Method for building unified information space for practical doctor

FIELD: medical information technologies.

SUBSTANCE: in accordance to method, medical databases are created and regularly updated; informative characteristics of patients health condition are formed on basis of case histories in medical databases; on basis of detected informative coefficients, deciding rules are created, considering cause-effect connections between pieces of medical information and biological age and health condition of patients; client units of practical doctors are equipped with software means for using formed deciding rules for information support of practical doctors; data pertaining to research and patient examination are recorded in client unit; appropriate deciding rules are used in client unit to determine biological age and to evaluate health condition of patient by groups: healthy, belongs to risk group or sick; to predict, when patient is included in risk group, the course of disease or pathological process; to provide, when patient is included in "sick" group, the clinical diagnosis with consideration of nature and severity degree of changes in main life support systems, individual features of organism and constitution factor of patient.

EFFECT: increased precision of diagnostics.

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The invention relates to medical information technologies. Intended to be preventive, rehabilitation and Wellness institutions, mobile and stationary diagnostic centers, services, rescue, medical expert commissions, insurance companies, health and beauty, as well as for complex biomedical experiments, including in extreme conditions and remote treatment. Can be used in preventive medicine in medical examination, including doctor visits in order to identify population groups at risk of reduced life provision and monitoring of health status, examination of the reliability of activity and occupational health. And can also be used in General, surgical, obstetric, anesthetic and intensive care, pediatric, trauma, dental, Toxicological, geriatric, forensic practice, practice, doctors, laboratory medicine, medicine critical conditions, sports medicine, medical statistics, clinical pharmacology. Can be used to evaluate the dependence of the regional health from environmental and socio-economic factors.

Currently in health care use is tsya information systems, which can be conditionally divided into three groups:

1. Reference medical programs: electronic health records, information-analytical software complex "Assistant"medical information system "MYDIALOG", medical information system, "AMULET";

2. Medical diagnostic computer programs: LABTRAK, Information System Cytological laboratory, analytical information system "OMIS", computer systems and MEDAP Master Labs, Integrated control and information system of medical institutions "INTERIM";

3. Specialized programs: MedTrak, information system "Avicenna"health information system "HEALTH center", STEL-Computer Systems, information systems: Maxs & Soft, Med Work, Diagon, a medical information system for pathology services, Software system management, hospital and polyclinic "ARTEMIS", Information System Office Manager of the Clinic, the automated information system "ORBIT", information system ANALYST, computer system Expert evaluation and prediction of reproductive health of married couples due to the influence of environmental factors and living conditions of the population".

Currently lying to the medical information system designed to solve a narrow, specialized tasks of medical practice, and therefore none of them can perform the functions of a single information space for the practitioner, although they can be considered as components of this space.

The closest analogue in our opinion, is the technical solution described in the patent RU 2145114 "Method of storage, handling and use of information in blood banking (information technology "PELICAN") [18].

According to this invention are the various databases of donors, tracked all information about the harvested blood and cooked ingredients. The blood service is now considered a single production-technological complex. This solution is aimed at solving the problem of improving the work of the service institutions of harvesting and processing of blood.

For the development and implementation of the proposed technical solution is the improvement of the work of practitioners through the implementation of a single information space, based on the achievements of medical science in areas such as health organization, evidence-based medicine, computer simulation using the method of pattern recognition and system analysis.

The technical result of zakluchaetsa increase the accuracy of diagnostics, reducing the treatment time and therefore material costs.

Common information space is considered as a unitary structure, aimed to provide information for clinical decision making practical physician, and improves the quality of accounting, forecast development, diagnosis, monitoring, treatment and rehabilitation of various diseases, syndromes and pathological conditions.

The invention is designed for all social groups and involves the introduction of various medical institutions of appropriate software and hardware components, as well as organizational techniques. It does not require a significant expansion of the fleet of the institution.

The components of the unified information space (Technology MedHelp allows you to define the initial stage of development of the pathological process in the absence of clinical manifestations, allows the selection of risk groups for adequate correction of violations. Diagnosis already developed pathology verification stage of the process and evaluation of the severity of the patient's condition, timely etiopathogenetic therapy leads to the prolongation of remission in chronic process and reduce the duration and frequency of exacerbations. When Bo is dstvennogo pathology, for example, when Protamine deficiency With the patient, it is possible to predict the nature of the development of coagulopathy in children and grandchildren of probands on the basis of research hemostasiogram only the patient, i.e. to simulate the pathological process in the family, which allows timely address family prevention of the disease and thus prevent the progression of hemostatic disorders and the possible development of clinical symptoms of coagulopathy, as well as to choose the optimal model and patient management in ambulatory and stationary conditions. The method comprises training program preclinical functional rapid diagnosis of various pathologies (cardiovascular, diabetes, pancreatitis and other diseases), forecast, tactics, schemes of treatment and rehabilitation.

The basis of the proposed technology on the regulation of health data collection, doctors, ways of transmission to the processing center for analysis and construction of decision rules, which is then channelled to the use of urban and rural medical practitioners, medical assistants, nurses. Key figures in the technology are experts (doctors or scientific staff of high qualification and practitioners.

