Personalized accounting of medicines: health care facility pharmacy. Medical Computer Technologies AIS “MKT-Personalized accounting of medicines Personalized accounting of medicines in healthcare facilities program
DEPARTMENT OF HEALTH PROTECTION OF THE POPULATION OF THE KEMEROVSK REGION
ORDER
ON THE IMPLEMENTATION OF PERSONALIZED ACCOUNTING OF MEDICINES IN TREATMENT AND PREVENTIONAL INSTITUTIONS OF THE REGION"
Based on the order of the Ministry of Health and Social Development of the Russian Federation No. 110 dated February 12, 2007 “On the procedure for prescribing and prescribing medicines, medical products (prescriptions and specialized medical nutrition products,” I order:
1. Approve the Regulations on the department of centralized personalized accounting of medicines of a medical institution (hereinafter referred to as the CPMC) (Appendix 1).
2. Approve the application form for medical prescriptions (Appendix 2*).
________________
* Appendix 2 is not provided. - Database manufacturer's note.
3. To the heads of territorial health authorities, chief doctors of central city and district hospitals, state medical and preventive institutions, to ensure timely and high-quality implementation of medical prescriptions, strengthen control over the accounting of medicines and medical products:
3.1. within the period before November 1, 2010, create a central medical treatment center for drugs in subordinate treatment and preventive institutions;
3.2. organize the work of the Central Control Center of Medicines in accordance with the approved Regulations;
3.3. ensure the maintenance of records and reporting, timeliness and completeness of the submission of information to monitor the activities of the Central Administration of Medicines;
3.4. by October 1, 2010, provide step-by-step plans for the implementation of personalized accounting of medicines in medical institutions to the chief regional specialist T.V. Druzhinina by e-mail: [email protected].
4. Director of KOMIAC L.E. Isakova by 10/15/2010, ensure the development of software and monitoring of the activities of the central control center with the provision of information to the department on a monthly basis no later than the 5th day of the month following the reporting one.
5. Responsibility for the execution of the order should be assigned to the first deputy head of the department O.V. Seledtsova, acting. Deputy Head of the Department V.N. Chegodaev.
6. I reserve control over the execution of this order.
Head of department
V.K.TSOY
Appendix 1. REGULATIONS ON THE DEPARTMENT OF CENTRALIZED PERSONALIZED DRUG CONSUMPTION ACCOUNTING
Annex 1
to the department order
public health protection
Kemerovo region
dated September 22, 2010 N 1088
1. General Provisions
1.1. This Regulation defines the main tasks, functions, rights and responsibilities of the department of centralized personalized accounting of drug consumption (CPMC).
1.2. OTsPU LS in its activities is guided by orders of the Ministry of Health and Social Development of the Russian Federation, other legal and methodological documents.
1.3. OTsPU LS is a structural unit of a medical institution, created and liquidated by order of the chief physician.
1.4. Management of the work of the department is entrusted to the head of the department, to whose position a person with a higher medical or pharmaceutical education is appointed by order of the chief physician.
1.5. The staffing level and structure of the department are approved by the chief physician within the existing staffing table, based on the characteristics of the department’s work and the need to ensure work around the clock.
1.6. OTsPU LS carries out its activities in cooperation with the pharmacy of the medical institution and all structural divisions around the clock.
2. Main tasks of the department
The main tasks of the OCPU are:
Optimization of drug provision for patients in healthcare facilities through personalized distribution of drugs;
Organization of centralized administration of antibiotics by injection;
Improving the accounting of medicines and medical products;
Ensuring reporting and monitoring the implementation of assigned tasks, the department for centralized personalized accounting of drug consumption performs the following functions:
Carries out requests for medical appointments from ward and guard nurses of the departments.
Receives drugs at the pharmacy upon request - an invoice drawn up on the basis of prescription sheets.
Carries out the layout of ampoule and tablet medications (in accordance with the entries in the prescription sheets).
Delivers ampoules of drugs for intravenous infusions, laid out personally for patients, to the treatment nurse.
Delivers tablet medications to each patient in the ward in accordance with the doctor’s prescription and indicating the rules of administration.
Performs intramuscular injections in the wards, according to the notes on the doctor's prescription sheets.
Informs medical units about the availability of medications.
Complies with the sanitary-epidemiological regime and pharmaceutical procedures in accordance with established rules.
Keeps records and prepares reports on drug consumption in the prescribed manner.
To perform the assigned functions, the OCPU nurse is obliged and has the right:
In a timely manner, in accordance with established rules, perform intramuscular injections to patients in hospital departments.
