It has become easier for residents of Kalmykia to get medical care

2023: Increasing the availability of an appointment with a doctor through the Gosuslugi portal

It has become easier for residents of Kalmykia to receive medical care - in a few months the share of successful appointments for a doctor's appointment on the Public services portal has doubled. Behind this result is the large-scale work of medical organizations, a medical information and analytical center (MIAC) and the Ministry of Health of the Republic of Kalmykia, as well as vendors working in the region. Netrika Medicine announced this on November 30, 2023.

At the end of September 2023, Kalmykia topped the daily rating of regions, which is within the framework of the federal "Incident 38" of the Russian Ministry of Health. In the monthly rating, which fixes the state of affairs in mid-October, the region entered the top five. Ratings for "Incident 38" are formed on the basis of the number of successful appointments for medical appointments and data on errors encountered by users of the corresponding service of the Unified Portal of Public Services.

At the beginning of 2023, the situation was different: less than half of the attempts to sign up were successful, and the region was in the eighth ten of the rating. The Ministry of Health of the Republic of Kalmykia and the republican MIAC undertook to correct the situation, involving the teams "Netrika Medicine" and "SAMSON Group" in the joint work.

The work began with the definition and analysis of the main errors, due to which residents of the republic could not make an appointment with a doctor on the State Public services portal. Thus, most of the errors were associated with the attachment of patients to medical organizations. After all, in order to record a specific person in the necessary medical organization, it is necessary at the regional level to ensure the availability of up-to-date data from the territorial compulsory medical insurance fund (TFCMI).

TFCMI services are not directly related to the composition of the GIZZ and are located in their own secure network. At certain points (for example, during preventive work), they may not be available for regional services accessing to verify patient attachment data. Another reason for such mistakes is that many residents of the republic attach themselves to medical organizations in other regions, where they go to study or work and, returning to the republic for the weekend or stay, cannot receive medical care under their old policy.

The solution proposed by the specialists of Netrika Medicine helped to eliminate these problems. Inside the protected digital circuit of the region, a caching service was created, similar to the TFCMI service. The service contains information about attachments in the minimum requirements and allows you to regularly update information. The appointment service for a doctor's appointment switches to it if the TFCMI information system is unavailable. If it turns out that the patient is attached in another region, the service offers him to enroll in an emergency room specially created in the Elista City Polyclinic. Thus, the patient in any case can get an appointment and get help from a doctor.

The tasks and challenges of the management organizers health care related to Incident 38 are familiar to us, because we cooperate with many regions and vendors in this area. For most typical situations, best practices have already been developed that correspond to both federal methodological recommendations for organizing an appointment with a doctor and the interests of patients, "said Pavel Suchkov, Development Manager of Netrika Medicine." Together with our colleagues, we took part in most of the meetings on Incident 38, organized at the regional level, offered our ideas and solutions. It is nice that most of the proposals were heard and that our joint work brought such high results.

Another important factor that helped change the situation in the region was the launch of analytical reporting forms created specifically for Incident 38. This software solution collects data on errors encountered by residents of the region when making an appointment with a doctor through the State Public services portal. In the reports generated and configured by the Netrika Medicine team on the basis of the N3.Analitika service, you can see and analyze both technical errors (for example, the number of errors in each medical organization, according to each method of the appointment service) and identify organizational complex problems.

Organizational errors include, first of all, the lack of a schedule and free coupons for the next 14 days. The reason may be the appointment schedule incorrectly added to the system or the lack of doctors of the desired specialty in a specific medical organization. Based on data on organizational errors in the region, the necessary management decisions are made to increase the availability of primary health care.

Analytics for us is an important tool that performed well when working with Incident 38. We track information on all errors on analytical panels, on all indicators we form a rating of medical organizations to identify leaders and laggards in order to better understand the priorities of joint work. These data help to optimally allocate resources and specifically work out the most acute issues, - said the Minister of Health of the Republic of Kalmykia Bulat Saraev, - Systematic work is bearing fruit, as evidenced not only by good positions in federal ratings, but also by an increase in patient satisfaction with the doctor's appointment service through the Public services portal. Our cooperation with colleagues from St. Petersburg, including on the federal "Incident 38," allows us to make medical care for residents of Kalmykia more accessible, and the path to it is more convenient and easier.