As decision rules in the program lays the existing principles of clinical and cost the RCM analysis (ABC, VEN and others), existing clinical standards and population norms, including those obtained in the process of self-study programs.

Economic feasibility:

- the introduction of technology MedHelp involves the use of existing material base of medical institutions, including existing personal computers and network computers (servers);

- software products (technology components) can be implemented in stages in the mode of self-sufficiency, the estimated payback period for a multidisciplinary hospital - not more than 1 year;

- development of software products available to ordinary users without the cost of professional development.

The way to build a unified information space for practical doctor (MedHelp), aimed to provide information for making a clinical decision, includes the creation of interoperable nodes information space, among which are the processing centers and client sites.

Processing centers are equipped with methods of analysis, and client nodes - methods of data collection and the application of the rules.

The role of these nodes can act as both the organization and individuals. In addition, the functions of the nodes of both types can be combined in a single entity. For example, in the role of processing centers can lug the ü research institutes, specialized diagnostic centers, and in the role of client nodes, clinics, outpatient centers, hospitals, private practice doctors.

For communication between the nodes of a single information space, methods for data transfer and data replication methods. Under replication refers to moving data from one node to another. Replication may be accompanied by a process of matching between dictionaries nodes.

The main actors in the processing center experts (doctors of high qualification and/or academic staff)who analyze the data and create rules, as well as administrators responsible for the operation of the node.

In the client node in the main persona is a practical physician, which is the claimed technology. Practice physician is also involved in the collection and processing of medical data, thereby further filling and development of the processing node.

Client node communicates with serving its processing center and/or multiple centers, if the client node is designed to solve several tasks. Developing a client node can be upgraded using appropriate methods, it may acquire the status of the processing center.

Processing centers can wsimages who participate with their client nodes and with each other, forming a network of processing centers.

A single information space provides iterative creating, at each iteration, which can be distinguished stages:

1. The analysis of the real world.

This stage is:

- definition of the tasks for which it is being created (or changed) common information space;

- identification and description attributes.

2. The deployment of a unified information space. This stage is:

- updating of dictionaries (enter new or edit the description of the available attributes);

- commissioning of new or modernization of existing sites, development of new (or improve existing) methods for their equipment;

- development of the rules of interaction sites, search and training. Filling a single information space includes:

- enter data;

- data processing using rules;

- analyzing data and creating new rules.

Creating, compiling and deploying a unified information space can occur in different ways on the basis of existing tools and techniques, and the formation of new ones.

Centralized method involves the creation of a single information space from scratch, starting with the processing center of the upper level. Thus equipped for the I nodes are developed dictionaries and methods.

Decentralized method involves the formation of space on existing sites other systems. Special significance is given to the methods of data replication.

The level of implementation of the unified information space as a whole depends, firstly, on the level of implementation of components of the equipment units and, secondly, on the number of nodes and the quality of relations between them.

Consider the examples of implementation of components of the unified information space (MedHelp).

Computer programs for collecting data are intended for use in the client nodes. These programs are of three kinds:

- software that collects the readings that are used to measure the required attributes.

program to enter the data manually by the practitioner using the information in dictionaries (for example, such programs can be automated questionnaire, electronic card, electronic medical record, and the like);

program Deposit, analysis and statistics electronic database.

Also for use in client nodes are computer programs for applying the rules. In fact, this expert system, "stuffed" certain rules.

Functions of the software to collect data and programs for the application of the rules can be combined in one program.

Computer program the guide to data analysis are intended for use in the processing centers. It's all kinds of mathematical systems (Mathcad, Statistica) and pattern recognition (STARC, QUASAR). Programs for data analysis are the most difficult part of the information space on their quality depends on the quality of the space. In addition, in the processing centers are equipped with information, analytical, diagnostic, export-analytical medical system.

When designing a unified information space for the practitioner sets out criteria for assessing the quality of space. Such criteria may include, for example, the assessment of the representativeness of the data, quality assessment rules assessment nonredundancy data, etc.

For example, when assessing the quality of a rule by using the control sample is created so-called control sample is an information array for which is true:

- vector control sample have the same attributes as the vector of the corresponding training sample;

- vector control sample not included in the training sample;

the task, for which the estimated solved for the control sample using other methods.

Vector control sample are the rule. The percentage of correct decisions made by the rule, lays the basis of assessment rules.

Consider the example of the invention's implementation.

Highly qualified doctors together with mathematicians and programmers based on the analysis of case histories created database identified informative indicators and built the decision rules that make up the essence of the information space. The main user - to-practice physician: a practical physician receives information support in the application of technology MedHelp, and takes part in the filling of a single information space: enters information in electronic form, electronic card, electronic health records, etc. that supports communication with a processing center.

For example, technology MedHelp allows practitioners to conduct a stepwise examination of the patient. This technology can be installed on the computer doctor to be available over the network, recorded on any medium (paper, diskette, CD-ROM).

