A single digital circuit in healthcare based on Uniform State Health Information System

2020

Government cuts budget for single digital circuit in healthcare

The draft budget for 2021-2022 includes a reduction in the financial support of the federal project to create a single digital circuit in healthcare on the basis of a single state health information system (Uniform State Health Information System). This follows from the draft federal budget for 2021-2023 submitted by the government to the State Duma.

From the published documentation for the project, it follows that for 2021 for a single digital circuit in health care, a reduction in budgetary allocations is provided in relation to the previously pledged almost 10%, to about 12 billion rubles, for 2022 - also by 10%, to 12.9 billion rubles. And for 2023, compared to the financing provided in the project passport, the amount is 10% less - 9 billion rubles.

The draft federal budget until 2023 revised the allocations within the framework of the national project "Healthcare"

The downward revision of funding was preceded by a "shock" year: for the 2020th approved allocations for this project amounted to more than 40 billion rubles and about the same amount was allocated for subsidies for the implementation of regional projects to create a single digital circuit in health care based on the Uniform State Health Information System.

Now the draft federal budget provides for an approximately 10 percent decrease in the volume of subsidies to the regions in 2021-2022. For 2021, subsidies are laid in the amount of about 10 billion rubles, for 2022 - about 6.87 billion rubles, and for 2023 - about 4.82 billion rubles.

According to the plan, in 2020-2022, work should be carried out in the constituent entities of the Russian Federation to introduce state IT systems in the field of healthcare and connect all medical organizations of the regions to them, create centralized systems on their platform in order to ensure continuity of medical care, routing patients and monitoring the provision of medical care for certain profiles of diseases. The same is necessary for the organization of telemedicine consultations and automated dispatching of sanitary transport.

And by 2022, all constituent entities of the Russian Federation must introduce a system of electronic prescriptions and automated management of preferential drug provision.

It is expected that the connection to the Uniform State Health Information System of information systems of medical organizations and state information systems in the field of health of subjects will subsequently provide citizens with access to various services and services in the personal account of the patient "My Health" on a single portal of public services.

The project to create a single digital circuit based on Uniform State Health Information System was not the only one in the national project "Healthcare," which provides for a reduction in previously planned budget allocations. From the documents published to the draft budget, it follows that the reduction in financial support also affects, for example, the federal projects "Combating cardiovascular diseases" and "Development of children's health care, including the creation of a modern infrastructure for the provision of medical care for children."

At the same time, there is an increase in financial support for such a project as "Providing medical organizations of the health care system with qualified personnel."

Another 300 million rubles have been allocated for the revision of the Uniform State Health Information System in the regions

By the end of July 2020 Russia , the creation of a unified state information system () is being completed health care UNIFORM STATE HEALTH INFORMATION SYSTEM. Another 300 million was allocated for its rubles refinement in the regions.

As reported on the website of the Government of the Russian Federation, the Cabinet of Ministers approved the distribution of subsidies to the regions of the Russian Federation for 2020 to co-finance expenditure obligations related to the achievement of the results of the project "Creating a single digital circuit in healthcare based on Uniform State Health Information System" (part of the national project "Healthcare").

The government approved the distribution of subsidies to the regions for the Uniform State Health Information System project

The adoption of the draft order will allow the completion of work on concluded state contracts as part of the implementation of activities of regional Uniform State Health Information System projects in order to achieve the indicators and results of the federal Uniform State Health Information System project, according to the website of the Cabinet.^[1]

At a government meeting on July 24, 2020, Prime Minister Mikhail Mishustin noted that the creation of a single digital circuit based on Uniform State Health Information System would "reduce the paper load on doctors."

It will be easier for them to find records of patients, see the entire medical history. And visitors to medical institutions will have to wait less for an appointment, - he said the prime minister.

After signing the relevant order, funds in the amount of 300 million rubles will be distributed among 14 constituent entities of the Russian Federation. Which regions are in question is not specified.

According to Vademec, the costs of creating the Uniform State Health Information System by the end of July 2020 exceeded 40 billion rubles, but these funds were not enough to fully complete the project.

According to the passport of the federal project "Creation of a single digital circuit in healthcare based on Uniform State Health Information System," by the end of 2019, at least 80% of state and municipal medical institutions  had to use the Uniform State Health Information System subsystems. By the end of 2022, all 85 regions of Russia should be connected to the Uniform State Health Information System.

2019

Deputy Minister of Health E. Boyko at TAdviser SummIT - about the role of "numbers" in increasing life expectancy in Russia

Speaking at the TAdviser SummIT conference on May 29, 2019, Deputy Minister of Health Elena Boyko spoke about the digitalization of the industry with an emphasis on how it will affect all citizens. Citizens are the main asset of the nation, the deputy minister emphasized, adding that due to the demographic crisis of the 90s in Russia today there is a natural population decline. Most often, our citizens die from cardiovascular and oncological diseases.

Elena Boyko on TAdviser SummIT

Presidential Decree No. 204 is aimed at a strategic increase in the "main asset": in accordance with it, it is necessary to ensure a steady natural growth in the population of the Russian Federation and by 2030 to enter the "club of 80 + countries," i.e. those where life expectancy is more than 80 years.

Slide from the presentation of Elena Boyko

The decree involves a complete transformation of the health care system, and digital technologies will play one of the main roles in this. In 2019, in connection with the decree, the national project "Healthcare" was launched, which includes a set of mutually related measures divided into 8 federal projects. One of them is digital medicine.

Slide from the presentation of Elena Boyko

Elena Boyko spoke about the main issues that the organizers of information systems at various levels in health and participants of IT companies who will participate in the project should set for themselves. The questions are: where to treat, who will treat, how to treat and who will be treated? She considered in detail what was included in the solution of each issue, and what technological resources were created and will be created for this.

