of the clinics of the Moscow Department of Health (611 million rubles) and the subsystem "Clinical Information System" - to expand its functionality and "streamline the movement of patients" (135.3 million rubles). The work will also affect two specialized segments of EMIAS - the service "Management of the provision of medical care to patients in the oncological profile" and the processes associated with the provision of medical care to HIV-infected people. In the second case, there is a need to modernize outdated information systems, the processes in which are not automated, which is why data exchange with other clinics and departments is impossible or unsafe.

Several tenders provide for the modernization of a number of services: these are "Patient's Personal Account," "Citywide Patient Register," "Contingent Management Service," "Management of the Prevention Department in School Institutions," "Register of Electronic Medical Documents," "Consolidated Management Accounting System." In total, at least 1.6 billion rubles are allocated for these purposes.^[6]

The transition of hospitals and clinics in St. Petersburg to a single IT system

Hospitals and clinics in St. Petersburg are being transferred to a single IT system. This was reported in the city committee for informatization and communications on October 23, 2023.

We are talking about connecting St. Petersburg medical institutions to a single information and analytical system (EMIAS) developed by the information technology department of the Moscow mayor's office. As part of the pilot project, the Mariinsky and Alexander Hospitals, the Dzhanelidze Research Institute of Emergency Medicine, Children's Hospital No. 5, War Veterans Hospital, Hospital No. 26, as well as a number of other medical institutions in St. Petersburg will be connected to EMIAS. By October 2023, about two dozen information systems are operating in St. Petersburg at once, but 85% of the market is occupied by five: Ariadne, Samson, Avicenna, Vista.Med and qMS.

The Committee on Informatization and Communications told Fontanka that the transition is planned to be completed by the end of 2024. By October 23, 2023, the Health Committee and the Informatization Committee are preparing the city infrastructure for the transition. The committee has not yet been able to name the volume of investments in this project. The press service only noted that the amount will become known after the preparatory stage, which consists in examining the city infrastructure and resolving organizational and regulatory issues.

Market participants interviewed by the publication expressed concern that the forced transition to a new medical system could create new problems. So, in their opinion, a single MIS does not take into account all the features of specialized medical institutions and will not become a panacea. And doctors, instead of treating people, will have to spend time retraining, there will inevitably be technical difficulties and delays in the process of work. This situation is fraught with social risks - both from the doctors themselves and from the patients.^[7]

Ability to call an ambulance

City ambulance workers will be able to call a doctor at home to patients using digital tablets and a unified medical information and analytical system (EMIAS). This was announced on August 24, 2023 by the Deputy Mayor of Moscow for Social Development Anastasia Rakova.

This may be required in a situation where a person's condition does not require emergency hospitalization in a hospital, but he needs further observation and consultation with a specialist. The innovation simplifies the interaction between the capital's ambulances and city polyclinics, reduces the time for transferring applications for calling a doctor and, accordingly, the waiting time for a specialist by the patient, she explained.

According to Rakova, before the innovation, ambulance officers kept lists on paper with the names of those patients who need to call a doctor at home, after that they came to the substation and gave the list to the dispatcher, he sent applications to clinics, to which people in need of help are attached, through a specialized service 122.

By August 24, 2023, if there are indications for calling a doctor at home, paramedics or ambulance doctors send an application through a tablet to the clinic to which the person is attached on his own, the deputy mayor added.

In the same way, the corresponding application will be processed if Muscovites contact 103. If the dispatcher, after listening to the patient, decides that his condition does not require an urgent departure of the ambulance team, then he will connect a doctor who will conduct a special survey and decide who exactly to call at home. After that, the application is transferred to EMIAS, Rakova said.

She recalled that thanks to the integration of the capital's ambulance and emergency station with EMIAS, doctors and paramedics can even familiarize themselves with his electronic medical card before arriving at the patient through a tablet.

In addition, a section was created specifically for the ambulance staff in the electronic medical record, which displays important indicators of the patient's health, including signal diagnoses, Rakova emphasized. These data include date, time, team composition, diagnosis, and so on. They are also available to attending physicians and patients themselves.

Doctors of city polyclinics when visiting a patient at home also work on tablets connected to EMIAS. According to the deputy mayor, all documents that were created during the visit are also uploaded to the system.^[8]

Use in emergency hospitals in Moscow along  with tablets

Tablets with the new Triage IT system were delivered to all hospitals in Moscow, where they provide round-the-clock emergency assistance to the adult population, to quickly assess the condition of patients. On February 10, 2023, the capital's mayor Sergei Sobyanin wrote about this in his Telegram channel. Read more here.

The introduction of a unified laboratory IT system has begun in Moscow hospitals. She passes the test results to EMIAS

In January 2023, the introduction of a unified laboratory and information system (LIS) began in Moscow hospitals. She transmits the test results to EMIAS. Read more here.

=== 2023:

2022

CT and MRI images from clinics in Moscow became available in the electronic medical record of EMIAS

On November 2, 2022, it became known that residents Moscow can now see the results - and CT- MRI studies made in private clinics. electronic medical record (EMR) 15 private clinics and 25 federal institutions are already participating in the project.

According to the website of the mayor and the government of Moscow, citing Deputy Mayor Anastasia Rakova, thanks to the innovation, it will become easier for specialists in various clinics to interact, in addition, this will help to have more detailed information about the health of patients. Muscovites will no longer need to transmit data on the procedures carried out themselves.

The results of the studies will appear in the electronic medical record on the mos.ru portal and in the EMIAS.INFO application. They can be found in the "My Research" section and downloaded from the links that will be working within 5 days, then they can be requested again.

Since research is carried out using sophisticated medical equipment, the result is provided as a picture in DICOM format. The archive will have a special program for viewing such images, as well as instructions for its use. Links for downloading files will be valid on the page with the study protocol for five days. If a study reference expires, you can request it again.

In addition, earlier users had access to the results and images of instrumental studies of positron emission tomography combined with X-ray computed tomography from eight private and seven federal institutions.

According to Andrei Tyazhelnikov, chief freelance specialist in primary health care for the adult population of Moscow, the capital's doctors have already made sure of the convenience of this service.

In the EMR, the specialist sees all the information necessary for making a diagnosis and prescribing therapy in a structured format, - he noted.[9]

Moscow allocated 170 million rubles for the digitization of paper medical records and extracts

In September 2022, a tender was announced for updating the Unified Medical Information and Analytical System (EMIAS) to digitize paper medical records and extracts. The winner of the competition will be able to count on the conclusion of a contract worth up to 171.8 million rubles.

According to the terms of reference, the contractor will have to allocate a separate module in the EMIAS interface that will allow the patient to upload scanned copies of documents stored only in paper form to the system. We are talking about the data of the outpatient card, the conclusions of the medical commission, oncological epicrises, sheets of updated diagnoses and discharge epicrises of the day hospital. Some documents, for example, extracts from an outpatient card, users should be able to digitize directly through a mobile device.