At the 1st stage, the physician enters information about the patient: history, medical and biological research, data of objective inspection, etc. In the analysis of the data entered by the physician obtains information about the patient's condition: healthy, belongs to the group of risk or sick. When this analysis is based on biological age. When assigning the patient to a risk group are more the surveys. When referring to the group of patients verified affected system and is determined by the degree of its destruction by the results of the study with regard to differential diagnosis.

At the 2nd stage predicted "scenario" (character) of the disease (pathological process) in the early stages of the disease and have already developed the disease.

On the 3rd stage is a clinical diagnosis based on information support, as well as the nature and severity of changes in the basic life support systems, taking into account individual characteristics of the organism and constitutional factors.

On the 4th step is to forecast the development of the most severe complications of any pathological process, such as thrombosis, bleeding, multiple organ failure, giving the highest level of lethality.

Let's look at each stage of the clinical decision making practical doctor in detail.

First, determine the biological age of the patient. Technology MedHelp includes 2 formulas for definition of biological age: according to all the parameters and informative indicators of hemostasis.

The determination of the biological age based on total parameters: pulse blood pressure; static balancing; body weight; the sum of the scores in the test of subjective the th assessment of health status.

Body weight is determined in light clothing, without shoes, on an empty stomach. Subjective assessment of health status is made on the basis of the score test. This value is included in the formula to determine the biological age. Evaluation of the individual values of biological age is made by comparing with the proper biological age (FAD), which is the population standard.

Obtained in absolute numbers deviations BV from DBV estimated in table 1.

Table 1.
Evaluation of the individual values of biological age
Functional classDeviations BV from population standardNotes
FirstFrom 15.0 to -9,0Best
SecondFrom 8.9bn to -3,0
ThirdFrom -2,9 to +2,9
FourthFrom +3.0 to +8,9
Fifth+9.0 to +15,0The worst

To the first functional class (the best) are the patients, the rate of aging which generally lags behind sredneoblastnogo standard (FAD). E.g. the motif, to five (worst) functional class includes people with accelerated aging; their biological age is above the average biological age group 9-15 years.

Is also anamnestic assessment generic risk factors of thrombophilia. It turns out the history of thrombosis, the presence of hereditary coagulopathy, obesity, hypertension, especially in combination with insulin-independent diabetes, varicose veins, heart disease and artificial pacemakers, coronary heart disease, tumors, severe injuries with prolonged immobilization in the past year, long-term administration of synthetic steroids.

For the assessment of biological age on the hemostatic system built decision rule on the basis of informative parameters: fibrinogen level; the number of platelets; activated partial thromboplastin time; fibrinolytic activity; soluble fibrin-monomer complexes; antithrombin III.

Clinical testing of the constructed rule is conducted on 145 retrospectively examined patients.

Clinical interpretation of biological age as assessed by the hemostatic system, is carried out by comparison with sredneoblastnymi integral indicators of biological age different age groups.

stage 1 - op is adelene the patient's condition, taking into account the biological age is carried out using the following rules.

1. A universal rule evaluation of the health status of the patient based on syndromic diagnosis.

When creating this rule prediction analysis was performed constants homeostasis, describing the activities of the main life support systems, pre-formed taking into account the most severe in terms of the prognosis for life and common syndromes in various pathological processes.

The criterion for ascertaining the development of syndromes was a set of informative features:

For DIC: the number of active platelets (<120·109/l), the level of D-dimers (>0.1 ng/ml), the level of plasminogen (<120%), proteolysis (>15%).

For metabolic syndrome failure: hemoglobin (<70 g/l), free hemoglobin (>0.5 g/l), the integral indicator nephrotic syndrome (>1,25 used)functional hepatocytes as target cells (decision rule).

For respiratory distress syndrome - respiratory rate (less than 6 and more than 35 cycles per minute), oxygen index.

In the final rule as factors included: the presence of DIC syndrome (DIC - 1, no - 0); the presence of metabolic syndrome insufficiency (+2, -2 no); presence of respiratory distress syndrome (from 1.18 to 3.45 the syndrome is present from 0 to - 0,62 syndrome is absent).

With p the power of the specified rule is projected condition of the patient healthy at the time of the survey ("norm"), or is at risk, or sick, i.e. there is a development of the pathological process ("pathology").

Pre-test check on 352 patients showed the following: the correct classification is 88% for the "norm," 81% "pathology" at a significance level of p<0,001.

2. A universal rule evaluation of the health status of the patient based on the nature of the activity of stress-realizing systems.

A rule is built on the basis of informative indicators: the number of active platelets (109/l), endothelial cells (104/l), lymphocytes 3 type (%), plasminogen (g/l).

Pre-test inspection showed the following results: status "standards" are accounted for at the value with the probability of correct classification of 86% at a significance level of p<0,001; status "pathology" forecasted in value with the probability of correct classification of 88% at a significance level of p<0,001.

This rule reflects the original model of the causal relationships in time between the reaction cell ("active" platelets, endothelial cells), humoral defense systems, and immune responses (lymphocytes type III, plasminogen), on the one hand, and the development of pathological process on the other side.

