Outstaff Developers for Medical System Support
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Support and Enhancement of the Medical Information System of the Russian Federation

PHPSupportBackendFrontend
December 29, 2023

PROJECT TIMELINE: April – December 2023

PROJECT TEAM (OUTSTAFFING): 1 full-stack developer

TECHNOLOGIES: PHP 7.4, CodeIgniter, MSSQL, PostgreSQL, MongoDB, HTML5, CSS, JavaScript, Ext.js, Git, Docker, Docker Compose

PROJECT COST: > 2.5 million rubles 

ABOUT THE PROJECT

Our client's Medical Information System (MIS) is a high-load digital platform, serving as an automated workspace for healthcare professionals. Within the system, doctors create patient records and maintain the history of their interactions. Information is stored in secure databases and is accessible only to medical institutions in the city connected to the MIS.

In addition to doctors, various medical staff from different departments and categories utilize the platform. Each user role in the MIS has a personalized interface and functionalities. For example, when a doctor issues a patient referral for tests in their personal cabinet, a laboratory technician, upon entering their own dashboard, sees and confirms this appointment. Upon completion, they input the results into the system, immediately reflected in the patient's record managed through the doctor's account.

The MIS has already been implemented in organizations across 30+ regions of Russia. Over 100 IT specialists from different cities are involved in the development and maintenance of this digital system. It's a complex project with teams assigned to specific areas of responsibility. Our department comprises 10 specialists: project owner, two analysts, team leader, four developers, and two testers.

GOAL

Enhance the performance and functionality of the Medical Information System.

PRIMARY TASKS

  1. Provide technical support for the Medical Information System (MIS) with the development and enhancement of automation functionality for form completion, data transmission, sending referrals, and tracking risks during and after pregnancy.
  2. Modify and create modules for the frontend and backend sections of the "Assisted Reproductive Technologies" subsystem of the system.

SYSTEM TECHNICAL SUPPORT

Work on the project strictly follows specifications and deadlines. A sprint is formed every two weeks, and its approval goes through analysts, methodologists, and the team lead. Once our solutions to the assigned tasks are ready, they undergo phased redirection from the team lead to the tester, then to analysts, the project owner, and enter regression testing. Afterward, they are implemented on the platform.

The fifteen-year-old digital system has its peculiarities. Major changes cannot be made to it to avoid serious code compatibility conflicts. It has old and new interfaces on two versions of the ExtJS framework, and the created code must consider the features of different revisions. In addition, the platform has several databases, and working with them requires independently crafting queries. Despite the project's complexities, we have closed around 70 tasks for fixing and implementing functional capabilities in the MIS, including:

  • Automatic completion of the pregnant woman's questionnaire based on previously specified diagnoses.
  • Calculation of newborn risk.
  • Development of consents and refusals for neonatal screening (NS) and expanded neonatal screening (ENS).
  • Autofill data from the outcome form of pregnancy and the medical certificate of child birth for NS/ENS referrals.
  • Sending notifications about critical obstetric conditions to healthcare workers.
  • Calculation of pregnant women's risk in accordance with the order of the Ministry of Health of Russia No.1130n and setting risk indicators in the pregnant woman's questionnaire. 

We also corrected the logic of interaction with an external service and resolved dependency issues on it. After successful implementations of the developed solutions, we were entrusted with the subsection of the MIS - Assisted Reproductive Technologies (ART). It contains functionality for obstetricians, gynecologists, and other specialists in clinics where ART is performed to achieve pregnancy in cases of infertility.

ENHANCED ART SYSTEM

The doctor transitions to the ART (Assisted Reproductive Technologies) subsection only after examining the patient and, if necessary, prescribing treatment for infertility. Initially, the doctor logs into their personal cabinet, creates an electronic patient record, or finds it in the system. Next, they initiate a case of inpatient or outpatient treatment, fill out a form with the patient's complaints, and gather medical history. Based on the collected data, the doctor assigns an appropriate diagnosis and prescribes tests.

 

Within the digital system, the test assignment is transferred to the laboratory. Later, the results are returned, and the doctor can establish a more accurate diagnosis at the next appointment. If, based on the research results, the patient is allowed to undergo ART, the doctor creates a corresponding specification. In it, they fill in fields about prescribed procedures, indications, limitations, and contraindications.


Next, the patient's consent to ART and information about the decision made by the council of doctors are recorded in the protocol. After filling out and saving the form in the system, a plan with stages of medical care appears on the screen. The visual and sequential management of the patient in the MIS (Medical Information System) simplifies the doctor's control over prescribed medications and the course of changes. They can promptly identify deteriorations and make adjustments to the treatment, which continues until the stage of diagnosing pregnancy. After that, information about ART will be available when examining the pregnant patient by any registered obstetrician-gynecologist in the MIS.


RESULTS

In 8 months of collaboration, we have successfully addressed approximately 70 tasks to enhance the functional capabilities of the Medical Information System (MIS), which is implemented in institutions across 30+ regions of the Russian Federation.

Despite the complexity and scale of the project, we have seamlessly integrated the ART (Assisted Reproductive Technologies) subsection into the platform, meeting the requirements of our client.

As of the writing of this case study, we continue to support the MIS and contribute to the advancement of modern technologies for the field of medicine. 

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