Moscow City SIMI Project

In 2016 Better Platform was deployed as a structured and standards-based clinical repository for the City of Moscow’s centralised Electronic Health Record. Over 670+ healthcare providers in Moscow now use Better Platform when caring for their patients.

In 2011, Moscow City council decided to adopt a different approach for managing the health and social services of its 12.6+ million citizens. Prior to 2011, Moscow’s service systems were isolated from each other, and this is why the city council decided on the new approach. It launched an eHealth project which would digitalise all of the health-care organisations in the municipality. The aim of the project was to separate data from applications and store it in vendor- and technology-neutral format, because this was seen as a crucial step in delivering better and more efficient care. For this project, Better was chosen to develop a centralised EHR system that used Better Platform, a cloud platform which stores clinical data in a vendor-neutral, openEHR format.
100%
facilities in Moscow
use electronic prescribing
657,000
hours
of doctors’ work saved per year
100%
of facilities in Moscow
have Electronic medical records

Project scope

Moscow City is responsible for all of the health and social services of more than 12.6 million citizens, and this covers primary, community and social care, and outpatient clinics. The scope of the system is enormous: it has 255 medical legal entities; 85 hospitals with 150 branches and 408 units and 170 outpatient clinics with nearly 500 branches and 665 units. More than 55,000 doctors take care of the 9+ million people who visit medical institutions across Moscow every year.

Challenges

There were many challenges, and the most crucial was to create an open platform which would support all the health and social care services in Moscow, an extremely complex and vast system. The core of the approach was to separate data from applications, and store it in a vendor- and technology-neutral format, and openEHR was chosen to accomplish this goal. Moscow has now deployed Better Platform and IHE’s (Integrating the Healthcare Enterprise’s) XDS components for electronic document sharing.

The size of the system meant an incredibly large amount of data:

  • Daily online entries: 500,000
  • Yearly appointment bookings: 287 million
  • Documents per year: 1 billion, 25 TB
  • IT specialists involved: 4,500 people in 30+ companies
“Moscow is a large city and one of the challenges we faced together with Better during this project was the magnitude of the operation. In a single year, nearly half a billion laboratory tests are carried out and nearly 8 million people visit medical institutions all across the city. This results in an enormous amount of clinical data, so the provision of scalability is probably the biggest project challenge we had to deal with alongside Better.” Vladimir Makarov
deputy head of Moscow City Department of Information Technology

Results

Moscow has now deployed Better Platform and IHE’s (Integrating the Healthcare Enterprise’s) XDS components for electronic document sharing.

After a successful pilot project, the concept was rolled out across the city. Better Platform was deployed as a structured and standards-based clinical data repository for the City of Moscow’s centralised Electronic Health Record. The system’s records are stored in the cloud, and all data is stored in a vendor-neutral format. Hence, the council now keeps data in an open and structured format that is technology- and vendor-neutral, and has tools which are easy to use for healthcare professionals. The system also enables powerful querying functions and doing analyses of standardised healthcare data, which can be further used for the coordination of national or regional care.

One of the goals achieved was separating data from applications and storing it in a vendor- and technology-neutral format, and openEHR was chosen to accomplish this goal. The client was also able to build applications on top of Better Platform for all of their primary care and hospitals. This gives them a great deal of flexibility in how they build their next applications from here on, because they have a stable data platform as a foundation.

EMIAS services and functions
 
EMIAS (Unified Medical Information and Analytical System of the City of Moscow) makes medical services more accessible, convenient, and easy to use. Medical teams no longer need to spend time filling in unnecessary paperwork, and have better access to the information they need. At the same time, administrative personnel at healthcare facilities have reliable tools to effectively manage the entire city’s healthcare system.
 
Better impact:

  • Consolidated user interface
    Implemented in 450+ medical facilities
     
  • Electronic medical records – primary care
    11.76 million Electronic Medical Records (EMR) created
    1.3 billion documents stored in the EMRs total
     
  • Electronic medical records – hospitals (Better Platform is deployed in 17 hospitals)
    275.000 Electronic Medical Records (EMR) created
    75 million documents stored in the EMRs total
     
  • Laboratory services
    36+ million queries per year processed successfully; piloted at 5 facilities
    30+ million electronic results of laboratory services per year
“Better, the supplier of Better Platform, provided cutting edge technology, which allowed us to separate clinical data from processes and application logic. This was the main reason we chose this platform for our project.” Vladimir Makarov
deputy head of Moscow City Department of Information Technology was in charge of implementing Moscow City’s eHealth project.

Key benefits

Moscow City improved health data management and optimised the processes in their healthcare system.

  • Data is now in an open, finely grained, structured format that is vendor- and technology-neutral, and comes with the right tools to easily engage health and care professionals.
  • Powerful querying and analyses of normalised healthcare data can be used for the coordination of national or regional care.
  • Delivering quick wins with XDS can ensure that the right document is available at the right place and time to support safe and efficient care.
“Modern technologies allow us to radically change the image of the healthcare system by increasing the safety and effectiveness of the treatment provided.” Vladimir Makarov
deputy head of Moscow City Department of Information Technology
The Client
Moscow City
 
Key statistics
  • Population: 12.6 million people
  • Medical entities: 255 of which
    • 85 hospitals with 150 branches and 408 units
    • 170 outpatient clinics with nearly 500 branches and 665 units
  • Doctors: more than 55.000
  • Beds in hospital: 83.000
Client needs
  • To reduce the number of administrative tasks for doctors (prescribing, referrals, etc.).
  • A transformation from paper-based to digital document management (prescriptions, referrals, sick-leaves, etc.).
  • To reduce waiting times.
  • The separation of clinical data from processes and applications.
  • Data sharing in a vendor-neutral format among several entities.
Key outcomes
Time saved for medical teams:
  • time per prescription: from 3,5 minutes to 30 seconds (3 minutes saved on average);
  • 657,000 million hours of doctors’ work saved per year.
A reduction of waiting times:
  • the data analytics provided by Better Platform have helped reduce waiting times to 48 hours.
A reduction in manual input errors:
  • 1.96 billion less errors in manual inputs.
Paper cost savings:
  • 31 million sheets of paper saved per year.
Electronic sick leaves penetration/share:
  • 80% of facilities in Moscow;
  • 60% of all sick leave certificates are electronic.
Electronic prescriptions:
  • 100% of facilities in Moscow;
  • 98% of all prescriptions are electronic.
Electronic medical records:
  • 100% of facilities in Moscow.
Product
Better Platform

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