According to the materials of the tender, the modernization of the service is carried out "in order to effectively make decisions regarding the health of patients, the doctor needs to provide the most complete information about his state of health recorded in various medical organizations during his life." In addition, the number of medical documents that need to be transferred from paper to digital is constantly growing.

The service will have to support the ability to process up to 1 million scans of documents from outpatient cards per year, according to the technical part of the tender.

In accordance with the order of the Moscow Department of Health, medical documents in children's and adult clinics are now formed in electronic form in EMIAS. These include patient information, examination protocols, discharge epicrisis, appointment of consultations and procedures, a certificate of incapacity for work, an ambulance call card, laboratory and instrumental test results, prescriptions, vaccine prophylaxis and others.^[10]

Moscow clinics begin to automatically report a child's illness to schools

In early September 2022, the Moscow mayor's office reported that city clinics had the opportunity to automatically report a child's illness to school, and parents would no longer need to warn teachers about it. A similar opportunity applies to kindergartens in the capital.

Moscow has opened the opportunity for private and federal clinics to transfer information about the absence of a child due to illness to schools and kindergartens automatically. By the beginning of the school year, 35 such medical institutions had already begun to draw up certificates in form 095/y in electronic form. Inspection protocols with a recommendation to exempt a student from visiting an educational institution are transferred to a single medical information and analytical system (EMIAS), the statement on the website of the mayor of Moscow says.

It is noted that information about the absence of a child due to illness will be displayed in the teacher's electronic journal. Information about the liberation of children from physical education will also be automatically transmitted. The parent himself will no longer need to bring paper certificates about the treatment of the child. Anastasia Rakova, Deputy Mayor of Moscow for Social Development, noted that a new opportunity has been introduced for the convenience of students and their parents.

Information about the child's illness, as well as the period of exemption from physical education, is automatically transmitted from clinics to school. This became possible thanks to the integration of the largest metropolitan platforms - the Moscow Electronic School (MES) and EMIAS. Parents also no longer need to bring paper certificates to school if the child has been treated in a federal or private clinic.

Previously, parents had to first inform the educational institution about the child's illness in person or using an electronic diary, and then bring the corresponding paper certificate to school. Now all the necessary information is automatically transferred to the electronic log. The health worker of the educational organization will be able to get acquainted with the certificate in the system. EMIAS School. "More^[11]

Moscow asked private and federal medical centers to join EMIAS

The authorities Moscow suggested that private and federal clinics transfer certificates of the child's illness to electronic form. To do this, medical institutions will need to connect to the capital's Unified Medical Information and Analytical System (EMIAS), the Moscow Deputy Mayor for Social Development said at the end of May 2022. Anastasia Rakova

Any licensed medical organization can apply. The list of clinics will be on the website of the Moscow Department of Health. As Rakova noted, in city polyclinics by the end of May 2022, a year of certificates after a child's illness have been issued electronically and automatically transferred to the EMIAS system. School. "

Teachers see them in a magazine and understand when a child is exempt from classes, including physical education. In 2021 alone, this saved Muscovites from collecting 2.5 million extra paper certificates, said Anastasia Rakova.

We continue to develop the service - now we invite private and federal clinics to participate in the project. This will help save parents from the need to transfer paper certificates to school or kindergarten after visiting such medical organizations, simplify the transfer of information to educational institutions and eliminate the likelihood of accidental loss of certificates, she added.

To participate in the project, private and federal clinics need a valid license to carry out medical activities. You will also need to go through the procedure of connecting to the EMIAS to transfer data to the system. According to the regulations, information on certificates should be transmitted within 24 hours.

As noted in the metropolitan Department of Information Technology, information on certificates of form 095/y issued in city, as well as private and federal clinics connected to EMIAS will be available to citizens in the electronic medical record of the child in the section "Certificates" on the mos.ru portal or in the mobile application "EMIAS.INFO."^[12]

2021

Moscow hospices connected to EMIAS

In mid-November 2021, it became known about the connection to the Unified Medical Information and Analytical System (EMIAS) of all metropolitan palliative care institutions of the Moscow Department of Health.

As noted in the press service of the capital's social development complex, thanks to the connection of hospices to the EMIAS, the continuity of treatment will be ensured, as well as the convenience of storing and transmitting information. The unified digital platform gives doctors the opportunity to devote more time to patients, which is especially important in palliative institutions, the department emphasized.

It is clarified that now the discharge epicrisis in electronic medical records on the mos.ru and mobile application "EMIAS.INFO" has become available to hospice patients and legal representatives of minor patients.

As of November 2021, palliative care in Moscow is provided at the Palliative Care Center and eight of its branches, as well as on the basis of 13 hospitals and one non-state clinic. About a thousand beds have been deployed in the institutions. Children can also receive care in a hospital, 101 palliative beds have been deployed in four hospitals. To provide palliative care at home, 19 visiting patronage services were organized (18 for adults, one for children).

The introduction of EMIAS and the infrastructure re-equipment of medical organizations of the capital are engaged in the complex of social development of Moscow and the Moscow Department of Information Technologies. 75% of hospitals are connected to the Unified Medical Information and Analytical System.

Earlier, the Levada Center conducted an all-Russian survey, and it turned out that not only ordinary people, but even doctors in the majority do not know what palliative care is. Doctors admit that they do not understand where to send terminal patients, do not have the skills to treat pain.^[13]

Connection of medical offices in Moscow schools to EMIAS

From October 5, 2021, information about children's appeals to health workers in schools and kindergartens in Moscow began to be stored electronically. Doctors and paramedics of these institutions were able to fill out a digital protocol in the Unified Medical Information System (EMIAS), according to the website of the mayor of Moscow.

As noted by the Deputy Mayor of Moscow for Social Development Anastasia Rakova, with the help of the EMIAS. School system, a doctor in an educational institution will be able, if necessary, to send a child to laboratory, instrumental studies and procedures in city polyclinics.

Previously, all appeals of the child in sudden acute conditions and diseases were recorded on paper in the journal of admission of outpatients. To refer to an additional consultation of a specialist or for diagnostic studies, an appeal to the city polyclinic was required. Now there is no need for this: an electronic medical record with all relevant information about the child and the EMIAS School system are available to health workers in schools and kindergartens, in which the doctor can maintain an examination protocol and open the necessary directions. Moreover, all the data created by the medical unit employee at EMIAS will be available to both polyclinic doctors and parents in an electronic medical record, she explained.

By October 5, 2021, medical records for educational institutions in form 026/y have already been transferred to electronic format. The process of recording the results of inspecting children in city educational institutions for scabies and pediculosis will also soon be transferred to digital format.

