Академия наук

The estimation of the system of means of communication in the innovative processes of documentation support in medical institutions

Author: Inessa Tymoshenko, applicant KNUKIM

The documentation facilities performing the innovative function or the function of transmission of medical knowledge into clinical practice, such as circulars, guidelines, annual analytical reports on the most important home and foreign medical achievements are analyzed in the article.

Key words: innovative processes, documentation support, means of communication, circulars, guidelines, analytical report.

Nowadays medical establishments require some new technical approaches to the prosperity and growth of the medical service efficiency as never before. The final aim of the medical service activity is the materialization of the achievements in the world medical science and practice. The newest, the safest and the most effective medical technologies can be materialized owing to a well-organized system of means of communication in the innovative processes of the documentation support. But to create this system we need some coordination between the Academy of Medical Sciences (AMS), the Ministry of Health Protection (MHP) and medical and prophylactic establishments (MPEs) in the process of means of scientific communication formation.

The public importance of medical establishments documentation support evokes permanent scientific interest to this sphere. As far back as in 1980-s              A. R. Uvarenko made the analysis of the effectiveness of information and documentation resources in health service. There are such scientists as                      N. O. Artamonova, A. V. Stepanenko, A. I. Prytuliak, L. M. Novhorodska,               N. V. Romaniuk who work in the documentation support of medical institutions sphere these days.

The objectives and main tasks of the article are to find a systematic dynamics in the process of the means of communication in the documentation support formation in medicine and to analyze the peculiarities of the documentation medical resources usage.

The medical documentation system is oriented to the maintenance of the integral communication inside the whole system of medical and prophylactic establishments.

Unfortunately, our home health care system is at the very beginning of the process of scientific documentation improvement in the innovative sphere. That is why this problem achieves decisive importance and is the most actual for the formation of the modern market of medical innovation and channels of communication.

At the present stage, it is acceptable to consider documentation resources as a part of strategic resources of the society and as an important factor of its political and economic development. Documentation and information resources in medical and prophylactic establishments have some peculiarities conditioned by the specific tasks of the medical sphere and characteristic only for medicine as a science and health care as a sector of the national economy.

Taking into account all means of communication existing at the documentation market nowadays, we can say that the first place is taken by scientific medical publications. However, because of objective causes a great number of scientific publications cannot satisfy the needs of users. Such factors as scattering of information in the amplitude of publications and the long period of preparation have a negative influence on the information efficiency. All these problems encourage us to create an accurate system of means of communication.

According to the survey among the medical documentation users where the problems of children’s and teenagers’ health care were taken as an example, the authors of the work defined circulars and guidelines as the most important source of a communication channel.

Personal research on the survey method usage also proved [1, 35] that the most effective means of communication for medical innovation introduction are: guidelines (21.0%), circulars (16.0%) and also licence agreements (14.0 %), seminars (13.0 %), lectures (13.0 %) etc.

The above-mentioned means of communication are spread through the administration of the health service system, in particular through the leading specialists responsible for the application of scientific achievements in the region. Moreover, an expert evaluation of these means of communication provided by the Ministry of Health Protection and the Academy of Medical Sciences problem commissions and reviewing by the leading specialists from the Ministry of Health Protection of Ukraine ensures the quality of these means of communication.

Examining the means of communication and documentation that are used in medical institutions nowadays, the special attention should be paid to the most important ones:

- circulars;

- guidelines;

- an annual generalized analytical report.

The peculiarities of circulars are: briefness, specificity and purity of information, absence of information noise, convenience of use and easiness of distribution.

A circular as a document is a definite problem data medium. It finds a user through an administrative system of a health care organization, especially through its leading specialists responsible for the introduction of scientific research in a definite region. An additional efficiency of getting information is provided by that. Circular quality is guaranteed not only by the results of the authors’ own research but also by the expert estimation of the Ministry of Health Protection and the Academy of Medical Sciences problem commissions, the reviewing by the leading specialists from  the Academy of Medical Sciences and by the practice of additional reviewing by the edge-wise scientific institutions (departments) specialists.  [6, 105−108].

We can mention some positive features of circulars. First of all, their publication doesn’t cost much; secondly, the information included doesn’t have any information noise; thirdly, circulars are very convenient; fourthly, the promptness of representation depends only on the date of its submission by the author, because the terms of scientific research sometimes enlarge to 5−7 years (especially for theses) and circulars make it possible to notify the medical world of some partial results accelerating their materialization.

As for the analyses of the thematic structure of circulars, it is important to say that the first place is traditionally taken by pediatrics (11% from the total number of circulars), then goes surgery (8%), obstetrics and gynecology, environmental health, social hygiene, cardiology and rheumatology (5%).

According to the circular publication rates in different medical institutions, it has been detected that there is a tendency of circular growth in the medical institutions which are not under the authority of the Ministry of Health Protection or the Academy of Medical Sciences, for example, Medical Institute of Ukrainian Association of Folk Medicine, Volyn State University, Sumy State University. These circulars usually reflect the important problems of practical health care and give science-based recommendations for their solution.

A circular must become an integral part of modern publications. The efficiency of  information obtaining, its quality and scientific  basis, usage convenience and low cost give an opportunity to get information by a wide circle of medical workers.

Guidelines regulate, explain, specify innovations, include a short substantiation of the necessity of a definite medical technology, show its advantages and describe the conditions of use [4, 76; 5, 56; 7, 110].

