scholarly journals eHealth as a united information space for doctors and patients

2020 ◽  
pp. 26-27
Author(s):  
V.S. Vasyliev

Background. The national primary healthcare system (PHS) includes 1939 institutions, 27.7 million patients, 24,607 doctors, 1122 pharmacies and 9395 pharmacists. The eHealth informational space was created to coordinate the work of the PHS. Objective. To describe the features and functioning of the eHealth informational space. Materials and methods. Analysis of the current situation regarding the work of eHealth. Results and discussion. An important function of eHealth is the transition to electronic prescriptions and electronic referrals to specialists under the medical guarantee program. Adopted in 2020 budget of this program amounted to 72 billion UAH, which was allocated to primary care, secondary, tertiary, emergency and palliative care, medical care for children, medical care for pregnancy and childbirth, medical rehabilitation. In total, UAH 1758 billion was spent on the diagnosis and treatment of oncological diseases, of which 80.7 % – on diagnosis and chemotherapy, and 29.3 % – on the diagnosis and radiation treatment. The eHealth system provides the cooperation between the Ministry of Health of Ukraine, the National Health Service of Ukraine and medical institutions with medical information systems. Benefits of the united informational system include the elimination of paperwork, creating a united medical card of each patient, online registration for a doctor’s consultation, eliminating the possibility of drug receipt falsification, increasing the availability of telemedicine consultations, improving communication between healthcare professionals, planning and monitoring of strategic procurement. If the patient uses a smartphone, this informational space allows him to transmit his data (for example, the results of blood pressure measurements) through a mobile application to the telemedicine platform with their subsequent analysis and correction of prescriptions. Additional opportunities of the informational space include monitoring of drugs’ side effects, educational programs for doctors, and the possibility of creating professional communities. Conclusions. 1. The eHealth system enables Ukrainian doctors and patients to use electronic prescriptions and electronic referrals to the specialists. 2. Benefits of this informational system include the elimination of paperwork, the creation of a united medical card of each patient, online registration for a doctor’s consultation, improved communication between health professionals, improved planning of strategic procurement, etc. 3. The eHealth system includes a number of useful services for both doctor and patient.

2020 ◽  
Vol 46 (3) ◽  
pp. 46
Author(s):  
O. D. Gavlovskyy

Abstract Purpose of the study. Investigate the current legal mechanisms for organizing and providing rehabilitation assistance to participants and victims of the armed conflict in the eastern regions of Ukraine. Materials and methods. To achieve these goals, a standard methodological apparatus for scientific research was used: bibliosemantic, for the analysis of periodical literature, and content analysis, for the analysis of legal documents. Results. As stated in the regulations, one of the main responsibilities of the state is to ensure the social protection of participants in the armed conflict in the east of the country. To fulfill this function, a number of laws and regulations have been enacted at the legislative levels, which are constantly being revised to improve social, medical and psychological care for participants in the joint force operation (anti-terrorist operation) and its victims. Comprehensive assistance to disabled military personnel and combatants includes statutory guarantees and procedures for their rehabilitation and adaptation. This list includes medical rehabilitation (provision of medical care, including prosthetics and orthoses, provision of technical means of rehabilitation); psychological rehabilitation; social rehabilitation; vocational rehabilitation. Conclusions. In Ukraine, there is a welldeveloped legal regulation of the process of providing rehabilitation assistance to participants in the armed conflict in the eastern regions of Ukraine. Organizational mechanisms for rehabilitation are constantly being improved: the International Classification of Functioning, Restriction of Life has been introduced; qualification characteristics of rehabilitologists and rehabilitation specialists, occupational therapists, physical therapy assistants and occupational therapists have been developed. It has been established that there are no unified protocols for medical rehabilitation in Ukraine: only a protocol of measures for post-traumatic stress disorder has been developed. A «road map» for medical care, reparative treatment and rehabilitation measures in health care facilities is available and applicable. Keywords: medical rehabilitation, joint force operation, legal regulation, organization of medical care.