Parents and guardians can look at their children's electronic medical records with protocols of examinations of doctors in the city polyclinic, results of laboratory and instrumental studies, as well as hospital extracts, valid prescriptions, vaccination history.^[14]

Moscow Mayor's Office strengthens surveillance of patients with COVID-19 for 175 million rubles

In early October 2021, it became known about a new tender of the Department of Information Technologies (DIT) of Moscow, which is aimed at the development of the Unified Medical Information and Analytical System (EMIAS). Thanks to this project, the authorities want to deeply analyze data on the incidence of coronavirus (COVID-19) infection and find people who have come into contact with the infected.

According to Kommersant, citing the relevant public procurement, the contractor will have to create a new module for EMIAS, which will allow analyzing the flows of patients with suspected coronavirus in real time, collecting data on the results of PCR tests and CT studies, the location of patients, sick pensioners and children.

To monitor the health and movement of sick children, a block "contact persons in educational organizations" will be developed. It is integrated with the Moscow Electronic School information system. So the city authorities will be able to receive data on sick schoolchildren, teachers and those who have contacted them.

The contract value is 175 million rubles. The winner of the tender will have to complete the work in a maximum of 410 days.

The publication noted that, judging by the terms of the tender, the authorities want to organize a search for those in contact with patients with coronavirus. To do this, the contractor will have to develop a block "Search - contact persons." The documents do not contain information on how the authorities plan to search for these people. The DIT explained to the newspaper that the search means that a person should be warned about contact with a patient with coronavirus and the need to isolate. Also, doctors should come to him for examination and taking tests. At the same time, the authorities will not use data on the geoposition of citizens' devices for this, the department assured.^[15]

2020

Moscow pharmacies will be connected to the EMIAS system in 2021

Moscow pharmacies will be connected to the EMIAS system in 2021. This became known on December 23, 2020.

The patient will be able to receive information about the prescriptions, dosage regimen and recommendations for admission in his personal account on the mos.ru portal, as well as mobile application "EMIAS.INFO" in the information kiosk.

The extract of prescriptions for drugs is planned to be transferred to electronic form. The corresponding decree was signed by Sergei Sobyanin.

Despite the fact that the doctors of Moscow polyclinics draw up electronic prescriptions using EMIAS, they still need to be printed out for presentation at the pharmacy.

The electronic prescription system will become a single information tool for effective interaction between a doctor, patient and pharmacist and will completely eliminate paper prescriptions from circulation.

Having come to the pharmacy, the patient will have to show the pharmacist a special QR code on the screen of a mobile device, after which he will be released the prescribed drug.

In the future, it will be possible to receive information about the availability of medicines in pharmacies and book them with prescriptions at full cost, including on the websites of pharmacy services.

The electronic recipe system has many features, including:

• exclusion of prescription forgery;
• safety of the recipe - in electronic form it will not be lost or torn;
• exclusion of unlawful multiple dispensing of the drug on the same prescription.

The connection of city pharmacies to EMIAS and the start of the introduction of electronic prescriptions is scheduled for 2021. At the same time, at the request of patients, they will be able to receive traditional prescriptions on paper^[16].

ERIS Moscow launched a program for recognizing lung cancer by CT scans

In the unified radiological system of Moscow, the Botkin.AI CT scan lung cancer recognition program has been launched. This platform, developed by Intellojik, will analyze images taken in 46 capital medical institutions.

The doctor receives tips that will help him not to miss the signs of lung cancer, "explains Sergey Sorokin, founder of the Botkin.AI platform, CEO of Intellozhik. - It is very difficult to see these signs at an early stage - this is evidenced by the results of numerous studies.

According to Sorokin, it is important to identify the disease in the early stages, because if it is too late to notice it - by August 2020, according to statistics, this happens in 70-80% of cases - the probability that a person will live more than five years is only 2-13%. With early diagnosis, this probability rises to about 70%, and the cost of treatment is significantly reduced.

As a result of processing by the AI system, the doctor will first of all be sent the results of research with pathology, says Sergei Morozov, director of the Center for Diagnostics and Telemedicine Department of Health of Moscow. The radiologist will do the descriptions not in the order in which the patients conducted the studies, but in terms of the degree of probability of the presence of pathology. First of all, the doctor will see those computer tomograms where the tumor process is likely to be detected, he said.

Such smart sorting, without exaggeration, can save the patient's life, - emphasized Morozov.

CT studies are automatically unloaded and analyzed by artificial intelligence (AI) -based technology. By August 2020, 7 thousand studies were completed, in total it is planned to analyze more than 20 thousand images every month.

Services using artificial intelligence are being introduced into ERIS during an experiment on the use of solutions for the automatic analysis of computed tomography, mammography and radiography results.^[17]

Health data will be uploaded to the electronic medical record automatically from the phone

The electronic medical card is available to Muscovites in the mobile application "EMIAS.INFO." From the gadget, you can automatically load health data into it. This was announced in July 2020 by the Deputy Mayor of Moscow for Social Development Anastasia Rakova. Read more here.

You can now attach to women's consultations in Moscow online

At the end of February 2020, the opportunity to attach to women's consultations in Moscow via the Internet was realized. The provision of the service takes up to three working days.

Now it will be even more convenient for women to monitor their health. You no longer need to spend time going to the antenatal clinic to submit an application - you can attach yourself on the mos.ru portal without leaving your home, - said Anastasia Rakova, Deputy Mayor of Moscow for Social Development.

You can apply on the mos.ru portal through the service catalog in the "Health" section. In order to submit an electronic application, you must select "Attachment to antenatal clinic" in the catalog of services on the mos.ru in the "Health" section. Next, you need to enter passport data, the series and number of the Moscow compulsory medical insurance policy, contact phone number, email address, registration and actual residence address.

If the data has already been specified in your personal account, the system will add them automatically. With the help of an interactive city map, the user will be able to choose the desired antenatal clinic, the system itself will tell the institution closest to the place of residence. The site shows addresses, phones, types and numbers of sites, surnames, names and patronymics of doctors.

Residents of Moscow over 18 years old will be able to attach to the antenatal clinic if they have a Moscow compulsory medical insurance policy. If the policy is not issued in the capital, patients can apply for attachment only upon a personal visit to the clinic.

By the end of February 2020, there are more than 130 women's consultations in Moscow, which work at city clinical hospitals in all districts of Moscow. There, patients are provided with comprehensive dispensary and gynecological care, observed during pregnancy and after childbirth, and prepared for childbirth.^[18]

2019

Muscovites opened access to their electronic medical records

Main article: SIMI EMIAS (Integrated Medical Information System of the Unified Medical Information and Analytical System of Moscow)

On January 14, 2020, Muscovites were opened access to their electronic medical records. This was reported in the personal blog of the capital's mayor Sergei Sobyanin.

