Advisor to the Minister of Health, Rufat Hajialibeyov: "The main goal of the work being carried out is the formation of a single ecosystem of medical information."

The Ministry of Health of the Republic of Azerbaijan presented the project "Digitalization of the pharmaceutical sector within the framework of the transformation of the healthcare system" at the beginning of this year. Within the framework of the project, the "Electronic prescription" system and the corresponding mobile application were presented. Digitization of the healthcare sector is important. That is why the measures implemented by the ministry reflect the sequence of purposeful steps. At the same time, these steps aim to ensure the expansion of the application of digital tools, increasing the efficiency and effectiveness of health services based on innovative approaches. We spoke in more detail about the stages of these processes with Rufat Hajialibeyov, advisor to the Minister of Health.

- Mr. Rufat, first of all, would you briefly explain to the readers what the concept of "Digital healthcare" is...

- Formally, the term "Digital Health" refers to the use of digital technologies in the health sector. This system ensures the collection of medical data necessary for the analysis and assessment of the quality of public health, both in the individual aspect and on the scale of the country's population. The goal of digital health is to combine medical information in the health sector in a single digital framework and to make the most of this information. The analysis of these data will ensure a high level of quality of medical care and public health care, efficient management of infrastructure assets, as well as an important contribution to the strategic planning of the health sector.

- What were the first steps taken by the Ministry of Health regarding the implementation of digital health care?

- The first steps towards digitization in healthcare started in 2006 and were determined by the requirements of that time. This includes, first of all, the creation of IT infrastructure, the introduction of multiple digital medical registers within the framework of the citizens' health card system, the system of accounting for medical workers across the country, the introduction of electronic services, including the register of disability determination, and many other measures in this direction.

I would like to note that in previous years, the specialists of the Healthcare Informatization Center have done great work in the field of digitalization of the sector. Today, the Unified Healthcare Information System of the Ministry of Health operates 20 electronic systems, including more than 70 software modules, many of which were created by the Center's specialists.

- What has changed in the requirements for digital healthcare in the modern world? What tasks do you consider to be the priority in this field?

- First of all, the role of medical data, which is the basis for analyzing the health status of citizens, has increased. Analysis of medical data collected by citizens throughout their life cycle allows us to better understand the cause of the disease, make a more accurate diagnosis and determine the most appropriate treatment.

In the field of radiology, artificial intelligence data and algorithms are an invaluable tool in diagnosing diseases at an early stage. In addition, the analysis of big data allows for the optimization of processes and field financing for the health sector, preventing the spread of pandemics, as well as building management models that prioritize the improvement of the quality of health care and the life expectancy of citizens.

This fundamental technological approach is used in modern healthcare practice in the developed countries of the world.

Digitization is on the agenda of the Ministry of Health as one of the priorities of the transformation of the sector. Digitalization will make it possible to consolidate progress in the field of medicine, create a strong foundation for medical achievements and consistent and planned development of medicine in the country in the coming years.

In the digital healthcare strategy prepared within the framework of the working group of the "Healthcare Transformation Center" with the relevant Decree of the President of the Republic of Azerbaijan, all priorities are focused on the care of citizens' health and the provision of a digital ecosystem that allows to achieve this goal effectively and in the shortest possible time.

The main task we are working on is the formation of a single medical information ecosystem that connects all medical institutions of the country, providing medical workers with continuous access to this information. Most importantly, it is the integration of medical information into the decision-making process of diagnosing diseases and prescribing the most effective treatment methods by medical professionals.

The main source of information will be the registry called "Citizen's Medical Digital Twin", which will reflect all information about citizens' health from the moment of birth to the moment of death. If we look at this issue more broadly, we can say that the information will cover the period from the mother's application to the medical institution to determine the fact of pregnancy to the moment of organ transplantation (if the citizen has agreed to use the organs as a donor after death).

The medical history, diagnoses, treatment methods, test results, radiology, prescriptions and other information collected in this registry during the entire life cycle, including the anamnestic history of genetic predisposition to diseases, will become the main tool for in-depth analysis and determination of the causes of the disease by doctors. As a result, it will allow to clarify the diagnosis and determine the most effective treatment methods. The collected medical data is used for macro analysis of the health status of the population throughout the country, the demand for medical services and their satisfaction with their quality, the planning of the development of the infrastructure required in health care, the use of efficient economic models including insurance, the development of human resources and flexible planning for the development of the sector accordingly, in front of the state in health care will be the main factor for the implementation of priority tasks.

- The Ministry announced the creation of new digital platforms. Can you rank any of them in order of importance?

- If you are asking about important applications, I cannot but mention the electronic inquiry tracking system developed for the "Call Center" for psychological assistance and medical rehabilitation of war veterans and families of martyrs of the Ministry of Health. This is a socially significant initiative related to state care for people who sacrifice their health in the fight for the sovereignty and territorial integrity of our country. The mentioned electronic system allows monitoring the implementation status of citizens' applications within a single digital framework and in real time and directing them to the relevant medical institutions of the Ministry of Health. At the same time, in accordance with the subject of the application, the Ministry of Labor and Social Protection of the Population, the State Agency for Compulsory Medical Insurance, the Management Union of Medical Territorial Units, and the YAHAT Fund, which have access to this system, have the opportunity to direct the action.