2021 ◽  
Vol 65 (5) ◽  
pp. 411-417
Author(s):  
Sergei S. Budarin ◽  
Andrei V. Starshinin ◽  
Andrei A. Tyazhelnikov ◽  
Elena V. Kostenko ◽  
Yulia V. Elbek

Introduction. The study of public opinion as the basis for strategic planning of the activities of medical institutions is more relevant than ever, as it allows finding ways to solve the problems of ensuring the availability and satisfaction of citizens with medical care. Purpose. Comparative assessment of the availability of primary health care based on the results of a sociological study of public opinion and data from the Unified Medical Information and Analytical System of the City of Moscow (UMIAS). Material and methods. To study public opinion, the practice of population survey was used, which was conducted through direct interviewing with filling out questionnaires of visitors to Moscow polyclinics and the method of questioning doctors based on a questionnaire developed by researchers. To analyze the data, the authors used general scientific methods of cognition, including the dialectical method, a systematic approach, logical correspondence and harmonization, detailing and generalization. As part of the study, the index value of the patient loyalty to the medical institution (MI) was calculated according to Net Promoter Score (NPS) method as the difference between the share of the “Promoters” group and the share of the “Critics” group in the total number of responses. Results and discussion. The established correlations indicate the opinions of doctors and citizens to coincide and the UMIAS data on the issue of assessing the accessibility of admission of level 1 doctors for citizens. Based on the results of a sociological survey, the number of dissatisfied patients is mainly affected by managing medical care and its availability. The study confirmed that the higher the availability of an appointment with a level 1 doctor, the lower the number of visits the doctor on duty. Conclusion. The conducted research has shown the practicality of an integrated approach to evaluating the activities of medical organizations based on the results of public opinion research and UMIAS data.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Fu ◽  
Tianwei Tang ◽  
Junhao Long ◽  
Bohuai Lin ◽  
Jiayue Li ◽  
...  

Abstract Background Internet medical care has been advancing steadily, especially during the coronavirus disease 2019 pandemic, the development momentum of Internet medical care in China is more vigorous. This study aimed to explore the factors associated with using the Internet for medical information, to examine the popularisation and implementation of Internet medical treatment and feasible strategies, and promote the further development of Internet medical treatment. Methods A cross-sectional study was conducted on 408 medical patients who had used online medical services. The one-way analysis of variance or independent samples t-test was used to compare the differences in the influence of demographic characteristics on behavioural intentions of different people seeking medical care. Pearson’s correlation was used to evaluate the correlation between different measurement variables. A mediation regression analysis was used to explore the mediating role of trust in Internet medical care. Results The difference in the influence of Internet medical use frequency on the behavioural intention of different participants was statistically significant (F = 3.311, P = 0.038). Among the influencing factors, personal trust propensity (r = 0.387, P < 0.01), website credibility (r = 0.662, P < 0.01), hospital credibility (r = 0.629, P < 0.01), doctor’s credibility (r = 0.746, P < 0.01), and online patient trust (r = 0.874, P < 0.01) were positively correlated with patients’ behavioural intentions. In the analysis of intermediary factors, the total effect of the credibility of the diagnosis and treatment website on the behavioural intention of patients was 0.344. The total effect of the credibility of the diagnosis and treatment hospital on the behavioural intention of patients was 0.312; the total effect of the service doctor’s credibility on the patient’s behavioural intention was 0.385; the total effect of the personal trust tendency on the patient’s behavioural intention was 0.296. Conclusions This study found defects in various factors that produce distrust in Internet medical treatment. It also reveals the positive effect of trust factors on the development and implementation of Internet medical treatment and provides some ideas for improving the use of Internet medical treatment by the masses.


