Karelian Medical Information System (KMIS)

The Karelian Medical Information System (KMIS) is urged to increase first of all quality and availability of medical services. Today maintaining documentation takes away too much time from the doctor: cards, directions, protocols, statements, registration forms and so forth. The offered software for medicine will allow to keep easily complete account of all rendered services, the made tests, the written-out recipes. Means of complex automation of medical institution the electronic out-patient map and the clinical record form, reports are formed and medical statistics is kept.

Circle of tasks

One of main objectives of implementation of KIIS is a creation of a common information space of health facilities that, in turn, allows to create the automated jobs of doctors, to organize work of department of medical statistics, to create databases, to conduct electronic stories of diseases and to integrate all medical, diagnostic, administrative, economic and financial processes in a whole. Automation of clinic or a hospital considerably simplifies a number of workflows and increases their efficiency. Control, accounting and planning in a single system as a result lead to improvement of working conditions and qualities of the provided services and also to improving competitiveness of health facilities in the market.

Construct

Architecturally KIIS consists of over 60 software modules (subsystems) united in the general medical information system. Are included in structure of KIIS as subsystems, universal for any health facilities, in which the most important functionality of KIIS, and separate modules for automation of clinic, a hospital, etc. is concentrated. Work of large multi-profile medical institutions will be organized due to sharing of all (or parts) these modules. Among basic functions of KIIS there is a maintaining the electronic clinical record and out-patient map, automation of diagnostic divisions, conducting medical document flow, accounting of temporary disability, medical examination, prof surveys, vaccinal prevention, automation of laboratory, statistical and financial accounting, automation of drugstores with system implementation of the personified accounting of medicines, automation of DLO.

Properties

KIIS has a number of unique technologies: multiplatformity, support of work in clusters, support of a multiserver architecture, a connectivity of an unlimited number of branches and remote offices of general practitioners, a possibility of off-line of access, the most powerful security subsystem, integration with any sources and receivers of data (integration with external information systems).

Environment

As a development environment and functioning the IBM Lotus Notes/Domino and the Microsoft SQL Server are used. As tools of programmers IBM Lotus Notes Designer, CodeGear Delphi, Eclipse and Java are used.

FSTEC certificate

The procedure of certification KIIS on compliance to requirements of FZ-152 "About personal data", including compliance to requirements of Regulating documents of FSTEC (State Technical Commission) of Russia is complete: "Information technology security. Criteria for evaluation of information technology security" (State Technical Commission of Russia, 2002) on the OUD 2 level, and "Protection against unauthorized access to information. Part 1. Information security software. Classification by the level of absence control of not declared opportunities" (State Technical Commission of Russia, 1999) on the 4th level of control (NDV 4). During certification the assessment of a possibility of use of KIIS in automated systems to a class of security 1G inclusive and for data protection in personal data information systems to the 1st class inclusive was carried out. Based on assessment and examination of results of the assessment which is carried out by GNIII PTZI of FSTEC of Russia the positive conclusion is issued.

Fund of the replicated information systems of the electronic governments of the subjects of the Russian Federation and electronic municipalities

The "End-to-end Medical Information Systems" company announced in May, 2012 carrying out successful expert evaluation and testing of the main flagship software product for automation of health facilities in Federal State Unitary Enterprise VNIIPVTI and state registration in Fund of the replicated information systems of the electronic governments of the subjects of the Russian Federation and electronic municipalities.

Expert evaluation and testing of KIIS were directed for confirmation of conformity of the functions and tasks implemented in a system, to regulatory, technical, functional and economic requirements taking into account the generalized criteria stated in Provisional regulations for Fonda and the Demonstration test stand of the replicated information systems of the electronic governments of territorial subjects of the Russian Federation and electronic municipalities and also state standard specifications for making decision on registration of a System in the Register of Fund. To perform work on expert evaluation and system testing the working group of experts and technical specialists of the structure of Expert advice of Fund was created.

Based on examination compliance of KIIS to all main existing orders of the Ministry of Health and Social Development and Federal Compulsory Health Insurance Fund, including "The concept of creation of Uniform State Health Information System" is confirmed, to the Order of Federal Compulsory Health Insurance Fund No. 79, etc. Among other regulatory legal acts, on compliance to which experts estimated a system, we will note the following:

• Order No. 1030 10/1/1980 "About the statement of forms of primary medical documentation of health facilities"
• Order of the Ministry of Health and Social Development No. 624n of 6/29/2011 "About the statement of an order of issue of leaves of disability"
• Order of the Ministry of Health and Social Development of the Russian Federation No. 347n of April 26, 2011. "About the statement of a form of the form of a leaf of disability"
• The order of Federal Compulsory Health Insurance Fund No. 97 of 5/8/2009 "About the statement of the Order of the organization of carrying out by territorial funds of compulsory health insurance of interterritorial calculations for the medical care provided to citizens in the Russian Federation out of the territory of insurance by the types included in the basic program of compulsory health insurance"
• Order of the Ministry of Health and Social Development of the Russian Federation No. 782n of December 26, 2008. "About a statement and an order of maintaining medical documentation; certifying cases of the birth and death"
• Order No. 256 (edition No. 794 of 12/24/2007) "About an order of medical selection and the direction of patients on sanatorium treatment"
• Order No. 170 3/14/2007 "About the organization of activity of the medical commission of the medical organization"
• Order No. 110 "About an order of appointment and invoicing of medicines, products of medical appointment and specialized products of clinical nutrition"
• Order No. 77 1/31/2007 "About the statement of a form of the direction for medico-social examination by the organization rendering the treatment-and-prophylactic help"
• Order No. 413 of 12/30/2002 "About the approval of accounting and reporting medical documentation"
• Order No. 154 5/21/2002 "About introduction of a form of accounting of kliniko-expert work in treatment and prevention facilities"
• Order No. 241 8/7/1998 "About improvement of the medical documentation certifying cases of the birth and death in connection with transition to MKB-10"

Besides, as a result of tested experts of fund confirmed that:

