In his speech, the Head of State noted the importance of digitalization of the healthcare system, which includes the integration of databases, the creation of a monitoring system for patients undergoing treatment. In the modern world, one of the main factors of competitiveness is deep digitalization. For Kazakhstan, the transfer of modern digital technologies and the introduction of elements of Industry 4.0 are extremely important.
Today it is impossible to talk about the effectiveness of medicine without the digitalization of all business processes in the healthcare system. The ongoing pandemic has affected health systems around the world more than other areas. The load on it remains high and forces it to adapt to new conditions. The digital transformation in healthcare has been accelerated by the pandemic and has become an unsolicited catalyst for digital transformation in healthcare.
Today it is already obvious that digitalization will change the entire healthcare system, in which pharmaceuticals are a strategically important link. The use of digital technologies will open up new opportunities for the pharmaceutical industry and will not only improve patient outcomes, but also reduce costs.
In 2020, in order to fulfill the instructions of the Head of State, a project to improve the information systems of the Single Distributor was initiated within the framework of the program of Restarting the activities of SK-Pharmacy LLP.
The SK-Pharmacy restarting program is a dynamic and continuous process of improving the activities of the Single Distributor. The formation of conditions for improvement, which, on the one hand, will ensure stable work on improving quality, and on the other hand, being the basis for the disclosure of innovative potential, will allow the Single Distributor to flexibly respond to changing market requirements and be a patient–oriented company.
The development of information systems of the Single Distributor involves the solution of two main tasks:
Specialists of the Atameken National Chamber of Entrepreneurs of the Republic of Kazakhstan, representatives of the business community from the fields of information technology, logistics, pharmaceutical activities were involved in the formation of proposals for the development of information systems. The draft concept was sent for consideration to the Ministry of Health of the Republic of Kazakhstan, the Ministry of Digital Development, Innovation and Aerospace Industry of the Republic of Kazakhstan, the National Scientific Center for Health Development named after Salidat Kairbekova of the Ministry of Health of the Republic of Kazakhstan.
The main problem of digitalization of drug provision is the lack of accurate information on drug residues in medical organizations. Currently, medical organizations compile reports on balances by manually entering the current consumption of medicines, which does not ensure the relevance and quality of information.
Single Distributor has organized visits to medical organizations and regional health departments to study the issue. Also, the information on the Medical Information System used in medical organizations on the functional capabilities in terms of drug accounting is analyzed.
As a result, it can be stated that most Medical information systems do not have the functionality to account for the use and residues of medicines. In most cases, medical organizations keep records of medicines and medical products in accounting systems, while there is no information exchange between the accounting system and the Medical Information System. Thus, the accounting of medicines does not take place in real time and without indication the specific patient who received the medicine.
The second problem is the long supply cycle of medicines. The main reasons for the duration of deliveries are the lack of norms of approved balances and the duration of procurement procedures.
The third problem is the low accuracy and efficiency of inventory accounting. For example, the write-off of medicines some time after their actual use.
The presence of these problems ultimately leads to a deterioration in the quality of medical services and the satisfaction of the population with medical care in general.
The main goal of digitalization of drug provision is to increase the speed and accuracy of the supply of medical organizations. To do this, firstly, it is necessary to obtain accurate data on the stocks of medicines throughout the country on the basis of a single directory of medicines. This will make it possible to make a real forecast of the need and conduct analysis in a business analytical system, as well as ensure transparency of data for the public and regulatory authorities.
Secondly, it is necessary to shorten the cycle of drug supply. It will be necessary to approve the norms of irreducible balances for each item both in medical organizations and in the warehouses of the Single Distributor, which has already been implemented. This made it possible to make planned maintenance of stocks and accelerate the supply of medicines. In order to speed up procurement, it is planned to fully automate the competitive procedures.
Thirdly, due to accurate data on stocks in medical organizations, it will be possible to implement a system for working with medical institutions for automatic reminders of the need for an order to replenish balances. Additionally, functionality for automated calculation of needs will be implemented in Medical information systems or the system of the Ministry of Health of the Republic of Kazakhstan . Currently, a pilot project is being carried out to automatically calculate the need for outpatient drug provision.
The target architecture of information systems of the Single Distributor assumes the presence of a single reference book (a single classifier of medicines and medical devices). With its help, it will be possible to establish interaction with Medical information systems or accounting systems of medical organizations, to ensure the accounting of drug residues.
At the moment, a memorandum has been signed with an official representative of 1C in Kazakhstan to ensure the consolidation of balances in medical organizations (hospital) based on information from the accounting systems of medical institutions. As part of the pilot project, a test service was provided for the informational interaction of the Single Distributor systems with 1C systems.
In the current model of drug provision, there are problems of incorrect drug planning in medical organizations, inefficient spending of budget funds, as well as the presence of a multi-stage process of collecting and approving applications in medical organizations, health departments and the Medical Insurance Fund.
In this regard, a new model of medication planning has been proposed as part of the Reboot. A working group has been created and, with the direct participation of the Single Distributor, a draft of Rules and a methodology for the formation of the need for medicines within the framework of free provision and in the medical insurance system has been developed.
From April 15, 2021 pilot has been launched on the basis of the information system of the Republican E-Health Center for calculating automated needs based on the data of the average daily dose (WHO DDD), average course duration and quantity (multiplicity) courses of application per year for each drug with the appropriate nosology, taking into account the treatment regimens and dosages recommended by the Kazakhstan National Drug Form, clinical protocols of the Republic of Kazakhstan and according to the instructions for the medical use of drugs, with the calculation of the annual need per patient in units of procurement of medicines. According to the results of the pilot, all formulas in the Methodology were optimized. The results of the pilot are sent to all freelance specialists and research institutes to obtain a conclusion.