3. A universal rule evaluation of the health status of the patient based on a comprehensive integrated assessment of anamnese is practical, paraclinical data and data of objective inspection at the time of the survey. A rule is built on the basis of the following indicators: patient's height (cm); weight of patient (kg); the level of arterial pressure at the time of the survey (used); the value of hematocrit (l/l). Pre-test check conducted on 125 patients, allowed us to predict the state of the "norm" in 74% and "pathology" of 71% at a significance level of p<0,05.

4. The rule evaluation of the health status of the patient based on the nature of the activities of the integrated systems of the body. The basis of the rules laid analysis of peripheral blood from a transcript of the following indicators: hematocrit, erythrocytes,. leukocytes, eosinophils, stab neutrophils, segmented neutrophils, hemoglobin, lymphocytes, monocytes.

Results pre-test check on 152 patients showed the effectiveness of this rule prediction for "normal" 90%, and for "pathology" - 86%. The probability of errors of the first kind was ("norm" mistakenly classified as "disease") is 1.5%, the probability of type II errors ("pathology" mistakenly attributed to the group "norm") of 0.5%.

For patients who are diagnosed with a critical layer of endothelial cells and is classified as "pathology", we developed decision rule forecast of development of the pathological process, the basis for the who laid the degree of endothelial dysfunction. Projected development of the pathology with the probability of correct classification of 96%, and the patient's state of health is evaluated as "normal", with the probability of correct classification of 92% at a significance level of p<0,001.

5. Methods of assessment of health status on the nature of the activity of one of the life support systems

a) Method of valuing health States the nature of the immune status of the organism based on the construction of the decision rule on the basis of informative parameters: lymphocyte type III (used), interleukin I (PG/ml). The probability of correct classification is 95% for "pathology", 91% for "normal". The level of significance of p<0,001.

b) means for estimating the state of health of the endothelial system based on the construction of the decision rule on the basis of informative features: von Willebrand factor (%), the number of free endothelial cells (104/l). Projected development of the pathology with the probability of correct classification of 96% at a significance level of p<0,001.

C) means for estimating the state of health according to the nature of the changes of acute phase proteins is based on the construction of the decision rule on the basis of informative features: fibrinogen (g/l), fibronectin (g/l), plasminogen (g/l). Projected development of the pathology with the probability of correct classification of 84% at a significance level of p<0,001.

Stage II. Forecast "scenario" (character) the course is I of the disease.

1. The method of prediction of the nature of the disease with early development of the pathological process is based on the construction of the decision rule on the basis of informative parameters: D-dimers (ng/ml), an index of leukocyte activity (ial group) (used), platelets (109/l). Forecast: mild course of the disease; the disease of moderate severity, area of uncertain prognosis. The probability of correct classification of 90% for the diagnosis of mild at the significance level of p<0,05, and 95% for moderate severity. Approbation built rules examination was carried out on the sample (retrospective analysis of 145 records).

2. The index of risk of development of pathological process on the preclinical stage is a decision rule, built on the basis of the following informative parameters: lymphocyte type III (%), D-dimers (ng/ml), fibronectin (g/l), endothelial cells (104/l). Expected: "normal", "Primatology" and "pathology". The probability of correct classification is 98% for the prediction of the state of "normal", 91% for "primatologie", 71% for "pathology" at a significance level of p<0,01.

Stage III. Algorithm information decision support clinical diagnosis consists of two rules. The calculation of the diagnostic index X is based on informative is ukazatelej: active platelets ((10 9/l) and D-dimers (ng/ml).

If X>0, then the subject is attributed to the group of the pre-clinical stage of the pathological process ("Primatology"); if X<0 - diagnosed normal state of the organism ("norm"). The probability of correct classification for the group "norm" 82%for group primatologia" - 78% at a significance level of p<0,01.

When assigning examined the patient to the group "Primatology" it is necessary to conduct additional tests to clarify the diagnosis. Used for this purpose is clarifying the rule, consisting of indicators of systems of the body responsible in the future for the formation of the pathological process, severity and outcomes: the lymphocyte type III (used), D-dimers (ng/ml); plasminogen (g/l). The probability of correct classification of 92% for the development of pathology, 76% for the norm. The level of significance of p<0,01.

IV stage. Forecast of development of serious complications: thrombosis, bleeding, multiple organ failure.

1. Model end-to-end forecast of coagulopathy in a screening population-based population survey (preclinical stage) is based on informative indicators of homeostasis and consists of decision rules and indices of thrombohemorrhagic complications (TGO).

At the first stage of the survey using the decision rule of the I-th stage is projected state DIN the economic equilibrium of the hemostatic system and the absence of threats to the development of coagulopathy.

Each of the components of this decision rule assumes clinical load, becoming a base in future.

Pre-test inspection was conducted on 115 patients, 12 of which are healthy (donors). The following results are obtained: the safety of the hemostatic system is projected in 79% of cases, the status of the risk of coagulopathy is projected in 81% of cases at a significance level of p<0,001.

