Analysis of the services of the Unified Electronic Registry of the Yamalo-Nenets Autonomous Okrug

On May 24, 2017, Integrated Medical Information Systems announced the implementation of the Regional Information and Analytical System (RIAS) of the YNAO IAC.

The system has been in operation since August 1, 2016. Work on the creation and addition of forms to the YNAO RIAS is carried out as the need arises.

Statistics of visits to the site of the Unified Electronic Registry

The results of monitoring the operation of the Unified Electronic Registry resource during 5 months of 2017 indicate that the service is in demand by the population, the Integrated Medical Information Systems (K-MIS) reported.

This is also indicated by the indicators of the use of the appointment service in electronic form, calculated from the total number of records allocated for the primary appointment of patients:

Automation of the process of recording an appointment with a doctor made it transparent, revealed organizational problems in hospitals. Based on these results, it became possible to approach the optimization of work with patients when making an appointment with a doctor and unload registrations in hospitals. At the current time, 80% of primary reception stamps are allocated for recording in by means of a single electronic registry, EPGU, self-recording terminals. For the remaining 20% of stamps for primary admission, registration is made by registrars in a medical organization when patients contact in person or by phone. At the primary appointment, a doctor records the secondary and subsequent appointments of patients through a medical information system.

The medical organizations of the region provided the opportunity for patients to come to a doctor's appointment directly upon recording through the "Doctor Appointment Record" service in electronic form without visiting the register in the hospital, while the medical card is already in the doctor's office. The waiting period for the appointment of a doctor for a patient who has signed up by electronic recording does not exceed 10 minutes. The number of complaints following the results of 5 months of 2017 significantly decreased compared to 2013:

"In general, when moving to work with the Unified Electronic Registry, the number of records to the doctor in electronic form increased significantly. This, of course, is the result of work in hospitals, as well as the result of work to ensure the stability of the operation and accessibility of the service, optimize its work, organize technical support for patients when working with a regional information resource, "summarized in K-MIS.

Project development

2017

Services for patients and modernization of the Unified Electronic Registry

In order to call a doctor at home, a resident of Yamal does not need to get through to the registry of his clinic, it is enough to go to the http://www.yanaozdrav.ru/ website, select the appropriate menu item on the main page and go to fill out the application.

The service is available for authorized users in the Personal Account from 07:00 to 12:00 on working days. The user can call a doctor both for himself or for his relative or acquaintance (for this it is enough that the patient's card is entered in the Personal Office of the authorized user). At the same time, the patient's age system automatically determines who needs to transfer the call to a pediatrician or therapist. After filling in the information on complaints, the address of actual location and indication of additional information, the application is automatically submitted for further verification and processing to the medical organization to which the doctor's call is made.

After submitting an application, the user can monitor her status in his Personal Account in real time in a special section "My doctor's calls to the house," and will also receive notifications about changing her status to his e-mail. In addition, the Personal Office will preserve the history of all calls in the context of available patients.

In addition, it is possible to cancel from the made call by the patient independently in the Personal Office until his appointment to be executed by a doctor by a medical organization. The presence of such an opportunity is aimed at minimizing the number of false calls - when the doctor arrived at the place of call, but the patient was not there.

Thanks to the built-in specialized reporting on the work of the Doctor's Call to the House service, available to medical organizations providing these services and the service operator, the Medical Information and Analytical Center, it is possible to analyze the amount of use of electronic service, the structure and number of calls made through the site, as well as track the number of false calls.

Another, no less popular service, is an appointment with a doctor through an intelligent voice service. The patient makes an appointment in the usual way - by calling a single toll-free telephone number, while automatic search and identification of data voiced by the patient takes place. This service operates in 24/7 mode, thus providing the possibility of recording from the phone at any time and even without access to the Internet.

In addition, the voice service allows you to make 100% outgoing calls with a reminder of the upcoming reception without involving a human resource. The call is carried out on the eve of the reception according to the configured time. If the patient fails, the system will free up time for other records or move the record to a convenient time. The introduction of this service, in addition to the convenience and increase in patient satisfaction, significantly simplified the work of the registry and made it possible to optimize the load of doctors.