We should say that according to State Policy of Standardization [2, 28], a guideline is an educational or applied explanatory edition on a definite topic or question of a subject or a practical activity with the execution procedure of some tasks and actions. A practical edition is a piece of information on technology, technique and industrial engineering and other spheres of social practice for the specialists of a definite type. An educational edition is an edition of systematized data of a scientific or applied direction which is given in a convenient form.

First of all, this is a newsletter or an educational edition giving a system of scientific or applied information about medical technologies, treatment, preventive measures and management decisions properly written for the users of such kind of scientific information [9, 101; 10, 91].

The guidelines are directed to practical health care specialists and scientists and aimed at the fastest and fullest giving of new proposals about the scientific research to the users and their introduction into our medical practice. The introduction of the proposals taken from foreign sources is also acceptable.

The quality of the recommendations for our country does not satisfy modern requirements and international standards, so the problem of estimation and quality is urgent [5, 55−58].

As for the quality of guidelines, there are some facts when the methodology of instrumentation without any documents from the appropriate authorities allowing its use in practical medicine is described [7, 111].

The causes hampering the preparation of guidelines for the coordination with the Ministry of Health Protection are:

• the lack of proper document execution (reviews, decisions of problem commissions, the leading  MHP specialists comments or medicines registration cards);
• the non-observance of the requirements to the structure, content or availability of the statistical data or lack of them;
• the discrepancy between the  methods of treatment or use of medicines suggested by the authors and existing standards;
• the lack of confirmation of the proposal efficiency in practice.

The guidelines received by Ukrmedpatentinform are subjected to expert appraisal in order to check their conformity with the requirements according to the instruction documents regulating the preparation and publication of means of scientific communication. The system of examination of methodological materials concerning duplicating and novelty of medical technology is tested. In the case of inconformity to the requirements of the documents some improvement, correction or even refusal to publish can be proposed. Annually about 10 guidelines (approximately 7%) are not published [5, 57].

965 guidelines have been published for the last five years. Most of them were prepared in the field of obstetrics and gynecology – 12 (6%); gastroenterology and endocrinology − 11 (5%); oncology, ophthalmology, children’s and teenagers’ health care, pharmacy −10 (4.6%); other directions − 84.4%.

Some government institutions are more active in the guidelines development. They are: higher medical schools and postgraduate educational institutions subordinated to the Ministry of Health Protection of Ukraine (50%); research institutes under the authority of the Academy of Medical Sciences (35.0%) and research institutes subjected to the Ministry of Health Protection (15.0%).

An annual generalized analytical report on the most important home and foreign achievements in medicine has been formed by Ukrmedpatentinform since 1998.

An annual report reflects the achievements of specialized scientific institutions. The conclusions about the effectiveness of financial use, the results of scientific research and research teams can be made up from the report. Annual reports can be used as a material for the analysis of scientific rates changes and the participation of research teams in the fulfilment of the sectorial innovation policy. At last, the report shows the level of awareness of our scientists about foreign achievements in medical science and practice [3, 72].

Taking into consideration that any achievement is a result of scientific research satisfying the requirements of the world level of novelty and usually protected by a patent, it is quite clear that its adoption into a definite sphere is an important contribution into a specific applied problem solution.

An absolutely new method of diagnostics, prevention, treatment, rehabilitation, course of disease prediction, a new device, a useful germ strain or an effective medicine can be qualified as an achievement.

The most important achievements are those that surpass the existing level of medicine and health care development and distinguish themselves by novelty and originality of decisions, high technical and economic indicators and are the most effective for the solutions of the urgent problems of medical and health care institutions at an accelerated pace.

According to the data [3, 74], the compilers of the annual reports often acquire only improved or new medical technologies not corresponding to the effectiveness characteristics, as achievements.

That is why from the total number of information cards with the materials about the potentially important scientific achievements sent for the consideration to research institutes or higher educational institutes under the authority of MHP, there are only 133 (about 33%) that were selected to be used in the preparation of the annual report.

From all the scientific achievements selected for the report there are about 70 % that are protected by patents. The distribution of proposals according to the departmental subordination testifies that 84.0% of proposals are developed by sectorial scientific institutions, higher educational establishments and postgraduate institutions; 3% are processed by other scientific organizations of Ukraine and 13% are qualified as foreign proposals. In particular, 67.0% of medical achievements concern to new medical technologies and 33.0% are new medicines, technical equipment, theories, conceptions, models etc.

Guidelines are not used enough in the scientific, information and communication supply of innovation processes in medicine and annual report preparation and, as a result, the makers of scientific achievements often inadequately qualify some home and foreign research works as the most important achievements, that is why, the number of potential achievements which are sent for the annual report by research institutes, higher educational establishments and postgraduate institutes under the authority of MHP grows annually.

As a number of important scientific achievements in research institutes, universities and postgraduate institutes is comparatively insignificant, there is a necessity to increase the effectiveness of scientific research in medicine.

Despite the fact that the state of patent license work in scientific and educational institutions has been improved, it needs further activation which has to appear in the documentation support of medical establishments.

Essential changes in the system of documentation support, the level and forms of scientific communication, the channels and technologies of knowledge spreading substantially influence the process of scientific medical activity that means the total qualitative change of science and the increase of its role in the society. So, constant complication of the communication system influences the process of forming a new system of scientific medical information services oriented to the improvement of documentation support with the help of new ways of communication and their efficiency and use estimation.

Thus, the analysis of modern ways of communication and documentation support of medical and prophylactic institutions shows that the forms of knowledge conservation and sharing don’t give an opportunity to apprehend and use it.

Therefore, the imperfection of this form of knowledge sharing needs revising  of publication forms and other ways of medical documents description,  the improvement of documentation support with the help of new methods and the estimation of their efficiency.

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