At the second stage of the survey in patients allocated to risk group at the first stage, carried out in-depth study of the hemostatic system for predicting the likelihood of development of DIC with verification stage.

When signs of DIC description gemokoagulyatsii at the time of the study reflects the pronounced imbalance of links of hemostasis that in the absence of pathogenetic therapy will lead to a breakdown of the compensation mechanisms, which are thrombohemorrhagic complications (TGO).

Technology MedHelp gives the probability of correct detection at risk for the development of decompensated stage of DIC in 71% of cases at a significance level of p<0,001.

After the second stage of the survey formed the group risk on the possible development of decompensated stage of DIC, it is necessary to test these patients for further compromised link system games the Aza with verification of thrombosis or bleeding.

For this purpose the phase III survey, based on the assessment of orientation readings hemostasis expect development index TGO with verification of thrombosis or bleeding. Forecast: compensated state, a state of unstable equilibrium of the hemostatic system (zone of uncertain prognosis and the risk of TGO.

The probability of correct classification is 98% for the forecast compensated state, 91% for zone uncertain forecast, 71% for MSW.

For patients referred to the area of an uncertain Outlook, it is necessary to conduct additional tests to clarify the diagnosis. Used for this purpose is clarifying the rule, consisting of indicators, including different stages of hemostasis considering constitutional factor. The result is determined by the orientation changes of hemostasis with verification of thromboembolic or hemorrhagic complications.

2. Forecast of development of the PON according to the homeostasis with the early stages of the disease. Decision rule is built on informative indicators: the number of cells type III (%); the number of free endothelial cells (104/l); the level of interleukin-6 in serum (PCG/ml); the index of leukocyte activity (used); fibrinogen concentration (g/l); the level of D-dimers (ng/ml); SVR (Dyne·s·with the 5); the number of platelets (109/l). The rule gives the probability of correct detection at risk for the development of multiple organ failure in 69-71% of cases at a significance level of p<0,001.

3) the Forecast of development of the PON according to the homeostasis in the presence of clinical symptoms of the disease. Decision rule is built on informative indicators: the level of interleukin-6 in serum (PCG/ml); the level of D-dimers (ng/ml); the number of free endothelial cells (104/l); the level of lymphocytes type III; SVR (Dyne·s·cm5); the number of platelets (109/l), an index of leukocyte activity (used). Our proposed method gives the probability of correct detection at risk for the development of multiple organ failure in 82% of cases at a significance level of p<0.001 and the probability of correct detection of the group of patients without the development of PONT in 71% of cases at a significance level of p<0,001.

4) the Index of risk of development of multiple organ failure (PONT) in a patient with the patient the nature of the activity of the major systems of the body consists of two discriminant functions:

D1=11,4+1,K+0,K+1,CS-0,1 K4+0,005 K5,

where K1 - interleukin VI (PG/ml),

K2 - activated platelets (109/l)

K3 is the number of endothelial cells (104/l)

K4 - molecule Wednesday mass in the erythrocyte,

K5 - fibrinogen (g/l).

D2=4,2-0,1X1+0,H,H-0,H+0,0016 X5,

where X1 is the haemostatic potential (pled),

X2 - activated platelets,

X3 - powelliphanta (g/l),

X4 - molecule cf. mass (adept raft.),

X5 - fibronectin (g/l).

If D1>0,55 projected development PONT (class 3), if D1<0.55 and D2>1,3 predicted the pathological process without development PONT (class 2), when D <0.55 and D2<1,3 - diagnosed condition "norm" (class 1). The probability of correct classification is 95% for class 1, 90% for class 2, 78% for class 3 at a significance level of p<0,001.

Pre-test inspection revealed the probability of correct classification for class 1 - 90%, for class 2 is 82% and for class 3 - 79% at a significance level of p<0,001.

5) Forecast development PON according to homeostasis with verification of the affected systems regardless of the stage of the disease decision rule has the following form:

F=K1 0,0018 - K2 0,2021865 + K3 0,42014 - K4 0,00301 + K5 0,01114+0,04018

where k1 is a structural point of AD (pled),

k2 - D-dimer (ng/ml),

k3 - active platelets (109/l)

k4 - peripheral blood erythrocytes (%),

k5 - fibronectin (g/l).

When F<0,05 PONT is not expected, the probability of correct classification is 76% (class 1), when F>0,05 projected development PONT with the probability of correct classification of 89% (class 2). When F is equal to from 0.07 to 0.1, with a probability of 84% (class 3) MON occurs with damage to two systems of the LM is failure: cardiovascular, hepatolienal. When F is equal to from 0.1 to 0.2, with a probability of 71% (class 4) MON occurs with damage to three or four systems: cardiovascular, hepatolienal, hemostasis. When this value of F, the maximum risk to the forecast of development of thrombohemorrhagic complications. When F from 0.2 to 0.4 with a probability of 77% (class b) predicted irreversible condition with fatal outcome. The significance level is p<0,001. The result of pre-test checks the following: for class 1 was 79%, for class 2 71%, for class 3 91%, for the 4th grade 88%, for grade 5 99%. To conduct pre-test checks retrospectively analysed card resuscitation brigade 1 CL - 45 persons, 2 CL is 94 persons, for 3 CL - 71 persons, 4 CL - 70 people, 5 CL - 17 people (the analysis for 4 years).

