The primary medication non-adherence occurs when a patient does not collect his or her newly prescribed medication. Various studies give estimates that this occurs between 0.2 percent and 74 percent. Recently, this topic has been researched by analyzing data in national electronic prescription systems. The database of the Czech electronic prescription system was used to obtain the number of all prescriptions issued and collected in 2021 for fifty particular substances (associated with six medication groups). Additionally, a similar query was performed with an additional criterion that the same substance had not been prescribed within the last 365 days. The data were obtained separately in five age categories. The total number of prescriptions analyzed in this study was over 21 million, which represents almost 30 percent of all prescriptions issued in the Czech Republic in 2021. The primary medication non-adherence in the selected substances was 4.56 percent, which negatively correlates (rxy = 0.707) with the age of a patient. There is a higher primary non-adherence in the Psychoanaleptics and Lipid modifying medication groups than in the whole studied sample (p < 0.05). Lipid-modifying medication group and several other particular substances showed a larger difference between primary non-adherence and overall non-adherence, indicating issues in the initiation of these drugs. The results of our study are following earlier studies with similar methodologies from other countries. However, the difference between primary non-adherence and overall non-adherence had not been observed in other studies before. The electronic prescription system proved to be a valuable tool for conducting this type of research.

Background It is very difficult to find a consensus that will be accepted by most players when creating health care legislation. The Czech electronic prescription system was launched in 2011 and new functions were introduced in 2018. To ensure that these functions will not conflict with any other existing law, a process modeling tool based on the patent “Method and system for automated requirements modeling” was used successfully in the Czech Republic for the first time. Objective The aim of this project was to develop another successful application of process modeling to add COVID-19 vaccination records to the existing electronic prescription system. Methods The method employed was based on the mathematical theory of hierarchical state diagrams and process models. In the first step, sketches that record the results of informal discussions, interviews, meetings, and workshops were prepared. Subsequently, the architecture containing the main participants and their high-level interactions was drafted. Finally, detailed process diagrams were drawn. Each semiresult was discussed with all involved team members and stakeholders to incorporate all comments. By repeating this procedure, individual topics were gradually resolved and the areas of discussion were narrowed down until reaching complete agreement. Results This method proved to be faster, clearer, and significantly simpler than other methods. Owing to the use of graphic tools and symbols, the risk of errors, inaccuracies, and misunderstandings was significantly reduced. The outcome was used as an annex to the bill in the legislative process. One of the main benefits of this approach is gaining a higher level of understanding for all parties involved (ie, legislators, the medical community, patient organizations, and information technology professionals). The process architecture model in a form of a graphic scheme has proven to be a valuable communication platform and facilitated negotiation between stakeholders. Moreover, this model helped to avoid several inconsistencies that appeared during workshops and discussions. Our method worked successfully even when participants were from different knowledge areas. Conclusions The vaccination record process model was drafted in 3 weeks and it took a total of 2 months to pass the bill. In comparison, the initial introduction of the electronic prescription system using conventional legislative methods took over 1 year, involving immediate creation of a text with legislative intent, followed by paragraph-by-section wording of the legislation that was commented on directly. These steps are repeated over and over, as any change in any part of the text has to be checked and rechecked within the entire document. Compared with conventional methods, we have shown that using our method for the process of modification of legislation related to such a complex issue as the integration of COVID-19 vaccination into an electronic prescription model significantly simplifies the preparation of a legislative standard.

