In 1994, it was decided to allocate the assigned amount from the state budget for the implementation of highly qualified medical care - VMP (which will be described in more detail below). The first institution funded for innovative operations was the All-Russian Scientific and Production Cardiology Center. After some time, new technologies in medicine became available for other clinics. Before the Federal Law “On the Basics of Protecting Citizens' Health in the Russian Federation” was issued, the Ministry of Health and Social Affairs annually approved a regime for referring patients to provide high-quality medical care. In 2012, a new procedure was adopted by law. Since its entry into force, its action is unlimited. Consider how to get to institutions using new technologies in medicine. What documents are needed for this? How is the direction filled? Who makes the decision and how? Read about it later.
Direction. General information
VMP passport is a type of primary documentation. It includes information used to organize the accounting and control of each direction. It is filled out by the public health management body (health care institution) individually after submitting documents to the commission for the selection of patients for VMP (what kind of commission this will be explained below). The documentation should contain records of the medical institution. In the process of filling out a referral for medical care , only the Russian language is allowed. The document includes the 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.
How to fill in the direction to the VMP?
What kind of document is this, we have already found out. Below are some rules for filling. Computer technologies in medicine are used not only in the treatment of pathologies or their diagnosis. Also, their use allows you to quickly draw up various kinds of documentation. The VMP pass is no exception. Its dark fields are made out only in electronic form at the stages of sending the patient's documentation to the medical institution in absentia and providing information about the decision made from it. The darkened fields are filled in a certain form. Provides information from health authorities, medical facilities. The presence of a competent medical opinion is also required. If the medical institution considers it necessary to resort to a face-to-face consultation or sets a date for the alleged hospitalization, the healthcare management body draws up a VMP coupon in paper form, which includes the passport. When connected to a common information system, a document number is generated automatically. In other cases, it is installed in accordance with the instructions in the “Reporting Handbook”.
Passport part
Section "T" contains the details of the direction. Paragraph T.1 indicates the date, month and year of submission of documents pre-filled by the medical institution to the commission of the health management body. The details of the MU are filled in section M. Paragraphs T.2, T.3, T.4 contain the information indicated in numbers, according to the comments in each of them. Clause T.5 provides information in figures about the authority that gave the direction. Here is an example of such digital notation:
0 - health management body of a representative of the Russian Federation;
1 - Ministry of Health and Social Formation of the Russian Federation;
2 - Federal Agency for Assistance;
3 - Biomedical Agency (Federal).
If in paragraph T.3 the numbers 1 or 2 are indicated, information on patients is entered in the information on the provision of VMP to citizens. Section "M" contains the full name and details of the medical institution to which the patient was referred. In the sections "I" and "U" the patient data is indicated - last name, first name, middle name, date of birth and place of registration, gender, corresponding to the passport. Clause I.4 indicates the insurance number of his personal account, which must correspond to the document for a number of social services. Clause I.8 contains a document type code established by a single classification. In clauses U.3, U.5, U.6 information is provided by the corresponding figures. Clause U.4 is filled in for those categories of patients who enjoy benefits. Zeros are put in the line until the first significant digit appears. In paragraphs U.7 and U.8, information about the patient is indicated by V.
Stage No. 1. Health Management Authority
If there is a need to conduct additional examinations or reissue documents, paragraphs 1.1 and 1.2 are marked with a V, and information about the patient is entered in the “Waiting list”. When the patient provides the necessary information, in paragraphs 1.3 and 1.4, the numbers and the date of the decision are made, respectively. If the refusal to provide assistance has come, in clause 1.3 the reason code for the refusal should be indicated. The VMP pass closes. Clause 1.5 is customary to fill in according to the rules of the International Statistical Classification of Diseases and Problems, guided by information about the severity, stages, process of the disease. In clause 1.6, codes corresponding to the “Reporting Handbook” are indicated. Clause 1.8 discloses the full name of the medical institution, which coincides with its name in the registration documentation. In paragraph 1.9, the code of the region where the institution sending information about the patient is located is indicated. This information is necessary for making the right decision and is presented in the form of a referral filled in according to the established rules. It indicates a detailed written extract from the medical history containing the conclusion of the responding chief specialist with an explanation of the need to provide high-quality medical care. Also in this section contains information about 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 old. Clause 1.10 indicates the date the documentation was sent using email. The medical institution must send confirmation of receipt of these documents.