Timely and efficiently, in accordance with established requirements, arrange medications in departments according to assignment sheets and distribute ampoule medications for intravenous infusions to procedural nurses.
Distribute tablet forms directly to patients in the wards in a timely manner, in accordance with the rules for taking medications.
Check expiration dates of medicines.
Follow the rules for storing medicines in accordance with established requirements.
Follow the technological rules for intramuscular injections.
Complete current documentation in accordance with established requirements.
Submit daily requests to the head of the OCPU for medicines to replenish supplies.
Comply with sanitary requirements in the workplace.
Take part in the inventory of inventory items in accordance with the instructions of the head of the department.
Systematically improve your qualifications and study specialized literature.
Strictly comply with internal labor regulations, fire safety and labor protection rules.
In all difficult cases, receive advice from the head of the department related to the distribution of medications.
Take advantage of regulated breaks to maintain performance throughout the entire work shift.
Make suggestions to improve the work of the department.
Participate in events held at the hospital.
To perform the functions assigned to it, the department of centralized personalized accounting of drugs is given the right to:
Request and promptly receive from departments sheets of medical prescriptions and lists of discharged patients.
Monitor the correct completion of applications for the availability of the drug dose, frequency of administration, and indicative course.
Inform senior nurses of departments about mistakes made by ward nurses when filling out applications from the Central Medical Center for Medicines.
To perform functions and exercise rights, the OCPU interacts with:
With the hospital pharmacy on issues of providing the department with medications and consumables.
With medical departments regarding the receipt of applications for medical prescriptions.
With the central accounting department on the submission of accounting and reporting documentation.
With the economic department on issues of supplying office supplies, as well as on issues of carrying out repairs in the premises assigned to the Central Control Center of Medicines.
Department employees bear individual responsibility:
For the correct placement of intramuscular injections, placement of medications and timely delivery of tablet forms to patients.
For the sanitary condition of your workplace.
For the safety of inventory items.
For compliance with internal labor regulations, fire safety and labor protection.
Algorithm for the action of a nurse at the Central Clinical Hospital when distributing medicines to departments
I. Preparation for distribution
1. Before starting work in the drug distribution room, the workplace is wet cleaned in accordance with current regulations.
2. Before starting the layout, perform hygienic treatment of the hand in a hygienic manner.
3. Put on special clothes located in the layout room.
4. Place the necessary equipment for work on the layout table: clip bucks (packaging bags), wax paper, a container for tablet forms, scissors, as well as a pen and a marker.
5. Place packages of medications on the desktop according to pharmacological groups or alphabetically.
II. Distribution
The layout is carried out according to the algorithm:
1. Check that the applications are filled out correctly, that they contain the dose of the drug, the frequency of its use, the course of treatment and the signature of the ward nurse.
2. Distribution of ampoule dosage forms should be carried out in packaging bags (clipbucks) indicating the department, full name. patient, ward N.
3. Distribution of tablet dosage forms should be carried out in containers for tablet forms, indicating the department, full name. patient, room number, time of admission (morning, lunch, evening, night).
4. Place the distributed medications in special trays for each compartment.
Attention:
When distributing, pay attention to the expiration dates of medications;
When working, follow safety rules.
Upon completion of distribution, clean the workplace.
1. Arrange the remaining drugs in storage cabinets according to pharmacological groups.
2. Remove packaging material.
3. Carry out a wet cleaning of the desktop.
Note:
Prohibited:
1. The presence of unauthorized persons in the room for drug distribution.
2. Use cell phones.
3. Eating, smoking and having extraneous conversations.
4. Store personal belongings in a specially designated place.
The ward nurse works with appointment sheets only in the document processing room<**>.
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<**>The regulations are subject to modification in each health care facility depending on local conditions. For the effectiveness of personalized accounting of drug consumption, it is necessary to consider the centralized distribution of all forms of medicines, medical products, and specialized medical nutrition products.
The Regulations should include the procedure for maintaining records and reporting, a mechanism for determining the need, generating an application, informing doctors about the availability and receipt of medicines, and the procedure for issuing requirements.
This order does not apply to emergency departments, intensive care units, and maternity wards.
The administration of narcotic, psychotropic, potent and toxic substances is carried out in accordance with previously established procedures.
Currently, personalized accounting of medicines makes it possible to increase the safety of pharmacotherapy and optimize the labor costs of medical personnel.
How to build a system in a health care facility pharmacy? The peculiarity of this system is that medications are dispensed personally to each inpatient directly from the hospital pharmacy, bypassing the “storage rooms” of senior nurses of the departments, along a short chain “pharmacy - nursing station”.