Patients over 15 years old can get access to electronic medical records on the official portal of the mayor and the government of Moscow (Mos.ru) in the "Services" section, as well as in any of the centers of public services "My Documents." After the appeal, access will be open within five working days.

To use the service through your personal account on the portal of the mayor of Moscow, you need to indicate passport data, a series and number of the compulsory medical insurance policy, a mobile phone number and attach your color photo with a passport in your hand. 

By January 14, 2020, in the electronic map, you can see the protocols for examining doctors from 2017, the results of tests and studies and epicrises from hospitals from 2019. All studies that will be carried out from 2020 will be automatically entered into the electronic map.^[19] 

In the future, information will be opened on an appointment with a doctor, medical examination, vaccination of children, etc. It is planned that in the future patients will have the opportunity to enter data into their card, for example, about a visit to a doctor in a private clinic.

Sergei Sobyanin stressed that such cards cannot be lost. By mid-January, the service will work in test mode.

We will gradually develop it, make it more convenient and informative, "said Anastasia Rakova, Deputy Mayor of Moscow for Social Development.

She said that so far the personal electronic card is available only on stationary computers, but within a year and a half it is planned to create a mobile version of the electronic card.

Parents and legal representatives of the child can access the children's electronic medical record in Moscow from January 14, 2020.

2018

All medical records in Moscow polyclinics will be equipped with RFID tags

On September 24, 2018, it became known that all medical records in Moscow polyclinics were equipped with radio tags. Thanks to the introduction of technology, patient cards can be searched faster, and the risks of their loss will decrease.

As reported on the website of the capital's mayor's office, all medical records in children's and adult clinics in the city will receive RFID chips by February 2019. Labeling will begin in October 2018 in polyclinic No. 121 and children's polyclinic No. 131.

The radio tag will allow you to fix the location of the map, as well as monitor its movement outside the registry where it is stored. As noted, the scanning process lasts only a few seconds, and installing the chip itself takes about one minute. According to the head of the Moscow City Health Department, Alexei Khripun, equipping cards with radio tags will reduce the risk of losing the document and reduce the time to search for it.

A pilot project for the introduction of radio tags was launched in May in the city polyclinic No. 46, where chips were installed on more than 9 thousand paper medical records, and was recognized as successful.

In July 2018, Moscow Mayor Sergei Sobyanin proposed creating a program for the reconstruction of metropolitan polyclinics in order to achieve the same quality of service in all medical institutions. According to him, the previous program to bring polyclinics to a single service standard cost the budget 100 billion rubles.

Despite the fact that most patients already have electronic records, the attending physician should always be able to get information  about which specialists he previously contacted in order to form a complete clinical picture. In any case, the paper equivalent of the card will be in demand until the necessary information about the patient appears in electronic form, - said Khripun.[20]

ATI to design ICT infrastructure for AIS EMIAS

Company. " IT Information Technologies "May 28, 2018 announced the conclusion of a contract with the state government institution of the city" Moscow Information and Analytical Center in the Field " health care for the design of system and technical infrastructure that ensures the functioning of subsystems and services of AIS EMIAS.

The main goal of the work is to create an ICT infrastructure project for automating processes in the capital's medical organizations of the state health care system, providing specialized, including high-tech medical care in inpatient conditions.

Under the terms of the iT contract, a set of work is to be carried out aimed at the development of subsystems and services of AIS EMIAS. This, in turn, should provide an automated end-to-end process of patient management, a single format for storing medical documentation, creating a unified system for recording medical services, reducing the time spent on performing routine or concomitant procedures, real calculation of the cost of each treated patient, reducing the number of medical errors, increasing the level of reliability of medical documentation, etc.

During the project, it is planned to audit the existing infrastructure in order to assess the possibility of using its components in the future. When designing the system and technical infrastructure, iT specialists will have to prepare a draft description of sufficient network, computing and storage resources for the uninterrupted and fault-tolerant functioning of AIS EMIAS, as well as provide for the possibility of horizontal scaling without interrupting the work of subsystem components and services.

During the design, it will also be necessary to ensure the safety and continuity of operation of existing information systems. In general, the project should cover 66 medical organizations To Moscow in and, Moscow region including hospitals, dispensaries, maternity hospitals.

The project provides for demonstration to the customer of the developed technical solutions for their operability and compliance with the requirements. To do this, the demonstration stand of the designed system and technical infrastructure will be deployed and fully configured.

It is necessary to complete all the work of iT by the end of 2018.

2017

API EMIAS received 28 commercial Internet companies

About 28 commercial Internet companies have access to the API EMIAS in terms of appointment. These are giants such as Yandex, Mail.Ru Group and many other companies that are able to meet safety and reliability requirements.

The key direction of development of EMIAS is the continuity of medical information about the patient in all state health care institutions of the city. This will help doctors make timely and informed treatment decisions. Already, access to the system is open to ambulance and emergency teams, which allows them to familiarize themselves with the patient's medical history and find out vital information along the way to it. In the future, integration with hospitals, which are still very lagging behind in terms of technical equipment, said the representative of DIT Moscow^[21]

Moscow received an international prize for the creation of EMIAS

Moscow received the Global mobileGov awards 2017, which is awarded for achievements in the development of electronic mobile services for citizens by the state. The prize was awarded to the Department of Information Technology (DIT) for the creation of the Unified Medical Information and Analytical System (EMIAS). The presentation took place at the global conference mobileGov World Summit 2017, which was held in early May in British Brighton^[22].

In total, more than 100 projects claimed to receive Global mobileGov awards. Over the course of two rounds, the top 15 were selected, followed by the top three. EMIAS took third place among them. The first place went to the Government of Bangladesh for the program for the development of mobile applications. In second place were the UAE, which presented its digital innovation center at the competition.

The first three are the absolute winners of the competition. However, in addition to them, various projects were awarded in additional nominations mobileGov Honorable Comments Awards (three projects) and mobileGov Special Recognition Awards (seven projects), without specifying the order. The first additional category presents the achievements of India, Azerbaijan and Chile. Azerbaijan was awarded for Asan İmza mobile electronic identity card. In the second additional category, the awards were received by the governments of South Korea, Slovakia, Colombia, Malaysia, Nepal and Turkey.

11.4 doctors and 5.1 thousand students were trained

11.4 thousand practicing medical workers and 5.1 thousand students of medical colleges have been trained under the educational program of the Unified Medical Information and Analytical System (EMIAS) of Moscow over the past 2 years.

In 2016, 8.7 thousand medical practitioners were trained, of which 8 thousand were on the course "Use of an electronic medical record." The speed of its implementation largely depends on how successfully doctors master the service. 3.1 million Muscovites received an electronic medical card.