In the third quarter of 2017, new services for patients were constantly put into operation on the resource of the Unified Electronic Registry: "Calling a doctor to the house," "Ordering and issuing certificates," access to their medical data (viewing information from cards maintained in medical information systems), as well as a service to automate the process of recording for appointment with a doctor through automatic communication of a voice robot with patients by phone. As expected, this will allow providing the service 24 hours a day 7 days a week, including patients who do not have access to the Internet, as well as patients with disabilities (pensioners, veterans, disabled people).

In 2017, the modernization of the functionality of the resource of the Unified Electronic Registry in accordance with the norms of the current legislation was also planned. Including work on:

• adaptation of the EER site for the visually impaired;
• service implementation of service quality assessment (integration with federal service);
• implementation of the service of pre-trial appeal in the provision of the service (integration with the federal service);
• providing an opportunity to make an appointment with a doctor by professional examination or medical examination.

Integration of the Unified Electronic Registry with the federal

In 2017, the Unified Electronic Registry was integrated with the federal electronic registry through the FER Service Hub service, which allows you to provide the "Doctor Appointment Record" service at EPSU using the My Health LC.

"As part of the resource of the Unified Electronic Registry, it is possible to collect various forms of reporting, which allows you to quickly collect up-to-date information, including the number of available tickets for recording, the number of registrations through the service from various sources (single electronic registry, terminals installed in medical organizations, EPSU, call center) without involving hospitals," said Angelina Pashkevich, deputy director of the IAC YNNAO. - This statistics is used to monitor the quality and accessibility of the provision of the state service "Medical Appointment Registration" in electronic form to residents of the region. "

Project Progress

2015

Start of "Patient's Personal Office"

For patients of the Unified Electronic Registry resource, the Patient's Personal Account service was created, authorization in which takes place through the Unified Identification and Authentication System (ESIA) federal information system. In the "Personal Office," the patient can once enter information about himself and relatives for further use, make an appointment with a doctor, track the status of the appointment, leave feedback about the medical organization and the specialist to whom the appointment was made. Also, the section "Reference Information" is implemented for users in the public domain, where the schedule of doctors, information about the location of medical organizations and territorial services for patients in the areas are posted online.

Connection of medical organizations to the Unified Electronic Registration

Since 2015, all medical organizations providing primary health care in outpatient settings, including 6 specialized institutions, have been connected to the Unified Electronic Registry. Recording is possible both for local doctors and for narrow specialists.

Medical organizations work with a regional information resource through the integration of their medical information systems, which ensures the principle of one-time information entry. The medical organization operates only in its medical information system, including the creation, maintenance of doctors' schedules and processing of records. As a result of the fact that the patient independently completes his identification data when applying for an appointment with a doctor through the Unified Electronic Registry, the registrar in the medical organization does not spend additional time recording the patient's personal data.

From the moment the system is put into operation, a centralized technical support service of the Unified Electronic Registry website has been created on the basis of the YNAO IAC, which handles user communications in case of registration or registration questions on the site. The centralization of technical support for the service ensured a reduction in the load from hospitals to support their "Doctor Appointment" sites.

Deployment of YNAO RIAS

The "Regional Information and Analytical System" (RIAS) of the Yamalo-Nenets Autonomous Okrug (RS Uniform State Health Information System Yamalo-Nenets Autonomous Okrug) was launched in 2015 as part of the complex of work on the development of the regional segment of the unified state information system in the health sector, as one of its components. Subsequently, the developers and employees of the MIAC carried out work on setting up analytical forms, debugging procedures and integration processes, and validating data.

The system is a centralized web solution that includes an integration gateway for connecting data sources, a primary information storage system on the PostgreSQL platform, a BI platform for processing accumulated data, and a web interface for use and management. The BI platform is Prognoz Platform.

