In 1994, it was decided to allocate a designated amount from the state budget for the implementation of highly qualified medical care - VMP (what it is - will be described in more detail below). The first institution funded for innovative operations was the All-Russian Research and Production Cardiology Center. After some time, new technologies in medicine became available to other clinics. Before the Federal Law “On the Fundamentals of Protecting the He alth of Citizens in the Russian Federation” was issued, the Ministry of He alth and Social Development annually approved the regime for referring patients to high-quality medical care. In 2012, a new order was adopted by law. Since its entry into force, its effect is indefinite. Consider how to get into institutions using new technologies in medicine. What documents are needed for this? How is the referral completed? Who decides and how? Read more about it below.
Direction. General information
VMP is a type of primary documentation. It includes information used toorganization of accounting and control of each direction. It is filled in by the he alth management body (HMO) individually after submitting documents to the commission for the selection of patients for the VMP (what kind of commission this is will be explained below). The documentation must contain the records of the medical institution. In the process of filling out a referral for medical care, only Russian is allowed. The document includes a passport part. It includes sections T, M, I, U, and 6 sections that correspond to the periods of referral for the provision of high-quality medical care. Next, consider how the document is drawn up.
How do I fill out a referral 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 documentation of various kinds. The VMP ticket is no exception. Its dark fields are drawn up only in electronic form at the stages of sending the patient's documentation for a correspondence consultation to a medical institution and providing information from it about the decision made. Shaded fields are filled in a certain way. Information is provided from he alth authorities, medical institutions. The presence of the conclusion of a competent medical staff is also required. If the medical institution deems it necessary to resort to a face-to-face consultation or sets the date for the proposed hospitalization, the he alth authority issues a VMP coupon in paper form, which includesand passport part. When connected to a common information system, the document number is generated automatically. In other cases, it is set in accordance with the instructions given in the Reporting Handbook.
Passport part
The "T" section 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 he alth management body. Details of MU are filled in section M. Items T.2, T.3, T.4 contain information indicated in numbers, according to the comments in each of them. Item T.5 provides information in numbers about the body that gave the referral. Here is an example of such digital designations:
0 - he alth management body of the representative of the Russian Federation;
1 – Ministry of He alth and Social Development of the Russian Federation;
2 - Federal Relief Agency;
3 – Biomedical Agency (Federal).
If the numbers 1 or 2 are indicated in paragraph T.3, information about patients is entered into the forms of information on the provision of HCW to citizens. Section "M" contains the full name and details of the medical institution to which the patient was referred. In 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 paragraph I.4, the insurance number of his personal account is indicated, which must correspond to a document for receiving a number of social services. Clause I.8 contains a document type code established according to a single classification. In paragraphs U.3, U.5, U.6, information is provided by the corresponding numbers. Item U.4 is filled out for those categories of patients who use benefits. The string is filled with zeros until the first significant digit appears. In clauses D.7 and D.8, patient information is indicated by the symbol V.
Stage 1 He alth Authority
If there is a need to conduct additional examinations or reissue documents, points 1.1 and 1.2 are marked with a V mark, and information about the patient is entered on the "Waiting List". When the patient provides the necessary information, in paragraphs 1.3 and 1.4, the numbers indicate the code and the date of the decision, respectively. If a refusal to provide assistance has come, in clause 1.3, the reason code for the refusal should be indicated. At the same time, the VMP ticket is closed. Item 1.5 is usually filled out 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 indicates the codes corresponding to the "Handbook for reporting". Clause 1.8 discloses the full name of the medical institution, which matches its name in the registration documentation. Section 1.9 indicates the code of the region where the institution sending information about the patient is located. This information is necessary for making the right decision and is presented in the form of a referral filled out according to the established rules. It specifies in detaila written extract from the medical history containing the conclusion of the responsible chief specialist with an explanation of the need to provide high quality medical care. This section also 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 of sending the documentation using e-mail. The medical institution must send confirmation of receipt of these documents.
Step 2
In paragraph 2.1, it is indicated when the voucher for the provision of HTMC and the patient's medical documentation was received by e-mail from the he alth authority. The date must match the one registered in the electronic notification register. If there is a need for an additional examination of the patient, re-issuance of documentation by the commission of the medical institution, then a mark V is made in paragraphs 2.2 and 2.3. Information about the decision taken is addressed to the he alth management body with an explanation of the necessary types of additional examinations and instructions for paperwork. If the commission of the institution decided to provide the patient with a VMP, the number 1 is indicated in paragraph 2.4. At the same time, the date of the proposed hospitalization is put in paragraph 2.7. Clause 2.6 must contain a code for the type of service. Patient data is placed in the "queue for the VMP". After that, the information is sent to the he alth authority in electronic form. If a decision was made to refuse to receive the TMC, paragraph 2.4 must contain the reason for the refusal (indicated in numbers).