The introduction of technology in MedHelp medical practice allows you to:

- to store the data of all research results and any other information about the patient;

- exchange of doctors of all information relating to patients, the results of the research, conclusions, view the dynamics of the visits of the patient-specific diagnosis;

to access the help of medical resources;

- obtain information on disease code;

- generate a plan physician based on specialty, type of admission, the characteristics of medical institutions;

- conduct remote medicine the ski consultations;

space is in constant development, which is both due to the increasing functionality and improving existing ones.

One of the advantages of a single information space for the practitioner is the possibility of its functioning in manual option that allows the physician to navigate the abundance of health information regardless of the degree of material-technical equipment of medical institutions.

The method can be proposed for widespread use in medical practice.

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The way medical information support, namely, that creates the medical data based on the histories and constantly improve them in the process of information support clinicians; and the detection of the Ute informative indicators of the health status of patients based on the analysis of highly qualified specialists histories, stored in the databases of medical data; forming on the identified informative indicators of the decision rules that represent models of cause-effect relationships in time between the data of medical and biological research and objective examination of the patients and the biological age of the patients, the patients ' health, prognosis, prospective patients of diseases or pathological processes, clinical diagnosis of existing patients diseases; equip the client nodes clinicians software, providing the use of the generated decision rules for information support practitioners; enter on a specific client node data of the patient's history and the results of his medical and biological research and objective examination; using a client node the corresponding decision rules, so that on the basis of input data: to establish the biological age of the patient; to assess the state of health of the patient based on the set of his biological age in three groups: healthy, belongs to the group risk and sick; to predict when assigning the patient to a risk group for the disease or pathological process in the early stages of the disease, and already developed pathology; to put in allocating the patient is the group of "sick" clinical diagnosis taking into account the nature and severity of the changes in basic life support individual characteristics of the organism and constitutional factors of the patient.



 

Same patents:

FIELD: systems for selling goods and services to population, using network technologies.

SUBSTANCE: in accordance to invention, in unified informational consolidating center, data input/output and identification block is meant for identification of user being buyer, seller, manufacturer, activation of controlling software block, for access to blocks of unified informational consolidating center depending on its user status. If user is buyer, then block for controlling personal account of buyer is initiated, if user is seller, then sales block is initiated for charging personal account of buyer with a part of price of product, and seller terminal is meant for, during purchases, to receiver payment of part of product price from buyer, and remaining part of price is received from virtual bank block.

EFFECT: creation of new software-hardware complex for selling goods with compensation of consumer losses.

2 dwg

FIELD: cash-dispensing automatic teller machines, in particular, technology for detecting failures of display module of machine.

SUBSTANCE: in accordance to invention, ATM performs a check of its display module, during which it is determined whether display module is incapable of outputting data to display in acceptable form, for which purpose transferred to display module is a predetermined sequence of colors to be displayed, and sensor, positioned near the screen of display module, records the colors displayed on display. ATM controller determines whether color sequence is displayed correctly by display module. In response to failure of display module to display proper sequence of colors in display module, error signal may be generated. Display module check may be carried out multiple times for continuous updates of data about its display condition.

EFFECT: detection of ATM display image output error, ATM displays may belong to different types.

6 cl, 7 dwg

FIELD: automatic teller machines, in particular, banknote cartridges.

SUBSTANCE: cartridge contains a set of moveable buttons - indicators of cartridge information, each button may be turned around its axis for changing its position. Buttons may be moved along axis in outward or inward direction relatively to body of cartridge by their rotation. Different plans of positioning of buttons along the axis display appropriate various characteristics of cartridge content. Cartridge may be inserted into ATM, where button positions may be read by ATM.

EFFECT: unused buttons may be kept in the cartridge, button locations may be changed without opening the cartridge.

33 cl, 72 dwg

FIELD: method for delivering sent mail.

SUBSTANCE: in accordance to method, delivery address is inputted for delivery of mail; delivery address is changed for delivery of mail; delivery address is changed in accordance to automatic procedure, predetermined by recipient, on basis of table stored in memory, containing assigned times of delivery and addresses of delivery, to make it possible for mail company in each case to make delivery to address preferred by recipient, while delivery addresses in table include one electronic system of chambers for deliveries or chamber of electronic system of chambers for deliveries, delivery address is changed depending on presence of free chambers in system of mail chambers, if this electronic system of mail chambers is assigned as delivery address, mail is delivered to changed delivery address.

EFFECT: increased speed and reliability of delivery of sent mail.

2 cl, 1 tbl

FIELD: method for delivering sent mail.

