Characteristics of the object
1. Currently, in the Ukrainian health system, there is a low efficiency of information management in the health care system, primarily in terms of poor data availability, accuracy and promptness. In particular, this deals with the response to the epidemic of non-communicable diseases, including cardiovascular ones which are characterized by the highest mortality and morbidity rates in Ukraine.
Main reasons for such a state of affairs are (i) not well regulated information management on health sector (based mainly on isolated data registries and old fashioned filling of statistical data forms), and (ii) insufficient and non-coordinated use of modern information and communication technologies (ICT) in the health care sector. In particular:
• data management in medical institutions and statistical system is in some cases non-regulated, but in some cases over-regulated, resulting in non-coherent health data management that produces results that are not adequate to efforts employed in data management;
• the health information space is fragmented, many indicators on national level are hard to be produced; there are no prompt and reliable data on most of the health care parameters, to mention only few:
- data on a type, scope and qualitative features of care delivered to a patient;
- data on a type, scope and discharge regarding a patient and his consumption of drugs and medical products;
- analytical data on planning of needs in drugs, medical products for specific categories of patients (patients with hypertension, acute coronary syndrome, etc.);
- resource availability in health care institutions (staff, stock of drugs, fixed assets for their activities, etc.);;
• there is no clear scope of necessary sectoral regulatory acts on development, introduction, operation and development of information technologies;
• there is no regulatory framework of IT penetration in the health care sector;
• even though there are cases of successful utilization of IT in medical facilities, there is no wide application of modern information and communication systems directly in medical practices;
• there is no formalized criteria for establishing efficiency of implementation and operation of information technologies;
• there are hardly any qualified health informatics specialists in medical facilities;
• technically obsolete equipment, or information and telecommunication systems that operate are incompatible;
• there is no adequate information protection in most of the available information systems and information transmission networks;
• there is no possibility to share data with electronic resources of external agencies (e.g., data bases of the Mandatory Social Insurance Fund);
2. Yet, several new eHealth implementation efforts already exist resulting in various levels of support to health information management system, mostly depending on the agility and capacity of regional administration and health care facility management. The ICT industry in Ukraine reacts well to these efforts and provides certain number of solutions that are at various levels of implementation.
However, the whole process is not well coordinated and stimulated from central government: there is no coherent regulatory framework for eHealth development, while central systems that would allow better integration and data collection/exchange virtually do not exist. In addition, the lack of architectural and functional standards result in a completely open and unregulated environment in terms of quality of systems implemented, with some low quality systems implemented in some health care facilities.
The consequence is that the overall improvement of information management cannot be done by introducing more partial solutions in data management (“more forms to be filled in”), and more partial discussion on every particular IT solution to be implemented, but through more systemic approach to setting the regulatory and technology foundations of the health information management.
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