• Are included in structure of KIIS as subsystems, universal for any health facilities, in which the most important functionality of KIIS, and separate modules for automation of clinic, a hospital, etc. is concentrated.
• KIIS has a number of unique technologies: multiplatformity, support of work in clusters, support of a multiserver architecture, a connectivity of an unlimited number of branches and remote offices of general practitioners, a possibility of off-line of access, the most powerful security subsystem, integration with any sources and receivers of data (integration with external information systems).
• A system is certified to class 1G inclusive and for data protection in personal data information systems to the 1st class inclusive. Based on assessment and examination of results of the assessment which is carried out by GNIII PTZI of FSTEC of Russia the positive conclusion is issued. As a result of this work the KMIS company received the FSTEC certificate about compliance of "The Karelian medical information system" to requirements of FZ-152 "About personal data" (certificate No. 2307, is issued on March 29, 2011, valid till March 29, 2014).
• KIIS completely supports cloud computing, including can be used as the centralized regional system "from a cloud".
• KIIS supports work in hardware thin clients.
• KIIS supports all fundamental industry standards, including HL7.
• Flexible terms of use of a system, including classical delivery of licenses, delivery of the general license for the region and also the implementing solutions KMIS according to the SaaS model are provided.
• KIIS actively supports Open Source. In particular, a system supports operation of servers and workstations of users running Linux and also free export of any reports to the ODF format.
• KIIS supports integration about SIEI.
• The database of a system can be implemented (is unrolled) both at the level of health facilities, and at the level of the region (DPC the Region or DPC of JSC Rostelecom).
• In a System electronic services with implementation of provision of services via the Portal are implemented.
• The staff of treatment and prevention facilities, citizens, authorized bodies of health care, Federal Compulsory Health Insurance Fund, insurance companies and drugstores can act as users of a System.

The overall settlement rating of a system in general was 99.39 points that is extremely high rate. At the same time it was tested more than 130 parameters (metrics) on all components of assessment. Assessment of different objects and system performance was carried out on the basis of GOST P ISO/IEC 9126-93, including the analysis of functionality, reliability, practicality, efficiency, a soprovozhdayemost, mobility, etc.

Results of stress testing unambiguously confirmed that at simultaneous operation of 1,000 users the program works comfortably.

Besides, the system economical legal treatment was confirmed, including the status of the owner of a system is confirmed.

Based on testing by specialists of Federal State Unitary Enterprise VNIIPVTI the relevant positive decision on the basis of which a system was registered in the Register of Fund was issued. Registration number of the certificate in the register of fund - 86 2214 0022 of May 10, 2012.

List of functionality KIIS

Registry (accident ward)

Features:

• The automated export of information on the attached contingent from other information systems (for example, a compulsory health insurance DB)
• Possibility of registration of the patient.
• Detailed accounting of passport data, residences (using KLADR), work locations (study), etc.
• Possibility of the automated creation of the electronic out-patient map or the clinical record, the coupon of the ambulatory patient and the medical record who left a hospital.
• Possibility of printout of these documents.
• Possibility of flexible configuration of a printed form of these documents, including possibility of creation in health facilities of own options of printed forms of any documents.
• The automated record on acceptances of specialists or in offices of diagnostic service.
• Accounting of failures from hospitalization.
• Accounting of exempts and disabled people. The automated maintaining the register of the exempts and disabled people assigned to health facilities.
• Possibility of introduction of policies of compulsory health insurance, VHI, agreements on service.
• Possibility of introduction of identity documents.
• Possibility of introduction of special marks (the VIP-person, Ministry of Internal Affairs/FSB, etc. is searched)
• Possibility of introduction of information on storage location of the out-patient card (in registry, on the patient's hands, etc.)

Electronic Medical Record (EMR)

Features:

• Maintaining the electronic medical record, including the electronic clinical record (ECR) and the electronic out-patient map (EOPC).
• Automation of introduction of diary entries of the doctor due to use of templates of surveys.
• Possibility of an execution of specialized documents of surveys or possibility of their creation by forces of own IT personnel.
• Automation of drawing up secondary documentation (epikriza, statements)
• Reuse of personal medical data of the patient from archive of clinical records or the out-patient card.
• Possibility of accomplishment of all necessary medical and diagnostic appointments directly from the clinical record or the out-patient card.
• Reduction of routine operations on execution of documentation. For example – automatic filling of passport data and data on the policy of compulsory health insurance in any EIB and EAK, automatic formation of the sheet of final diagnoses, the statistical coupon, card which left a hospital the sheet of beam loading.
• Quick access to archives of documents of the patient, including – to archives of results of diagnostic testings, including archives of graphics images of radiodiagnosis or the video images registered at endoscopic researches.
• Support of the most widespread medical specialties: therapy, cardiology, pulmonology, gastroenterology, surgery, gynecology, stomatology, urology, ophthalmology, etc.
• Possibility of automation of advisory acceptance about use of the magazine of record on consultation, maintaining calendars of acceptance of consultants and a design of the directions on consultation directly from EAK and EIB.
• Possibility of maintaining personal calendar of appointment.
• Opportunity for work with personal e-mail.

Some electronic documents specific to a hospital:

• Clinical record.
• The card left a hospital.
• Sheet of appointments.
• Plan of treatment.
• Primary survey of the doctor.
• Diary entry.
• Preoperative epicrisis.
• Protocol of transaction.
• Protocols of small surgical interventions and blockade.
• Preoperative survey of the anesthesiologist.
• Protocol of an anesteziologichesky benefit.

Some electronic documents specific to clinic

• The finished case
• Primary survey of the doctor.
• Control survey of the doctor.
• Medical record.
• Sheet of final diagnoses.
• Sheet of vaccination.
• Sheet of beam loading.
• Coupon of the ambulatory patient.
• Representation on the medical commission.
• Epicrisis of the medical commission.
• The statement from the out-patient card.
• Quality evaluation of medical care.
• Recipe.
• Sick-list.

Diagnostic service

Features:

• Maintaining the reference book of possible diagnostic testings in health facilities.
• Automated system of record on diagnostic testings (calendars of offices).
• Possibility of entering of results of diagnostic testings into EAK and EIB.
• Support of document templates with results of diagnostics for the purpose of reduction of labor costs of medical employees when entering these results into a DB.
• Support of a possibility of archiving of images, including results of radiodiagnosis or a video.
• Support of the most widespread types of diagnostic testings: ECG, daily monitoring of the ECG, VEM, spirometry, electroencephalography, ekhoentsefaloskopiya, ultrasonography, fluorography, roentgenography, roentgenoscopy, tomography, angiography, fibrogastroduodenoskopiya, proctosigmoidoscope. Possibility of development by IT personnel of health facilities of own document forms of diagnostics.
• Possibility of introduction of marks about a payment method of diagnostic testing (for a fee, compulsory health insurance, VHI, under agreements, for the budget).
• Possibility of sharing of the medical equipment used in diagnostic service with MIS.
• The automated formation of statistics on results of work, including a possibility of report generation about loading.
• Automatic maintaining magazines of department of functional diagnostics, department of radiodiagnosis and department of endoscopic diagnostics.
• Automatic calculation of loading for the executed conventional units of work (CUW).