Stage number 2
Clause 2.1 indicates when the VMP and medical records for the patient were received by e-mail from the health authority. The date must correspond to that registered in the electronic alert register. If there is a need for an additional examination of the patient, re-issuance of the documentation by the commission of the medical institution, then in paragraphs 2.2 and 2.3 a mark is made V. Information about the decision is addressed to the health care authority with an explanation of the necessary types of additional examinations and instructions on paperwork. If the commission of the institution decided to provide the patient with VMP, the number 1 is indicated in paragraph 2.4. At the same time, in paragraph 2.7, the date of the alleged hospitalization is set. Section 2.6 must contain the code of the type of service. Patient data is placed in the “queue at the UMP”. After that, the information is sent to the health authority in electronic form. If a decision has been made to refuse to receive VMP, clause 2.4 should contain the reason for the refusal (indicated in numbers).
Stage number 3
If the decision of the Commission of the medical institution on hospitalization is positive, the public health authority sends the patient to the place where the treatment will take place. Moreover, in clause 3.2, the date of the decision is set. Clause 3.3 contains information about the date of issue of the VMP coupon to the patient, which is issued in paper form and filled out in accordance with the data of the second stage, as well as accompanying documents. When indicating the date, the time taken to travel is also taken into account. Paragraphs 3.4 and 3.5 indicate the day the coupons were issued to the place of recovery by the Social Insurance Fund of the Russian Federation and their number, respectively. In the event of limitation of the patient's ability to work of the third degree, paragraph 3.6 makes a note about his support. After filling out the 3 sections, the coupon direction is sent to the medical institution in electronic form. Further, a document with the signature of the public health authority and its seal is issued to the citizen in paper form.
Stage number 4
In paragraph 4.1, the doctor indicates the date of the patient’s visit to the medical institution with the provision of a VMP coupon issued in a specific order, an extract from the documentation containing the conclusion of the chief specialist explaining the need for the provision of services. Also in the direction should be indicated the results of the diagnostic procedures required for this disease, with a prescription of less than a month. If the institution’s commission has authorized the receipt of VMP, in paragraph 4.2 the number 1 is indicated, in paragraph 4.5 the day on which the decision was made is indicated, and in paragraph 4.6 the date of hospitalization is entered. If it was refused, then in clause 4.4, using certain numbers, the basis for it is indicated. Then the information is sent to the health authority, and the document itself is handed over to the patient.
Stage number 5
Clause 5.1 should contain the date of discharge of the citizen to whom the VMP was provided, in accordance with paragraph 22 of form No. 066 / y-02. In clause 5.2, the results of the provision of VMP are indicated in numbers. Paragraph 5.3 contains information on the forms, severity, nature of the course of the disease, which is taken from the documents in accordance with the International Statistical Classification of Diseases and Health Problems. In paragraph 5.4, the codes of standards of medical care provided are indicated in the “Reporting Handbook”. Paragraph 5.5 contains information on the result of hospitalization in numbers. In paragraph 5.6, the planned date of the second visit to the medical institution, if it is required, is noted. Then, in the direction - a form filled out in paper form - the signature and seal of the head of this organization are put, 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.
VMP quota
Previously, it was issued after applying to the department, ministry or commission directly. To do this, it was necessary to have an extract from documents containing recommendations, copies of a passport, a pension certificate and a compulsory medical insurance policy. The structure of the health authority included a special commission that selected patients for the provision of VMP. For 10 days she made a decision. On December 28, 2011, the Order of the Ministry of Social Development No. 1689 was approved. In this regard, the line at the PMF has changed somewhat. The decision from that moment is made by the commission of the public health authority of the subject of Russia for the choice of patients. Now the selection of citizens and their referral to this commission is 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 the extract from the patient’s medical documents. This statement should include the diagnosis, information about the patient’s health status, the diagnosis code in accordance with the International Statistical Classification of Diseases and Health Problems, examinations and treatment, and the reasons for the involuntary provision of VMP. In addition, the results of all the types of diagnostics carried out, corresponding to the specifics of the disease, as a result of which a specific diagnosis was made, are attached to the statement. 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 adopted decision before sending is made out by the protocol. The basis for the decision is medical indications for the provision of services, given the list of species.
In the event that a medical commission decides to send patient documentation to the Commission of a constituent entity of the Russian Federation, it must form and send a set of documents to health authorities within three working days. A citizen who is provided with assistance has the right to require a protocol of the decision of the medical commission and an extract from his medical record in his hands, as he can take them independently to the health authorities. In the case of refusal to provide an upper urinary tract, the patient should be issued a protocol with the decision made. It will indicate the grounds for refusal and extract from the documentation. This is how the direction to the VMP occurs. What is it as a whole, how is the filling of the accompanying documentation itself, now it should be clear. In conclusion, I would like to give some statistics.
Cities of federal significance
How are citizens sent to the VMP? Moscow, for example, as a city ​​of federal significance, has special conditions. Patients are selected 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, more than 58,000 medical and diagnostic procedures are carried out each year, involving the use of advanced developments. Many city hospitals have traumatology departments, where about 3,500 surgical interventions for large joint arthroplasty are performed.