In 1994, it was decided to allocate the designatedthe amount from the state budget for the implementation of highly qualified medical care - VMP (which will be described in more detail later). The first institution funded for innovative operations was the All-Russian Scientific-Production Cardiology Center. After some time, new technologies in medicine became available for other clinics. Before the Federal Law “On the Basics of Citizen Health Protection in the Russian Federation” was issued, the Ministry of Health and Social Formation annually approved the referral of patients for providing high-quality medical care. In 2012, a new order was adopted by law. Since its entry into force, it is indefinite. Consider how to get to the institutions that use new technologies in medicine. What documents are needed for this? How is the direction filled? Who makes the decision and how? Read about it below.
Coupon for rendering VMP - primary viewdocumentation. It includes information used to organize the accounting and control of each direction. It is filled in by the health care management authority (GMS) after submitting the documents to the commission on the selection of patients for the VMP (what kind of commission this will be explained below). The documentation must contain medical records. In the process of completing a referral for medical care, it is allowed to use only Russian. The document includes a passport part. It includes sections T, M, I, Y, and 6 sections, which correspond to the periods of referral to the provision of VMP. Next, consider how the document is drawn up.
What is this document, we have already figured out. Below are some rules for filling out. Computer technologies in medicine are used not only in the treatment of pathologies or their diagnosis. Also, their use allows you to quickly arrange the documentation of various kinds. Is no exception and the VMP coupon. His dark fields are drawn up only in electronic form at the stages of sending the patient's documentation for an extramural consultation to a medical institution and providing information about the decision made from it. Shaded fields are filled in a certain form. Provides information from the health authorities, medical institutions. Also, the presence of the conclusion of the competent medical staff. If the medical institution deems it necessary to resort to face-to-face consultation or set a date for the proposed hospitalization, the health authority shall issue the VMP coupon in paper form, which includes both the passport part. When connected to a common information system, the document number is generated automatically. In other cases, it is installed in accordance with the instructions contained in the “Handbook of reporting”.
The "T" section contains details of the direction. Paragraph T.1 specifies the date, month and year of submission of documents, previously filled by the medical institution, to the commission of the health management authority. Requisites of MU are filled in section M. Clauses T.2, T.3, T.4 contain the information specified in figures, respectively comments in each of them. Item T.5 provides information in figures about the authority that gave the direction. Here is an example of such numerical designations:
0 - health authority of the representative of the Russian Federation;
1 - Ministry of Health and Social Formation of the Russian Federation;
2 - Federal Aid Agency;
3 - Medical and Biological Agency (Federal).
If at T.3 numbers 1 or 2 are indicated, patient information is entered into the information forms on the provision of citizens to the FMP. Section "M" contains the full name and details of the medical institution to which the patient was sent. In the sections "I" and "U" the patient's data are indicated - last name, first name, patronymic, date of birth and place of registration, gender, corresponding to the passport. In clause I.4 the insurance number of his personal account is indicated, which must correspond to the document for receiving a number of social services. Item E.8 contains the document type code established according to a unified classification. In clauses У.3, У.5, У.6 the information is provided in corresponding figures. Item U.4 is filled for those categories of patients who enjoy benefits. The line contains zeros until the first significant digit appears. In clause У.7 and У.8, the patient information is indicated by the sign V.
If there is a need to holdadditional examinations or reissue documents, paragraphs 1.1 and 1.2 are marked with a V mark, and patient information is entered into the "Waiting list". When the patient provides the necessary information, in paragraphs 1.3 and 1.4, the numbers indicate the code and date of the decision, respectively. If a refusal to provide assistance has arrived, in clause 1.3 you should indicate the reason code for refusal. The vpon coupon closes. Clause 1.5 can be filled in according to the rules of the International Statistical Classification of Diseases and Problems, guided by information about the severity, stages, and process of the disease. Clause 1.6 specifies the codes corresponding to the “Handbook of Reporting”. Clause 1.8 discloses the full name of the medical facility, which is the same as its name in the registration documentation. In paragraph 1.9 is indicated the code of the region where the institution is located, sending information about the patient. This information is necessary for making the right decision and is presented in the form filled in according to the established rules of referral. It contains a detailed extract from the medical history file containing the conclusion of the responsible chief specialist explaining the need to provide high-quality medical care. This section also contains information about the clinical, laboratory and other studies and diagnostics that are required for a particular type of disease. This information should be no more than a month ago. Clause 1.10 indicates the date the documentation was sent using email. The medical institution must send confirmation of receipt of these documents.
In paragraph 2.1 indicates when the VMP coupon and medical records of the patient were received by e-mail from the health management authority. The date must correspond to the one registered in the register of electronic notification. If there is a need for additional examination of the patient, re-registration of documentation by the medical institution's commission, then note V is given in paragraphs 2.2 and 2.3. Information on the decision made is addressed to the health management authority explaining the necessary types of additional examinations and guidelines for the paperwork. If the institution's commission decided to provide the patient with a VMP, in paragraph 2.4 the number 1 is indicated. At the same time, in paragraph 2.7 the date of the proposed hospitalization is put. Section 2.6 must contain the code of the type of service. Data about the patient is placed in the "queue at the VMP". Then the information is sent to the health authority in electronic form. If a decision was made to refuse to receive an FMP, paragraph 2.4 should contain the reason for the refusal (indicated in figures).
