Russia Visit
I haven't blogged recently, because I took my family to Moscow and St. Petersburg to learn and experience more about this fascinating country with a rich and proud history – a trip that I highly recommend.
While I was there -- I decided to learn a bit about their health system and its challenges. As is well known, Russia has substantial long-term challenges related to a projected decline in population and a relatively low mortality age. The country is using its new wealth to address health infrastructure needs -- but as in most countries, the health system is big; it sits under different sets of jurisdictions (fragmented); and is largely operated at the local level.
I had the opportunity to visit a leading oncology hospital outside Moscow (#62). It is set in a tranquil, park-like setting outside the suburbs and has multiple buildings on this relatively small campus. Its new surgery center (less than 3 years old) is outfitted with modern equipment and a local vendor-driven, HIS-like system of which they are very proud. Parts of the long-term bed facility were under construction.
The HIS system was built on Windows and uses Citrix terminal servers. They demoed it and its broad feature set to me for over an hour, putting up with my incessant questions about how things worked. They showed it to me in a small auditorium setting, which is used every morning by the head of surgery to go over the previous day’s results and today’s planned surgeries. The system was pretty complete -- managing the obvious things like patient registration and patient data, up to and including identification of which patients should be prepped for discharged that day or the next day. Reducing the length of a patient stay (the Russian average is much longer than in US) is one of the priorities of the administration, in order to reduce service wait times.
More interesting than the HIS system, was speaking with the deputy director of the hospital, who is still a practicing physician. We had a very engaging discussion, which made it clear that he was quite proud of his facility, of the improved results he had been able to accomplish over the last few years, and the fact that an executive from Microsoft was interested in learning from him. He opened a fresh bottle of a Russian brandy drink (it was late in the day) to share over our conversation. He was proud that their HIS implementation had enabled him to operate the facility more effectively: manage drug costs better (major expense), manage his resourcing better, be able to tell which docs were doing well and which ones weren't (to intervene), and to improve overall capacity…the key basic things he needed to improve results.
His main point was that he needed to get more done, (i.e. see more people, get wait lists down and so on), without any additional funding. It was about managing priorities and resources to get the most out of them. Now maybe that shouldn't be surprising -- but it was striking to me nearly 8000 miles away from home, in a dramatically different environment and economic/payment system -- that the needs were similar and that IT was being used effectively by pioneers to improve their results in meaningful ways.