nmpЖурнал им. Н.В. Склифосовского «Неотложная медицинская помощь»Russian Sklifosovsky Journal "Emergency Medical Care"2223-90222541-8017“N.V. Sklifosovsky Research Institute for Emergency Medicine”10.23934/2223-9022-2017-6-1-10-16nmp-344Research ArticleОРГАНИЗАЦИЯ НЕОТЛОЖНОЙ МЕДИЦИНСКОЙ ПОМОЩИMANAGEMENT OF EMERGENCY MEDICAL CAREОРГАНИЗАЦИОННЫЕ, ПРАВОВЫЕ И ТЕХНОЛОГИЧЕСКИЕ АСПЕКТЫ ОБМЕНА МЕДИЦИНСКОЙ ИНФОРМАЦИЕЙORGANIZATIONAL, LEGAL AND TECHNOLOGICAL ASPECTS OF HEALTH INFORMATION EXCHANGEКарасевН. А.KarasevN. A.

Москва

Moscow

ВасильевВ. А.VasiljevV. A.

Москва

Moscow

МаксимовА. И.MaksimovA. I.

Москва

Moscow

МолодовВ. А.MolodovV. A.

научный сотрудник лаборатории организации стационарной неотложной помощи,

Москва

Researcher of the Laboratory of Automated Control System for Diagnostics and Treatment,

Moscow

valenod@gmail.comГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского Департамента здравоохранения г. Москвы»РоссияN.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare DepartmentRussian Federation201729032017615257Copyright © Карасев Н.А., Васильев В.А., Максимов А.И., Молодов В.А., 20172017Карасев Н.А., Васильев В.А., Максимов А.И., Молодов В.А.Karasev N.A., Vasiljev V.A., Maksimov A.I., Molodov V.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jnmp.ru/jour/article/view/344

В работе рассмотрены организационные и правовые аспекты обмена электронной медицинской информацией в развитых странах, особенности внедрения электронных медицинских записей в США и Европе, а также актуальные проблемы, связанные с вопросами стандартизации внедрения информационных технологий в области здравоохранения. Кратко описываются наиболее популярные стандарты, используемые в электронной медицине, такие как Digital Imaging and Communications in Medicine (DICOM), openEHR и HL7. Рассматриваются вопросы синтаксической и семантической совместимости при обмене электронными медицинскими документами и некоторые аспекты применения электронной цифровой подписи. Предлагаются механизмы реализации электронного документооборота и обмена цифровой медицинской информацией как одного из наиболее важных направлений развития информационных технологий в здравоохранении. Отмечается, что в настоящее время ситуация в Российской Федерации складывается таким образом, что главным сдерживающим фактором в обеспечении обмена цифровой медицинской информацией становится нерешенность правовых вопросов, т. е. отсутствие законодательной базы использования электронных медицинских документов, при этом уровень развития самих информационных технологий в нашей стране представляется вполне достаточным для выполнения текущих задач. Указывается, что, несмотря на нерешенность ряда проблем (например, степень полноты предоставления пациенту и родственникам его медицинских данных в критических ситуациях и др.), скорейший переход на единую электронную карту способен вывести врачебную помощь на качественно новый уровень, особенно в учреждениях экстренной и неотложной медицины.

The article discusses organizational and legal aspects of electronic health information exchange in developed countries, particularly, introduction of electronic medical records in the United States and Europe, as well as topical issues related to standardization of information technologies in health care. We briefly describe the most popular standards used in e-medicine, such as Digital Imaging and Communications in Medicine (DICOM), openEHR and HL7. The questions of syntactic and semantic interoperability in the exchange of electronic medical records and some aspects of the digital signature use are also considered. We suggest mechanisms for implementation of electronic document management and sharing of digital medical information, as one of the most important directions of information technologies in health care. It is noted that today, the main limiting factor in providing the digital exchange of health information in Russian Federation is unresolved legal issues, i.e. the absence of a legal framework of electronic medical records share. At the same time, the level of IT development in our country is quite sufficient to meet current challenges. It is stated that, despite the unresolved number of problems (for example, completeness of medical data on a patient, given to relatives in critical situations), the adoption of a single electronic card is able to bring medical care to a new level, especially in emergency and urgent medicine.

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The authors declare that there are no conflicts of interest present.