Scientific Journal of KubSAU

There are about 575 thousand of citizens in the Krasnodar Region that are entitled to a preferential medical maintenance in accordance with the Federal Law of 17.07.1999 (№178-FZ) "On state social assistance." About 120 thousand of preferential prescriptions for 150 thousand of medicines are serviced per month. In order to make the drugs prescription process based exceptionally on real medical indications in accordance with modern concepts of medical service quality it is necessary to plan the medical-economic drugs prescription validity control (MEC). The work proposes the analysis and synthesis method of decision support system (DSS) modules for automation the selection of drugs prescription and medicinal maintenance cases, concerning the federal benefit recipients, while performing the MEC. DSS allows medical experts to estimate the efficiency of federal funds costs, that are spent on the preferential medicinal maintenance, moreover, it can serve as a basis for future purchases planning, as well as to correct and improve the efficiency of medical prescriptions. The DSS was developed in accordance with the approved procedure of information exchange in the Krasnodar Region; it involves the integration with existing systems. Furthermore, as the federal register of persons, entitled to the state social assistance, has common formats among all the Russian Federation subjects, the developed system can be easily adapted in other regions

The federal program on essential drugs provision (EDP) is one of the most significant and socially important state projects; it is directed to the reduction of morbidity and mortality together with the improvement of life quality of the society and its social climate. In accordance with the federal law “On social state assistance” from 17.07.1999 №178- FL, the essence of the program is that medical recipes are dispensed for preferential medicines to be received by federal program participants. The medical-economic control (MEC) of the drugs designation and provision of federal benefit recipients is performed basing on the automated registries examination of released drugs. The number of passed and failed examination recipes is determined according to the registers processing results. A certain percentage of the accepted for payment prescriptions is a subject for MEC. For the purpose of the recipes selection for testing, the paper proposes the mathematical models of criteria application and MEC-planning. The game model of organization and MEC performance in health care organizations is build basing on the theory of games. The considered play model suggests that the health services quality examination need to be adjusted and some strategies are to be improved. The solution on the planning of checked recipes number allows to perform the inspection of all the health care organizations, involved in EDP program

The problem of availability and quality of medical care is a priority nowadays. The Medical Centres for Information and Analysis (MCIA) have been created in the regions for the purpose of gathering information about the quality of services rendered and subsequent data are transferred to the Ministry of Health Care of Russia. Regional MCIA are complex and developed systems that solve simultaneously many problems, one of which – the organization of collection, processing, recording and analysis of information on the provision of medicines. It has been established in the course of conducting an analytical review of examination systems of preferential recipes and information protection that the level of automation of routine operations of the MCIA activity of the Krasnodar Region is high, but there is no qualitative information processing. As a result of the comparative analysis it was determined that the automated review of medical prescriptions for privileged drugs allows identifying abnormalities in the reference data without any analytical conclusions about the causes and consequences of the case. Taking into account the fact that in the provision of essential medications there still exists quite understandable demand for software products which automize the routine work of specialists, it remains obvious that the directions of improvement of software products are not implemented fully. In this regard, the present research proposes measures to improve the existing systems by integrating with the information system of medical and economic control of the prescription of medicines

On the performance of basic healthcare informatization in constituent entities of the Russian Federation in 2011-2013 the use of open source software became preemptive. The heads of medical organizations were recommended to coordinate medical information systems with the new federal requirements taking into account the regional features and preserve the priority of the open source. To solve this problem for the Krasnodar Region, the article proposes measures of program infrastructure modernization of medical and administrative activity automation within medical-diagnostic processes. It specifies the medical organization infrastructure. The aims and objectives of the existing system modernization are also determined there. The federal requirements for medical organizations’ information systems are adapted to the region peculiarities. The article has a practical significance since it can be used to prepare the technical specifications for modernization and/or maintenance of medical information systems in medical organizations and to support the educational process and scientific research works in the field of research and development of medical information technologies in Universities. It is addressed to the heads of government healthcare departments of constituent entities of the Russian Federation, the heads of medical organizations and to the healthcare informatization staff. It will be useful for the preparation of practical assignments for students to create the software technical documentation

According to the Federal Law "On state social assistance" of 17 July 1999 ( 178-FL), the medicaleconomic preferential drugs prescription control (MEC) is considered to be one of the tools for improving the management activity by enhancing the information efficiency and reliability at all management levels in the health care hierarchical structure. MEC is one of the medical care quality examination forms. Theoretical and applied research of system linkages and regularities of the MEC process functioning is a relevant direction of information technologies development in medicine. The importance of application of system analysis methods to the health care sphere consists in the development of new and the improvement of existing methods and analysis tools, data processing and management of complex automation systems of medical and economic drugs prescription validity control (MEC) planning. The developed decision support system (DSS) includes the MEC information system as basic and the ABC / VEN-analysis subsystem, implemented as a standalone application. The interaction between the DSS modules is provided by the unified exchange formats of preferential recipes data. At the same time, the MEC information system and ABC / VEN-analysis subsystem could be the most effective tools as an integral part of situational centers