With a positive decision of the Medical CommissionInstitutions for hospitalization The health management authority sends the patient to the place where they will be treated. In this case, clause 3.2 sets the date of the decision. Clause 3.3 contains information on the date of issue of a coupon for a patient to a VMP, which is issued in paper form and is filled in accordance with the data of the second stage, as well as accompanying documents. When specifying the date, the time spent on travel is also taken into account. In paragraphs 3.4 and 3.5, the day of issuance of tickets for travel to the place of recovery by the Social Insurance Fund of the Russian Federation and their number, respectively, is indicated. In the case of a third-degree patient’s disability, paragraph 3.6 makes a note about his accompaniment. After filling in the 3 sections, the coupon-direction is sent to the medical institution in electronic form. Further, the document signed by the public health authority and its stamp is handed out to the citizen in paper form.
In paragraph 4.1, the doctor indicates the date of the patient's visit to the medical institution with the provision of a coupon for the provision of VMP, issued in a certain order, an extract from the documentation, which contains the conclusion of the chief specialist explaining the need to provide services. Also in the direction should be indicated the results of diagnostic procedures required for this disease, with a prescription of less than a month. If the institution's commission has permitted receipt of the FMP, in paragraph 4.2 the number 1 is indicated, in paragraph 4.5 the date on which the decision was made is entered and in paragraph 4.6 the date of hospitalization is entered. If it was refused, in clause 4.4 with the use of certain numbers the basis for it is indicated. Then the information is sent to the health authority, and the document itself is given to the patient.
Clause 51 must contain the date of discharge of the citizen to whom the VMP was provided, in accordance with paragraph 22 of form N 066 / y-02. In clause 5.2 the figures indicate the result of the VMP. Paragraph 5.3 introduces information on the forms, severity, nature of the disease, which is taken from the documents in accordance with the International Statistical Classification of Diseases and Health Problems. Clause 5.4 indicates the codes of standards of medical care provided, which are listed in the “Handbook of Reporting”. Clause 5.5 contains information on the result of hospitalization in figures. In paragraph 5.6, the planned date of the second visit to a medical facility, if required, is noted. Then in the direction - a form filled in paper form - is signed and stamped by the head of this organization, after which it is handed over to the patient. On the day of discharge, the electronic form of the document is sent to the health authority.
Previously, it was issued after contactingdepartment, ministry or commission directly. For this, it was necessary to have an extract from the documents containing recommendations, copies of the passport, pension certificate and the OMS policy. The health authority consisted of a special commission that conducted a selection of patients to provide them with the VMP. For 10 days she made a decision. On December 28, 2011, the Order of the Ministry of Social Development No. 1689n was approved. In this regard, the queue at VMP has changed somewhat. The resolution has since been issued by the commission of the public health authority of the subject of Russia on the choice of patients. Now the selection of citizens and their referral to this commission are carried out by medical institutions in which patients were observed and treated. The appointment is issued on the recommendation of the attending physician, based on an extract from the medical records of the patient. This extract should include the diagnosis made, information about the patient’s health, the diagnosis code in accordance with the International Statistical Classification of Diseases and Health Problems, examinations and treatments, and reasons for the involuntary VMP. In addition, the statement attached the results of all types of diagnostics, corresponding to the specifics of the disease, as a result of which a definite diagnosis was made. The medical commission for three days analyzes the information and makes a decision consisting of permission or refusal to send documentation to the Commission of the subject of the Russian Federation. The resolution adopted before shipment is drawn up by the protocol. The basis for the decision are medical indications for the provision of services, given the list of species.
In the event that the medical board acceptsthe decision to send the patient's documentation to the Commission of the constituent entity of the Russian Federation, it must, within three working days, form and send a set of documents to the health authorities. A citizen who is provided with assistance has the right to request the protocol of the decision of the medical commission and an extract from his medical card in his hands, as he can take them independently to the health authorities. In case of refusal to provide VMP, the patient should be given a protocol with the decision made. It will indicate the reasons for refusal and extract from the documentation. This is the direction of the VMP. What is this in general, how the filling of the accompanying documentation takes place, should now be clear. In conclusion, I would like to give some statistics.
How are citizens referred to VMP? Moscow, for example, as a city of federal significance, has special conditions. The selection of patients is carried out in institutions of the state system of the city and in federal organizations that are subordinate to the Ministry of Health of the Russian Federation. To date, 36 Moscow hospitals provide over 80 types of VMP. According to statistics, each year more than 58,000 medical and diagnostic procedures are performed, involving the use of advanced developments. Many urban hospitals have departments of traumatology, where about 3.5 thousand surgical interventions for endoprosthetics of large joints are performed.