SUBSTANCE: in accordance to method, delivery address is inputted for delivery of mail; delivery address is changed for delivery of mail; delivery address is changed in accordance to automatic procedure, predetermined by recipient, on basis of table stored in memory, containing assigned times of delivery and addresses of delivery, to make it possible for mail company in each case to make delivery to address preferred by recipient, while delivery addresses in table include one electronic system of chambers for deliveries or chamber of electronic system of chambers for deliveries, delivery address is changed depending on presence of free chambers in system of mail chambers, if this electronic system of mail chambers is assigned as delivery address, mail is delivered to changed delivery address.

EFFECT: increased speed and reliability of delivery of sent mail.

2 cl, 1 tbl

FIELD: means for distributing goods and services in network marketing.

SUBSTANCE: system contains subsystem of banking establishment with block for receiving money, block for registering participants and payment block, controlling company subsystem, containing recording device, registration block and block for receiving information about participants of system, output block for aforementioned subsystem is meant for producing information recorded in memory device and transfer over communication channel into block for receiving and counting money of subsystem of payments, which is also connected to payment block of banking establishment.

EFFECT: provision of automated counting equipment in service distribution system, with ensured reliability and trustworthiness of data exchange inside given system.

1 dwg

FIELD: engineering of devices for realization of transactions, during which bill composition event occurs.

SUBSTANCE: meta-data, connected to application, are stored in database of transactions administrator, when wireless device loads appropriate, unprocessed information of transaction is sent and stored in database. Unprocessed transaction data include a subset of metadata and additional information, introduced by other devices and/or systems. Bill composition events are created by linking metadata and unprocessed transaction data. Also, events for composition of subscription bills, for which bills are composed in repeated manner, are computed by evaluating transactions, which have subscription transaction type, and their metadata, stored in database.

EFFECT: increased speed of tracking of transaction in data transfer network when composing bills for communication operators.

5 cl, 5 dwg

FIELD: method for controlling electronic chamber systems for parcels.

SUBSTANCE: in accordance to invention, data for controlling electronic systems of parcel chambers are stored at server and transformed to commands for controlling systems of chambers for parcels, at server side, checking procedure is executed to check, whether changes have been made to data, present on server, and control commands are transformed through interface into system of chambers for parcels, as soon as predetermined number of changes is made in data array.

EFFECT: simplified adaptation of electronic system for chambers for parcels to fast and reliable change of its parameters.

12 cl

FIELD: method for controlling electronic chamber systems for parcels.

SUBSTANCE: in accordance to invention, data for controlling electronic systems of parcel chambers are stored at server and transformed to commands for controlling systems of chambers for parcels, at server side, checking procedure is executed to check, whether changes have been made to data, present on server, and control commands are transformed through interface into system of chambers for parcels, as soon as predetermined number of changes is made in data array.

EFFECT: simplified adaptation of electronic system for chambers for parcels to fast and reliable change of its parameters.

12 cl

FIELD: banking machines.

SUBSTANCE: in accordance to invention, banking machine receives inserted documents, such as bank notes, checks, present certificates or other securities. Inserted documents after receipt in machine and processing are moved to container. Container has internal zone, which is limited by vibrator element, supporting inserted documents. Device performs function of controlling the operation of executive device, which activates vibrator element for shaking documents, to promote compact storage thereof in container. Container is made with possible extraction from device for facilitating comfort of extraction of inserted documents. Movement of container from machine is facilitated due to rolling supports and extending handle.

EFFECT: creation of banking machine ensuring increased protection, simplifying user operations and ensuring improved access to service.

10 cl, 27 dwg

FIELD: means for registering rights to real estate property and transactions with it.

SUBSTANCE: in accordance to invention, central server station is made with possible determining of set of rights for different categories of clients, nominal registration of each client in accordance to rights belonging to registered client, and control over correspondence of access of registered client to appropriate database in accordance to set of rights; generation of individual certificate and subsidy plans, including a set of stages, while access of client to each following step is provided after completion of previous step; recording of individual certificate and subsidy plans in database; demonstration on client computers, at each step, of individual certificate and subsidy plans of information page; dispensing of filled blank of certificate to given material benefit to client.

EFFECT: ensured centralized systematization of control, operative realization of transactions.

5 dwg

FIELD: computer technologies, possible use during automatic structuring of computer codes adequate to information being processed.

SUBSTANCE: complex contains interconnected input block for forming n channels for processing computer codes, block for forming autonomous databases of sets of computer codes, block for selecting auxiliary databases of subsets of computer codes, block for transformation of computer codes, composed of unit for dividing sets of computer codes on subsets, unit for encoding subsets of computer codes, unit for matching subsets of computer codes, and block for processing subsets of computer codes, consisting of unit for determining volumes of intersecting parts of subsets, unit for cutting out intersecting parts of subsets and unit for distributing intersecting parts of subsets.

EFFECT: increased speed of structuring of computer codes.

1 dwg

FIELD: computer engineering, in particular, automated system for forming arrays of data of air transportation.