Advantages of a personalized medicine accounting system
- exemption of senior nurses from the obligation to receive, store and dispense medications. Concentration of the entire stock of medicines in the pharmacy of the healthcare facility;
- transfer of medical prescriptions from hospital departments directly to the hospital pharmacy through the medical organization’s automated control system;
- pharmacy specialists complete a daily set of medications for each patient and deliver them to the departments;
- personalized accounting of the dispensing of medications during the process of placing an order in a pharmacy;
- production of infusion mixtures in an aseptic box in a pharmacy.
But the main advantages of the unit dose system are:
- savings of up to 30% of a medical organization's allocations for medicines by concentrating the stock of drugs in the pharmacy of a healthcare facility. Interestingly, these American data are fully consistent with the ICH data obtained as a result of the implementation of a system of personalized intrahospital distribution of drugs;
- the possibility of additional pharmaceutical control of drug prescriptions by health care facility doctors and their timely adjustment;
- increasing the safety of pharmacotherapy as a result of assigning responsibility for the quality of drugs received by patients to pharmacy staff;
- release of nursing staff to perform their direct functions.
How to implement a personalized drug accounting system
Scheme of personalized intrahospital distribution of drugs
Carrying out this work requires certain technical equipment for hospital pharmacies, the acquisition of which is currently within the capabilities of large hospitals, in the context of modernization.
Firstly, the hospital pharmacy must have modern computer equipment and software built into the automated control system of the healthcare facility and allowing online receipt of medical prescriptions, generation of invoice requirements for medications, keeping records of drugs dispensed, transfer of accounting and reporting documents to the accounting department of the healthcare facility, and also provide the pharmacy with the necessary professional information.
Secondly, medications must be dispensed from the pharmacy in a specific package. This could be a plastic jar containing the daily dose of the drug, for example 2 tablets of diclofenac for 2 doses per day. A large variety of equipment for packaging individual doses of drugs is produced in the United States. There may be packaging in blisters, contour cells, etc. The name of the drug, warning labels and other necessary information are applied to the packaging of drugs using self-adhesive tape. In the case of dispensing single doses in health care facilities, it is advisable to purchase medicines angro (total weight), for example, in a package of 1000 tablets, etc., which creates additional savings for health care institutions.
Thirdly, health care facilities must be equipped with means of delivering individual sets of medications to nursing stations in departments. In large healthcare facilities in the United States, medicines are delivered to departments by pneumatic mail or in gurneys with boxes according to the number of beds in the department. Gurneys are usually used as exchange ones, i.e. in one gurney, drugs are delivered to the department for the current day and left directly in it for a day, and the gurney vacated from the previous day is returned to the pharmacy.
Fourthly, if you transfer the production of infusion mixtures from treatment rooms to a pharmacy, it is necessary to purchase a unit with a laminar flow of sterile air for introducing medications into vials or bags with sterile solutions of solvents or diluents (isotonic solution of sodium chloride, glucose, etc.) under aseptic conditions. Preparing infusion mixtures in a pharmacy instead of treatment rooms improves the quality of the prepared mixtures, eliminates errors made by nursing staff in departments, and ensures strict adherence to the rules for the manufacture and storage of infusion mixtures.
The costs of equipping large healthcare facilities with the necessary equipment are recouped by saving costs on medicines, the costs of which amount to tens of millions of rubles monthly.
Problems of implementing personalized accounting in health care facilities pharmacy
The problem that arises when introducing personalized intrahospital distribution of medicines is, on the one hand, a lack of understanding of the benefits obtained by the management of health care facilities, and on the other hand, the desperate resistance of senior nurses, and sometimes heads of departments, who are often deprived of very significant supplies of medicines in the departments .
Describing the difficulties of implementing the system in question, American experts note that to achieve success, the will of the leader is necessary first of all. Thus, the initiator of the introduction of a system of personalized intrahospital distribution of medicines in 1991 in the ICHB and three other health care facilities was the chairman of the health committee of the administration of the Irkutsk region. The described system operates in these medical organizations to the present day.
And finally, an extremely difficult problem is the selection and training of specialists for the pharmacy of medical institutions, ready to work in new conditions, who understand the role of the pharmacy in organizing rational and safe pharmacotherapy in hospitals.
