I want to talk about the draft application that I started to develop when I was still working as the head of the IT department in one of the central district hospitals in the Russian Federation.I am telling in order to share experience, and, possibly, to push someone towards the idea of implementing an interesting product. I tell you as much as possible without slipping into professional slang and omitting some details.
In parallel, I will tell you how and why medicine (as an organization) works in the modern world. Let's start with the theory and we will talk on the example of the “fashionable” now COVID-19 disease, which is also SARS and pneumonia at the initial stage of the disease.Let's start from the very beginning - with the idea of the application.Idea!
The idea was to create a web version (with API) and create a mobile application that would include:- Appointment to the doctor
- View the quality of care for the diagnosis
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Now the provision of medical care has actually led to the provision of services to the population. That is why there are so many negative stories about the indifference of doctors, incorrect diagnoses and everything that you hear and encounter so often. Why is that?TFOMS
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TFOMS has developed various reference books in which linked all medical manipulations and their connection with the diagnoses. Directories are usually made in the format of XLS or DBF files. What is convenient to convert to various databases.Insurance Company
An insurance company is a company that pays health care providers monthly bills for medical services rendered. In fairness - there are other ways of financing, but we will not go into details and features. We delve into the specifics of the project.My experience- – . ? . , , . 200 , 5-7 . , 500 . 450. .
The insurance company can track the quality of the services provided to you, and you can help it.The idea of the software product was for the patient to be able to diagnose how well the service was provided to him and, if necessary, file a complaint with the insurance company to influence the health care facilities.How can this be realized?Diagnoses
What is the diagnosis in modern medicine? This is an alphanumeric entry in the directory of medical diagnoses, which is based on a single directory of medical services of the World Health Organization (WHO). The reference is called ICD-10. ProofClasses ICD-10 / J00-J99 / J00-J06 Acute respiratory infections of the upper respiratory tract (J00-J06)
As you can see, the diagnoses are divided into groups of letters and a set of numbers. And all this is folded into a table that can be easily loaded into the database.Thus, you already receive a directory of diagnoses and medical procedures.Treatment as a service
Due to the fact that in recent decades, medicine has been turned into a service sector, healthcare managers had to standardize everything. So two types of document appeared:- Standard of care
- Clinical recommendations
Let's take them apartStandard of care
ProofThis is a structured document for each diagnosis from the ICD-10 handbook, which summarizes:- . , , , , . , , , – « , ». , , , .
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All this is framed in a structured document that can be used to create a database of standards for assistance.Clinical recommendations
ProofThis is a very powerful and detailed document. It is also divided into diagnoses according to ICD-10. But it contains all the information on the disease. Symptoms, causes, treatment, complications. This is a very detailed document, often the fruit of the work of international teams. It has everything that a disease needs.To make it clear, according to our diagnosis, J10, in the clinical guidelines for diagnosing inpatient conditions (!), An algorithm (!) Of actions of not only the doctor, but also the average (!) And junior (!) Staff is described. That is, the document separately examines and describes the situation of diagnosis, not as usual, in the clinic at the place of residence, but in the hospital and schedules the work of doctors, paramedics, nurses and nurses.Since it is structured, it can also be translated into several tables in the database.So what is the idea?
The idea was quite trivial - to collect data from directories, and implement the API (asp.net + MS SQL), also implement a web-interface that would allow patients to learn:- whether they were diagnosed correctly, because for some types of diseases, more than half of the diagnoses of primary care are erroneous. I personally attended the videoconferencing, where the main oncologist loudly expressed dissatisfaction with the fact that more than 62% of the prescribed directions from district oncologists are not confirmed in his medical facility. On the one hand, this is good, but on the other, it is often late.
- if a diagnosis is made, you can check whether the doctor recommended the treatment correctly and ask questions if the appointment is very different from the standard.
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Convenient search and access to information will make it possible to expand the customer base for you.In general, the idea was like this. As you can see, the information is available, structured. I am sure that among you there will be those who will like the idea and it implements the functionality.If there are questions for the post, I will tell you how else you can use this data, based on my personal experience working with doctors and farm representatives. And separately, how can a conditionally automatic analysis of medical documentation be implemented, for example, to organize a continuous check of the quality of medical care from regulatory organizations or insurance companies.Various ready-made reference books on the topic Directories explanations to them Letter