Концептуальные и методические подходы к построению рейтингов медицинских организаций на основе независимой оценки качества медицинской помощи
In the internal medicine wide spectrum the gastroenterology is one of the chapters, less enlightened by the scientific evidence. It does not mean that the practice of the grasntroenterology may ot be improved by the systematic use of the approaches of the evidence based medicine
The main purpose of public health is quality improvement of medical care. Ranking of healthcare organizations is rather effective information and marketing tool for external quality management of medical care. The author reviewed international experience in selecting quality measures of medical care to rank healthcare organizations that could be used as a methodological framework for designing rankings of healthcare organizations in Russia. The aim of the study was to identify methodological basis of international rankings of health care facilities: major indicators and criteria for evaluating quality of medical care. The author analyzed methods for developing rankings of international healthcare organizations through the analysis of international scientific sources and information made public by state organizations working in the area of health management as well as through four expert interviews with experts in health management. The author attempts to structure indicators and criteria for quality evaluation of medical care based on Donabedian’s triad as well as identify definitions, content and balance between clinical and non-clinical indicators.
This prototype development explains the challenges encountered during the ISO/IEEE 11073 standard implementation process. The complexity of the standard and the consequent heavy requirements, which have not encouraged software engineers to adopt the standard. The developing complexity evaluation drives us to propose two possible implementation strategies that cover almost all possible use cases and eases handling the standard by non-expert users. The first one is focused on medical devices (MD) and proposes a low-memory and low-processor usage technique. It is based on message patterns that allow simple functions to generate ISO/IEEE 11073 messages and to process them easily. MD act as X73 agent. Second one is focused on more powerful device X73 manager, which do not have the MDs' memory and processor usage constraints. The protocol between Agent and Manager is point-to-point and we can distribute the functionality between devices.
Developed both implementation X73 Agent and Manager will cut developing time for applications based on ISO/EEE 11073.