RIAS users - heads of health institutions - received online access to a number of health indicators, for example, data on fertility, mortality and population, which are generated by the statistics service.

The mechanism of integration and daily transfer of data from regional systems and registers provided access to operational information on mortality, formed from a single database of the region on issued medical certificates of death (System of Operational Mortality Monitoring - OMS YAMAO). Access to indicators on oncology, medical examination of certain groups of the adult population is organized, etc.

The procedure for calculating a number of indicators has been simplified for employees of the YNAO IAC, now they are formed automatically in RIAS, according to pre-laid down algorithms based on loaded data.

2014: Launch of the resource "Unified Electronic Registry of Yamalo-Nenets Autonomous Okrug"

In October 2014, a modernized resource was put into continuous operation - the regional information resource "Unified Electronic Registry of Yamalo-Nenets Autonomous Okrug," which provides, among other things, the provision of the state service "Acceptance of applications (recording) for appointment to a doctor" in electronic form, based on the software "Electronic Registry in 3.1" of the company "Integrated Medical Information Systems."

The Doctor Appointment service is available to users on the Internet at the former www.yanaozdrav.ru web address, including its mobile version (recording through mobile devices and tablets), as well as through the Unified Portal of State and Municipal Services (www.gosuslugi.ru, EPSU) and self-recording terminals installed in medical organizations.

2013: Decision to upgrade Internet Registry resource

Taking into account the experience gained based on the results of the operation of the Internet registry information resource and the Doctor Appointment service, in 2013 a decision was made on the need to modernize it. Firstly, the Internet Registration was transferred to the computing capacity of the data processing center (currently the regional computing center for the health sector) on the basis of the subordinate health institution of the health department of the Autonomous Okrug - the Medical Information Analytical Center of the Yamalo-Nenets Autonomous Okrug (IAC Yamalo-Nenets Autonomous Okrug). Secondly, the layout and architecture of the new resource have been developed, coordinated with the medical organizations of the Autonomous Okrug. The terms of reference for the resource modernization have been prepared. This was followed by the development of a new version, testing, training of registrars in medical organizations and implementation according to the schedule.

Project Tasks

The need for a system is due to the need of the region for a tool for analysing heterogeneous information accumulated in the information systems of the Yamal health sector, which has been stored in the file archive of statistical and operational reports for many years.

Screenshot of the software window, (2017)

The Department of Health of the Autonomous Okrug and the YNAO IAC proposed to create an analytical workplace for the head, through which reports, summaries, charts, graphs, and heat maps are visualized in a convenient form. So there was a task to develop and implement RIAS in Yamalo-Nenets Autonomous Okrug.

Prerequisites

In December 2012, the Internet Registry information resource appeared in the region, which was supposed to solve the task of centrally recording an appointment with a doctor of the population of the Autonomous Okrug. No more than 12 medical organizations of the Autonomous Okrug, providing primary health care in outpatient conditions, worked with the resource.

The work of medical organizations with the Internet Registry was based on the principle of either repeatedly entering the information of the same name, such as the list and schedule of doctors, stamps for recording patients, or referral to the official sites of medical organizations, where the appointment registration service was directly provided.

Thus, patients when registering for appointments through the Internet registry resource to various medical organizations dealt with different interfaces, there was no single personal office in which it was possible to track the status of their entries to various medical organizations. For the governing body, it was not possible to independently generate statistics on the region, in terms of providing the service of recording an appointment with a doctor in electronic form, without additional requests to medical organizations.

In addition, the Internet Registry resource was physically located on computing facilities that are not subordinate to the executive body of state power in the field of health care - the health department of the Yamalo-Nenets Autonomous Okrug. This led to the unstable operation of the resource, it was not possible to quickly resolve issues on its technical support and support, which resulted in numerous complaints and appeals of patients to medical organizations.

Despite the fact that the regional service was integrated with the federal electronic registry of the first stage, the indicators for the region were low, according to the results of the rating of the Ministry of Health of Russia, Yamal was on the list of regions that do not work well with the Doctor Appointment service in electronic form.