BACKGROUND It is very difficult to find a consensus that will be accepted by most players when creating health care legislation. The Czech electronic prescription system was launched in 2011 and new functions were introduced in 2018. To ensure that these functions will not conflict with any other existing law, a process modeling tool based on the patent “Method and system for automated requirements modeling” was used successfully in the Czech Republic for the first time. OBJECTIVE The aim of this project was to develop another successful application of process modeling to add COVID-19 vaccination records to the existing electronic prescription system. METHODS The method employed was based on the mathematical theory of hierarchical state diagrams and process models. In the first step, sketches that record the results of informal discussions, interviews, meetings, and workshops were prepared. Subsequently, the architecture containing the main participants and their high-level interactions was drafted. Finally, detailed process diagrams were drawn. Each semiresult was discussed with all involved team members and stakeholders to incorporate all comments. By repeating this procedure, individual topics were gradually resolved and the areas of discussion were narrowed down until reaching complete agreement. RESULTS This method proved to be faster, clearer, and significantly simpler than other methods. Owing to the use of graphic tools and symbols, the risk of errors, inaccuracies, and misunderstandings was significantly reduced. The outcome was used as an annex to the bill in the legislative process. One of the main benefits of this approach is gaining a higher level of understanding for all parties involved (ie, legislators, the medical community, patient organizations, and information technology professionals). The process architecture model in a form of a graphic scheme has proven to be a valuable communication platform and facilitated negotiation between stakeholders. Moreover, this model helped to avoid several inconsistencies that appeared during workshops and discussions. Our method worked successfully even when participants were from different knowledge areas. CONCLUSIONS The vaccination record process model was drafted in 3 weeks and it took a total of 2 months to pass the bill. In comparison, the initial introduction of the electronic prescription system using conventional legislative methods took over 1 year, involving immediate creation of a text with legislative intent, followed by paragraph-by-section wording of the legislation that was commented on directly. These steps are repeated over and over, as any change in any part of the text has to be checked and rechecked within the entire document. Compared with conventional methods, we have shown that using our method for the process of modification of legislation related to such a complex issue as the integration of COVID-19 vaccination into an electronic prescription model significantly simplifies the preparation of a legislative standard.

Při návrhu informačních systémů pro eHealth je podstatné dob-ře popsat strukturu procesů navrhovaných systémů. Modely využívající hierarchické stavové automaty (statecharts) jsou efektivním nástrojem pro jejich dynamický popis a následnou simulaci, která je podkladem interdisciplinárního porozumění mezi architekty informačních systémů, lékaři a tvůrci legislativy. Dobře navržené procesy umožní vyhnout se chybám v navr-hované architektuře i nezbytné legislativní podpoře, které se později těžko napravují.

V dnešní době je patrný trend digitalizace zdravotnických ar-chivů a související dokumentace, nastává tedy čas na zapojení technologií označovaných Big Data v oblasti biomedicínské informatiky. Tyto technologie nabízí rychlejší a efektivnější zpra-cování a sdílení obrovského množství dat. Vzhledem k tomu, že zdravotní péče pracuje s velmi citlivými daty, je jedním z hlav-ních zájmů ochrana dat pacientů. V mnoha zemích probíhá programové zavádění elektronizace zdravotní péče. Například v USA probíhá „Health Information Technology for Economic and Clinical Health Act“, (HITECH). Cílem výzkumu je návrh a de-finice pravidel, která zamezí zneužití a únikům citlivých biome-dicínských dat. Současně však v minimální míře omezí efektivitu jejich zpracování a kvalitu výstupních dat. Hromadnost zpra-cování osobních a citlivých dat se postupně stává obrovským rizikem a současně příležitostí pro nastavení pravidel a procesů vedoucí k minimalizaci, či dokonce eliminaci těchto rizik. Big Data skrývají obrovský potenciál pro výzkum v oblasti biomedicíny v mnoha oblastech ať již při analýze segmentace pacientů, cen a výsledků léčby, kde umožní zjistit zdravotně a cenově nejefektivnější postup léčení pro konkrétního pacien-ta a také například v proaktivní identifikaci pacientů, u nichž by se vyplatila zdravotnická prevence. Principiálně jsou Big Data použitelná k tomu, aby z analýzy výskytu chorob bylo možné dělat epidemiologické závěry a navrhovat preventivní opatření, mohou pomáhat při detekci a minimalizaci pokusů o podvody ve zdravotnictví a veřejném zdravotním pojištění a také přiná-šejí příležitost spolupráce s farmaceutickými společnostmi tak, aby pro ně bylo snazší identifikovat skupinu relevantních paci-entů pro klinické testy (za předpokladu předchozího souhlasu pacientů a dodržení etických norem).Článek si bere za cíl vysvětlit rozdílné přístupy a oblasti bezpečnosti v souvislosti s hromadným zpracováním dat ať již z pohledu bezpečnosti databázových dat jako celku, zamezení možnosti nepřímého získávání konkrétních údajů z neanony-mizovaného nebo i anonymizovaného souboru dat a z oblasti netriviálního dotazování.