3) date of birth;
4) place of birth;
5) citizenship;
6) details of the identity document;
7) place of residence;
8) place of registration;
9) date of registration;
10) insurance number of an individual personal account (SNILS), adopted in accordance with the legislation of the Russian Federation on individual (personalized) accounting in the compulsory pension insurance system;
11) number of the compulsory health insurance policy of the insured person;
12) information about the medical insurance organization chosen by the insured person;
13) date of registration as an insured person;
14) status of the insured person (working, non-working);
Information about changes:
Order
15) information about the medical organization chosen by the insured person in accordance with the legislation of the Russian Federation to receive primary health care;
Information about changes:
Clause 3 was supplemented with subclause 15 from February 11, 2019 - Order of the Ministry of Health of Russia dated January 15, 2019 N 12N
16) information about the medical worker selected by the insured person in accordance with the legislation of the Russian Federation to receive primary health care.
4. Personalized recording of information about medical care provided to insured persons includes the collection, processing, transfer and storage of the following information:
1) number of the compulsory health insurance policy of the insured person;
2) information about the medical organization that provided medical services;
3) types of medical care provided;
4) conditions for providing medical care;
Information about changes:
Clause 4 was supplemented with subclause 4.1 from February 11, 2019 - Order of the Ministry of Health of Russia dated January 15, 2019 N 12N
4.1) forms of medical care;
5) timing of medical care;
6) volumes of medical care provided;
7) the cost of medical care provided;
8) diagnosis;
9) profile of medical care;
10) information about the medical services provided to the insured person and the medications used;
11) applied standards of medical care;
12) information about the medical worker or medical workers who provided medical services;
13) the result of seeking medical help;
14) the results of monitoring of the volumes, timing, quality and conditions of medical care.
5. Information about the insured person and the medical care provided to him can be provided both in the form of documents in written form and in electronic form, subject to guarantees of their reliability (authenticity), protection from unauthorized access and distortion in accordance with the requirements established by the legislation of the Russian Federation on the protection of personal data. In this case, the legal force of the submitted documents is confirmed by an electronic digital signature in accordance with the legislation of the Russian Federation. The decision on the possibility of presenting information in electronic form is made jointly by the participants in the information exchange.
6. Insurance medical organizations and medical organizations store copies of paper documents and electronic archives containing personalized information about insured persons and the medical care provided to them, submitted to the territorial compulsory health insurance fund (hereinafter referred to as the territorial fund) for personalized accounting, according to the rules of the organization of the state archival affairs.
7. After the expiration of the period established for storing copies of documents on paper and electronic media in a medical insurance organization, they are subject to destruction in accordance with the legislation of the Russian Federation on the basis of an act of their destruction, approved by the head of the medical insurance organization.
8. Information about the insured person and the medical care provided to him is classified as restricted information and is subject to protection in accordance with the legislation of the Russian Federation.
III. Maintaining the regional segment of the unified register of insured persons
9. Information about each insured person specified in paragraph 3 of this Procedure is entered into the unified register of insured persons.
10. Maintaining the regional segment of the unified register of insured persons is carried out by the territorial fund on the basis of information about insured persons provided by an insurance medical organization, medical organization, tax authorities, military commissariats, as well as on the basis of information provided within the framework of interdepartmental interaction from other state information systems in in accordance with this Procedure.
11. The insurance medical organization, medical organization and territorial fund, by orders, determine the employees allowed to work with the regional segment of the unified register of insured persons, and comply with the requirements of the legislation of the Russian Federation on the protection of personal data.
12. When entering information about an insured person into the regional segment of the unified register of insured persons, the insurance medical organization ensures the accuracy and correctness of the entered information and carries out checks to prevent the appearance of duplicate entries in the regional segment of the unified register of insured persons:
1) for the presence of repetitions of last name, first name, patronymic, date and place of birth;
2) for the presence of repetitions according to the data of the identity document;
3) correct indication of the gender of the insured person;
4) for the presence of repetitions by date of birth and address of registration at the place of residence;
5) for the presence of repetitions of last name, first name and patronymic and registration address at the place of residence;
6) for the presence of repetitions according to the insurance number of the individual personal account (SNILS).
13. In order to update the regional segment of the unified register of insured persons and enter information about insured persons into it, the insurance medical organization generates and transmits information files with changes in information about insured persons provided for in subparagraphs 1-13 of paragraph 3 of this Procedure (hereinafter referred to as files with changes) , to the territorial fund as needed, but at least once a day if there are changes in information about the insured persons, in accordance with the agreement on financial support for compulsory health insurance.
In order to update information about the medical organization and medical worker selected by the insured person in accordance with the legislation of the Russian Federation to receive primary health care, the medical organization generates and transmits information files with changes in information about the insured persons provided for in subparagraphs 1, , , and 16 paragraph 3 of this Procedure, to medical insurance organizations and the territorial fund as necessary, but at least once a day if there are changes in information about the insured persons.