In February of 2016, the Russian Ministry of Health confirmed the guidelines on functionality introduction of medical information systems for medical organizations (MIS MO). The required MIS development levels (of basic and advanced functionality), the capacity status (required and recommended) and a set of subsystems were defined there. One of the subsystems is the "Information support of patients" and all of its functions, being advisory in nature, represent the advanced set of MIS functionality, namely: the support for information terminals and screens, as well as providing the patient or his legal representatives with the access to medical documentation and background information. However, the opportunity to make an electronic appointment to see a doctor on your own plays the leading role as the most widespread and socially oriented medical service. The research is concerned with the issues of the e-registry work support (ER) via the data terminal for patients, including printing the appointment tickets, made via the data terminal. The paper suggests a new patient oriented algorithm of the prompt way to make an appointment to see the doctor. The idea is simple – avoid a large number of clicks on the ER interface tabs and immediately suggest the most appropriate time of reception, basing on previous patient visits. The algorithm was tested on the infomat software, run by "Smartcity" in MO of Krasnodar Region and used to make the appointment to see a doctor by patients on their own, without any assistance of registry staff in MIS

In the region, there is a problem of effective management of the pharmaceutical benefits under the benefit programs and the implementation of the therapeutic process. In health care in prescription health products of preferential category of citizens we have more than five different software developers involved that doesn’t allow controlling the prescription at all levels of health administration of the region. In order to form information flows into a single space it is necessary to have an integrated software product involved, both in the prescription, and in their service. The article presents a review of existing systems for issuing and servicing of preferential recipes, and prescriptions for controlled medicines, in the context of healthcare of the Krasnodar region, including considered the variety of products offered by different developers. The concept of integration of existing systems, which will allow overcoming the difficulties associated with fragmented solutions in automation preferential drug provision. For information exchange we encourage to use the XML format, examples of requests and responses in SOAP

The dynamic development of information technologies in medicine of the Krasnodar region, associated with the introduction of modern information systems in healthcare for 2011 - 2014 years has an impact on the system of issuing and servicing preferential recipes and prescriptions for controlled drugs. The introduction of a fundamentally new system of health care based on modern standards, common to the whole territory of the Russian Federation could not be possible to implement without providing healthcare organizations the tools to monitor indicators of prescribing beneficiary drug coverage (BDC) transmitted electronically to pharmacies. In supplying all the participants of the program with the necessary drugs (ND) in the Krasnodar region there is an urgent problem and visualization of information of BDC activities. Improving management by improving the efficiency and reliability of the information for all levels of management in a hierarchical structure of health is directly related to the quality of social services for certain categories of citizens in accordance with the Federal Law issued on July, 17th 1999 178-FZ "On state social assistance." This paper describes a methodology for the creation of a single automated database, which can be placed in both the private secure cloud and in the public, with the possibility of access to information in the workplace using the Internet. Working with a database is implemented by means of language T-SQL. Access to the system of end-users is implemented with taking into account the information security by means of the technology called "thin client". As an application, we use the Services Reporting Services - Reporting server platform that provides opportunities for convenient work with reports of various data sources. The database is filled according to the information of the state health care budget "Medical Information and Analytical Center" of The Ministry of Health of the Krasnodar region. We have also solved the problem of the processing of personal data by the method of introducing their depersonalization identifiers

The current problem of environmental pathology has emerged because of physical, chemical and biological factors, most of which are of anthropogenic origin. The environmental pathology is determined by appearance of new and unusual diseases, atypical course of known diseases, and "rejuvenation" of some diseases (diabetes mellitus, hypertension, myocardial infarction and even cerebral stroke among children). Examples of "new" diseases are environmental dioxin syndrome; "strange" disease Minamata (paralysis, mental retardation due to the damage to the Central nervous system of methyl mercury accumulated in marine food products); general immune depression – "chemical AIDS", caused by dioxins, heavy metals, toxic radicals, and others. Environmental issues gradually aroused the need to allocate separate spheres of legal regulation of public relations in the field of natural resources and environment from negative impacts in the course of economic activity. The task of the law in the field of regulation of public relations concerning the surrounding natural world – to define rules of behavior, which will be based on the knowledge of the natural laws. Global environmental problems associated with degradation of natural objects, separate ecosystems and the environment in General, contributed to the formation within the Russian legal system of environmental law as an independent branch of law. The article investigates methodological aspects of improvement of ecologicaleconomic mechanism of management in the sphere of nature management and environmental protection. The legal framework of the state policy in the field of environment protection is to ensure balanced solution of socio-economic tasks, preservation of favorable environment, biological diversity and natural resources in order to meet the needs of present and future generations, strengthening the rule of law in the field of environmental protection and ensuring environmental security. The article defines the interrelation between the level of pollution and the amount of population, analyzes official data for the Krasnodar region