Author(s):  
Liliya Andrush

The article analyzes the legal framework for the health care of police officers and their families. Three main models of providing police officers with health services (health insurance, budgetary, mixed) are outlined, and it is noted that Ukraine finances departmental health care institutions at the expense of budgetary funds and provides basic services that are free of charge. It is emphasized that the fundamental rules governing the relevant issues are contained in the Law of Ukraine “On the National Police”. Article 95 of this Law is analyzed, according to it the main categories of persons who are entitled to free medical care in the health care institutions of the Ministry of Internal Affairs (police officers, their families - children 18 or 23 years of age in the study in higher education institutions, husband or wife) main forms, family members of the dead or missing police officers, police officers with disabilities in service). It is stated that such services are eligible for some categories of former police officers and their families. It is also about the legal provision of rehabilitation, sanitary and health resorts, wellness as well as recreation measures in departmental medical rehabilitation centers, sanatoriums, rest homes, boarding houses and health institutions of different categories of police officers, their families. Various instructions and regulations are being analyzed to clarify the categories of persons applying for medical care, rehabilitation and recreation in departmental health care facilities, conditions for free rest, etc. The study also reveals a list of institutions that are part of the departmental health care system.


Author(s):  
S. N Puzin ◽  
S. S Memetov ◽  
Marina A. Shurgaya ◽  
I. G Gal

Tasks of the organization of medical care at the present stage lie in the effective and economical use of available health care resources and in the increase of the accessibility and improvement of the quality of medical services. The effectiveness ofprovision of medical services to veterans is based on the systematic monitoring and permanent implementation of health measures aimed on social support of the older generation, along with the maintenance and preservation of health. Emerging trends of population aging as a complex phenomenon of the general civilizational character, reflect at the same time the results of the sequential implementation of legislation in relation to older people in the Russian Federation at Federal, regional and municipal levels. In the current socio-economic conditions on the territory of the Rostov region (RR) there was created and developed and a comprehensive system of rehabilitation ofdisabled persons. In the article there is highlighted the activity of the RR "Hospital for veterans of wars", which in the region is the only the state institution intendedfor the provision of specialized medical care to participants and invalids of the Great Patriotic War and equivalent categories of the population


2018 ◽  
Vol 2 (4) ◽  
Author(s):  
Prentice A. Tom

I few years ago, I coined the term, “Medicine Without Walls”1 to describe our future healthcare delivery system—an environment where patient and healthcare practitioner are unencumbered by physical location or limitations in access points due to human resource restrictions, where medical information is transferred not only between patient and clinician but also between any number of care practitioners and healthcare institutions—a world where patients have open and ready access to medical care when and where needed.


Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 2110-2110
Author(s):  
Azusa Nagao ◽  
Akiko Ioka ◽  
Takao Nakamura ◽  
Yoichi Murakami ◽  
Misako Makishima ◽  
...  