14. The territorial fund provides round-the-clock reception and processing of files with changes received from insurance medical organizations and medical organizations.
15. When processing files with changes in the territorial fund, format-logical control of data, identification of records in the regional segment of the unified register of insured persons, and entry of information about insured persons are carried out.
16. After processing files with changes in the territorial fund, files confirming and/or rejecting changes are generated, which are sent to the relevant insurance medical organizations and medical organizations to adjust information about insured persons.
17. Tax authorities quarterly, no later than the 15th day of the second month following the reporting period, provide in accordance with the Agreement on information exchange between the Federal Compulsory Medical Insurance Fund (hereinafter referred to as the Federal Fund) and the federal executive body authorized to control and supervision in the field of taxes and fees, to the relevant territorial fund, information about working insured persons, provided for in subparagraphs 1-10 and 14 of paragraph 3 of this Procedure, for entering them into the regional segment of the unified register of insured persons.
18. Military commissariats quarterly, no later than the 15th day of the month following the reporting period, transfer to the territorial funds information about citizens called up for military service, provided for in paragraphs 1 and 6 of part 2 of Article 44 of the Federal Law of November 29, 2010 N 326- Federal Law "On Compulsory Medical Insurance in the Russian Federation" (Collected Legislation of the Russian Federation, 2010, No. 49, Art. 6422; 2012, No. 31, Art. 4322, No. 49, Art. 6758; 2013, No. 48, Art. 6165; 2014, No. 1098; 2015, No. 7245; 2018, No. 4857) (hereinafter referred to as the Federal Law “On compulsory health insurance in the Russian Federation”), and termination of military service in accordance with Part 8 of Article 49
19. Territorial fund:
1) as necessary, but at least once a day, checks the accuracy of information about the insured person received from the medical insurance organization by sending requests to the authorities that issue and replace identification documents of a citizen of the Russian Federation on the territory of the Russian Federation, and if inconsistencies are identified in the information about the insured person, sends information files to the medical insurance organization indicating them;
2) weekly on the basis of information on state registration of marriage or divorce, establishment of paternity, change of name contained in the Unified State Register of Civil Status Records, provided as part of interdepartmental cooperation in accordance with Article 13.2 of Federal Law of November 15, 1997 N 143 -FZ “On Acts of Civil Status” (Collected Legislation of the Russian Federation, 1997, N 47, Art. 5340; 2016, N 26, Art. 3888; 2018, N 31, Art. 4857, 4861, N 53, Art. 8454) , identifies the insured person in the regional segment of the unified register of insured persons in order to determine the medical insurance organization in which he is insured, and in case of changes in information about the insured person, sends the specified information to the medical insurance organization to ensure control over changes in information about the identity document the insured person, re-issuing a compulsory health insurance policy and further sending information files to the territorial fund for updating the regional segment of the unified register of insured persons within 30 days from the date of state registration of marriage or divorce, establishment of paternity, change of name;
3) monthly:
a) on the basis of information on state registration of death contained in the Unified State Register of Civil Status Records, provided as part of interdepartmental interaction in accordance with Article 13.2 of the Federal Law of November 15, 1997 N 143-FZ “On Civil Status Acts” (Meeting legislation of the Russian Federation, 1997, No. 5340; 2016, No. 3888; 2018, No. 4857, 4861, No. 8454):
Terminates the compulsory health insurance policy for persons whose information is available in the regional segment of the unified register of insured persons;
Sends information files to the Federal Fund with information on state registration of death for persons whose information is not available in the regional segment of the unified register of insured persons;
b) makes a request to the Federal Fund to obtain information about persons whose information is available in the regional segment of the unified register of insured persons, but who died outside the territory of the subject of the Russian Federation in which he is insured;
c) on the basis of information received from the Federal Fund, recognizes the compulsory health insurance policy as invalid in the event of:
Termination of citizenship of the Russian Federation in the absence of grounds for recognizing a person as an insured person in accordance with Part 1 of Article 10 of the Federal Law “On Compulsory Health Insurance in the Russian Federation” - from the date of receipt of information in accordance with subparagraph 1 of paragraph 27.1 of this Procedure;
Cancellation of a residence permit in relation to foreign citizens, stateless persons - from the date of receipt of information in accordance with subparagraph 2 of paragraph 27.1 of this Procedure;
Cancellation of a temporary residence permit in relation to foreign citizens and stateless persons - from the date of receipt of information in accordance with subparagraph 3 of paragraph 27.1 of this Procedure;
Loss or deprivation of refugee status - from the date of receipt of information in accordance with subparagraph 4 of paragraph 27.1 of this Procedure;
4) quarterly:
a) based on information about the insured person provided for in paragraph 17 of this Procedure, within 15 working days from the date of receipt:
Updates the regional segment of the unified register of insured persons and sends information files with information about working insured persons to the Federal Fund;
Sends information files to the Federal Fund with information about working insured persons, information about which is not available in the regional segment of the unified register of insured persons;
b) no later than the 15th day of the third month following the reporting period, provides the policyholder for non-working citizens with information about insured persons who are registered as non-working insured persons, and information about which is provided for in subparagraphs 1-10, 14 of paragraph 3 of this Procedure, not provided in accordance with paragraph 17 of this Procedure;
c) on the basis of the information provided for in paragraph 18 of this Procedure, suspends the compulsory health insurance policy.