Slide from the presentation of Elena Boyko

For example, in terms of the availability of medical care, at the federal level there are registers of medical organizations and workers, information about them is displayed on the map, which allows you to make decisions and plan to attract additional resources.

One of the trends in health, the deputy minister called the use of medical robotics, including robotic assistants for various operations. In Russia today there are more than 30 such installations, Elena Boyko cited the data.

To the question of who will treat, Boyko pointed out the importance of training personnel, taking into account new technological realities.

To make a digital breakthrough in healthcare, we need people to connect physicians and IT professionals. These are specialized analysts who will be well versed in medicine, in medical processes and will be able to write appropriate programs, systems, and develop medical equipment, says Elena Boyko. - Therefore, today in almost all medical universities of the country new specialties appear.

Slide from the presentation of Elena Boyko

In the question "How to treat?" one of the most important elements is the accurate diagnosis and timeliness of medical care. For this, there are appropriate algorithms for each case, for each disease. The task is to digitize and integrate these algorithms with the medical systems of organizations, Boyko said.

Big data will accumulate as medical information is translated into a figure. Using machine learning technologies, new services can be built on their basis, says the deputy minister. We are talking, for example, about the diagnosis of diseases based on medical images. At the same time, it is important to determine how service developers will be able to receive this data.

Slide from the presentation of Elena Boyko

Speaking about the question, "Who to treat?," Boyko mentioned that all approaches in health care are aimed at moving from the trend of treating advanced diseases to their timely prevention. Various digital services will also be involved in communicating this idea to the population and helping them consciously lead a healthy lifestyle.

Slide from the presentation of Elena Boyko

Elena Boyko also noted that within the framework of the digital health project in the future of 3 years, the task is to introduce digital technologies into all structural divisions of medical organizations and ensure information exchange between organizations and interdepartmental exchange.

Slide from the presentation of Elena Boyko

О TAdviser SummIT

TAdviser SummIT was held in Moscow on May 29, 2019 and attracted more than 640 participants - heads and experts of IT divisions of the largest companies and government departments of Russia, representatives of IT developers and contractors. During the event, the prospects for digital transformation of business and government agencies, the development of technologies, products and services were discussed. More than 70 reports were made in the plenary part and five thematic sections. The event was held in 5 halls of the Sokolniki Holiday Inn.

Single Digital Loop Tasks

Deputy Minister of Health Elena Boyko in May 2019 in an interview with TAdviser said that the tasks of the federal project "Creating a single digital health care circuit based on Uniform State Health Information System" are much wider than its predecessor, the priority project "Electronic Health"^[2].

As part of the national project "Health" there are eight federal projects. They are devoted to the fight against the main diseases of the population - cardiovascular and oncological diseases, increasing the effectiveness of providing medical care to children, developing primary health care, preventing diseases, training medical personnel.

A Zyfra Path is a project that provides a project. It is not only about public services and IT infrastructure. Its results are a tool for implementing the rest of the federal health projects.

For the constituent entities of the Russian Federation, the largest tasks are: restructuring of regional health care processes, interdepartmental interaction, the development of medical information systems, their implementation in all structural divisions of medical organizations, connection to centralized regional systems and Uniform State Health Information System, training of medical workers, as well as the development of IT infrastructure - these are data centers, computers, secure channels, etc. The Ministry of Digital Development connects paramedic points to the Internet at the expense of the budget of the national program "Digital Economy."

OBJECTIVE: To improve the efficiency of the health care system by creating mechanisms for interaction between medical organizations based on the Uniform State Health Information System and the introduction of digital technologies and platform solutions, innovative medical technologies, including an early diagnosis system and remote monitoring of patient health until 2024, forming a single digital health care circuit to ensure measures aimed at reducing the mortality of the working-age population, from diseases of the circulatory system, neoplasms, infant mortality.

Digital Health Circuit Totality

• ICT infrastructure
• Medical Information Systems of Medical Organizations
• State Information Systems of the Constituent Entities of the Russian
• UNIFORM STATE HEALTH INFORMATION SYSTEM

Budget

For the implementation of the project for six years, about 107 billion rubles are provided from the federal budget plus co-financing of the constituent entities of the Russian Federation. For the first three years of the project, 70% of the indicated amount was laid.

Most of the funds are intended for the implementation of measures in the constituent entities, the federal part is the development of the Uniform State Health Information System, the competence center, as well as for federal institutions. Out of 107 billion, 81 billion rubles are provided for the subjects.

Expected indicators

End-to-end technology needs for digital health circuit projects

White Paper: Digital Economy End-to-End Technologies

List of end-to-end technologies (PTs) - basic set:

• Big Data
• Neurotechnology and Artificial Intelligence
• Distributed Registry Technologies
• Quantum technologies
• Industrial Internet/Internet of Things
• Wireless Technologies
• Virtual and augmented reality technologies

What needs to be determined to decide on the use of PTs and ensure effective government support?

• Generalized consumer characteristics of CTs and solutions based on them;
• Feasibility of using a specific PT, including together with other PTs to create synergies and breakthrough effect;
• Level of industry/nosological need in each CT and possible state support for its development and implementation

Cross-cutting technology (end-to-end technology, hereinafter referred to as ST) is a key scientific and technical/technological/technical solution, the implementation of which provides a breakthrough, changing rule of play, improving the position of a sector or sector of the economy in the established industry (sector) of the economy

2018

http://portal.egisz.rosminzdrav.ru

Results of the federal project Digital Health Circuit

Medical Information Systems Basic Functionality

Organization of functioning of the Digital Health Circuit

Notes