Today, how never loudly spoke to the automation of health. Sooner or later this most automation is implemented everywhere, and then ... And what, in fact, will be then? Bureaucracy in medicine will not be? - This reflection on this topic is divided by the author of this article.
Content
If you happened to hurt or your child - a schoolboy, try to read the next strange text to the end.
«Each class teacher for each visit to school every student fills the school visits coupon (form 025-10 / y) of the following content: surname, name, patronymic, date of birth, insurance medical policy, place of registration, place of actual accommodation, social status, category benefits, School visit date, the themes of each lesson, the topic is completed or continues, the marks received, the signature of the teacher, the signature of the student. Coupons are filled along with a class magazine and must match him. They give up daily to the Department of Folk Education. The number of coupons is taken into account when financing the school. Incorrect filling and duplication of coupons involves penalties.
Filling the coupons does not free the teachers from the obligation to qualify to teach their subject».
Phantasmagoria? Sure. But replace «school» on the «Polyclinic», «Teacher» on the «Plot doctor», «Student» on the «Patient» - And you will get even a simplified description of the true shape 025-10 / y - coupon of an outpatient patient.
General phrase that the doctor is overloaded with routine work - nothing. To understand the horror of the situation, you need to see this form. She, of course, is far from the only one. But the most expressive in the quality of the examplelessness and disrespect for the doctor, the patient and the law.
Nonsense - because it represents a multiple repetition of the history of the disease, because it stimulates not effective treatment, and the frequent walking in a patient to the doctor. Disrespect for the patient and to the law - because personal data on citizen, including what is called a medical secret, is repeatedly replicated and transmitted to the hands of various intermediaries that are not related to the treatment of the patient. About respect for the doctor what to say - absurd work on the rules that cannot be observed, self-directed hills, so that they realized their nonsense.
For the January holidays, I completed the promised: in Arme a doctor, the polyclinic most of the rows of this creation is filled automatically. Left for manual field entry «Professional», «ITU» and «medical services» - I do not understand what to make it there. I will comprehend this wisdom - automating them. Only who and what will do with such information? With what user?
But if the tickets are injected, then it is necessary to someone? So it is necessary that in each coupon there is at least one error? What for? Only in order to keep a doctor in the thrill before the instances under the threat of punishment ruble unknown for which (not for how he treated, it certainly, because the controller himself does not know how to treat).
How many people and organizations are engaged in that they produce coupons and other forms, distribute them, then they collect, check, count! And they make computer programs for their surv., introduce programs in the field, teach them to use. And still control in the field (in medicine, the controllers do not understand, their case is a form). And also cause to themselves at the meeting of the main doctors, their deputies and statisticians - they teach them correctly. Not with patients - with forms.
And where is the result? Where the benefits of at least the tickets? At what stage of the hierarchical staircase, the processing of the coupons accepted at least one person for useful thoughts about improving health care? I want to see this person! But in every province there are Miaz - Medical Information and Analytical Center. Who enjoys his analytical products? Where is she? And there is TFOMS - territorial health insurance fund. And other centers and funds. Everything for its existence requires a doctor «Form» And, it is necessary to think, work on her. Take yes throw at least one, the most meaningless document hanging on the doctor to work, mean it is sensitive to hurt many. No, if he is not like that, we will develop it and complement it. Create, invent, try - on doctors and patients. Silver, I remember, not knowing how to bring the order, they decided to dampen their heads. But in their own. Nowadays, improved.
Now I will catch what money and creative energy will come to the implementation of the National Project «Health». It is the structures that are the best recommendation of which is exactly the current accounting and reporting Vacanaly will be implemented. Whether it is necessary to be surprised that already projects are ready - this is easy for us. All documents are assumed «Improve» (Some crazy replaced with others). And send information, computerization, automation here. Just send, attach, add. It would seem that automation should exclude all accounts. Leave one, primary and natural, - electronic history of the disease. The doctor reflects everything in it. It means that who needs, even if everything is getting out and gets. Myself. Not touching Lekary. It turns out, not. Automation - by itself, and «Forms» from the doctor - by themselves. He will not go anywhere - will fill them and answer them for them. And there will be a lot of work all those who do not treat and does not know what it is. Unemployment not threaten.
Do not believe? Read the project «State Information System of Personalized Accounting for Medicine Citizens». Want to believe, you want no, everything is ready: specific plans for 2009-2011 and in them already exactly everything is counted that anyone is expensive: and 13939 million. rubles, and 13163 automated therapeutic institutions, and a typical software and technical complex (where it is - immediately typical - appeared?), and, of course, a new federal data processing center (FDCD) in addition to 86 miatsam, and new-new forms (including not only «Carton of outpatient patient», but also «Cartoon of services rendered», «Invoice», Registries and others. and so on.). And what are the forecasts! What will be «Quality services»! What a win in finance! Everything is also precisely counted! That's just with finite medical care indicators - clinical and demographic - sent. And not about them said the initiators of the national project a year ago?
Who invents forms and information programs in health care? How to justify their need? Who calculates their consequences? Why health care is organized and reorganized without doctors and chief doctors? With full neglect of their opinion? Who rules the ball? Especially now, when money went to health?
Please note how the control system transformed. It was like this: the doctor wrote the history of the disease, the controller checked them. Now the primary document has become controlled: it is difficult to read it, to delve into it - you need to know medicine. From doctors - for the convenience of controllers - demanded filling in secondary documents. The most information that he once has already been eased to the primary document - the history of the disease. At the same time (due to the same doctors) additional «the effect»: Any rewriting is associated with new errors, and errors - the controller bread.
Further more. Secondary documents are well formalized. Processing can be entrusted to computers. But the computer is capable of immeasurably greater than the controller itself. So, secondary forms can be enriched, complicate, multiply. Computers will cope. True, these enriched forms are also needed, but for this, they exist doctors. And computers can be moved closer to them - to therapeutic institutions. Let the input of secondary documents exercise themselves. But how much mistakes will be revealed! And, above all, you can report on the automation of therapeutic and prophylactic institution. Progress!
So perverts the idea of automation in medicine. As long as the doctors are only in isolated cases, timidly and feel trying to move to an electronic history of the disease, hoping for the improvement of the conditions of their work, officials use computerization totally, without knowing what they do.
Two new powerful factors begin to influence medical practice: ruble and automation. These forces must be attached to those points that stimulate medical and organizational ideas. Then there will be a considerable sense. But they are attached bypassing thoughts, bypassing medical professionals. They are kept in their hands and allow officials and financiers in their understandability.