Abstract Introduction: FVIII prophylaxis for hemophilia A (HA) has reduced the bleeding frequency in patients and enabled the prevention of hemophilic arthropathy and severe bleeding. However, the treatment/disease burden remains a concern, as evidenced by requiring intravenous injections two/three times a week; regular hospital visits to receive a prescription for medication, as drug delivery is not a provision in Japan; and frequent hospital visits because of complications, like bleeding. Moreover, there is no national patient registry for hemophilia in Japan, and few studies have examined the state of medical care and patient burden due to symptoms and medical practices. Herein, data from medical information databases (DBs) were assessed to investigate the state of medical care and patient burden for HA patients in Japan. Methods: The DBs of health insurance subscribers provided by JMDC Inc. (JMDC-DB) and of electronic medical care records provided by Real World Data Co., Ltd. (RWD-DB) were reviewed. Two DBs were used because the differences between them, such as data source for HA patients, may lead to intergroup differences in the characteristics and traceability of each patient. The targets of analysis were HA patients (ICD-10 code: D66) prescribed FVIII concentrates, emicizumab, or bypassing agents. The definition of targets in this analysis was deemed appropriate in a separate validation study. The occurrence rates of intracranial hemorrhage, ischemic heart disease, hospitalizations, emergency visits, and outpatient visits were calculated to evaluate patient burden. Further, data on the number of hospitals visited and prescribed amounts of FVIII concentrates per month were tabulated and descriptive statistics, applied. Table 1 shows the outcome measures. Results: The number of patients included, based on the target period and inclusion criteria, was 459 from JMDC-DB (January 2005 to March 2020) and 229 from RWD-DB (January 1985 to March 2020). Both DBs had a large proportion of patients aged 0-9 years (23.09% in JMDC-DB and 47.16% in RWD-DB) and a small proportion of patients aged ≥60 years (2.61% in JMDC-DB and 5.68% in RWD-DB). The mean (standard deviation [SD]) and median values for the monthly prescribed amount of FVIII concentrate were 10526.36 IU (11260.42) and 8594.91 IU in JMDC-DB and 12569.11 IU (54846.02) and 1514.35 IU in RWD-DB, respectively. The yearly trends of monthly prescribed amounts of FVIII concentrate for patients in JMDC-DB were analyzed. The median values for every 3 years since 2007 were as follows: 1916.67 IU (2007), 3375.00 IU (2010), 7229.17 IU (2013), 8614.58 IU (2016), and 10000.00 IU (2019), indicating an increasing trend in recent years. The occurrence rates (95% confidence intervals [CIs]) of intracranial hemorrhage, ischemic heart disease, and hospitalizations were 2.61% (1.36-4.52), 0.00%, and 32.68% (28.40-37.18) in JMDC-DB and 4.42% (2.14-7.99), 0.44% (0.01-2.44), and 57.08% (50.35-63.62) in RWD-DB, respectively. The age-stratified occurrence rates (95% CIs) of intracranial hemorrhage in JMDC-DB and RWD-DB were 9.43% (4.62-16.67) for 0-9 years, 1.67% (0.04-8.94) for 40-49 years, and 4.00% (0.10-20.35) for 50-59 years and 3.70% (1.02-9.21) for 0-9 years, 13.04% (2.78-33.59) for 10-19 years, 9.09% (1.12-29.16) for 30-39 years, and 6.67% (0.17-31.95) for 40-49 years, respectively. The overall occurrence rates of intracranial hemorrhage were similar in the two DBs: 2.61% (JMDC-DB) vs. 4.42% (RWD-DB). Additional results of our analysis will be presented at the conference. Conclusions: The prescription of FVIII concentrates for Japanese patients with HA is increasing, probably because FVIII prophylaxis in the clinical setting has become more common. The widespread use of FVIII has many benefits for HA patients. However, there are still treatment burdens that should be considered, such as the need for several drug prescriptions and severe bleeding, such as intracranial hemorrhage. Figure 1 Figure 1. Disclosures Nagao: CHUGAI PHARMACEUTICAL CO., LTD.: Consultancy, Honoraria, Speakers Bureau; Takeda Pharmaceutical Company Limited.: Honoraria, Research Funding; Bayer Yakuhin, Ltd.: Honoraria, Research Funding; Sanofi K.K.: Honoraria; Fujimoto Pharmaceutical Corporation: Honoraria; KM Biologics Co., Ltd.: Honoraria; Pfizer Japan Inc.: Honoraria; Japan Blood Products Organization: Honoraria; Novo Nordisk Pharma Ltd.: Honoraria; CSL Behring K.K.: Honoraria. Ioka: Chugai Pharmaceutical, Co., Ltd.: Current Employment. Nakamura: Chugai Pharmaceutical Co., Ltd.: Current Employment. Murakami: Chugai Pharmaceutical Co., Ltd.: Current Employment. Makishima: Chugai Pharmaceutical, Co., Ltd.: Current Employment. Okada: Chugai Pharmaceutical Co., Ltd.: Current Employment. Sakai: Bayer Yakuhin, Ltd.: Consultancy, Speakers Bureau; Novo Nordisk Pharma Ltd.: Consultancy, Speakers Bureau; CSL Behring K.K.: Speakers Bureau; Takeda Pharmaceutical Company Limited.: Speakers Bureau; CHUGAI PHARMACEUTICAL CO., LTD.: Speakers Bureau; Sanofi K.K.: Speakers Bureau.