20. The territorial fund ensures the updating of the regional segment of the unified register of insured persons on the basis of information in accordance with subparagraphs 2-4 of clause 19 of this Procedure, notifies medical insurance organizations about this and sends information files to the Federal Fund for updating the central segment of the unified register of insured persons.
21. The territorial fund updates the regional segment of the unified register of insured persons on the basis of information received from the Federal Fund from the central segment of the unified register of insured persons.
22. In case of violation of the deadlines established by the agreement on financial support for compulsory medical insurance for the provision of data on insured persons, as well as information about changes in this data, the insurance medical organization is obliged to pay the territorial fund at its own expense a fine in the amount established by Part 10 of Article 38 of the Federal Law "On compulsory health insurance in the Russian Federation."
23. The territorial fund exercises general control over the regional segment of the unified register of insured persons. If errors and inconsistencies are detected, the territorial fund sends the relevant information to the insurance medical organization and the medical organization indicating a list of inconsistencies.
IV. Maintaining the central segment of the unified register of insured persons
24. When making changes to the regional segment of the unified register of insured persons, the territorial fund generates files with changes, which it sends to the Federal Fund to update the central segment of the unified register of insured persons as necessary, but at least once a day if there are changes in information about the insured faces.
The files with changes include all newly entered and changed information about insured persons since the last submission.
25. The Federal Fund provides round-the-clock reception and processing of files with changes from territorial funds.
26. When processing files with changes, a check is made to ensure that the insured person has a previously issued valid compulsory medical insurance policy of a single sample in the central segment of the unified register of insured persons.
27. In the central segment of the unified register of insured persons, information files with information about the insured person are processed, including on the suspension of the compulsory health insurance policy, on the invalidation of the compulsory health insurance policy, on state registration of death, on the status of insured persons (working, unemployed), about medical organizations and medical workers chosen by the insured persons.
Information about changes:
The rules were supplemented by paragraph 27.1 from February 11, 2019 - Order of the Ministry of Health of Russia dated January 15, 2019 N 12N
27.1. The Federal Fund quarterly, no later than the 15th day of the month following the reporting period, ensures the processing of information received from the federal executive body in the field of internal affairs, provided for
4) on persons recognized as refugees on the territory of the Russian Federation, if they lose refugee status or are deprived of their refugee status in accordance with Federal Law of February 19, 1993 N 4528-1 “On Refugees” (Collected Legislation of the Russian Federation, 1997, N 26, art. 2956; 2000, no. 3348, art. 4537, art. 35, Art. 3607; 2007, Art. 29, N 3616; , N 10, Art. 1166, Art. 6397, Art. 2013, N 3477;
28. The Federal Fund maintains the central segment of the unified register of insured persons and provides general control over the updating and use of the unified register of insured persons.
29. The exchange of data between insurance medical organizations, medical organizations, territorial funds and the Federal Fund for the purpose of maintaining personalized records of information about insured persons provided for in paragraph 3 of this Procedure is carried out electronically via dedicated or open communication channels, including the Internet, using electronic digital signature in accordance with the requirements established by the legislation of the Russian Federation for the protection of personal data.
V. The procedure for maintaining personalized records of information about medical care provided to insured persons
30. Personalized records of information about medical care provided to insured persons are maintained electronically by medical organizations and medical insurance organizations operating in the compulsory health insurance system, and by territorial funds.
31. A medical organization, an insurance medical organization and a territorial fund, by order, determine the employees who are allowed to work with information about personalized records of medical care provided to insured persons, and ensure their confidentiality in accordance with the requirements of the legislation of the Russian Federation on the protection of personal data.