Step 3
With a positive decision of the Commission of the medical institution on hospitalization, the he alth authority sends the patient to the place where he will receive treatment. In this case, in paragraph 3.2 the date of the decision is put. Clause 3.3 contains information on the date of issuance to the patient of the voucher for VMP, which is issued in paper form and filled in in accordance with the data of the second stage, as well as accompanying documents. When specifying the date, the time spent on the journey is also taken into account. Paragraphs 3.4 and 3.5 indicate the date of issue of coupons for travel to the place of rehabilitation by the Social Insurance Fund of the Russian Federation and their number, respectively. In case of disability of the patient of the third degree, a note is made in paragraph 3.6 about his accompaniment. After filling out section 3, the referral coupon is sent to the medical institution in electronic form. Further, a document signed by the he alth authority and its seal is given to the citizen in paper form.
Step 4
In paragraph 4.1, the doctor indicates the date the patient applied to the medical institution with the provision of a coupon for the provision of high-tech medical care, issued in a certain order, an extract from the documentation, which contains the conclusion of the chief specialist with an explanation of the need for the provision of services. Also, the referral should contain the results of diagnostic procedures required for this disease, less than a month old. If the commissionthe institution allowed the receipt of VMP, in clause 4.2 the number 1 is indicated, in clause 4.5 the day on which the decision was made is entered, and in clause 4.6 the date of hospitalization is entered. If it was refused, then in paragraph 4.4, using certain numbers, the basis for it is indicated. Then the information is sent to the he alth authority, and the document itself is handed over to the patient.
Step 5
Item 5.1 must contain the date of discharge of the citizen who received the VMP, in accordance with clause 22 of form N 066 / y-02. In paragraph 5.2, the results of the provision of VMP are indicated in numbers. In paragraph 5.3, information is entered on the forms, severity, nature of the course of the disease, which is taken from documents in accordance with the International Statistical Classification of Diseases and He alth Problems. Clause 5.4 indicates the codes for the standards of medical care provided, which are given in the "Handbook for reporting". Item 5.5 contains information about the result of hospitalization in numbers. Clause 5.6 indicates the planned date for a second visit to a medical institution, if it is required. Then, in the direction - a form filled out in paper form - the signature and seal of the head of this organization is 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 he alth authority.
GMP quota
Previously, it was issued after contacting a department, ministry or commission directly. To do this, you had to have an extract from the documents that contained recommendations,copies of the passport, pension certificate and compulsory medical insurance policy. The he alth authority included a special commission that selected patients for the provision of VMP. She made a decision in 10 days. On December 28, 2011, the Order of the Ministry of Social Development No. 1689n was approved. In this regard, the queue at the VMP has changed somewhat. From that moment on, the decision is made by the commission of the he alth authority of the constituent entity of Russia at 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 an extract from the patient's medical documents. This extract should include the diagnosis made, information about the patient's state of he alth, the diagnosis code in accordance with the International Statistical Classification of Diseases and He alth Problems, examinations and treatment carried out, the reasons for the forced provision of VMP. In addition, the results of all types of diagnostics carried out, corresponding to the specifics of the disease, as a result of which a certain diagnosis was made, are attached to the extract. The medical commission analyzes the information for three days and makes a decision, consisting of permission or refusal to send documentation to the Commission of the subject of the Russian Federation. The adopted resolution is documented in a protocol before being sent. The decision is based on medical indications for the provision of the service, taking into account the list of types.
In the event that the medical commissiondecides to send the patient's documentation to the Commission of the subject of the Russian Federation, it must form and send a set of documents to the he alth authorities in three working days. A citizen who is provided with assistance has the right to demand a protocol of the decision of the medical commission and an extract from his medical record in his hands, since he can take them on his own to the he alth authorities. In case of refusal to provide VMP, the patient should be given a protocol with the decision made. It will indicate the grounds for refusal and an extract from the documentation. This is how the direction to the VMP happens. What it is in general, how the accompanying documentation itself is filled out, should now be clear. In conclusion, I would like to give some statistics.
Federal cities
How is the direction of citizens to the VMP? Moscow, for example, as a city of federal significance, has special conditions. The selection of patients is carried out in the institutions of the state system of the city and in federal organizations that are subordinate to the Ministry of He alth of the Russian Federation. To date, 36 hospitals in Moscow provide over 80 types of HTMC. According to statistics, every year more than 58,000 medical and diagnostic procedures are performed using advanced developments. Many city hospitals have traumatology departments, where about 3,500 surgical interventions for arthroplasty of large joints are performed.