In addition to the daily appeals of citizens, the employees of the "Call Center" proactively communicate with war veterans and family members of martyrs, studying their possible needs and current problems. If necessary, appeals are registered in the system and resolved jointly with state institutions participating in the system.

From April 2023 until today, more than 50,000 proactive contacts have been made by the employees of the "Call Center". In addition to providing necessary medical assistance to thousands of citizens, other structures that have access to this system of appeals have also helped in solving social issues.

- Can you give more detailed information about the "Electronic prescription" system announced at the beginning of this year?

- In order to ensure the efficiency of regulation in the field of pharmaceuticals, the creation of the "Electronic prescription" system within the framework of the "Strategic Roadmap for the development of telecommunications and information technologies in the Republic of Azerbaijan" was entrusted to the Ministry of Health. The created system is a unified register of registration and management of prescriptions of medicines written to citizens in state and private medical institutions of the country. The "Electronic prescription" system can be used by all citizens receiving services under compulsory medical insurance, persons belonging to the preferential category, as well as citizens receiving services under private medical insurance and those without insurance.

The very convenient and intuitive interface of this solution, available both on personal computers and mobile devices, allows the doctor to write prescriptions based on the international classification of drugs and diseases officially registered in the country. The citizen will see all the prescriptions written to him in his interface in a simple structured and easy-to-read form. The mobile program can be downloaded from the reseptim.az website, as well as from the "AppStore" and "Google Play" software stores. The system allows you to write prescriptions based on the active ingredient. This gives the buyer freedom of choice when buying medicine. In the future, the integration of this register into the register of monitoring the circulation of medicines, as well as the integration of the control-cash register with the database, will allow to strengthen the control over the operations carried out during the sale of medicines, including the prevention of the distribution and sale of fake and unregistered medicines.

This registry is also a source of medical information for citizens and will later be integrated with the "Citizen's Medical Digital Twin" system to ensure the integrity of the citizen's medical information in their digital profile. I would also like to note that the "Electronic prescription" system is one of the main initiatives in the direction of improving the quality of medical care and digitizing the country's healthcare. It is very commendable that we have implemented this project at the initial stage of transformation in healthcare.

- Digitization of healthcare involves not only managing the healthcare system, but also the transformation of the practical activities of doctors on the ground and raising the level of knowledge of the doctors themselves in the field of digitalization. How are these processes carried out?

- In order to implement these processes, the relevant department of the Healthcare Informatization Center conducts face-to-face or online training courses during the introduction of new electronic systems. Training video materials are distributed, instructions for using electronic systems are sent. It should be noted that the educational process has been established and improved over the years. Experience shows that it is possible to train relevant medical personnel of the country on various systems within two months.

The "National Strategy for digital health for 2024-2028" envisages steps towards the implementation of educational content for the use of digital skills in health. Pre-diploma education will be organized at the Azerbaijan Medical University and medical colleges. Appropriate content and curriculum will be developed for this. The training of existing medical personnel can be carried out at the Azerbaijan State Institute for the Advancement of Doctors, as well as with the resources of the relevant department of the Center for Healthcare Informatization.

- What kind of work is being done by the Ministry in the direction of implementing an innovation such as telemedicine in the future?

- Of course, important work is being done in this direction. In order to identify the most promising telemedicine scenarios for our healthcare, we even implemented a pilot project based on two medical research institutes. The result of the pilot project showed the effectiveness of using telemedicine in reducing the flow of citizens during the initial visit to the medical institution (just getting an initial consultation or agreeing on steps that do not require a personal visit). In addition, the positive effect of telemedicine services was also shown in the process of explaining citizens' medical examinations. Therefore, there is no need for citizens to apply again to the medical institution for relevant explanations. These are the first and obvious advantages of the telemedicine application, reflecting the reduction of the burden of healthcare subjects, the increase of targeted assistance to the population by doctors, and the reduction of the time and financial costs of citizens applying to medical institutions. Considering the large number of citizens arriving in the capital from the regions, then this is a very important factor that also reduces carbon dioxide emissions related to logistics, which is one of the pressing problems affecting global climate change.

We also plan to explore scenarios for remote patient monitoring via telemedicine. This will help to determine the need for scenarios when introducing the service to the country's healthcare system. In addition, appropriate legislation is required for the implementation of this type of service. In this regard, we must work together with the relevant state regulators and structures involved in the process.

- What has not yet been realized in digital medicine? What steps are you considering to take to a new level?

- Over the past 2 years, great work has been done, from the preparation of the "National Strategy for digital health care for 2024-2028" to the large-scale implementation of a number of technological projects throughout the country. These include "Electronic prescription", "Follow-up and monitoring of medicines", "Electronic newsletter", "Electronic epicrisis", etc. systems, as well as an electronic system for tracking applications within the framework of providing psychological assistance and medical rehabilitation to war veterans and families of martyrs. All difficulties can be overcome if you know what to do and how to do it. The consistent implementation of the healthcare digitization strategy will bring great benefits to the application of technology in this sector, first of all to its employees. This will fundamentally raise health care in the country to a new level.