"First Bit" optimized the performance of the "1C: Medicine" system for Sechenov University

2023: Performance Optimization "1C: Medicine"

On May 30, 2023, First Bit announced that it had optimized the performance of the 1C: Medicine system for Sechenov University

The clinical center of Sechenov University is one of the medical institutions of the Russian Federation: more than 5,000 employees work in the center for May 2023. As part of the project, the team of the IT integrator "First Bit" increased the performance of the infrastructure and reduced the total use of RAM by 40% (100 GB).

Most of the employees of Sechenov University work with the 1C: Medicine. Hospital system, which is the primary point of entry of information for both doctors and employees of registrations, reception departments and a call center. In the same system, in addition to registration and medical documentation, financial records of the medical services provided are kept.

However, over the past six months, problems with system performance began to arise due to significant user growth - by more than 35%, problems with the performance of the 1C system appeared. For successful operations, the clinical center was important to reduce the load on the processor and the amount of memory consumed, ensure stable system operation, and speed up business operations.

Before the start of work, working groups were formed from Sechenov University and First Bit, Sportivnaya office. The project was also attended by a team from 1C TsKTP. Experts of the Corporate Technology Support Center (CPT) monitored the progress of work and, if necessary, provided methodological support.

During the project, monitoring of the equipment of 1C and DBMS servers was configured, as well as an analysis of their hardware and settings. In addition, the 1C: Medicine application solution code was optimized.Hospital and the problem with excess memory consumption was fixed. As a result, the platform version 8.3.20.2257 was switched. The result of the project was a significant acceleration of operations on basic medical documents and reports.

As a result of the work performed, it was possible to reduce the average call time of the main ¬ operation by five times - from 5.28 seconds to 1.08 seconds, and reduce RAM consumption by 40% (100 GB). This significantly influenced the speed of work of doctors and their effectiveness: instead of wasting their time on the system, they were able to devote it to patients, - said Mikhail Vladimirovich Ankudinov, head of the Information Technologies Department of the Clinical Center of the First Moscow State Medical University named after I.M. Sechenov.

2019: Transition to Electronic Health Records

On January 15, 2020, 1C: First Bit announced the completion of the 1C: Medicine system implementation. Hospital "at the Sechenov University Clinical Center.

Previously, administrators of the Clinical Center registry recorded patients for an appointment with doctors in a paper journal. Doctors spent 5-15% of their time on medical drawing up cards, a sheet of daily registration of patient movement, diary entries, preoperative epicrises, protocols operations. Data diagnostic and laboratory tests were texted manually. For example, it took from 3 to 5 hours to perform one biochemical blood test - from prescribing indicators to registering them and transferring them to a doctor. Because of this, the clients of the center had to wait a long time for the next reception and their turn.

The clinical center has become needed an information system that would allow storing patient information in one database, working with electronic medical records (EMR), and providing prompt access to EMR for doctors and patients. It was necessary to speed up the design of epicrises and protocols, make a diagnosis, collect information about the patient for further analysis of his medical history. To reduce the number of examinations by insurance companies, it was necessary to exclude errors in the execution of medical documents.

To implement the project, the management of the medical institution turned to the company "1C: First Bit." To solve the tasks, the system "1C: Medicine. Hospital. "

The system, which covered 1,500 jobs as of January 2020, achieved the following results:

• Patient medical records are drawn up electronically. The system has created more than 200 templates of medical documents (SHMD): discharge and stage epicrisis, preoperative epicrisis, diary entry/bypass, consultation, oncological consultation, spermogram, embryo and oocyte cryopreservation protocol, doctors' consultations, etc.) and more than 3700 ready-made phrases for filling out SHMD. Doctors can add the phrases they most often use to their favorites and hide those phrases that they do not need. As a result, the time for issuing medical documents has been halved - from 40 to 20 minutes. Filling the EMR has doubled.
• Information about each patient at any given time is available to any physician in each of the 15 divisions of the facility. From the map you can get information about the results of medical examinations, about established diagnoses and forecasts of the development of diseases, about the methods of medical care and the risk associated with them, information about the possible types of medical intervention, its consequences and the results of care. Several clinic specialists can familiarize themselves with the contents of the EMR at the same time. At the same time, it is possible not only to read the card at the same time, but also to fill it out.
• If the patient is not admitted for the first time, his previous medical history is immediately extracted from the archive. The doctor can quickly view it and transfer information about the disease to a new medical history. When it is required to refer a patient for any study, the passport part (passport data, policy number) and the indications for the study are automatically collected from the previously entered information about the patient. According to these data, the patient is given a referral.
• Simplified registration of patient discharge from the hospital. All the information necessary for this is available in the system: data from the initial inspection, examinations, analyzes and consultations, protocols of operations, etc. The discharge epicrisis is filled twice as fast: earlier it took 35-40 minutes, after implementation - no more than 20. In addition, if the patient seeks medical help again after discharge, the doctor can quickly raise the medical history and choose the right tactics during the follow-up stage.
• Optimized management of the center's medical laboratory. Laboratory analyzers are connected to the system, with the help of which studies are performed. The system automatically transmits the received assignments to the analyzers as tasks and translates the results received from the analyzers into electronic patient records in a unified data format. This saves the doctor's time - the data of diagnostic and laboratory studies are transferred to the EC with one button in 1 minute, errors in the registration of results are excluded.
• Increased control over the correctness of filling out medical documents and the quality of medical care for patients:
  • It became possible to promptly record, fill out according to medical documents and print out mandatory protocols of medical commissions, including the "Protocol of the Subcommittee of Expertise of Temporary Disability," "Protocol of the Medical Control Subcommittee," "Protocol of the Subcommittee for the Study of Deaths"). Work with protocols is simplified, for example, in the "Protocol of the Medical Commission," as well as in other protocols, assistant buttons "On the patient's condition" are implemented. Data from the patient's diary is automatically transferred to the protocol. As a result, the doctor spends less time, errors in filling out the patient's passport data are excluded. If a patient needs an expensive drug, the insurance company must present a protocol for this drug. The program will remind you of the need to fill out such a protocol in advance.
  • Assessment of the quality of medical services provided to patients is carried out in accordance with Order of the Ministry of Health of the Russian Federation dated May 10, 2017 No. 203n "On Approval of Criteria for Assessing the Quality of Medical Care." Thanks to this, the main task is ensured - patients recover faster. The evaluation is carried out in the system in 2 stages. At the first stage, the doctor compares the criteria of the order with the real situation and notes in the system that it has been done, that it has not. At the second stage, the head of the department or deputy chief physician for clinical and expert work checks the system whether the documents are correctly executed, whether all the points of the protocol of the medical commission are filled out, whether the patient's consent to the provision of medical services has been obtained. If the inspector sees a discrepancy, he promptly opens the patient's electronic medical record and transfers the necessary data to the protocol.
  • A report has been created that allows you to track the occupancy of medical documents by doctors in the outpatient clinic. As a result, errors are excluded, and the insurance company will make a payment in full, and the medical institution will not incur unnecessary costs.
  • A report showing filling errors has been generated. For example, a diary entry is not filled out daily, there is no mandatory operational epicrisis before the operation protocol, a milestone epicrisis is not filled out every 10 days, a mandatory inspection by the head was not carried out on the papers before the discharge epicrisis. As a result, errors are eliminated in a timely manner, there are no problems with payment from the insurance company, funds are received in a timely manner and in full.

"Thanks" to 1C: Medicine. The hospital "and the team" 1C: First Bit "15 divisions of Sechenov University are provided with a unified system for maintaining and storing medical records. Doctors no longer need to do routine work. They can devote more time to patients and their treatment. Storing the history of diseases in electronic form ensures the free access of doctors to the patient's history, uninterrupted operation of each unit, saving the time and money of patients of the Clinical Center, " noted Ekaterina Rebrova, Head of the Department of Organizational Support and Quality Control of Medical Activities of the First Moscow State Medical University named after I.M. Sechenov

2018: Automation of the drug supply process

On July 23, 2018, the 1C: First BIT company announced the automation of the supply of medicines to clinical hospitals of the First Moscow State Medical University named after I.M. Sechenov with the help of 1C: Medicine. Hospital Pharmacy.

The clinical center is a structural unit of the Sechenov First Moscow State Medical University. The supply of medicines to all medical and diagnostic units is provided by the Centralized Pharmacy. In total, there are more than 100 multidisciplinary inpatient departments in hospitals and centers, and the number of purchased drugs is more than 1000 items.