32. Medical organizations provide information on medical care provided to insured persons, provided for in subparagraphs 1-13 of paragraph 4 of this Procedure, to the territorial fund.
33. The territorial fund, within two working days, based on the regional segment of the unified register of insured persons, carries out automated processing of information received from medical organizations about medical care provided to insured persons.
34. At the stage of automated processing of information about personalized records of medical care provided to insured persons, the following is carried out in the territorial fund:
1) identification of the insured person according to the regional segment of the unified register of insured persons, determination of the medical insurance organization responsible for paying the bill;
2) identification of insured persons who received medical care outside the insurance territory and determination of their insurance territory;
3) sending electronically the results obtained in accordance with subparagraphs 1 and this paragraph to the medical organization that provided medical care to the insured persons.
35. Based on the results of automated processing of information about medical care provided to insured persons, carried out in accordance with paragraph 34 of this Procedure, a medical organization submits it to medical insurance organizations in the amount and within the time frame established by the contract for the provision and payment of medical care under compulsory health insurance.
36. After monitoring the volume, timing, quality and conditions of providing medical care in accordance with Article 40 of the Federal Law “On Compulsory Medical Insurance in the Russian Federation”, the information specified in paragraph 4 of this Procedure in the form of information files is transferred by the insurance medical organization to medical organizations and territorial fund within the time limits stipulated by the agreement on financial support for compulsory health insurance.
37. In case of difficulties in determining the insurance territory of a person who received medical care outside the insurance territory, the territorial fund generates an electronic request to the central segment of the unified register of insured persons, where within 5 working days a check is carried out and a response is generated indicating the identified insurance territory and the current policy number of the insured person.
38. Data exchange between medical organizations, medical insurance organizations, territorial funds and the Federal Fund for the purpose of maintaining personalized records of information about medical care provided to insured persons is carried out electronically via dedicated or open communication channels, including the Internet, using electronic digital signatures in accordance with the requirements established by the legislation of the Russian Federation for the protection of personal data.
Since September 2012, a regional medical information system (RMIS) has been implemented in all healthcare facilities in the Ulyanovsk region, one of the components of which is an information system for personalized accounting of medicines and medical products. Currently: 78 institutions in the Ulyanovsk region use the program; 35 institutions write off medications for patients; 43 institutions carry out subject-quantitative accounting at the pharmacy level; EXAMPLES OF IMPLEMENTATION Also in 2012, a medical information system was introduced in the Saratov region, which united: 112 medical institutions 4 insurance companies (ROSNO, RGS, SOGAZ, MAKS-M) Health Committee of the cities of Engels, Balakovo Territorial Mandatory Medical Insurance Fund Ministry of Health of Saratov region
SYSTEM STRUCTURE PERSONALIZED DRUG ACCOUNTING INFORMATION SYSTEM INCLUDES: AWP “Head” – an automated workstation for the head of an institution that implements the functions of monitoring the movement of medicines in health care facilities. AWP "Pharmacy" - obtaining information about the requirement for medicines; entering data on the receipt/expense of medicines; generation and printing of an invoice for the release of medicines, monthly reports for accounting, a monthly report on the balance of medicines in the warehouse, a write-off certificate, an order for medicines. Ordering medicines to an authorized warehouse on-line. AWS “Senior nurse” - generation and printing of a report on the consumption and balances of medicines in the departments, a report on the balances of medicines for guard nurses, requests for medicines in automatic mode, an invoice for the release of medicines, a write-off act; entering data on medication consumption. AWP "Guard nurse" - generation and printing of a report on the consumption and balances of medicines in the departments, a report on the balances of medicines for guard nurses; entering information about a new patient, information about the patient’s discharge/transfer, data on medication consumption (per patient/to another department/written off according to the act); generation and printing of a write-off act, invoice for the dispensing of medicines. AWP “External control” is an automated workstation of the authorized head of the healthcare management body (employee of the Ministry of Health, TFOMS, etc.), implementing the functions of monitoring the movement of medicines in health care facilities in the region with the ability to generate reports (both for a specific health care facility and consolidated for the region). The System also includes the reference book “Radar. VIP Database" - A directory containing complete information about all medicines and medical products registered in Russia. The system is integrated with the Regional Medical Information System of the Ulyanovsk Region in terms of obtaining information on the movement of inpatients from RMIS to the System. The system is a Web interface for interactive interaction with a local user. The system has a centralized database providing remote secure access for healthcare institutions in the Ulyanovsk region
