eHealth: Building National Medical Information Systems

For decades, the healthcare system has operated with paper records, isolated local databases, and fragmented information exchange. In such conditions, a patient literally becomes a “courier” of their own medical history, and a doctor spends precious time collecting anamnesis instead of making clinical decisions.

Today, in 2017, we stand on the threshold of tectonic shifts. eHealth is transitioning from chaotic local initiatives of individual hospitals to the formation of a unified national system (eHealth). The team at IQusion IT LLC designs and implements architectural solutions that allow integrating medical institutions into a centralized digital circuit with guaranteed fault tolerance and data protection.

Our goal is much more ambitious than simply “digitizing records.” We are creating a scalable platform (Enterprise Service Bus) that unifies patient registries, electronic referrals, electronic prescriptions, and financial transactions into a single managed mechanism.

Unified Information Space: The End of the “Format Zoo” Era

Disparate medical information systems (MIS) in hospitals cannot “communicate” with each other. This lack of interactivity leads to duplication of expensive examinations and loss of critically important data when a patient is transferred.

IQusion IT LLC solves this problem through the implementation of service-oriented architecture (SOA) and powerful API gateways. We base data exchange on international medical standards:

• HL7 FHIR: for fast and structured exchange of clinical data (diagnoses, allergies, lab results).
• DICOM: for integrating medical imaging storage systems (PACS).
• MDM (Master Data Management): centralized management of МКХ-10 (ICD-10) and ICPC-2 directories, ensuring a unified interpretation of diagnoses in Kyiv, Odesa, or Lviv.

Process Automation and Financing: “Money Follows the Patient”

The medical reform currently underway fundamentally changes the philosophy of financing. eHealth becomes not only a clinical but also a financial instrument. Without automation, the transition to a new service payment model is simply impossible.

IQusion implements digital transactional modules that automate the lifecycle of a medical service: from creating an electronic referral to recording the fact of treatment and transmitting data to financial bodies (the future НСЗУ). We minimize paper bureaucracy and manual checks by implementing strict validation rules at the database level.

Personal Data Protection: The Zero Trust Concept

Medical information represents the highest level of confidentiality. The architecture of a national system cannot rely solely on basic passwords.

At IQusion IT, we build security on several levels:

• Cryptography and ЕЦП: every medical action (examination, referral, prescription) is mandatorily signed with the doctor’s Electronic Digital Signature (ЕЦП/КЕП). This guarantees legal significance and non-repudiation.
• Role-Based Access Control (RBAC): a family doctor sees the overall picture, a specialized professional sees their specific episode, and an administrator does not see clinical data at all.
• Immutable Audit Trail: every transaction (who, when, and from where viewed the record) is permanently recorded in the security log, making the system transparent for audit.

National System Stability: Readiness for Future Loads

In the coming years, the national eHealth system will serve tens of millions of patients and hundreds of thousands of doctors. Ordinary monolithic servers simply won’t cope.

Knowing that a massive campaign for signing declarations will begin in 2018 (generating colossal peak loads), IQusion designs the infrastructure using cloud patterns. We implement:

• Clustering and automatic horizontal scaling of components.
• Asynchronous message queues (Message Brokers) to smooth out request peaks.
• Strict control of SLA (Service Level Agreement) and RPO/RTO metrics for critical services, guaranteeing recovery within minutes in case of force majeure.

Conclusion: An Investment in Digital Evolution

After the full deployment of a centralized healthcare system in 2018–2020, Ukraine will gain a managed, data-driven model of medicine. Thanks to the technological solutions being laid today, we will transition from blind funding of hospital beds to payment for actual results.

IQusion IT is your reliable integrator. We build architecture that works stably today and is ready to meet all future challenges. Prepare for digital transformation with us.