Previously, hospital staff formed the needs of departments for medicines almost manually. Scattered applications were received by the pharmacy procurement department, then each department independently purchased the necessary drugs. The weekly volume of invoice requirements was about a hundred. The document flow between the pharmacy and hospitals was carried out only on paper, so the pharmacy staff spent several hours daily processing requests from hospitals. It was impossible to control the volume of purchased drugs. As a result, there were extra goods that quickly expired, and some drugs, on the contrary, were not enough. In addition, there were regular errors in the distribution of purchased drugs to departments in the pharmacy warehouse.

The institution began to need an automated system for supplying medicines to University Clinical Hospitals. To solve the problem, "1C: Medicine. Hospital pharmacy" was chosen. The implementation partner was 1C: First BIT.

Key Project Deliverables:

• The drug supply scheme of university hospitals has been optimized. In "1C: Medicine. Hospital Pharmacy," a Formulary has been created that limits the list of purchased medicines. It became possible to compare the need of the division for drugs with consumption statistics for the previous period. The system helps to analyze the leftovers in the pharmacy warehouse and optimize the number of medicines to purchase. Also, the Clinical Center can form a single purchase of drugs for different hospitals. The passage of each stage of procurement has accelerated significantly.
• A bar coding system for medicines has been introduced, unified forms of ordering pharmacy goods have been created. The formation of orders accelerated 3 times. The risk of errors in dispensing medicines from the pharmacy to the departments is minimized.
• At the stage of issuing the specification for contracts, you can see which department needs to release the drugs. The complexity of this task was that one product can be specified in the purchase requisition, and another (its analogue) in the specification. Based on the results of the project, the compliance of the requisition item and the specification item is established automatically when the specification is generated. Pharmacists spend half as much time preparing specifications.
• The system implements a mechanism for forming department requirements, taking into account goods received at the pharmacy for each specific department. As a result, the formation of a planned need for medicines has been accelerated by 15%. Department employees can see which drugs will soon arrive at the pharmacy warehouse and which have already arrived. If the pharmacist reveals that the department indicated an insufficient amount of the drug for a year in need, you can quickly issue a memo for additional purchase.

All this helped to reduce the costs of the Clinical Center for the purchase of medicines by 25%. Medicinal products are sold within the allotted shelf life. You don't need to wait long for the arrival of the necessary goods either.

"After the introduction of 1C: Medicine. Hospital Pharmacy, the drug supply scheme of University Hospitals has become much simpler and more efficient. We were able to reliably and quickly assess the rationality of the use of material resources. One of the advantages of the created system is the possibility of its development. In the near future, we plan to launch personalized drug registration. This will be possible with the help of individual staffing of medicines and patient identification bracelets. " Ekaterina Leonidovna Rebrova, Head of the Department of Organizational Support and Quality Control of Medical Activities of the Clinical Center of the First Moscow State Medical University named after I.M. Sechenova

2013: Implementation of the solution "1C: Medicine. Hospital "

The general contractor for the project was 1C. As a result of the competition, a set of solutions of 1C:Enterprise 8.3 system was chosen, which includes 1C : Medicine. Hospital, "" 1C: Medicine. Clinical Laboratory, "" 1C: Medicine. Dietary nutrition, "" 1C: Medicine. Hospital Pharmacy "and" 1C: Medicine. Federal registers. "

The implementation was carried out by a whole project team, which included specialists from six companies. Specialists "First BIT" carried out the functional part, including user training, the system part, and also optimized the system.

As part of its project, First BIT automated 650 of 800 jobs by implementing 1C: Medicine solutions. Hospital, "" 1C: Medicine. Dietary nutrition "and" 1C: Medicine. Federal registers. "

As a result, such processes as the work of the registry, obtaining laboratory results, and maintaining personalized accounting of the services provided were automated. Due to the integration of the system with the center's website, the availability of services has been increased - the coordination of the provision of paid services has been accelerated, the distribution of patients in the hospital has been optimized, dietary rations have been simplified, the cost of meals has been calculated, procurement planning has been planned, the registration of product movement has been automated, information interaction with the components of the federal level of the Unified State Information System in the field of health care has been ensured.

The specialists designed the IT infrastructure, developed the requirements for server equipment, and subsequently deployed the infrastructure based on this equipment, commissioned and configured the servers.