The Integrated Medical Information and Analytical System (IMIAS) was launched in 2011 by the Department of Information Technology and the Department of Healthcare. The Moscow project is a leading example of using IT in healthcare. Governments of other capitals around the world have so far been only discussing such ideas.
Greater accessibility and comfort: what is IMIAS?
The system stores medical records. It provides for patient flow management and personalised record-keeping of medical services. IMIAS users can find an outpatient clinic closest to their home, book an appointment with a doctor online, reschedule an appointment without cancelling it, and obtain a certificate or a subsidised prescription. The system collects and analyses data on patients’ choices of Moscow health clinics, hospitals and doctors, their workload and the average waiting time.
The IMIAS makes medical services more accessible, convenient and comfortable. Medical staff no longer need to spend time filling in unnecessary paperwork and have easy and convenient access to the information they need. At the same time administrative personnel at healthcare facilities have a reliable tool for effective management of the entire city healthcare system.
The system has been operational in 660 outpatient clinics for children and adults, health monitoring centres and diagnostic centres in Moscow. It includes over 23,600 doctors and 8.9 million patients. Nearly 500,000 new online entries are made daily on the IMIAS website, which contains more than 243 million appointment bookings. About 4,500 specialists from over 30 Russian IT companies are involved in the project.
Electronic sick leave certificate and online appointment scheduling
You can get a prescription using the subsidised prescription service, which has been operational at 437 medical institutions. The service allows doctors to see the full list of the drugs available, issue e-prescriptions and receive updated information on whether a patient is eligible for subsidised medication. Since the service’s launch, more than 22.38 million prescriptions have been issued. The system saves doctors up to three minutes per prescription.
Other services that reduce the amount of paperwork are issuing sick leave certificates and referrals for diagnostic tests. In the latter case the data is filled in automatically based on the patient’s diagnosis. A doctor can make a record during the appointment and print out instructions on how the patient needs to prepare for the tests. Over two million e-referrals have been issued by the IMIAS centralised laboratory service.
Electronic medical records provide comprehensive information about a patient’s medical history, diagnoses, referrals and other important data that may help improve the quality of treatment. The e-records have been tested and now the system has been put into service. Since February 2015, over 1.1 million electronic records have been created at 150 outpatient clinics.
An application for outpatient clinic registration can be filed online on the Moscow state services website. No in-person visit is required. Within three days, the patient obtains access to the remote appointment booking service on the IMIAS website, which also offers the option of rescheduling appointments.
It is also possible to cancel an appointment using the state services website, pgu.mos.ru; the emias.mos.ru website; via a mobile app and an interactive information kiosk; by calling the registration office; and on the emias.info website. The main advantage of online appointment rescheduling is that it allows the patient to choose a more convenient time without losing the booking. Patients at Moscow outpatient clinics cancel nearly 45,000 appointments weekly. This saves medical staff more than 40,000 working hours a month.
The Centre for Situation Monitoring
The Centre for Situation Monitoring opened in January 2015. It allows outpatient clinics managers to monitor the situation using online tools. The data collected is used to determine a physician’s schedule and how long it takes to get an appointment, to distribute the workload evenly, and to introduce staff changes if necessary.
The IMIAS Centre for Situation Monitoring analyses data on the accessibility of medical services provided at every Moscow hospital and by every doctor on a daily basis. The centre’s personnel include medical, technical and legal professionals. If they discover systemic mistakes in the organisation of patient appointments, they draft recommendations on how promptly correct situations. Due to the centre’s efforts, only seven Moscow outpatient clinics are still facing problems in satisfying the demand for medical services.
The future of IMIAS
The plans for the period up to 2018 include expanding the existing services and creating new ones. For example, accounting of the medical services will be classified for each patient, and services of dental clinics, first aid centres and primary care physicians will be automated. The Physician on Duty service will also be expanded to meet the needs of patients on the same day as a call is received. One of the priority areas is ensuring stable operations of the IMIAS during seasonal peaks in the incidence of different diseases. Other plans include introducing the cloud accounting service, comprehensive management of planned hospitalisation and its integration into the system of emergency aid. This year, emergency teams will be supplied with tablet computers connected to IMIAS. This will give ambulance personnel quick access to electronic medical records. As they travel to answer a patient’s call, the medics will learn about the patient’s allergies, chronic diseases and other health issues.