Abstract
The article reviews the questions related to building the e-health systems. The key element of the system is electronic healthcare record to be formed according to the modular approach in the form of primary and satellite electronic medical records. Person-centred healthcare is proposed as a foundation for e-health. Such an approach provides a potential opportunity for all the medical doctors to obtain necessary information about their patients at any time via the teleconsultations in particular. Transition to e-health is associated with the creation of new opportunities for making diagnostic and therapeutic decisions based on the use of build-in decision support modules. The computer-assisted software design or hybrid systems are considered as the fourth generation medical information systems. It is reasonable to implement the entire information space of e-health, including the information systems of medical institutions and regional data repositories, based on cloud-optimized storage and computing solutions. This approach is expected to be implemented in Russia as a part of the unified state health information system. The authorized access to integrated databases for medical doctors of various specialties is required. In the framework of e-health, telemedicine is considered as an important component. Main elements comprise the real-time access of medical consultants to personified medical databases and remote follow-up of patients by the means of personal or home-based telemedicine. The use of personal portable devices for the control of vital signs of the organism is especially promising. Electronic stethoscopes and specialized video cameras for acquiring objective information should be increasingly used by remote consultants. Unfortunately, this trend is still underdeveloped in Russia. In perspective, e-health as unified medical space will provide a transition to the integrated analysis of population health by medical doctors of various specialties from different countries and will open new prospects for studying health based on the intelligent analysis of integrated data of patients.
Highlights
E-health is a complex system aimed at solution of the entire spectrum of the health problems of the population
Real progression of the medical information system integration is feasible only in case of standardization of medical records (EHR fields) in coordinated fashion and extent based on the unified reference data including the standards for encoding and exchanging of health status clinical characteristics
In Russian hybrid system, for the department of children’s thermal injury, created at the Pediatric Research Clinical Institute, we developed an array of estimates and tooltips regarding the possible pathological processes upon input of certain data: 1) calculation of the injured area based on electronic graphic image of a human body; 2) calculation of infusion therapy volume depending on injury severity and patient’s age; 3) detection of shock depending on input clinical data; 4) calculation of risk index for infectious complications
Summary
E-health is a complex system aimed at solution of the entire spectrum of the health problems of the population. E-health requires person-centred approach [2] [3] based on the authorized access to patients’ personal medical data in distributed databases during the entire life of patients Using such an approach, general practitioners, consulting physicians, emergency medical care physicians, and medical doctors of different specialities who make decisions regarding specifics and levels of necessary medical service will have all required data about the previous diagnostic results, diseases, and treatments. Thereafter, we will review the person-centred paradigm as a system of conceptual framework for integration of medical data of patients independent on solutions of particular diagnostic and treatment tasks being solved in certain institutions at various levels of medical help In this case, doctors of different institutions will have a complete picture of the health status of patients throughout their disease and the effectiveness of previously applied treatments. Achieving this goal is only possible in the e-health in the implementation of person-centred paradigm
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