In 2016, 2.4 thousand students of medical colleges in the capital mastered the EMIAS curriculum. Thanks to the 36-hour course, future doctors now know how to keep an electronic schedule, make an appointment, fill out outpatient tickets, write electronic prescriptions and referrals. This will help them free the doctor from solving administrative tasks for direct work with the patient. The exams showed a performance rate of 83%. In addition to the basic course for students, training is carried out in the subjects "Use of an electronic medical record in the work of a doctor," "Preferential drug provision."

PC purchase for RUB 1.2 bln

On February 1, 2017, it became known about a decrease in prices for PCs under Linux for medical workers in Moscow by almost half - the Redsis company knocked down the price of the starting price of the lot at 2.19 billion rubles, by 44.5% - to 1.216 billion rubles.

The supply of 30.5 thousand computers as part of the modernization of the Unified Medical Information and Analytical System (EMIAS) will be carried out by Redsis for 1.216 billion rubles. A similar price was offered by Alma, but the contract did not go to her. The auction was competed by the Production Company Aquarius with an offer of 1.227 billion rubles. and Depot Electronics with 1.413 billion rubles.

In accordance with the tender documents (on the public procurement website), the purchased computers will form the basis for organizing the so-called "jobs of medical workers." In addition to PCs (in the "all-in-one" form factor - built-in monitor) included: keyboard, "mouse," smart card readers of two types (for health workers and patient cards: UEC, Criminal Police Service, electronic compulsory medical insurance policy), power distributor (network filter) and a set of cables^[23].

PC Configuration:

• a processor with at least two cores,
• DDR4 RAM at least 8 GB expandable up to 16 GB,
• built-in hard drive at least 256 GB,
• built-in webcam with a resolution of at least 1 megapixel and a mechanical shutter built into the all-in-one body in a factory way.
• monitor at least 23 inches with a resolution of at least 1920 × 1080, a matrix no worse than TFT IPS, without the function of a touch screen, with a brightness of no worse than 250 cd/m2 and a contrast of no worse than 1:1000.
• built-in microphone and stereo.

Planned: installation of Linux distributions on this technique and compatibility of the hardware configuration with Russian operating systems: ALT Linux 7 and Rosa 6.8.

2016: Registered 9 million patients, 100 million appointments

More than 9 million patients were registered in EMIAS, of which 800 thousand were added in 2016, as well as more than 20 thousand outpatient doctors. With the help of the system, more than 285 million records were made to doctors, more than 100 million - over the past year.

In 2016, the share of remote records to doctors - via the Internet, mobile application or by phone - increased by 15 percentage points compared to last year and amounted to 36%. New opportunities have become available for Muscovites: it became possible to schedule a visit to the doctor on the mos.ru portal and using TelegramBot. A new function has appeared on the pgu.mos.ru city services portal: residents of the capital can postpone a visit to the doctor on the portal without canceling the appointment.

According to the EMIAS, the availability of first-line doctors is at a high level: 88% patients could get to the therapist (85% to the pediatrician) on the day of treatment or the next day, and 89% patients get to see a doctor in the horizon of 20 minutes from the appointed time.

In 2016, more than half of Moscow's polyclinics began using electronic medical records (iEMK). 2.6 million patients have already received their EMR as they go to the doctors. In addition, 7,000 doctors have mastered the educational program "Using an electronic medical card," which helps them to maximize the functionality of the service.

An important event of the year was the introduction of a bill to the State Duma on equating electronic sick leave with paper. The adoption of the bill will help in the future to save doctors' time and paper on printing disability certificates. In 2016, Moscow doctors issued 1.3 million electronic disability certificates. Active work is underway on amendments to the legislation regarding the electronic prescription, which so far also has to be printed. With the help of an electronic prescription service, the capital's doctors have already made more than 28.5 million prescriptions of drugs, including 18 million in 2016.

According to the Quality Service of the Unified Medical Information and Analytical System of Moscow (EMIAS), the satisfaction of doctors with the service increased by 70% from July to November. This became possible thanks to the active interaction of EMIAS developers and medical practitioners who make their proposals for finalizing the service.

2015

Electronic medical record is ready for replication in Moscow

At the end of 2014 - the beginning of 2015, testing of the most anticipated new EMIAS service, the Electronic Medical Record (EMR), which will be implemented in all state outpatient and polyclinic institutions in the capital in 2015, is being completed.

Throughout 2014, development specialists, together with doctors, 14 polyclinics, which are part of 3 outpatient centers of the test zone, worked to create and improve the service. Today, more than 100 thousand electronic medical records of patients have already been created, more than 300 thousand different records have been made in them, and every day this number is growing faster. The work was attended by 580 doctors of 48 specialties, who made a great contribution to the creation of an electronic medical record.

In 2015, it is planned to expand the amount of information in the electronic medical record: data from laboratory and other studies, the results of vaccination and medical examination will be added.

Particular attention was paid to the security of data storage and transmission during the development. Personal data of the patient are contained in the MG MHIF databases, and medical - in EMIAS, in an impersonal form. In order to access the electronic medical record, the doctor is authorized into the EMIAS and sends a request, in response to which only one specific patient receives data and medical information through secure communication channels. Moreover, you cannot download this information to a computer.

Future doctors will learn to work with EMIAS

In early February 2015, a large-scale EMIAS training program for 4-year students of 24 Moscow medical colleges and schools will start. It is planned that by the end of 2015, more than 2.5 thousand people who receive middle medical professions will pass exams for the ability to work with the system. Classes will be conducted by more than 120 teachers who have been trained and today have successfully passed exams for the right to teach students and doctors to work with EMIAS.

The subject "Use of the Unified Medical Information and Analytical System of Moscow in the Work of Medical Personnel" was included in the mandatory part of the educational program. The pilot project took place in 2014 in 4 educational institutions of the capital, covering 220 students. More than 80% of those trained successfully passed the tests, and according to the results of the surveys, they consider the training useful. They are confident that the knowledge gained will be useful to them in the future. Given the fact that all 660 state medical institutions of the outpatient polyclinic link of Moscow were connected to EMIAS back in 2013, most future doctors will meet with the system at the workplace.

During the training, students get acquainted with the main services of EMIAS and learn to keep a schedule, fill out outpatient admission cards and other administrative documentation, make repeated visits and draw up referrals to other specialists, write out electronic prescriptions, and much more.

In order to deploy EMIAS training at 26 facilities - these are 11 colleges, 13 schools and 2 advanced training centers - each of them has special classes equipped with computers, smart cards, readers, infomats, printers. In fact, the training class has completely recreated the work of a medical specialist with EMIAS in the conditions of an ordinary Moscow outpatient center, with the only difference that all the data used will be virtual.

The program is designed not only for students of the last courses of medical educational institutions, but also for practicing employees of the city health care system. Therefore, the training process will be built in such a way that students can attend classes in the morning, and in the afternoon - medical workers of Moscow polyclinics, that is, those doctors, registry staff and nurses whose managers are interested in the effective work of their employees. And such a need may arise due to the fact that EMIAS is constantly developing, and this year it will offer users a number of new services - an electronic medical record, an electronic sick leave, a laboratory service and others. All of them will be included in the training program as they appear.