Laboratory

Features:

• Maintaining the reference book of possible laboratory researches in these health facilities with a possibility of change of the list of available researches, the applied units of measure and reference values. A possibility of planning of load of laboratory using limits of admissible appointments in laboratory (but taking into account an opportunity to execute appointment of CITO).
• Support of the most widespread types of laboratory researches: clinical blood test, biochemical blood test, immunofermental blood test, blood test on microreaction, blood test to electrolytes, hemostasis indicators, the analysis a calla, the analysis of urine, a cytologic research, the analysis of a phlegm, the analysis of dab, the analysis of pro-static contents, an eyakulyat research, the analysis of sinovialny liquid, etc.
• An opportunity to execute purposes of laboratory researches from any workplace of health facilities.
• Automation of work of staff of laboratory due to formation of work plans on laboratories and types of researches.
• Connectivity of the automated laboratory analyzers.
• Possibility of automatic maintaining magazines of work of laboratory.
• Possibility of automatic formation of marks about mismatch of the specific measured parameter to the set reference values.
• Intra laboratory quality control.
• Possibility of introduction of marks about a payment method of diagnostic testing (for a fee, compulsory health insurance, VHI, under agreements, for the budget).
• Possibility of statistical processing of results of work of laboratory.

Kliniko-ekspertnaya work

Features:

• The automated accounting of kliniko-expert work, including the electronic directions on the medical commission and the protocol of work of kliniko-commission of experts (on the basis of form No. 035/u-02 and the instruction for its filling).
• Representation on the medical commission.
• Protocol of the medical commission.
• The direction for medico-social examination (Form N 088/u-06, the Order of the Ministry of Health and Social Development No. 77 of 1/31/2007).
• Return coupon of ITU (Form N 088/u-06, Order of the Ministry of Health and Social Development No. 77 of 1/31/2007).
• Conclusion of kliniko-commission of experts.
• The medical certificate about damages of health at an occupational accident.
• Act of a research of the state of health.
• Protocol of quality evaluation of medical care.
• Magazine of work of kliniko-commission of experts (Form No. 035/u-02).
• Close integration with statistics subsystem.

Department of physical therapy

Features:

• Maintaining the reference book of possible medical manipulations in health facilities.
• The automated accomplishment of medical appointments.
• Opportunity introduction of marks about accomplishment of medical appointments as doctors and nurses of the relevant services.
• Support of the most widespread types of medical appointments: LFK, massage, acupuncture, manual therapy, electrophototherapy, etc.
• Possibility of introduction of marks about a payment method of diagnostic testing (for a fee, compulsory health insurance, VHI, under agreements, for the budget).
• Possibility of statistical data processing about accomplishment of medical appointments.
• Automatic calculation of loading for the executed conventional units of work (CUW).

Electronic calendars

Features:

• The automated maintaining the schedule of work of doctors and nurses of health facilities.
• Record of patients on appointments, inspection and treatment using electronic checks.
• Built-in system of accounting of function of a medical position, loading.
• Automatic reporting preparation on accomplishment of function of a medical position.
• The built-in system of limits, access restrictions, etc. for flexible configuration of the calendar under specific features of work of an office.
• Flexible functions of individual preference of the calendar for each user, including setup of display of checks, visible fields in calendar "grid", etc.
• The built-in function of the statistical recording of information on the directed doctor (health facilities, department).
• Close integration with a subsystem of statistics of KIIS.

Advisory service

Features:

• The protocol for appointment to the patient of consultation of the doctor.
• The integration of electronic Consultation with electronic calendars of KIIS allowing to select at once at purpose of consultation the most convenient time of consultation and the necessary specialist doctor.
• The automated maintaining the electronic journal of consultations.
• Close integration with a subsystem of statistics of KIIS for accounting of loading, automatic accounting of the diseases revealed by the doctor-consultants in form 12, etc.
• Possibility of introduction of marks about a payment method of diagnostic testing (for a fee, compulsory health insurance, VHI, under agreements, for the budget).

Accounting of temporary disability

Features:

• Maintaining electronic "Sick-list"
• Possibility of automation of the centralized statement of sick-lists
• Automatic maintaining LVN magazine
• The automated control of correctness of introduction of information on a time netrudosposbnost
• Close integration with a subsystem of statistics of KIIS, including automatic filling of form 16-BH
• Automatic citing information on temporary disability when filling different secondary medical documentation (statements, epikriza, the directions in other health facilities, etc.)
• Integration with a subsystem of quality control and automation of kliniko-commission of experts

Statistics

Features:

• Statistical processing of any electronic documents registered in a system.
• Statistical processing of any parameters (fields) registered in the document.
• Possibility of creation of selections of a DB of statistics on any documents and on any combinations of fields from these documents.
• Formation of standard state statistical reporting, for example – forms 16BH, forms 12, 57, 63, etc.
• Possibility of development by forces of IT personnel of health facilities of own statistic reports or modifications which are already available in a system.
• Possibility of creation of charts.
• Possibility of export of results of statistic reports to the documents Microsoft Office (Word and Excel), OpenOffice, PDF, JPEG. A possibility of reports generation in the Microsoft Office or OpenOffice formats without existence of these packets on user workstation.
• Possibility of export of reports and/or primary statistical information in external data files (DBF, DB, XML, etc.)
• Ability to integrate with third-party information systems, including integration with the regional information resources (RIR), the systems of level MIAC, RIAMS, etc.

Reference books

Features:

• Ready MKB-10 for use in coding of diagnoses.
• Ready KLADR for coding of the addresses, including data about over 181 thousand localities across all territory of the Russian Federation and over 743 thousand records about streets (with updating).
• The ready reference book "Register of Medicines" (RM) for accounting of medicines and the statement of recipes, including detailed data on medicines, dietary supplements and supplies (over 112 thousand names).
• Reference book MESOV, ready to work (medico-economic standards) containing data about over 64 thousand MESOV.
• The reference book of document templates, ready to work, for simplification and acceleration of filling of medical documents numbering over 3 thousand ready templates of protocols of inspection, surveys of doctors, protocols of surgical interventions and separate phrases.
• Possibility of maintaining own reference books, including reference books of the enterprises, resources of health facilities, personnel, the executed medical services, etc.
• Possibility of modification of the reference books provided in MIS.
• Possibility of creation of own reference books.
• The open reference book of health facilities, including the reference book of organizations, departments, sections, doctors, medical documents, etc.
• Possibility of the automated import and filling of reference books of KIIS from legacy DB.

Financial and economic system

Features:

• Calculations for compulsory health insurance.
• Calculations for VHI.
• Conducting paid services.
• Export of information on the executed services to external information systems.
• Import of information on the executed services from other information systems.
• Automation of formation of accounting calculations.
• Reporting.

Automation of service of a power supply

Main Features:

• Accounting of the appointed diets.
• Accumulation all appointed a diet and an additional power supply directly from electronic clinical records of patients in a uniform DB.
• Accounting of the additional contingent delivered on a power supply - for example, the staff of health facilities or third parties serviced under the contract or in cash.
• Inventory control.
• Automation of operations on accounting of arrival, expense and write-off of the food and other components used during the work of service of a power supply.
• The menu automated formations taking into account existence of products in a warehouse, the frequency and a variety of the ordered dishes, the quantities delivered on a power supply. The automated drawing up the menu layout and calculation, formation of other necessary documents.

Drugstore and drug treatment

Main Features:

• Maintaining reference books of medicines, warehouses, units of measure, etc.
• Accounting of the arriving medicines and supplies.
• Accounting of a consumption of medicines and other materials on health facilities, on divisions, on posts and on patients.
• Formation of all necessary reporting, including: turnover sheet, commodity report and many other things.
• Accomplishment of medical appointments taking into account availability of necessary medicines in drugstore or in a warehouse of health facilities. Possibility of purpose of own medicine of the patient.
• Possibility of implementation of canceling, adjustment or reassignment of medicine.
• Support of work of nurses of a procedural office and nurses on point duty. Introduction of marks about accomplishment of medical appointments.
• Control of the course of accomplishment of appointments from doctors and administration.
• Possibility of viewing all appointments executed on this post or in a procedural office in department.

Automation of medical examinations and medical commission (MC)

Features:

• Support of any quantity of types of surveys, including prof survey by order of No. 90, to order No. 189.
• Support of any number of the enterprises of any structure.
• Possibility of automatic formation of lists of specialists and volume of inspections necessary for carrying out survey.
• Introduction and storage of data on acceptances of specialists, the conducted examinations, passings of KEK and MSEK for restriction on a principle place of employment, need of employment, establishment of group of disability. Safety of data at suspicions of prof intoxication and occupational diseases, at the directions on hospital, sanatorium treatment, etc.
• Formation of statistics, including creation and calculation of any statistic reports.

Automation of carrying out medical examination

Features:

• Possibility of maintaining the electronic card of the dispensary observation (DO), including storage of statistical information on the fact DN on a specific disease, possibility of introduction of information on the patient's appearance on DN, including fields for the description of the status, recommendations, etc.
• Automation of obtaining operational information about a status of DN, including a possibility of formation of lists which are on DN appointed to the near future of the appearances which did not be in time, not having any appearance within a year. A possibility of export to Microsoft Office (Word or Excel), OpenOffice, PDF, HTML or JPEG and printings of the received lists.
• Possibility of filtering of the lists which are on DN on doctors, nozologiya, work location, the status of the DN card on sections, by date of taking on DN (year, month, the period).
• Automatic formation of standard form 30/U for printout of the DN paper card.
• Communication with the sheet of final diagnoses – at change of the diagnosis of DN or adding new is automatically updated information in the sheet of final diagnoses.
• Automatic accumulation and calculation of all necessary statistical information, including form 12.
• Report generation about efficiency of DN in the RTF format (opens in Microsoft Office or OpenOffice)

Vaccinal prevention automation

Features:

• Accounting of the executed and planned inoculations in the form of the specialized section of EAK of the patient.
• Accounting of a chronological order of the executed inoculations.
• Information storage about a type of an inoculation, number and a series of inoculative material (vaccine), an execution order of vaccine, reaction, the employee who executed an inoculation, type of its introduction, etc.
• Automatic planning of vaccinal prevention using the saved-up database of results of already executed inoculations.
• Formation of lists of the patients who are subject to vaccination (plan of vaccination).
• Report generation about the volume of the performed work for use at expense analysis of vaccines and determination of load of medical personnel (form No. 5 and form No. 6).

Electronic flyuoroteka and Electronic sheet of beam loading

Features:

• Automatic maintaining "Sheet of beam loading".
• Accounting of documents of all types of radiological researches in the sheet of beam loading, including - fluorography, roentgenography, roentgenoscopy, a tomography, mammography, intervention interventions.
• Automatic information storage about beam load of the patient in a year and during his life, given about researches in a year, marks about the executed fluorography.
• Automatic calculation of total beam load of the patient within a year.
• Automatic drawing up plans for fluorographic inspection with formation of lists of patients.
• Possibility of viewing the list on the screen or export to Microsoft Office, OpenOffice, PDF, HTML or JPEG.

Automation of calls of the doctor on the house

Features:

• Registration of citizens' appeals (calls of the doctor on the house);
• Possibility of fast navigation on different data views about the registered calls on the house: today's calls on registration time (the calendar of calls), today's calls by codes of doctors, the complete list of not serviced calls on work location, surnames of the patient, to registration dates, etc.
• Possibility of introduction of information on the serviced call.
• Possibility of automatic formation of a static load on the serviced calls (to become. coupons).
• Possibility of the placement of documents of calls for the house to EAK of patients.

Support of the additional provision of medicines (APM)

Features:

• Possibility of the automated filling of the reference book of the medicines prescribed on the DLO system.
• Possibility of automatic introduction of information on Insurance Numbers of Individual Ledger Account and privileges on the attached contingent.
• Possibility of formation of the preferential recipe in the automatic mode (simplification of creation of the document of the recipe, decrease in errors at its filling).
• Recipe printability on the typographical form (printing of data).
• Possibility of production of recipes with a barcode.
• Possibility of the centralized number generation of recipes at their statement with a barcode.
• Possibility of automatic maintaining the magazine of the written-out preferential recipes.
• Possibility of statistical information processing about the written-out preferential recipes, including export of the register.
• Possibility of communication with drugstores in respect of obtaining information on an available LAN in pharmaceutical institutions and about the redeemed preferential recipes.

Management subsystem of health facilities

Features:

• Automatic formation of operational daily reports and reports for work of health facilities
• The report "The daily report on hospital.
• Report on watch
• The daily report on department
• Report on the movement on departments (form 007)
• Formation of "Passport of a hospital"
• Formation of "Passport of clinic".

Office-work support

Features:

• Automation of personnel department.
• Automation of internal document flow.
• Accounting of accounts.
• An opportunity to unroll the internal or external web portal (own website of health facilities) in health facilities.
• Use of means of group work.
• Built-in e-mail.
• Embedded database with the medical legislation.
• Medical library.

"Cloud" edition of the medical information system

Cloud computing – actively developed direction in the world IT industry. Due to the emergence of potential interest from partners and customers of our company, K-MIS announces release of "cloud" edition of our medical information system.

"Cloud KIIS" is prepared with active support of specialists of IBM corporation. It allows to execute the centralized installation of a system in a "private" cloud and to connect to it an unlimited number of health facilities. In terms of functionality cloud edition of a system saved all functions of standard delivery of KIIS.

The "Cloud KIIS" based the special highly reliable and checked by time solutions of IBM is offered by us for implementation of regional projects of the most different level and complexity. "Cloud" KIIS allows to provide the following unique opportunities:

Cost reduction on the equipment (effective use of hardware resources)

• Virtualization – division of one physical system into sections;
• Simultaneous multithreading – work of independent MIS for each health facilities on one server;
• Dynamic redistribution of resources between sections according to current demands;
• Support of logical partitions thanks to which virtual servers KIIS for each health facilities can be separated into several independent sections each of which works running own copy of the operating system AIX, IBM I or Linux;
• Centralized operation

Cost reduction on engineering infrastructure (effective energy consumption)

• Power saving in comparison with classical decentralized options of delivery of KIIS;
• Energy management at the level of the processor;
• Decrease in energy consumption and heat release at the level of a system, i.e. cost reduction on the engineering systems

Cost reduction on the license software

• Significantly higher utilization of hardware resources (up to 80%), higher performance. As result – application at the level of the region of smaller number of physical processors, so – significantly smaller costs for the general-system licensed software;
• Support of Open Source, including an opportunity to use Linux as guest operating system of "cloud" of KIIS.

Cost reduction on implementation and service

• Reduction of time and costs for deployment and operation
• The ready-made set-up software solution for the organization of the "cloud" environment
• Automated management of deployment of images, applications and settings
• Management of service requests
• Built-in functions of monitoring
• Built-in functions of accounting of use and tariffings (billing system)
• The centralized installation of updates, setup and check of work
• Centralized system of automatic backup and recovery

The best performance, including

• IBM Lotus Notes/Domino platforms
• DB2 DBMS, etc.

The typical circuit of implementation of Cloud KIIS looks as follows:

• 1) If the large regional project, in which it is necessary to service much (50 and above), is planned by health facilities, then in such project creation of one general DPC is necessary for work of "a private cloud of MIS".
• 2) In each health facilities the infrastructure is created (networks, the PC, printers) and the communication channel from health facilities to DPC will be organized selected (it is desirable – optical) and also the alternative channel of communication is provided. This work does not differ from a normal problem of creation of infrastructure of objects (health facilities) behind the unique exception in any way – in health facilities there are no servers and storage systems for work of MIS.
• 3) In DPC the centralized stack of the server hardware and a storage system is established. In them special means for each health facilities create the "virtual" sections (servers) for service of a server part of MIS. In each such section the "virtual" KIIS drying only these health facilities functions. Due to separation of separate installations of KIIS reliable protection of medical and other data of health facilities against unauthorized access of other health facilities or other persons is reached (since security systems, authentications and recordings of access are completely isolated).

Except work as "cloud KIIS" in regional projects functioning of the selected virtual server for service of the regional information resource (RIR) is supposed. Since physically the RIR server is located in the DPC, data exchange between health facilities and RIR is performed as fast as possible and reliably. Also due to consolidation of virtual servers of health facilities in one DPC data exchange between health facilities is performed as fast as possible, and. owing to the fact that data transmission between health facilities through open channels) actually is absent protection against unauthorized interception of data significantly becomes simpler.

2016

Automatic data exchange with the laboratory Akross systems, Ariadna allowed customers to automate work of the laboratories completely. Integration with the system of the automated Call center of Medvoks company allowed to organize in the medical institutions using Electronic registry of the company, one more writing method to the doctor by phone. A system automatically offers available schedules of specialists and writes the patient for time selected by him, exchanging in real time all necessary information with Electronic registry.

The end-to-end KMIS medical system, changed "person". The appearance was simplified, control objects are changed, the color scheme and fonts are standardized. It in many respects allowed to accelerate an input of users in a system and work in it.

2013: KIIS 3.5

During 2008-2012 the company gradually developed a line of KIIS of version 3.3.x within which functionality of a system was improved, support of regulating documents and standards was provided, integration features and convenience of the user interface were added. In total 20 new versions of a system were during this time released.

Together with it in the company there was a full-time work on creation of the essential updated KMIS option which would support important technology innovations. The release of KIIS 3.5 means end of this research and development which formed the basis of the new version. Treat such changes: support of work with KIIS via the web browser (thin client); a full-fledged work of the KMIS server under control of a broad spectrum of operating systems, including UNIX Linux, AIX etc.; the improved cross-platform support of a client part; support of work on tablet computers; support of the new version IBM Notes/Domino of platform 9.0; support of work of KIIS running new program systems Microsoft, including work under management Microsoft Windows 2012 Server and Microsoft SQL Server 2012.

Besides, traditionally a system contains also a lot of functional improvements. Within work on adding of new functionality KIIS of version 3.5 includes 683 changes and additions, including a set of absolutely new features.

The final version of a cumulative service pack to KIIS of version 3.5 will arrive on the website of technical support service of the company in the nearest future and will be available to users and partners with the operating service of technical maintenance.

2011

KIIS 3.3.0.12

"The end-to-end medical information system" of version 3.3.0.12 includes 735 changes and additions, including:

• 18 absolutely new features, including several new subsystems
• 678 changes and additions of the existing KIIS functions.

Among the main changes and additions it is necessary to select the following:

• New subsystem of telemedicine
• New subsystem of transplantology
• Significantly the expanded and improved transfusiology subsystem
• The processed radiological information system (RIS) from the integration added by function with PACS servers and support of DICOM.
• The new additional KMIS application for system administrators – "The shift foreman of the name of health facilities"
• The new version of a financial and economic system with the improved interface, integration with a laboratory information system and the work of health facilities on the delivery of registers of compulsory health insurance in a format of the 79th order of FCMIF improved by support of paid services and a set of other useful changes and additions improved by support.
• Different new features for automation of hospitals – such as "Accounting of personal belongings" and "Accounting of telephone messages"
• New improved Drugstore
• The new version of Website of health facilities with function of the master of settings
• The new version a subsystem of accounting of services which allows to enter more quickly and conveniently information on the appointed and executed services has the improved module for introduction of this information (instead of the panel of coding of services applied earlier – PKU). The new version supports the centralized storage and quick access to information on all services appointed and executed to the patient on all payment methods. Also the expanded structure of accounting fields, more convenient representation and navigation according to information is provided in the new version. For example, storage of history of accomplishment of repeated services is supported now, there is an improved integration with a financial and economic system and the improved support of accounting of services in compulsory health insurance and also many other things.
• New version of "Sheet of appointments"
• The new opportunities for work of the traumatologist-orthopedist allowing to execute integrated assessment of functions of shoulder and coxofemoral joints after changes and operational treatment, having the built-in calculators which are automatically calculating score from normal
• New feature the "Change of types of payments" in "The passport of a hospital" allowing to change a financing source of the patients who are on treatment for the purpose of increase in cost efficiency of the rendered medical services.
• The advanced laboratory information system (LIS) to which the set of the new features which are generally directed to increase in convenience of work with a PIM is added. One of the most important functions is the improved barcoding support and also close integration with a financial and economic system.

A number of significant completions in "Fast statistics" (Faststat).

• The different improvements and completions in a medical examination subsystem which are generally concentrated on increase in convenience of work and completeness of medical documentation on dispensary work.
• Set of improvements and completions of a subsystem of prof survey in which it is included a number of completions of "The card of prof survey" and the new document "Passport of Health".
• The improved work of function of accounting of transfers between departments of a hospital, including for the purpose of simplification of work of users of this function and also to improvement of an accounting part in respect of formation of registers on payment on compulsory health insurance.
• The new reference book of radar station and change in documents of surveys of doctors and Recipe executed in connection with processing of radar station. Now work with the reference book of radar station and also the statement of recipes of steel even more clear and simplified.
• Completions of "The passport of clinic" and "The passport of a hospital" and also some other the KIIS magazines (the magazine of hospitalization, the magazine of statistic reports, the magazine of calls on the house, magazines of diagnostic service, etc.).
• The most various planned completions and corrections in the electronic medical record of the patient.
• Set of completions and improvements in printed forms of documents.
• Integration with Electronic registry of version 2.3 which will be released by separate release later it is probable – until the end of October, 2012.
• Integration with "A regional information resource of KIIS" of version 1.2 which will also be released by separate release until the end of October, 2012.
• Significantly the improved support of work of a client part of KIIS running Linux and Mac OS X.
• Support of work with KIIS on tablet computers under management Apple iOS/Android 27. Corrections of the found errors. Now a cumulative packet of KIIS 3.3.0.12 already access to the limited list of business partners and customers of the company on the website of technical support service. In the nearest future the packet will become available to all registered users and partners having the operating subscription to new versions of software KIIS.

The next version of "The Karelian medical information system" will support a full-fledged opportunity for work of users via the web browser (thin client). Recently the K-MIS Company received the large volume of requests from customers and partners of the company who were connected with the need to ensure a full-fledged work of users via the web browser. These requirements were caused:

• Desire to organize effective remote connection of users to the KMIS server out of walls of an information network of health facilities. For example, from the house, during the holidays or business trips, at departures in others the cities or the countries, etc.
• Reduction of administrative expenses on operation of KIIS due to failure from need to set the "fat" client of IBM Lotus Notes and also use of low-power or outdated computers which could ensure functioning only of the web browser, but were suitable for installation of "thick client" of Lotus Notes little.
• The need for ensuring bigger flexibility in difficult, including – regional projects – at the expense of an exception of need of configuring and special software configuration in workplaces of users during the work with KIIS and also in the amplifying attention from customers to cloud computing.

With a release of the new version of the platform IBM Lotus Notes/ Domino 9.0 specified requirements managed to be provided – thanks to inclusion in it of software of a special connectivity to the server via the browser. It is reached by installation of small "plug-in" (the special middleware) for the web browser at the expense of which all work with KIIS can be carried out in normal web now browser, and not just in the traditional "fat" client IBM Lotus Notes. Now the corporation IBM supports work of this "plug-in" in the environment Microsoft Internet Explorer and Mozilla Firefox for Windows, expansion of the list of the supported browsers is expected further. Thanks to participation in the program of early beta testing for partners of IBM, our company last year began the whole package of measures for testing and completion of a system for the purpose of ensuring stable and full-function work of users of a system via the web browser. So far all these works, including system testing, are in a closing stage

KIIS 3.3.0.11

"The end-to-end medical information system" of version 3.3.0.11 includes 532 changes and additions, including:

• 431 changes and additions of the existing modules
• 18 corrections for the found errors
• 24 new features
• 59 improvement of the existing functions

Among the main changes and additions it is possible to select the following:

1. the New version a subsystem of Drugstore in which the different completions and corrections directed to increase in convenience and stability of system operation are made. New Drugstore works with the new format of the database which is specially designed for the best operation of application and further development funktsionalnyz application opportunities now. New Drugstore supports work under control of IBM DB2.
2. Новая the version of "An electronic flyuoroteka" which is completely transferred to Lotus now. In the passport of clinic there was a new section Flyuorotek in which are collected the corresponding functionality.
3. the New version of a subsystem of vaccinal prevention including the new improved planning module, new reference books, support of form 063, a full-fledged work in Linux and Mac OS X.
4. the New version of a subsystem of medical examination including the module of operating control which is completely implemented in the environment of IBM Lotus, full support of work in Linux and Mac OS X, the improved management tools and settings. Different improvements and completions in electronic documentation on medical examination are also executed.
5. the New version of a financial and economic system which includes a set of the improvements and completions mainly directed to support of formation of registers of compulsory health insurance according to the order of Federal Compulsory Health Insurance Fund of April "07", 2011 No. 79.
6. the Advanced laboratory information system to which the set of the new features which are generally directed to increase in convenience of work with a PIM is added. The augmented list of the supported types of researches.
7. the New version of a subsystem of prof survey which includes support of the order MZSR No. 302, new reference books of prof survey and the new card of medical examination.
8. Множество improvements and completions of medical documentation for the perinatal centers and maternity hospitals.
9. Support of the order of Ministry of Health and Social Development of the Russian Federation No. 1664n of December 27, 2011. "About the approval of the nomenclature of medical services". The nomenclature of services approved by this order (simple and complex) is included in structure of a DB Federal NSI of a system and is suitable for coding of services in KIIS now. Further it is going to add support of this reference book for entering of information on medical standards into a system
10. Support of integration into the new version of Electronic registry 2.2., including support of integration of Electronic registry with the system of interdepartmental electronic interaction (SIEI) which is executed as completely cross-platform web application working under control of free Web servers
11. Improvements in the module Website of health facilities
12. Completions of a subsystem of support of temporary disability, including reduction of the document LVN in compliance in the order of the Ministry of Health and Social Development of the Russian Federation of April 26, 2011 No. 347n "About the statement of a form of the form of a leaf of disability". The main changes are adding of new fields and support of printing of information in the new form of the sick-list. Also composition includes the new, improved version of the magazine of temporary disability.
13. the Improved version of the protocol of transactions including the new reference book of transactions, support of an opportunity to configure own folders of transactions for more quick search of an activity code, more convenient work with the protocol of transactions.
14. a Number of significant completions in documents of a system of operational monitoring of death rate.
15. Planned completions and corrections in medical documentation.
16. Completions of "The passport of clinic" and "The passport of a hospital" and also some other the KIIS magazines (the magazine of hospitalization, the magazine of statistic reports, the magazine of calls on the house, magazines of diagnostic service, etc.).
17. Set of completions and improvements in printed forms of documents.
18. Set of improvements and completions in a subsystem Statistics.
19. Integration of the FastStat utility (fast statistics) which was a separate additional option for a system earlier.
20. the Improved version of "The temperature sheet" including faster work and the new, improved version of a printed form.
21. Corrections of the found errors.

Module "Telemedicine KMIS System"

It is known that one of the purposes of automation of health facilities is implementation of telemedicine technologies for exchange of medical information between specialists for quality improvement of diagnostics and treatment of specific patients. For achievement of this purpose the structure of KIIS includes the "Telemedicine KMIS system" which is based on the IBM Sametime platform from IBM Lotus product family.

The telemedicine KMIS system is intended for the solution of the following tasks:

• Element marked a spiskaprovedeniye of telemedicine consultations – an opportunity to exchange medical information on telecommunication channels in the mode of "real time". Importance of this task only increases recently.
• Element marked spiskaotlozhenny teleconsultations – an opportunity to send (to exchange) medical records via e-mail or an information exchange system of KIIS. It is applied when communication channels do not allow to use video of a real mode.
• Element marked a spiskateleobucheniye – an opportunity holding lectures, video seminars, conferences, etc. with remote demonstration of the electronic medical record and a video conferencing between doctors and audience. Allows to give to doctors an opportunity of life-long professional education without separation from work location. Lectures, as well as video consultations can take place in a multipoint mode, thus, the lecture can be given for listeners from several regions at once.
• Element of the patient marked spiskasovmestny discussion of the medical record – an opportunity to connect several far off the located specialists and to discuss with them results of inspection or treatment of the patient, including – with shared access to the electronic medical record of the patient.

The telemedicine KMIS system has the following functions:

• The developed possibilities of a video conferencing. The own or integrated means for voice data transmission (VoIP), high-quality video, video transmission under the point-to-point protocol are supported.
• Notification on presence: having installed the telemedicine KMIS system, you can see physical presence of doctors on the places, to see the status (it is busy, free, etc.), to see the status of availability of phone - to learn who can help right now and what means of communication it is the best of all to use, support of automatic detection of location - if for example the employee moves between divisions, then it is possible to know – in what place it is, etc. At the user's exit from a system or long employment when it does not work with a system, automatic change of the status works.

• Instant messaging system. For those users who got used or are interested in instant messaging on similarity of how it is implemented in Skype – the telemedicine KMIS server gives just the same opportunity – but already completely integrated into the client software of a system. Any user it can is necessary to select the employee and to send to him an instant message – which will be right there displaid in a separate window on the screen. Automatic recording of a log of a chat, icons of emotions, the editor who is built in by RichText, automatic spelling, a multi-user chat, and a set of other convenient functions is supported.
• The system of file sharing – is supported an opportunity to communicate and exchange files using secure system of message exchange of the corporate level. Function of creation of screenshots, including an opportunity to add comments on the created pictures is supported: she allows to make, for example, the picture of the tomographic image (or any other diagnostic result) from the workstation of the doctor-diagnostician, to lead round a certain place on the image (for example, pathological education), to add the comment and to send it to the attending physician or the narrow specialist for additional informing or teleconsultation.
• Holding interactive meetings – allows to organize the protected private discussion to which it is possible to connect remote users and in the mode of a video conferencing or a chat to exchange views, discussions, etc. Remote access to a desktop for discussion of results of diagnostic inspection or joint discussion of the electronic medical record is supported.
• The IP telephony — this function allows to turn the computer of the medical employee into intelligent phone with ability to integrate from the existing telephony infrastructure.
• Eotpravka of declarations – special function, allows to send the broadcasting or group declaration on users to report or remind them important information – for example, to invite to a meeting to the chief physician or to announce some emergency situation.
• Communication with patients via the website of health facilities. Thanks to the included Web client constructed on Web 2.0 tools there is an ability to integrate a telemedicine system of health facilities into the Web portal. So, administrators of health facilities can build in the website means of the notification on the on-line status of users and instant messaging and also the Click-to-Call function allowing to perform a telephone call of the employee of health facilities (for example, the registrar or the doctor of primary acceptance), having just clicked on the link on the page of results of staff of health facilities. There is a Click To Meet function allowing to set quickly connection with the employee several mouse clicks irrespective of where he is now and what communication device uses. Thus, patients of health facilities can begin a conversation with the doctor or the nurse directly on the Website of organization. Except everything, it is important to note – that all these opportunities are available with support of mobility using based on browser the client a chat forums for the platform Apple iPhone and also the mobile client to the devices working under management operating system Microsoft Windows Mobile.
• Integration – allows to use telemedicine service KMIS in close integration with other information systems. For example, integration with IBM WebSphere Microsoft Office Microsoft Outlook Microsoft SharePoint Microsoft Active Directory , etc. is supported. There are open API- interfaces for connection of the unknown systems, embedding of indication of presence of the employee on the website of health facilities and many other things is supported. Support of integration with Jabber-and XMPP communities, including support of TLS at connection to communities XMPP (if the specific XMPP server supports this function) and also a possibility of adding of the XMPP proxy server in a cluster configuration is provided. Using the special integration gateway users can announce the status and communicate with users of the systems AOL AIM, ICQ, iChat Apple, Yahoo Messenger and Google Talk, additional software licenses at the same time are not required.

KIIS 3.3.0.10

New KIIS 3.3.0.10 contains over 440 changes among which there are 36 new features, over 40 improvements in already existing software and also a set of changes or corrections. Generally all planned developments are made according to requests of the existing users of the company. Works on KIIS 3.3.0.10 were conducted from April 15 to September 1, 2011.

The structure of KIIS 3.3.0.10 includes the following main improvements and additions:

• New subsystem – Berth fund. This module is intended for control automation and control of bed fund in hospitals and sanatoria. It also contains control functions by settling for sanatoria.
• New feature of accommodation of patients in a power supply subsystem. With its help the doctor, appointing a diet, can always select for the patient the convenient location of a power supply (taking into account a class of service, availability of places or personal preferences of the patient on neighbors or arrangement of tables). As a result a system keeps account of the taken and empty seats of a power supply, and the staff of service of a power supply always visually sees accommodation of patients.
• Completely updated power supply subsystem. Among the major changes – completely again the written DB (for the improved high-speed performance and readiness of transition to other DBMS), the new user interface, significant simplification and completions of standard functions of work of the user.
• The new version of "The built-in website of health facilities", including a full-fledged new management system for the website via the web browser, the new engine on the basis of web 2.0 and XPages, new opportunities for administration and development of any websites of health facilities and many other things.
• Advanced laboratory information system to which the set of the new features which are generally directed to increase in convenience of work with a PIM and gradual accumulation of its functionality is added. So, are included in the current version of a PIM: a possibility of citing results of laboratory diagnostics in a tabular style, the master of cleaning of results, possibilities of flexible configuration of display of columns in the modules "Sheet of the Order" and "Introduction of Results", new reports for printing of the list of orders, an equation editor for calculation of different derivative indicators, improvement of function of autonumbering of test tubes, improvements in the statistical module PIM, etc.
• The advanced version of "A financial and economic system" in which the different completions and corrections directed to increase in convenience and stability of system operation are also made.

? The advanced version "Subsystems of Drugstore" including the improved implementation and printing of cross-industry M-11 form, improvement in the editor of radar station and the module of work with requirements. A set of improvements in the plan of performance and stability of the application and also in printed forms of reporting documentation.

• The advanced version "Statistics Subsystems" including the new improved interface, new administrative tools, performance of work significantly improved and a set of other changes.
• Significantly the improved integration of the workflow system and Statistics of KIIS meaning an opportunity to cause any statistic reports directly from an electronic document management system of health facilities (electronic journals and documents).
• New packet of statistic reports, including set of new features and corrections, such as block of the new reporting for sanatoria, expanded statistical reporting on death rate, improvements in the reporting under a hospital and clinic, improvements in the block of the state statistical reporting.
• The new version of a subsystem of support of temporary disability, including reduction of the document LVN in compliance in the order of the Ministry of Health and Social Development of the Russian Federation of April 26, 2011 No. 347n "About the statement of a form of the form of a leaf of disability". The main changes are adding of new fields and support of printing of information in the new form of the sick-list.
• Completions of the module of additional medical examination – changes according to the order MZSR Russian Federation No. 55n of 2/4/2010 are made to it.
• Planned completions and corrections in medical documentation.
• Planned further completions of electronic journals, including – "Passports of clinic", "The passport of a hospital", "The magazine of calls on the house", "A register of LVN", etc.
• Set of small improvements and corrections in the software for obstetricians-gynecologists, maternity hospitals and the perinatal centers.
• Set of completions and improvements in printed forms of documents.
• Set the small, but raising convenience of work, completions in Calendars.
• Integration with a recording system to the doctor via the Internet (Electronic registry) of version 2.1.

KIIS 3.3.0.9

KIIS 3.3.0.9 contains over 260 changes among which there are 47 new features and also a set of changes or corrections in already existing software. In general KIIS 3.3.0.9 is further work of the company on improvement of our main software product, increase in convenience and system effectiveness and its attractiveness to the user. Generally all planned developments are made according to requests of the existing users of the company.

The structure of KIIS 3.3.0.9 includes the following main improvements and additions:

• Support of "cloud model". Now KIIS can be installed as the centralized medical information system of the region based on cloud model of distribution of software.
• Advanced laboratory information system to which the set of the new small features which are generally directed to increase in convenience of work with a PIM is added.
• Advanced subsystem of Drugstore in which the different completions and corrections directed to increase in convenience and stability of system operation are also made.
• Significantly modifed subsystem of the station of emergency medical service in which accounting documents are brought into accord with the current legislation, the finished and added SSMP magazine is added and also the set of different statistic reports about work of SSMP is included
• The new module KMIS is a patanatomiya subsystem.
• Planned completions and corrections in medical documentation.
• Planned completions and improvements in a subsystem of planning of working time, among them - support of work with the electronic directions, the improved work with burst writing is added to several offices or checks, a new feature of transfer of the schedule in the calendar for other time, the improved integration with Electronic registry, the new statistic report on entertaining of offices at once
• Improvements and additions of reference book MKB-10, including adding of new codes.
• Completions of "Passport of clinic" and "Passport of a hospital"
• Planned improvements in a subsystem of accounting of temporary disability.
• Set of completions and improvements in printed forms of documents.
• New version of a subsystem of prof survey.
• Support of integration from HL7 and exchange of medical electronic documents with other health facilities using other medical information systems.
• The improved interface of the start page, databases of a core of a system and Administrator of KIIS with a possibility of shutdown of not used interface elements (a DB, programs).
• Set of improvements and completions in a Financial and economic system.
• Set of improvements and completions in statistical reporting.