Applications for the procurement and supply of medicines and medical products from medical organizations will be accepted on the current portal or through integration with medical information Systems.
The logistics system of the Single Distributor will be closely integrated with the systems of logistics service providers. Information about the balances will be consolidated from the data of WMS systems (warehouse management systems), and the current location of medicines during transportation will be determined according to the data of TMS systems (transport management systems) of suppliers, which in turn will use satellite navigation. This will allow you to accurately predict the delivery time of medicines to each medical organization.
In order to control the cold chain, the supplier's warehouses and vehicles must be equipped with temperature monitoring sensors that will transmit data to the system of the Single Distributor.
In order to improve the distribution of medicines, taking into account needs, movements and open applications, it is planned to introduce an MRP system (a system for planning needs). On the basis of consolidated data on balances and applications, the procurement plan will be calculated taking into account the availability of goods from the supplier. At the same time, on the basis of the plan, medicines will be procured on the procurement web portal. In turn, the portal assumes maximum automation of competitive procedures and prequalification of suppliers. The mutual integration of all systems will ensure the control of the execution of applications from the procurement to the shipment of goods to the medical organization.
Another step towards automation and traceability of medicines is the labeling of medicines. The introduction of mandatory labeling can significantly simplify the consolidation of information on drug residues, as well as ensure piece-by-piece accounting and traceability of individual packaging from the manufacturer to the patient, prevent the re-circulation of drugs and increase logistics efficiency.
In 2020-2021, Single Distributor together with Kazakhtelecom JSC conducted a pilot project on labeling and traceability of medicines within the framework of free provision. During the project, the procedures for acceptance, movement, and shipment of medicines in the warehouses of the Single Distributor were worked out.
In order to further automate the procurement of medicines from the Single Distributor, negotiations were held with Center for Electronic Finance JSC, which is a Single operator of the electronic procurement platform for medicines and medical devices, a memorandum was signed regarding full automation. The E-Finance Center conducted an analysis and confirmed the possibility of automating the tender through integration with E-gov, E-licensing and other information sources. At the same time, improvements were needed from the Ministry of Health of the Republic of Kazakhstan, in particular, the digitalization of GDP and GMP certificates, the refinement of E-licensing in terms of issuing permits for one-time import of medicines, the introduction of a Single classifier.
Currently, work is continuing to improve the existing information system of the Single Distributor. In 2021, a business and system analysis of processes was carried out, a package of documents for software modification was prepared. At the moment, work continues on the modification of the Unified Pharmaceutical Information System.
The events of recent years related to the COVID-19 pandemic and the January events have shown the fragility of offline markets. Lockdowns, home quarantines, office closures have led to the shutdown of a large number of retail outlets, including pharmacies, which are most important for the population during this period. A particularly difficult situation in the field of drug provision is observed in rural areas due to their remoteness, the impossibility of transport communication due to weather conditions, when people sometimes remain cut off from the planned logistics of vital medicines.
This has proved to be during the period of knockdowns, quarantines, emergency regimes, Internet outages, terrorist attacks, most vending machines, ATMs and terminals continued to work and serve people.
The experience of developed countries shows that the sale of the most popular medicines, medical devices and even medical services (measurement of height, weight, pulse rate, blood pressure) is carried out using vending machines. The modern vending machine is multifunctional, it accepts coins, bills, cards, QR payment. In Europe and the USA, vending machines for the sale of medicines and first aid products are installed in almost every pharmacy. Pharmacy vending and are also located in areas where there are no pharmacies. There are even special vending machines for prescribing medicines. The necessary conditions for storing medicines are maintained inside the vending machines, instructions for the use of the procured drug with indications and contraindications are displayed.
In this regard, Single Distributor is considering the possibility of introducing an automated drug supply system through such vending devices adapted in their functionality both for the sale of free prescription medicines within the state budget and medical insurance, and for the retail pharmacy network. This step requires careful consideration with the authorized body, potential vendors, the business community, as well as making a number of amendments and additions to the relevant regulatory legal acts of the Republic of Kazakhstan.
Along with this, on February 08, 2022, the Head of State instructed to ensure the centralization of the medical equipment procurement for medical organizations on the basis of the Single Distributor. To ensure the execution of this order, a meeting was held on February 22, 2022, chaired by the Minister of Health of the Republic of Kazakhstan.
According to the results of the meeting Single Distributor in a short time carried out work on the development, testing, implementation of software components of the module for collecting applications for centralized medical equipment procurement from medical institutions - public health departments of oblasts of regions.
On April 07, 2022, a demonstration of the application process was held for the public health departments of the oblasts and regions.
At the moment, work is continuing on the data exchange service with the electronic procurement Center for Electronic Finance JSC web portal, in order to ensure the procurement of medical equipment exclusively in electronic form.
Digitalization of healthcare is the use of digital technologies to transform traditional business processes in the healthcare sector. By analogy with other areas of the economy, such as banking or sales, where digital technologies make services faster, cheaper and more efficient for the population. There are many examples in healthcare of how digitalization reduces costs, improves the quality and efficiency of medical services.
Medicines tracking and patient feedback systems can contribute to a more rational use of drugs, especially high-cost ones. Business-analyst systems can contribute to solving public health problems, including improving epidemiological surveillance of infectious and non-communicable diseases, predicting morbidity and mortality.
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