Author(s):  
Ermolaev D.O. ◽  
Ermolaeva Yu.N.

The relevance is determined by the high proportion of diseases of the circulatory system in the structure of the total mortality of the population, as well as the potential modifiability of external factors of pathology. The aim of the research is to study the regional epidemiology of mortality from diseases of the circulatory system in the context of a regional program to reduce it. Materials and methods - аn analysis of the structure and dynamics of mortality rates from diseases of the circulatory system and the peculiarities of the organization of medical care for the population of the Astrakhan Region with cardiovascular diseases for the 7-year period from 2014 to 2020, based on the data of the Medical Information and Analytical Center and the Office of the Federal State Statistics Service for the Astrakhan Region, was carried out. Results and discussion - diseases of the circulatory system rank first in the structure of total mortality in the Astrakhan region, which accounted for about half (48%) of all deaths in 2020. During the study period, an increase in mortality from diseases of the circulatory system was established by 2.8% with a sharp increase of 17.6% in 2020 compared to 2019, which is associated with the spread of coronavirus infection. At the same time, the proportion of deaths outside the hospital was 65% in 2020. It’s indicates both the late seeking of medical care and the shortcomings of dispensary observation of the category of citizens with the maximum risk of developing cardiovascular complications. In the structure of mortality from diseases of the circulatory system, ischemic heart disease is steadily leading, with an increase of 5.8% over the reporting period. The second place is occupied by cerebrovascular diseases, which showed a slight decrease by 3.3%. In addition to the infectious threats associated with the spread of the coronavirus COVID-19, it is necessary to take into account such a stable phenomenon as the progressive aging of the population when predicting the mortality rate for the coming years. Conclusion. Research findings can be used to adjust activities to health care organizations for patients with cardiovascular diseases at the regional level.


Author(s):  
Oleynik A.V. ◽  
Mushnikov D.L. ◽  
Germakhanov Z.Z. ◽  
Drobysheva E.V.

The relevance of the study is due to the insufficient development of improving the structural component of the quality of medical care in terms of the cultural characteristics of the participants in their provision. The purpose of the study: to determine the contribution of the patient's culture factor to ensuring the quality of medical care of different profiles. The collection of material was carried out by the method of sociological survey of patients on the original questionnaires and the method of expert assessment of cases of medical care. The volume of the sample population formed by random selection amounted to 256 patients of dental profile, 320 therapeutic, 196 surgical (urological), 210 pediatric profile, respectively. An expert assessment of the quality of medical care was carried out according to the methodology that takes into account the implementation of its individual properties, for 984 cases of assistance. It is established that the quality of medical care is reliably influenced by the state of the cultural profile of patients. It was found that the assessment of the patient structural component of the quality of medical services without taking into account their profile was reduced to 40.6% relative to the maximum assessment, especially the characteristics of the sanological and information culture of the patient. The analysis of the role of patient cultural characteristics in the formation of the structural component of the quality of medical services showed the presence among them of characteristics that have a significant impact on the decline in the quality of services. The revealed differences in the value of the relative risk of the same patient cultural risk factor for reducing the quality of medical services in their different profiles substantiated the need to differentiate factors into high-risk and low-risk. The basis for managing the culture of patients should be measures to transform low gradations of cultural characteristics of patients into high ones, through medical information and education, socio-psychological counseling, patient education and the formation of behaviors focused on the preservation and promotion of health.


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