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The Ministry of Health and Social Development is trying to bring together databases on patients and medications
Along with the emergence of relatively large amounts of money in Russian healthcare, the leadership of the Ministry of Health and Social Development was faced with the question of creating a unified database that would reflect all the costs of maintaining clinics and hospitals. The current inconsistency of computer networks is fraught not only with underfunding, but also with high-profile scandals that could affect the reputation of both officials and socially significant programs implemented by the state. This was recently stated by several high-ranking officials of the Ministry of Health and Social Development, Roszdravnadzor, the Federal Compulsory Medical Insurance Fund (FFOMS) and the Social Insurance Fund (FSS) at a conference on information technologies in healthcare held in Moscow. According to Vremya Novostey, the task of creating a unified state register was assigned to the Ministry of Health and Social Development after the crisis of the program for additional drug provision, where about 7 billion rubles were stuck due to incompatibility of computers of several departments. It is expected that after its creation, the register will become the only basis for funding from the state budget of treatment and prevention institutions (HCI).Today, all medical structures have their own computer databases: the number of doctors and patients, the dispensing of preferential drugs and other parameters. However, reporting is carried out differently everywhere, and therefore it is not surprising that, for example, the Federal Compulsory Medical Insurance Fund and Roszdravnadzor can see different numbers of patients receiving medical care and medications in the same region. “There is no integration of various information flows coming to different federal bodies,” says Lyudmila Mikhailova, deputy head of the department for legal regulation of primary sanitary and emergency care of the Ministry of Health and Social Development. In addition, according to her, today the heads of medical institutions have to write three different statistical reports on the activities of the institution entrusted to them, and even in these documents there may be discrepancies.
The complexity is also created by the system of departmental medical institutions preserved from Soviet times, some of which are a “black box” for the Ministry of Health and Social Development, absorbing medicines but not reporting. “Today we have 30 thousand health care facilities of various subordination, that is, the environment is incredibly heterogeneous,” says Evgeny Nikonov, head of the department for coordinating the activities of territorial departments and national priority projects of Roszdravnadzor. “It’s very difficult to implement a single software.” He noted that with the change in the principle of healthcare financing - when it is not the health care facility itself that is financed, but the services that it provides - medical institutions actually for the first time felt a real connection between the data they present and the amount of funds received. And they became very thoughtful. “It is necessary to clearly define the responsibility of chief doctors for the data entered,” Mr. Nikonov suggested. According to him, checks of submitted reports often reveal the simply monstrous illiteracy of the officials themselves. “When we were compiling a register of medical workers, we received a lot of complaints from the regions that there was no ENT doctor in the list of specialties we proposed. We double-checked everything and found that the registry includes the specialty of otolaryngologist. The investigation showed that some local health care managers believed that these were two different specialties,” said a representative of Roszdravnadzor.
But ultimately, the Ministry of Health and Social Development is interested in monitoring the distribution of budget money through the reports it receives and drawing up applications to the Ministry of Finance that will avoid a shortage of funds in a particular program (after all, in the same DLO-2006 program, the application for medicines for beneficiaries was lower actual demand is twice). “We collect medical statistics in February-March, process them in May, and at this time the Ministry of Finance is already finishing the layout of the budget for the next year,” complained the speakers at the conference.