2021: Opening an entry for vaccination against COVID-19 on the official republican portal

From January 14, 2021, an entry for vaccination against COVID-19 became available in the Republic of Kalmykia. Residents of the region can receive a coupon on the official republican portal for an appointment with a doctor (kalmdoctor.ru). This was announced on January 15, 2021 by the Netrika company.

Until January 31, 2021, the Ministry of Health, together with the Ministry of Digital Science, on behalf of Deputy Prime Minister Dmitry Chernyshenko, implements a service for recording citizens for vaccination against coronavirus through the Unified Portal of Public Services. For this, all constituent entities of the Russian Federation need to ensure interaction with the Unified State Health Information System.

The Republic of Kalmykia was among the first to fulfill this task and opened an online record for vaccination against coronavirus for residents. From January 14, 2021, the service was launched in pilot mode in the Sarpinsky district, then it was launched in all medical organizations in the region. Residents can queue up for vaccination by entering their personal account on the appointment portal. The service is available to authorized users with a confirmed Unified Identification and Authentication System (ESIA) account.

To create a GIZZ of the region, we chose an integration approach. This means that the state medical institutions of the Republic are already connected to the regional subsystem of admission to the doctor, and all the necessary information is provided to the federal services of the Uniform State Health Information System and to the portal of Public services. Due to this, we managed to provide this electronic service for registering for vaccination in a short time - technical work took only four days, - notes Natyrov Badma Alexandrovich, head of the budgetary institution of the Republic of Kalmykia "Medical Information and Analytical Center."

In a pandemic, ensuring the technical ability to sign up for vaccination against coronavirus online requires efficiency from development companies. In the near future, the electronic service will be implemented in all regions where the N3 service works. Book an appointment with a doctor, "says Andrei Dyukov, Deputy Head of the Sales and Development Department of Healthcare of Netrika Group of Companies.

2016: Creation of a single integration bus for healthcare

In September 2016, it became known that a single integration bus for healthcare was created in the Republic of Kalmykia.

The modernization of the regional segment of the Unified State Information System in the field of health care in Kalmykia was carried out on the basis of the integration platform "N3. Healthcare" of the St. Petersburg developer "Netrika."

The project to modernize a single regional MIS was launched in Kalmykia in 2016 in connection with the emergence of new requirements for the system: in terms of integration with federal services, work with medical organizations in conditions of end-to-end automation, and the implementation of new functional needs of the LPU.

At the time of the start of the project in the Republic of Kalmykia, 24 medical institutions were already operating with the medical information system of the region. The IIA, introduced as part of the modernization programme in 2012, has been unaccompanied and updated for several years, making its further development difficult.

The developer was tasked with the phased modernization of the MIS without restricting citizens' access to services provided in electronic form - for example, a remote appointment with a doctor through the portal kalmdoctor.ru. It was also necessary to ensure integration with the federal service of electronic registration and the portal of public services.

"The fundamental requirement on our part was to ensure the uninterrupted operation of the remote appointment service for a doctor's appointment," said Badma Natyrov, head of the MIAC of the Republic of Kalmykia. - The developers of Netrika have fully fulfilled our requirements. The very next day after the update of the MIS in the "City Polyclinic" Elista, up-to-date information about free coupons and the schedule of specialists was available on the kalmdoctor.ru portal, the appointment for a doctor's appointment in electronic form was not interrupted. "

The Republic of Kalmykia is the tenth region of Russia in which the regional segment of the Uniform State Health Information System is built on the basis of the N3. Healthcare platform.

"We were able to deploy the platform and connect pilot institutions to it in an extremely short time - the implementation took less than 10 days. The developed methodology and the availability of ready-made integrations with more than 20 different IIAs allow us to quickly create working solutions with minimal interference in working processes, "comments Andrey Dyukov, Key Account Manager at Netrika.

According to Netrika experts, the phased approach to modernizing MIS, successfully applied in the Republic of Kalmykia, may be in demand in other regions: during the transition period, data exchange between the old and new MIS takes place through a regional integration bus.

"The integration approach to health informatization is more stable in the long term, reduces the dependence of the region on one IIA provider. Also, the integration approach with the creation of a data exchange bus corresponds to new methodological recommendations for ensuring the functionality of regional medical information systems (RMIS) from the 28.06.2016 of the Ministry of Health of the Russian Federation, "emphasizes Andrei Dyukov

See also

• Uniform State Health Information System (recommendations of the Ministry of Health on the creation of regional medical information systems, RMIS)