Medicine of the future. Programmer's Look
Good morning. For various reasons, I often encounter health workers and health care institutions. So in the age of high technology I am very surprised that most of the information is on paper. Moreover, if you are being treated by different doctors in different clinics, it starts to cause more inconvenience, because every doctor wants to know the full picture of the diseases from which I was treated. So you carry these piles of paper with you. A separate topic here is the receipt of references. Well, I think many were in queues.
So today I read the post " Medicine: electronic medical records - a view from the doctor " and decided to share my thoughts as a programmer on a possible implementation of such a system.
')
In my opinion, such systems should solve several problems:
Let us dwell on some points in more detail. The collection and analysis of medical research data - already now a large number of medical devices can give data in electronic form (I see no reason to keep them on paper). These data may in the future become the indispensable statistical base for research . Experience in any field is indispensable, especially in medicine. But I simply consider storing such data as the past - medical systems must take a step forward: they can help doctors avoid trivial errors in making diagnoses, they can help to make a correct diagnosis (this is more like systems on airplanes, when the pilot forgot to remove the landing gear after takeoff - the system will remind him of this). Perhaps in the future, the system itself will be able to make simple diagnoses (such as SARS, acute respiratory infections, ESR, and others).
Items such as informing and accessing the medical history via the Internet make the life of the patient easier. After all, this is not a healthy person, who may not be difficult to walk a couple of km to a medical institution. And so you sitting at home get all the desired results, as well as the destination. Quick and convenient. The big plus can be remote communication of the patient with the attending physician.
A single information space within the whole country gives you the opportunity not to care that having arrived in another city and having become ill, you will have to retell a new doctor what you once had been ill with. I am already silent about emergency cases, accidents, etc., where you need to act and not dig paper in search of contraindications for a particular patient. Perhaps it will save lives.
All data in the system should be stored without the possibility of their deletion and substitution. This is more like a version control system. All changes will be recorded, creating only a new version of the document, but not replacing the old one. Medical error will be available and visible immediately. Given the distributed data storage system, it will be difficult to “bring in” who needs to replace the data. On the same data it is possible to build a system for assessing the quality of services, objective, with numbers.
The big problem now is prescription drugs. The system may have affiliated pharmacies. Then the doctor simply informs the convenient pharmacy for the patient that a certain medicine will be necessary, and the patient will only have to come and pick it up (medicine).
As the standard scheme of interaction of the doctor and the patient can look:
Thus, the system stores all the complete comprehensive picture of the person’s disease and treatment methods. The availability of the patient's card in electronic form gives a significant increase in the speed of medical decision-making.
A big bet should be placed on mobile apps. So the workplace of the doctor can be mobile, and not tied to the office. Medic can assist and receive information in any place where there is access to the Internet.
I would single out four levels in the structure of the system:
To ensure security, you need to follow several rules:
I apologize for taking a lot of time, I just wanted to say how I would like to see the health care system of the future. I do not pretend to be the ultimate truth :). I will be glad to any criticism and comments.
PS I would be happy to take part in the development of such a system in Russia.
So today I read the post " Medicine: electronic medical records - a view from the doctor " and decided to share my thoughts as a programmer on a possible implementation of such a system.
')
In my opinion, such systems should solve several problems:
- translation of health-related documents in hospitals and beyond into electronic form;
- collection of medical research data (data of a medical examination, x-ray, ultrasound, tests, blood tests, etc.);
- analysis and systematization of the data;
- patient access to medical history and appointments via the Internet, mobile apps;
- reporting research results via sms, email, mobile apps;
- remote communication of the patient with the attending physician (including from another region);
- the creation of a system for an objective assessment of the effectiveness of the medical worker, health care institution or regional unit;
- exclusion of the possibility of substitution of these studies, their subsequent changes, concealment of medical errors - which should raise the level of quality of the services provided;
- a single centralized base will allow you to avoid a series of problems with obtaining a card or certificate, as any doctor even from another city is able to get the entire patient's history, regardless of where the card was opened;
- assistance in making a correct diagnosis based on a statistical analysis of previous experience (exclusion of a deliberately wrong diagnosis, help in predicting the course of the disease under certain conditions);
- access of the doctor to the generalized experience of other doctors;
Let us dwell on some points in more detail. The collection and analysis of medical research data - already now a large number of medical devices can give data in electronic form (I see no reason to keep them on paper). These data may in the future become the indispensable statistical base for research . Experience in any field is indispensable, especially in medicine. But I simply consider storing such data as the past - medical systems must take a step forward: they can help doctors avoid trivial errors in making diagnoses, they can help to make a correct diagnosis (this is more like systems on airplanes, when the pilot forgot to remove the landing gear after takeoff - the system will remind him of this). Perhaps in the future, the system itself will be able to make simple diagnoses (such as SARS, acute respiratory infections, ESR, and others).
