N3. Patient Index Patient Identification System

2024: Linux support from the Russian software registry

The company Netrika Medicine"" has updated the service that helps regional health care to identify patient systems and correctly form integrated ones. Electronic Medical Records (IEMC) Now the service supports operating systems families from Linux register of Russian software and even more precisely combines patient cards created in different medical institutions. The company announced this on January 23, 2024.

The N3.Index of Patients service solves one of the key tasks that arise during the digitalization of healthcare. It ensures the correct identification of the person seeking medical care from various medical organizations and registered in different information systems. At the time of the appeal, the doctor needs all the information on the patient, which was transferred to the integrated electronic medical record (IEMK) of the patient from polyclinics, hospitals, laboratories, diagnostic centers, ambulance systems, IE TFCMI, etc.

The service promptly receives from various medical organizations in the region all cards that may belong to the same patient. Then it analyzes them, calculates the level of similarity and either connects the cards with each other, or transfers them to the employees of the medical information and analytical center (MIAC) for manual verification. As a result, an IEMC is formed for each patient, including a history, advisory opinions, epicrises, certificates, research results, prescriptions and other data.

In the updated version of the service, a component such as the Patient Master Card appeared. It includes the data necessary for identification (full name, date of birth, address, contact phone numbers, SNILS numbers and other documents). If earlier the patient had a group of cards from those medical organizations to which he contacted, and each of the cards had its own ID, then one unique ID is assigned to the Master Card.

The master card makes it easier for medical organizations to obtain patient data, because now they do not have to be collected from all related cards. In addition, it simplifies interaction with third-party information systems and opens up prospects for a more accurate formation of regional patient registers, "said Elena Ryasnova, project manager of the Netrika Medicine IEMK team.

A master card helps, for example, when a patient first contacts a medical organization and has only an insurance policy on hand. By requesting a Master Card from the Patient Index, the medical information system (MIS) of the institution receives SNILS and other patient data necessary for work (including for interdepartmental interaction).

The Master Card ID is static, while the data in it is dynamic - it is updated every time the data in the patient's cards changes. In this case, the system always saves the previous version of the Master Map, and also takes into account the priority of data sources.

Most of all, the service algorithms "trust" the data that is transmitted from accounts in the Unified Identification and Authentication System (ESIA). The next priority source is considered to be records in the medical institution to which the patient is attached. All this helps to simultaneously ensure the relevance of data in the Master Card and to level out errors that may appear in information systems when manually entering patient information.

Another quality of this version of the service is cross-platform, that is, the ability to work with different operating systems. This is a response to an up-to-date request from solution customers - regional health authorities, government departments and institutions that are switching to using exclusively Russian software. Thus, the updated version of "N3.Index of Patients" is already successfully running on Astra Linux, which is included in the register of domestic software.

The transition to cross-platform allowed not only to ensure compatibility with operating systems from the registry of domestic software, but also, in fact, to completely revise the product, simplifying the source code and increasing the performance of the solution, - said Elena Ryasnova.

In particular, the speed of updating the service has significantly increased. If earlier this process required several hours of work, now it takes literally seconds and does not affect other components of the regional health care system (it does not affect the unloading of electronic medical documents to federal services or the availability of IEMK for doctors and patients).

The updated version of the service "N3.Index of patients" for January 2024 is already working in the Kemerovo and Leningrad regions, as well as in the Stavropol Territory.

2016: Presentation of the N3.Index of Patients System

In St. Petersburg, a system for identifying patients of medical institutions has been developed. "N3.Index of Patients" analyzes patient data coming from medical organizations and establishes links between records. As a result, the patient is correctly identified and an integrated electronic medical record is formed, which stores information about all requests for medical care from the patient to different institutions of the city. As of March 2016, the system is adapted to the processes of Russian health care and is capable of replacing foreign analogues.

The project was implemented by order of the Health Committee of the Administration of St. Petersburg. The developer of the system was Netrika, a company specializing in the development of IT solutions for government agencies.

In St. Petersburg, as in most regions of Russia, a large number of various information systems are used in medical institutions. Patient data in different systems differ in structure, volume, quality and content. When combining data from medical institutions to the regional level, it is necessary to be able to determine which patient the incoming record belongs to. There is a difficult task of global patient identification, without the solution of which the formation of an integrated electronic medical record is simply impossible. Solving the problem is complicated both by the limitations of software and by the human factor: errors often occur when entering data by the operator.

The classic patient identification scheme assumes the presence of a reliable source of information about the patient, available to all participants in information exchange. In Russian realities, it can be extremely difficult to determine such a source, and even more so to gain access to it.

The N3 Patient Index, developed by Netrika, allows you to determine with high accuracy the belonging of different records to one patient, even in the absence of a single publicly available data source.

The process of data movement and processing is carefully designed in this system. An entry in the local medical information system (MIS) appears about the patient who applied to the medical clinic. This data then goes to the N3.Zhealth service. The service evaluates data against several criteria using specialized algorithms. The result of the service is conditional "similarity scores," on the basis of which records about the patient's medical care are linked or divided. The service is able to distinguish namesakes, detects typos and errors that could have been made when entering data, prevents loss of information in case of human error, and stores a history of changes. In controversial cases, when information is insufficient, the decision will be made by the system operator, for which a user interface is provided.

The difference between Netrika's approach is that knowledge of patients is recorded exclusively to the extent necessary and sufficient to provide the service. There is no need to change the structure and content of data in local information systems. This significantly reduces the total cost of ownership for the region.

data management systems are widely used in healthcare projects around the world. "N3.Index Patients," developed by Netrika, is a Russian product that can replace foreign analogues and adapted to the processes of Russian healthcare, "said Denis Chumakov, head of Healthcare at Netrika. - This service can successfully work in Russian realities, when there is no single, common and reliable source of information about patients. The use of the service is not strictly limited to the industry, it can be used wherever you need to identify a person. "

When creating the regional patient index, the semantics of the FHIR standard was used - the international standard for healthcare, the most modern version of the industry standard HL7.

The service is scheduled to be launched in 2016.