SYSTEM STRUCTURE PERSONALIZED DRUG ACCOUNTING ARM PHARMACY receiving information about the requirement for medicines; entering data on the receipt/expense of medicines; generation and printing of an invoice for the release of medicines, generation and printing of monthly reports for accounting, a monthly report on the balance of medicines in the warehouse, a write-off certificate, an order for medicines. Ordering medicines to an authorized warehouse on-line Since the beginning of 2013, the Ulyanovsk regional system has created: invoices; 940 inventory documents
SYSTEM STRUCTURE PERSONALIZED ACCOUNTING OF medicinal products SENIOR NURSE's workstation generation and printing of a report on the consumption and balances of medicines in the departments, generation and printing of a report on the balances of medicines for guard nurses, requirements for medicines in automatic mode, invoice for the release of medicines, write-off act; entering data on medication consumption Since the beginning of 2013, movement documents have been created in the system
Information about medications issued to the patient SYSTEM STRUCTURE PERSONALIZED ACCOUNTING OF medicinal products GUARD NURSE ARM; generation and printing of a report on the consumption and balances of medications in the departments; a report on the balances of medications for guard nurses; entering information about a new patient, information about the patient’s discharge/transfer, data on medication consumption (per patient/to another department/written off according to the act); generation and printing of a write-off act, invoice for the dispensing of medicines. Ivanov Ivan Ivanovich For 2013, expense documents were created in the system, of which - expenses for the patient
SYSTEM STRUCTURE PERSONALIZED ACCOUNTING OF medicinal products “Radar. "VIP Database" is a reference book that contains complete information about all medications and medical products, along with their names. Each directory element contains over 40 fields describing its parameters. If the required name is not in the directory, healthcare institutions send an application to the State Health Institution MIAC to add the drug to the directory
ADVANTAGES: CONTROL OF EXPIRATION DATES The information system has the ability to control the expiration dates of medicinal products THE POSSIBILITY TO GENERATE A REPORT “CONTROL OF EXPIRATION DATES” IS IMPLEMENTED VISUALIZATION OF PAST EXPIRATION DATES IN THE PROCESS OF WORK EXPIRATION DATE EXPIRE IN 3 MONTHS
INTEGRATION WITH AN AUTHORIZED WAREHOUSE The procedure for electronic document management with an authorized warehouse When an authorized warehouse receives an order from the Moscow Region, it processes it and generates an invoice for the transfer of medicines to the Moscow Region. This invoice is automatically transferred to the MO and is displayed in the invoice journal. To promptly display information on the receipt of medicines and medical products by the Ulyanovsk Region Ministry of Defense, the integration of AIS and the program of the authorized warehouse of the Ulyanovsk Region was carried out. This integration allows you to automatically exchange data on ordering medicines to an authorized warehouse and on receiving medicines from an authorized warehouse. If you need to receive medicines delivered to an authorized warehouse, you must fill out the “Order to Supplier” document in the Personalized Accounting program, which is automatically transferred to the authorized warehouse. Since the beginning of 2013, 7,178 invoices were loaded into the system from the authorized warehouse, which amounted to 53% of the total number of incoming invoices. 100% of medical institutions in the Ulyanovsk region use automatic loading of invoices.
INTEGRATION WITH ROSZDRAVNADZOR Uploading information for Operational monitoring of Roszdravnadzor The resulting output file of a special format is uploaded to the Roszdravnadzor website. To quickly obtain information about the availability of drugs in the Moscow Region. Subject to monitoring on the Roszdravnadzor website, the program provides a specialized mechanism that allows you to automatically obtain a file of a special format containing the required data. Subsequently, this file is simply uploaded to the Roszdravnadzor website. Uploading in the program is carried out in the “Service” section. Since the beginning of 2013, about 300 downloads of information for Roszdravnadzor have been made from the system
OLAP ANALYTICS - cubes The use of OLAP cubes technology provides ample opportunities for building analytical reporting for all medical institutions in the region Average number of bed days per case Direct and indirect costs in the municipality Average duration of a case of inpatient treatment in healthcare facilities of the Ulyanovsk region - 22 days
ANALYTICS The implementation of the software product “Personalized Drug Accounting” allows you to receive Personalized information: Personalized information: about medicines spent on the patient, their names, quantities, costs. Generalized information: Generalized information: about consumed pharmaceutical products, including medicines, financial costs. Free information: Free information: ability to select a time period, individual parameter: patient, nosological form, unit (department), drug, pharmacotherapeutic group THANK YOU FOR YOUR ATTENTION! Implementation of healthcare system automation projects Actual and legal address: Ulyanovsk, st. Omskaya, house 104 Phone: +7 (8422) Email: Website:
