Shadayev: Electronic medical cards do not give in to monetization

The ministry of a state administration, IT and communication of the Moscow region aims to depart from the classical scheme of creation of IT systems at the expense of budgetary funds. Instead it tries to attract investors who would invest in the project and then "beat off" the investments due to the paid services tied to the created system. In a portfolio of the ministry already several similar projects, however with one of the major - implementation of the electronic medical record - were not succeeded to implement this scheme: department could not construct mechanisms of its commercialization.

In August, 2015 the minister of a state administration, IT and communication of the Moscow region Maksut Shadayev told TAdviser about how in its region the implementation project of the electronic medical record of the patient moves ahead. According to Shadayev, the contractor on solution development based on whom the card is created and also on its implementation was selected last year. According to the results of tender the Belgorod company "SofTrust" became it. The volume of the supplier contract was about 90 million rubles and is expected two years.

The Moscow region one-time licensed the product "Softrasta" and acquired the right to use it without restrictions in all health facilities of the region. Until the end of 2015 a system is going to be implemented in all children's clinics of area and also in antenatal clinics. In total in 2015 it is required to connect 146 nurseries of clinics and 68 antenatal clinics.

In 2016 it is going to connect to electronic cards based on the same solution and clinic for adults. Afterwards electronic cards should be also entered in stationary medical institutions.

Development of the medical electronic record was conducted at the expense of the regional budget. It should be noted that in the IT ministry of the Moscow region as the most preferable model of financing of creation of IT systems see public and private partnership: within it the investor implements the project on own means, and then has an opportunity to earn from it at the expense of the organization around the IT system of different paid services. In the region there are already several examples^[1] on creation of systems according to such scheme.

Electronic medical cards were "tough nut": according to Maksut Shadayev, the project was implemented at the expense of budgetary funds as it was not succeeded to construct the mechanism of its commercialization yet.

Financing of the project on creation of the electronic card of the patient at the expense of private means was also considered, however as a result it was paid at the expense of means of the regional budget, Maksut Shadayev told TAdviser.

"It is one of the few stories where we could not construct the commercialization mechanism", - he told TAdviser.

One of the ideas, according to Shadayev, is providing on a commercial basis of access to electronic stories of diseases to the insurers who are carrying out expertize of accounts on services which through Federal Compulsory Health Insurance Fund are provided by medical institutions for receiving financing. In certain cases insurers send the representatives directly to medical institution where those lift primary documentation of medical records and estimate compliance of what is written in the card to that bill which is made out.

Access to electronic stories of diseases would allow them to carry out more effectively expertize, having got rid of need to go to medical institutions, the minister argues. Its department conducts discussions with insurers about it. The final cost of such service which insurers could designate while is not present. According to Shadayev, in the end of the year when a system is implemented in children's clinics, it will be possible to create specific proposal.

The system of electronic cards of patients, as well as other systems of the region, are without fail integrated with the federal systems, the minister says.

When the Moscow region decided on how to build the strategy of health care in the region, was studied, including, experience of Moscow in this area, including – according to electronic medical records.

"The difference of our project from similar Moscow consists that we do very deep implementation, but on specifically taken segment – children's, but we do not go an even layer everywhere, - Shadayev says. - We recognized that at the initial stage we should close only a children's segment, but completely. Because children are our everything and, besides, children have no long saved-up clinical record which is very difficult to transferring to an electronic form. After that we will be able to estimate in terms of financial resources what we have opportunities to close an adult segment".

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