Items such as informing and accessing the medical history via the Internet make the life of the patient easier. After all, this is not a healthy person, who may not be difficult to walk a couple of km to a medical institution. And so you sitting at home get all the desired results, as well as the destination. Quick and convenient. The big plus can be remote communication of the patient with the attending physician.
A single information space within the whole country gives you the opportunity not to care that having arrived in another city and having become ill, you will have to retell a new doctor what you once had been ill with. I am already silent about emergency cases, accidents, etc., where you need to act and not dig paper in search of contraindications for a particular patient. Perhaps it will save lives.
All data in the system should be stored without the possibility of their deletion and substitution. This is more like a version control system. All changes will be recorded, creating only a new version of the document, but not replacing the old one. Medical error will be available and visible immediately. Given the distributed data storage system, it will be difficult to “bring in” who needs to replace the data. On the same data it is possible to build a system for assessing the quality of services, objective, with numbers.
The big problem now is prescription drugs. The system may have affiliated pharmacies. Then the doctor simply informs the convenient pharmacy for the patient that a certain medicine will be necessary, and the patient will only have to come and pick it up (medicine).
As the standard scheme of interaction of the doctor and the patient can look:
- Patient N went to hospital B;
- M1 doctor provides the patient with a document identifying him with the service session; For identification, a QR code is used that contains user identification data. And on the side of the system, only the session ID remains, and without a QR code to bind a specific person to this ID is not possible. This ensures the safety and anonymity of the data.
- The doctor M1 conducts the primary examination, enters the data of the primary examination into the system, registers the directions for research.
- the patient picks up the document identifying it with the maintenance session. And he goes to the doctor for a study which he had been prescribed.
- The doctor M2 scans the QR code and receives the session ID of the patient service. Conducts the study assigned to him and records the data in the system.
- Then the patient returns to the doctor M1. He scans the QR code and looks at the results of the study. Puts an interim diagnosis. The system fixes it. And writes assignments that are also recorded. The system gives the doctor a comprehensive accumulated statistical data on the disease based on the assumptions of the doctor and the analysis of the results of the research.
- Then the patient returns again for a second consultation with the doctor M1. He again scans his QR code and conducts a second inspection, fixing the dynamics of the course of the disease. If the prognosis is negative, then an additional interim diagnosis can be made if the first one was erroneous and new appointments were recorded.
- If the patient is cured, then the maintenance session is closed. And the doctor confirms the final diagnosis. Now the system can identify the entire experience of the interaction of the patient with a particular disease and doctor, as well as the experience of treating this disease.
Thus, the system stores all the complete comprehensive picture of the person’s disease and treatment methods. The availability of the patient's card in electronic form gives a significant increase in the speed of medical decision-making.
A big bet should be placed on mobile apps. So the workplace of the doctor can be mobile, and not tied to the office. Medic can assist and receive information in any place where there is access to the Internet.
I would single out four levels in the structure of the system:
- the level of interaction of the patient - the doctor. These include: doctor web interfaces, client web interfaces, results distribution systems, mobile applications.
- institution level. That part of the system that provides communication between institutions in one region.
- federal level. At this level communication is established between the regional centers.
- level. Here only the head center collecting information from all regional centers.
To ensure security, you need to follow several rules:
- the base should not contain direct links between research data and data that can identify a specific citizen;
- storages must be distributed (part of the data of the Tula region lies on the servers in Kaluga);
- the data must be duplicated (complicates the substitution - simultaneously replace the data in three sources - somehow an unlikely scenario);
- data exchange goes on encrypted channels.
I apologize for taking a lot of time, I just wanted to say how I would like to see the health care system of the future. I do not pretend to be the ultimate truth :). I will be glad to any criticism and comments.
PS I would be happy to take part in the development of such a system in Russia.
Source: https://habr.com/ru/post/136806/
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