Personal electronic health card

Personal Electronic Health Card (PECZ) is an electronic application used by patients to maintain and manage medical information about their personal health in a private, safe and confidential manner.

This information can be obtained from various sources, including from medical professionals and from patients themselves. PSKZ helps the patient reliably and confidentially store and control the medical information necessary for him in a standard form, including: medical history and examinations , dates of hospitalization, surgical interventions, chronic diseases, family history, laboratory tests and examinations, diagnoses, insurance policy data prescribed diet data from home monitoring systems ^[1] , prescription drugs and their use circuit genetic testing data ^[2] , the list of allergens , adverse reactions to m dikamenty, history and plan for immunization , the consent of the patient or vice versa refusal to donate organs in the event of death ^[3] , the contact numbers of doctors, clinics and rehabilitation centers, gyms, cosmetics and many other things necessary for the maintenance of health ^[4] .

For example, home systems will include wireless blood glucose meters , scales , sphygmomanometers , spirometers , pulse oximeters , ECGs such as CardioQVARK heart monitors, infrared thermometers that will transmit information to electronic medical records systems using 3G / 4G LTE / 5G communications ^[5] . This will allow for outpatients and elderly people requiring additional attention (for example, due to the inability to regulate excretory functions ( urination and defecation )). In addition, a nurse or paramedic will be able to conduct a comprehensive examination of patients in a rural outpatient clinic under the guidance of a doctor who is hundreds of kilometers from the patient using telemedicine systems .

In 2016, an attempt was made in Moscow to organize a “virtual hospital” designed for patients with severe heart diseases or other complex diagnoses. The patient was given a bracelet that is capable of measuring pulse, blood pressure, heart rate, cardiogram and blood sugar, and is also equipped with a GLONASS geolocation sensor ^[6] . It was proposed to introduce an electronic birth history that would contain data on drugs, laboratory tests, medical procedures, and the staff who performed them ^[7] . The PEKZ, which integrates analysis data, medical examination data, individual and family history, the risk assessment of certain diseases according to genetic testing and recommendations made on the basis of these data, including on sports and nutrition, is used in the Atlas Moscow medical center ^{[ 2]} .

When contacting a medical institution, such a card is used for registration without the use of paper ^[8] and allows the doctor to save time on filling in the patient data - he just needs to connect the PEKZ to his computer and supplement it with the results of his examination ^[9] .

When issuing electronic prescriptions, computer programs, analyzing the PECZ, can tell the doctor whether the medicine prescribed for the patient is suitable for the diseases that he has suffered and his health, and inform about the interaction of the prescribed medicine with other drugs, herbs, and food additives used by the patient. In the case of rare drugs or extemporaneous prescriptions, the patient does not have to look for them at different pharmacies - the system itself can find a pharmacy and send the prescription to it. ^[10] PECZ can be used to connect to systems of like IBM Watson ^{[11] [12] [13]} , including the Avicenna program created by IBM for automatic study of cardiograms and x-rays ^[14] ; Verily from Google Life Science ^{[15] [16]} or a medical robot such as “Ask A Doctor” ^[17] . As such systems develop, they will be able to issue more and more accurate diagnoses, removing the burden from hospitals and giving doctors the opportunity to focus on patients who are difficult to diagnose. In addition, PEKZ can be used to interact with online counseling organizations such as Carenet Healthcare Services that help patients to choose a medical institution for treatment, the advice of qualified nurses in matters of patient care, virtual consultations with a doctor, and solving legal problems related to healthcare.

In case of loss of the card by the patient and to exclude the possibility of falsification of data, with each new record it is duplicated in the Central (national) repository of the medical information system after automatic verification and verification of previous records ^[18] . When sending this data, a patient’s biometric authentication system is used , encryption and differentiated access of different doctors to information at the PECZ ^{[19] The} centralized system allows the doctor in any medical institution and ambulance to quickly get all the information about the patient, regardless of where the patient previously received it medical assistance ^[20] . The creation of the Unified State Health Care System may assist in the implementation of such a system, although the process is delayed.

Electronic medical records are legally binding. For example, from July 1, 2017, electronic sick leave began to operate throughout Russia. In the same year, it was reported that in Moscow there will be a complete transition to electronic outpatient cards ^[21] , as well as the issuance of electronic certificates from a neuropsychiatric and narcological dispensary ^[22] .