Moscow Mayor fired five chief doctors for falsifying electronic queues

Moscow Air Minister Sergei Sobyanin fired five Lavvraki polyclinics for falsifying electronic queue data, he said in February 2015 during a visit to the city polyclinic No. 64 in the east of the capital.

"We have recently released several leaders of polyclinics not only for problems related to the quality of service and large queues, but also for various kinds of tricks, postscripts, distortion of information. This is generally unacceptable, "said Sergei Sobyanin^[24]

In addition, he added that the authorities continue to work to improve the efficiency of the clinics, and handed a letter of thanks to the chief physician of the 64th hospital as one of the most advanced in this direction.

The day before, it was reported that the head doctors of polyclinics No. 219, 180, 62 and 19 were relieved of their posts based on the results of monitoring the availability of medical care. The situation center monitored the availability of a self-record for an appointment with a doctor: if the record was free, the medical institution was displayed on the interactive map in green, if it took 3-4 days to wait for the therapist, then the clinic fell into the so-called yellow zone, 5 days or more - in red. As a result, a number of the most problematic clinics were identified.

EMIAS as a "killer" of registrars: pilot projects in Moscow

In May 2015, the Moscow Department of Health announced ongoing pilot projects in a number of polyclinics as part of the implementation of the Moscow Standard Polyclinic city program. According to officials, this program takes into account the wishes of city residents to improve the work of clinics, which were collected following a special crowdsourcing project.

Based on the wishes of citizens, the Department of Health has developed a number of measures aimed at increasing the availability of appointments to doctors, improving comfort in the clinic, reducing patient expectations in queues, as well as improving the quality of treatment in clinics.

One of the changes in the work of polyclinics implemented in pilot projects is the reorganization of the registry. At a visiting meeting of the commission on health and public health in May, a representative of the polyclinic center No. 64, one of the pilot sites of the program, said that a "modern information desk" was organized in their institution on the site of the old registry.

In June, the Vademec.ru healthcare portal reported that as part of a pilot project in branch No. 3 of the polyclinic center No. 62, the registry was closed, and its registrar employees. An appointment with a doctor became possible only with the help of the EMIAS system through infomats , the Internet or a single call center.

From a conversation with an employee of the clinic center No. 62 TAdviser, I found out that the work of the registry through the window in their medical institution really stopped. An employee who can be found on the ground floor helps patients to make an appointment with a doctor if necessary. The center added that they are participating in the pilot project in accordance with the order that came to them from the Department of Health and noted that the pilot project should extend to their other branches.

Earlier, the message of the Moscow Department of Health following the results of the May visiting meeting of the commission on health and public health protection cited data from one of the heads of the department that by the end of the year a new standard for the operation of polyclinics should be introduced in all polyclinics in Moscow.

The Department of Health did not respond to TAdviser questions regarding plans to close registries at other health clinics. References to regulatory acts that regulate the implementation of the Moscow Standard Polyclinic program, as well as its full content in the department, were also not provided. In open sources, including the website of the Department of Health, this information is not.

It is worth noting that earlier, in April 2015 , the DIT of Moscow reported that it is planned to completely dismiss about a thousand stenographers who interrupt outpatient admission coupons to the automated system of accounting for medical care and the formation of accounts and reporting on compulsory medical insurance (ACS OMS). As explained in the DIT, the territorial MHIF began joining the MHI ACS to the EMIAS, as a result of which it is planned to set up an automated system where accounting for primary health care will be carried out in EMIAS with the subsequent upload of data to the MHI ACS. Thus, the coupons of the outpatient reception will not be interrupted by medical registrars in the offices of the medical statistician manually, but will automatically be poured from the EMIAS into the ACS OMS.

Most doctors have fully mastered the functionality of EMIAS

EMIAS of Moscow operates in all 660 city polyclinics, more than 23 thousand doctors and nurses use it every day. The opinion of doctors about the system and the depth of use of its functions are studied monthly during anonymous surveys.

Among the most popular services of EMIAS, which are used by 73% of doctors, are electronic referrals for re-appointments, for procedures, as well as for other specialists, including doctors of other medical institutions.

Doctors of a narrow specialization have mastered the dynamic observation service, which allows you to attach a patient to yourself so that in the future he will make an appointment, bypassing the therapist. This is used by 78% of the surveyed doctors. Such functionality is not only convenient for patients, but also frees up the time of the therapist, who does not need to mechanically redirect patients with chronic diseases to their attending physicians every time.

97% of doctors have mastered the function of "delayed intake," when a doctor suspends the intake of one patient, for example, if he has taken the medicine and waits for it to work, and begins taking another. The usefulness of this service is especially noted by ophthalmologists. Thus, EMIAS is adapted to the needs of specialists and takes into account the different specifics of admission management.

In order for doctors of Moscow polyclinics to master EMIAS faster, since February 2015, a large-scale training program has been launched in 26 specially equipped classes, in which more than 2.5 thousand medical workers will take part by the end of the year. More than 10,000 doctors have been given free training in blind printing skills and computer basics in the past two years. In addition, at any time, doctors can receive assistance in working with the system from technical support specialists, and 53% of respondents note that problems are solved quite quickly and competently. Every month, the quality service of EMIAS conducts similar surveys in medical institutions, collecting the wishes of doctors for developers.

The high level of ownership of the EMIAS functionality creates the necessary basis for the phased introduction of one of the most important services - an electronic medical record. At the time of mastering the new functionality, the burden on doctors will certainly increase, even taking into account the help of qualified specialists who will accompany the implementation process in each clinic. But ultimately, thanks to EMR, continuity of information and its preservation will be established between various medical institutions, which will improve the quality of medical care.

2014

More than half of the state-owned clinics in Moscow have mastered the design of recipes in electronic form

Main article: Electronic recipe

By the end of 2014, more than half of the state polyclinics in the capital had mastered the design of prescriptions in electronic form. This component of the Unified Medical Information and Analytical System (EMIAS) is already used by doctors in 370 clinics. It is planned to complete the implementation of an electronic prescription in all children's and adult polyclinics in Moscow in the first quarter of 2015. Read more here.

5.3 million patients registered

Status for January:

• A number of services in the following areas have been implemented or are undergoing the final phase of trial operation: planning and conducting preventive examinations, clinical examination and vaccine prophylaxis of the population, automation of processes related to preferential drug provision, interaction between medical institutions and clinical and diagnostic laboratories - a centralized laboratory service, support for the life cycle of disability certificates, appointment services for a doctor, doctor on duty, live queue, call a doctor at home, data analysis and reporting service and many others. Also this year, a large-scale introduction of electronic medical records will begin;

• More than 5.3 million unique patients were registered;

• More than 71 million different transactions were made, on average - 400 thousand per day. Of these, about half (190-210 thousand) are daily appointments of patients by metropolitan doctors. This number corresponds to the total population of the average Russian city. For example, Pskov, where, according to estimates by the Federal State Statistics Service, 206 thousand people lived in 2013;

• More than 20 thousand workplaces of employees of medical institutions were automated;

• More than 16.6 thousand doctors were trained to work at the EMIAS of the initial level.