SUBSTANCE: system contains voyages group data array identification block, six registers, adder, two counters, comparator, block for integration of reading signals, block for selecting generated data arrays, blocks for forming signals for recording and reading server database, blocks for forming server database recording signals, decoder, block for integrating recording signals, block for integrating address signals and block for integrating flush signals.

EFFECT: increased speed of operation of system due to localization of range of data search addresses in server database using identifiers of voyages group and given time period.

11 dwg

FIELD: computer engineering.

SUBSTANCE: system has first input unit, data source identification unit, input messages identification unit, unit for forming addresses of server database, data outputting channels commutation unit, second input unit, unit for selection basic addresses of data sources, unit for receiving records of server's database, unit for forming intervals of data reception, current result calculating unit, increasing result calculation unit and output data integration unit. Higher speed of operation can be realized due to localization of addresses of database records from identifiers of messages received by system.

EFFECT: higher speed of operation.

11 dwg

FIELD: electronic information systems.

SUBSTANCE: in the method identification code is assigned to each product unit, which is recorded in manufacturer server database, as carrier of identification codes, radio frequency mark in form of transponder with inbuilt antenna and microchip with identification codes recorded on it are used, with which a unit of product is provided on conveyor during production, and during movement of product at warehouse or realization station, identification codes are read and data are inputted into database on warehouse server or realization station and simultaneously into database of server of fiscal organ. During control read and recorded codes are compared.

EFFECT: increased trustworthiness and shorter terms of determining authenticity of product, and also increased efficiency of control over authentic product and its movement.

4 cl, 1 dwg

FIELD: falsification protection techniques.

SUBSTANCE: device for protection against motor vehicle identification signs falsification contains microcomputer (1), communicators (2), vehicle element falsification protection means (3), and information playback means (4). Device monitors, analyzes, and makes decisions regarding vehicle and its number plate. Device certificates them automatically under control of preloaded software or under control of administrative body by wireless communication channel, and passes the information outside based on the results of independent detection.

EFFECT: provided function of motor vehicle identification signs legality status monitoring.

13 cl, 7 dwg

FIELD: computer engineering, automated system for collecting and processing electronic polls data.

SUBSTANCE: system consists of input messages receiving unit, data from server database receiving unit, election committee identification unit, first and second units for candidates base addresses identification, polls results disclosure time cycles selection unit, polls results recording time cycles selection unit, input messages receiving time cycles selection unit, database read and write signals forming unit, final polls results data forming unit.

EFFECT: increased system performance due to database entries address localization using receiving messages identifiers and forming of progressive total of polls results in real-time.

9 dwg

FIELD: computer engineering; automated system for collection and processing of geographically-distributed objects information; for example, ticket sales by geographically-distributed Aeroflot agencies data.

SUBSTANCE: system consists of users requests reception unit, agencies identification unit, incoming messages attributes identification unit, server's database addresses forming unit, data output channels commutation unit, incoming messages reception unit, agencies base addresses selection unit, summary data receipt control unit, messages reception time intervals selection unit, current sales results evaluation unit, sales progressive total calculation unit, server's database data reception unit, and information channels aggregation unit.

EFFECT: increased system performance by localization of database records addresses using incoming messages identifiers from geographically-distributed Aeroflot agencies.

12 dwg

FIELD: computer science, in particular, analytic system of national population register.

SUBSTANCE: system contains block for receiving requests for analytical data processing, block for identification of base address of Russian Federation subject, block for determining data selection boundaries, block for generation of reading signal, block for integration of address signals of reading, block for determining request type, block for modification of read and write addresses, block for identification of sex of individual, block for receiving data from server database, block for identification of year of birth of individual, block for selecting cycle of output of requested data.

EFFECT: increased speed of system operation due to localization of addresses for analytic processing of data of citizens on basis of identifiers of Russian Federation subjects.

7 dwg

FIELD: computer science, possible use for controlling status of various changing objects.

SUBSTANCE: method includes preliminary creation of model of object with division or isolation of object in blocks, each of which is assigned at least one identifier: identifier of position of block in object and identifier of time period, during which block looks remained unchanged; isolation of one additional block during change of object with assignment of two aforementioned identifiers to block; building of model of additional block, selection of block on basis of time period identifiers, included in request, and building of model of object in accordance to identifiers of position of blocks in object.

EFFECT: creation of method for recording and visualization of type of changing object in any time moment, which can be realized using equipment, not having high productiveness and speed of operation.

2 cl, 2 dwg

FIELD: systems for selling goods and services to population, using network technologies.

SUBSTANCE: in accordance to invention, in unified informational consolidating center, data input/output and identification block is meant for identification of user being buyer, seller, manufacturer, activation of controlling software block, for access to blocks of unified informational consolidating center depending on its user status. If user is buyer, then block for controlling personal account of buyer is initiated, if user is seller, then sales block is initiated for charging personal account of buyer with a part of price of product, and seller terminal is meant for, during purchases, to receiver payment of part of product price from buyer, and remaining part of price is received from virtual bank block.

EFFECT: creation of new software-hardware complex for selling goods with compensation of consumer losses.

2 dwg

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