2013

Status for June

In the Unified Medical Information and Analytical System (EMIAS), 20,219,920 appointments were recorded. These are the data as of July 1, 2013. It is worth noting that as of March 1, 2013, this figure was 12,679,327. Thus, in four months, the growth was more than 7.5 million records.

Also during the reporting period, from March 1 to July 1, the number of unique users of the system, which are patients of Moscow city medical institutions, increased by 1.2 million . At the moment, 4,319,891 people are registered in EMIAS. Thus, every third citizen uses the system to make an appointment with a doctor.

As of July 1, the number of entries through the pgu.mos.ru public services portal increased 2.6 times - from 308,848 to 826,042. Appointment with a doctor using the free mobile application EMIAS for the specified period increased 3 times - from 8970 to 27,583 records. It is worth noting that this is one of the "youngest" remote recording channels for a doctor, which shows stable growth.

The above indicators indicate that Moscow residents are increasingly using the new technologies that the city provides them.

October: Moscow's EMIAS "collapsed" after Lanit updated it

From October 20-21, 2013 Moscow , a failure began in the work of EMIAS, which lasted for several days. As representatives of the city's health care system told TAdviser, after the weekend, in particular, for about two days, it became impossible to make an appointment with doctors through Internet and through the terminals installed in polyclinics.

By the middle of the week, the ability to record with doctors was restored, but the system began to work with errors: for example, issue coupons for appointments at the same time to several patients at once. The TAdviser correspondent also faced this problem in the middle of the week.

Doctors of one of the polyclinics in Moscow told a representative of the publication that these days the medical workers of their institution also experienced problems when working with EMIAS - "the system hung on computers, it was impossible to do anything in it from time to time."

A source in the Moscow government, close to the city's healthcare sector, told TAdviser that in the weekend before the crash , Lanit, one of the contractors for the creation of EMIAS, released a new release of a patient flow management system with a large number of new functions, including live queue. The latter means patients who come without an appointment, the number of which, according to some medical institutions in the city, can reach up to 40% of the total flow.

According to the interlocutor of TAdviser, it was because of their influx that the data center in which the system is hosted "lay down": "Lanit" did not predict the load, there were not enough servers for EMIAS to work, and there was a software failure, he explained.

The load on the system has also increased the seasonal surge of patients associated with SARS diseases in the autumn, adds a source in the Moscow government.

The "Lanit" itself did not comment on the situation with the violation of the work of the EMIAS. The IT department of Moscow told TAdviser that the data center plans to increase resources - a twofold increase in productivity, and expressed the hope that the situation will stabilize in the afternoon of October 24.

2012

Phase Two: SIMI Development

In mid-2012, it became known that the project to create a Unified Medical Information and Analytical System (EMIAS) in Moscow is moving to the next stage - the development of a system of integrated medical information (SIMI), which is designed to consolidate medical information about patients.

IEMK is a single repository of medical information of a citizen for all examinations and cases of appeal to medical institutions of the city, created once and replenished throughout a person's life.

It is assumed that the integrated electronic medical record will consist of the following sections:

• patient registration ID;
• vital medical data (blood type, allergies, chronic diseases, etc.);
• episodes (outpatient appeals and hospitalizations);
• personal electronic medical records (medical examinations, diagnoses, research protocols);
• multimedia data (X-ray, tomography, ultrasound, scans of paper documents);
• appointments;
• laboratory data.

Information will be stored and processed in depersonified form.

SIMI is designed as a centralized information system located on computing power in a citywide data center. Access to it from polyclinics Moscow is planned to be carried out through the EMIAS user interface generation subsystem using a thin client. In hospitals with local medical information systems, user access to the SIMI functionality will be mediated by the interface of these systems.

Free Software Usage

Status for October

Over the year that has passed since the start of the project of the Unified Medical Information and Analytical System of Moscow (EMIAS), the capital's polyclinics have acquired networks, infomats and computers in registrations connected to a citywide data processing center. Doctors received the first 3.8 thousand automated workplaces, and 1.8 million citizens tested the first launched EMIAS service - a patient flow management system (SUP), which allows you to remotely make an appointment with a doctor. According to the metropolitan Department of Information Technology, already now this service makes it possible to receive statistical data, analyze them and make management decisions to increase the efficiency of medical institutions, as well as the quality and availability of medical care. But this is just the beginning, there is much more to come than has already been done.

Other services will follow the PMS:

• Integrated Health Information System (IMI),
• a personalized accounting system for the medical care provided,
• consolidated management accounting system and
• medical register management system.

At the same time, the ISP will acquire new functions, therefore, simultaneously with its implementation, competitions are held one after another in outpatient institutions and contracts for the development of EMIAS are concluded. It is expected that the first development results under these contracts will be ready by December 2012, and in 2013 new services will begin to be deployed in polyclinics In^[25].

2011

Status for December

In December 2011, DIT began mass deployment of the service. All state polyclinics in Moscow are connected to EMIAS, as well as some other types of institutions - dispensaries, antenatal clinics, diagnostic centers.

The transfer to the electronic registry with the ability to remotely record for an appointment with a doctor has been completed. Already, the service makes it possible to receive statistical data, analyze them and make management decisions to increase the efficiency of the city's medical institutions and improve the quality and availability of medical care.

At the end of 2011, EMIAS united more than 500 medical and preventive institutions in the capital. By this time, more than 1.5 million Muscovites had used the services of the system - and this is every 8th resident of the capital - having appointed more than 4.7 million visits to doctors.

Phase One: Patient Recording Services

The first stage of implementation is to provide self-recording services for patients to the doctor (through the Moscow portal of public services pgu.mos.ru, electronic terminals in the halls of clinics, a single city call center and a special application adapted for the main mobile platforms).

Since December 15, 2011, the Department of Information Technologies (DIT) of the Moscow Government begins to deliver equipment to the capital's polyclinics, which will allow by the beginning of next year to introduce a system of automated control of patient flows in 112 pilot medical and preventive institutions. At the end of 2012, the system should cover all city polyclinics. At the moment, they were counted 547, but, as DIT admits, they were mistaken - they forgot to take into account polyclinics at hospitals; the error will have to be corrected.

Automated management of patient flows, according to officials, will allow monitoring the workload of various institutions and individual specialists and, if necessary, send the patient to another clinic, and personalized accounting of the volume and quality of assistance provided will help the authorities more quickly respond to the needs of metropolitan medicine.

According to the head of DIT Artem Ermolaev, in general, the project for the modernization of all levels of Moscow health care has the most significant funding under the state program "Information City" and, moreover, closes with other state programs related to all-Russian health care, which determines its extremely high priority and personal control of the mayor of Moscow.

The introduction of EMIAS is a pilot project in many respects. Depending on how successful it is, the Ministry of Health will decide on its replication in other cities of the country.

As the adviser to the head of DIT Vladimir Makarov, who oversees the health sector in the department, notes, attempts to informatize medical institutions have been made before, and their visible results are now very heterogeneous. The main problem of the predecessors of DIT, Mr. Makarov, believes that informatization was patchwork in nature (it closed some elements of the activities of doctors with some decisions), and plus the process was carried out for the sake of the process itself: people came, mounted some pieces of iron and disappeared. After that, at best, the equipment somehow worked, but the doctors were left to their own devices. At worst, the equipment failed or the computers themselves gradually migrated to the cabinets. Thus, according to Mr. Makarov, the high level of informatization, which can still be observed in certain places now, has developed not thanks to, but contrary to the efforts of the executive branch.

Taking into account the accumulated negative and positive experience, one of the main promises that Mr. Makarov made at a meeting with the chief doctors of the clinic was that by shipping the equipment, DIT would not disappear anywhere. First, remote centralized technical support will be organized according to the call-center principle. Secondly, any doctor can personally call the heads of DIT (including mobile phones). And thirdly, during the whole of the next year (and possibly longer), at least two technical consultants will be present at each clinic during the working day to help staff adapt to the system.

According to Mr. Ermolaev, DIT tried to create a solution that can be used not only to work with patients, but also to communicate personnel with each other - 22 thousand computers purchased for polyclinics are equipped with webcams, speakers and microphones.

But as for the rest of the technical equipment, DIT chose its main principle not to purchase equipment, but to buy the necessary services from third-party contractors who will provide the necessary equipment for rent and independently service it. All performers are now awarded long-term contracts for three years.

As Mr. Makarov emphasizes, EMIAS is a centralized solution located in a citywide data center and available in the workplaces of authorized medical workers on the principle of cloud service. This architecture will eliminate the need for polyclinics to place and operate sophisticated telecommunications equipment on the ground. Artyom Makarov does not hide the fact that he had to listen to many critical considerations regarding safety and resiliency, but, in his opinion, it is much easier to protect and control one place than several hundred places.

At EMIAS, information about each person will be collected from different medical facilities, accumulated and stored in an electronic record that will become available to any authorized medical professional. Privacy will ensure impersonal storage of data. If necessary, the specialist will be able to communicate in the same system with a colleague who examined the patient before him.

The system is integrated with universal electronic cards. Special card readers will be equipped with the workplace of each doctor with access to the EMIAS. This, in particular, will significantly reduce the time required to fill out prescription forms.

In addition, the doctor will not be tied to a specific PC. With the help of a personal identification card, he will be able to get to his virtual desktop from any office of the clinic.

According to Mr. Makarov, the task of DIT is to come with services to the office of each doctor by the end of 2012. However, at the same time, the department does not intend to force a person to work on a PC and fully maintain an electronic medical record. (There will be no clear dates: officials realize that most people take a very long period to study.) Nevertheless, the department will try with all its might to give doctors such tools that will motivate a person to learn. (After all, today it does not occur to anyone to print text on a mechanical typewriter; everyone uses a PC because it's really convenient.)

At the end of his speech at a meeting with the chief doctors, Mr. Ermolaev expressed hope for activity on the part of medical workers within the framework of the project. The official assured the audience that he would very much not want a formal approach to the matter, and called on everyone to dialogue and help.

The response of the audience from the outside could be assessed as restrained-positive. It remains to be hoped that the key to the success of the project will be the assessment expressed by one of the medical workers, who noted that for the first time in decades, officials offer the industry to become not executors, but partners of the project, for which the industry itself has been ready for five to seven years^[26].

Head of DIT of Moscow Artem Ermolaev on plans for informatization of healthcare (February 2012)

Performers

Project Management: Project Practice

Management of a large-scale project with the help of the involved company "Project Practice" only at the stage of implementation of the first stage of EMIAS components in 2012 cost the city budget more than 60 million rubles.

As of October 2012, in total, the Project Practice management company accompanies 35 current projects as part of EMIAS.

Networks: Comcor

Comcor builds a network infrastructure in 400 medical organizations and connects them via its fiber-optic network to the data center, providing a crypto-secure virtual private network service and a DHCP-relay service for managing unified IP addressing from EMIAS (October 2012^[25].

Data Center: Electronic Moscow

The servers where EMIAS "lives" are located in a data center rented by Electronic Moscow (October 2012)^[25].

Patient Flow Management System (PMS): Lanit and Croc

The creation of citywide information services in the capital health care began with a patient flow management system. Software for it was developed by the company LANIT"," and provided implementation services to CROC"." According to DIT, by September 2012, 351 polyclinics were connected to the system, Moscow registrars were technically equipped, the installation of infomats was completed and the equipment of doctors' offices with computers began.

As of October 2012, it was reported that LANIT is developing the functionality of the OMS.

SIMI: IBS

The Integrated Medical Information System (SIMI) is being developed by IBS, which won a contract worth 205 million rubles. The company is obliged to submit its version of IEMK to the Moscow Department of Information Technology two months after signing the contract (autumn 2012).

In addition to IBS, Medlinsoft and iT also participated in the tender. "Rostelecom," which won the competition of the Ministry of Health and Social Development for the creation of a federal IEMK for a symbolic ruble, was not allowed to participate in the Moscow competition: a proposal involving the storage of a patient's personal data in SIMI was found to be contrary to the terms of reference. In addition, according to the customer, Rostelecom ignored the integration of SIMI and external systems as part of EMIAS.

Contact Center: Rostelecom

Rostelecom participates in the EMIAS project, providing contact center services (2012).

Security System: Inline Technology

Inline Technologies won the competition for the development of the concept and design of an integrated security system for interdepartmental interaction with EMIAS services, including through secure communication channels. The amount of this state contract is 28.2 million rubles, work on it should be completed by November 2012^[27].

Personal Accounting System

In the near future (September 2012), the winner will be determined in another major DIT tender - for the creation of a personalized accounting system for medical care. The starting price of this state contract is 230 million rubles. Applications for participation in the competition were submitted by Armada Soft, Medlinsoft and iT.

Ambulance Control System: Asteros

Asteros is upgrading the control system of the ambulance and emergency station, which will be further integrated into EMIAS (October 2012^[25].

See also

• Information city (ICT program of Moscow)
• Unified Wi-Fi network "Moscow Transport" (MT FREE)

Links

Site емиас.рф

Notes