{"id":4470,"date":"2019-06-27T10:17:20","date_gmt":"2019-06-27T08:17:20","guid":{"rendered":"https:\/\/casopis.nlk.cz\/?page_id=4470"},"modified":"2019-06-27T10:17:20","modified_gmt":"2019-06-27T08:17:20","slug":"ceka-nas-lepe-dostupna-zdravotni-pece","status":"publish","type":"page","link":"https:\/\/casopis.nlk.cz\/en\/archiv\/2019-24-1-2\/ceka-nas-lepe-dostupna-zdravotni-pece\/","title":{"rendered":"\u010cek\u00e1 n\u00e1s l\u00e9pe dostupn\u00e1 zdravotn\u00ed p\u00e9\u010de?"},"content":{"rendered":"<p style=\"text-align: justify;\"><strong>Bc. Kl\u00e1ra MA\u0160KOV\u00c1, NLK<\/strong><\/p>\n<p style=\"text-align: justify;\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-4483\" src=\"https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Medsoft-300x209.jpg\" alt=\"\" width=\"300\" height=\"209\" srcset=\"https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Medsoft-300x209.jpg 300w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Medsoft.jpg 333w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/>Dvoudenn\u00ed semin\u00e1\u0159 <a href=\"https:\/\/www.action-m.com\/medsoft2019\/\">Medsoft<\/a> u\u017e podes\u00e1t\u00e9 hostil hotel Academic v&nbsp;Roztok\u00e1ch u&nbsp;Prahy, kde se se\u0161ly p\u0159es \u010dty\u0159i des\u00edtky \u00fa\u010dastn\u00edk\u016f. Leto\u0161n\u00ed 31.&nbsp;ro\u010dn\u00edk byl zah\u00e1jen vzpom\u00ednkou na&nbsp;RNDr. Josefa Cir\u00fdna, spoluzakladatele semin\u00e1\u0159e, kter\u00fd zesnul 8.\u00a0b\u0159ezna.<!--more--><\/p>\n<p style=\"text-align: justify;\">Tematick\u00fd obsah semin\u00e1\u0159e je velmi \u0161irok\u00fd. Objevuj\u00ed se na&nbsp;n\u011bm p\u0159\u00edsp\u011bvky jak z\u00a0oblast\u00ed zdravotn\u00ed informatiky \u010di biomedic\u00ednsk\u00e9ho in\u017een\u00fdrstv\u00ed, tak i&nbsp;z&nbsp;v\u00fduky a&nbsp;vzd\u011bl\u00e1v\u00e1n\u00ed v\u00a0oblasti zdravotnick\u00e9 informatiky nebo knihoven a&nbsp;v\u011bdeck\u00fdch informac\u00ed ze zdravotnictv\u00ed.<\/p>\n<p style=\"text-align: justify;\">Jedn\u00edm z&nbsp;nosn\u00fdch t\u00e9mat semin\u00e1\u0159e byl koncept elektronick\u00e9ho zdravotnictv\u00ed. Usnesen\u00edm vl\u00e1dy \u010cR ze dne 28.&nbsp;11.&nbsp;2016 \u010d.&nbsp;1054 byla schv\u00e1lena <a href=\"http:\/\/www.nsez.cz\/dokumenty\/schvalena-narodni-strategie-elektronickeho-zdravotnictvi-na-obdobi-2016-2020_13051_3558_31.html\">N\u00e1rodn\u00ed strategie elektronick\u00e9ho zdravotnictv\u00ed na&nbsp;obdob\u00ed 2016 &#8211; 2020<\/a> (d\u00e1le NSeZ). Jde o&nbsp;strategick\u00fd dokument formuluj\u00edc\u00ed strategick\u00e9 c\u00edle a&nbsp;ukazuj\u00edc\u00ed tak sm\u011br na\u00a0z\u00e1klad\u011b spole\u010densk\u00fdch podm\u00ednek a&nbsp;trend\u016f v\u00fdvoje na&nbsp;\u00farovni EU a&nbsp;\u010cR, kter\u00fdm by se m\u011bl v\u00fdvoj elektronizace ub\u00edrat. C\u00edle strategie jsou podporov\u00e1ny programem vych\u00e1zej\u00edc\u00edm z&nbsp;N\u00e1rodn\u00ed strategie ochrany a&nbsp;podpory zdrav\u00ed a&nbsp;prevence nemoc\u00ed \u201eZDRAV\u00cd 2020\u201c.<\/p>\n<p style=\"text-align: justify;\">Sou\u010d\u00e1st\u00ed strategie je zav\u00e1d\u011bn\u00ed n\u00e1stroj\u016f zvy\u0161uj\u00edc\u00edch celkovou efektivitu, \u00fa\u010dinnost a&nbsp;zejm\u00e9na udr\u017eitelnost cel\u00e9ho zdravotnick\u00e9ho syst\u00e9mu. C\u00edlem je zaji\u0161t\u011bn\u00ed dostupnosti zdravotnick\u00fdch informac\u00ed, kter\u00e9 mohou v\u00e9st k&nbsp;z\u00e1chran\u011b \u017eivota, a&nbsp;to ve&nbsp;spr\u00e1vn\u00fd \u010das na&nbsp;spr\u00e1vn\u00e9m m\u00edst\u011b. \u0158e\u0161\u00ed i&nbsp;specifickou oblast dostupnosti informac\u00ed v&nbsp;p\u0159eshrani\u010dn\u00edm pohybu ob\u010dan\u016f a&nbsp;pacient\u016f, nap\u0159.&nbsp;interoperabilitu zdravotnick\u00fdch informa\u010dn\u00edch syst\u00e9m\u016f. P\u0159\u00edkladem kl\u00ed\u010dov\u00fdch projekt\u016f jsou n\u00e1rodn\u00ed registry zdravotnick\u00fdch pracovn\u00edk\u016f a&nbsp;poskytovatel\u016f \u010di ePreskripce.<\/p>\n<p style=\"text-align: justify;\">\u00davod do&nbsp;t\u00e9to problematiky p\u0159edstavil Martin Zeman svou p\u0159edn\u00e1\u0161kou \u201e<em>N\u00e1rodn\u00ed centrum elektronick\u00e9ho zdravotnictv\u00ed (NSeZ) &#8211; pl\u00e1ny versus realita v&nbsp;roce 2019<\/em>\u201c. Zeman moment\u00e1ln\u011b pracuje jako \u0159editel N\u00e1rodn\u00edho centra elektronick\u00e9ho zdravotnictv\u00ed a&nbsp;ve&nbsp;sv\u00e9 p\u0159edn\u00e1\u0161ce prezentoval stav aktu\u00e1ln\u00edho pln\u011bn\u00ed NSeZ. N\u00e1rodn\u00ed centrum elektronick\u00e9ho zdravotnictv\u00ed vzniklo \u2013 podle n\u011bj s&nbsp;t\u0159\u00edlet\u00fdm zpo\u017ed\u011bn\u00edm \u2013 v&nbsp;\u0159\u00edjnu 2017 s&nbsp;c\u00edlem programov\u011b a&nbsp;hospod\u00e1rn\u011b koordinovat a\u00a0podporovat rozvoj digitalizace, a&nbsp;p\u0159edev\u0161\u00edm udr\u017eovat a&nbsp;rozv\u00edjet koncepci n\u00e1rodn\u00edho syst\u00e9mu elektronick\u00e9ho zdravotnictv\u00ed. Moment\u00e1ln\u011b se pracovn\u00ed skupina zab\u00fdv\u00e1 aktivitou 3, v&nbsp;n\u00ed\u017e vytv\u00e1\u0159\u00ed u\u017eivatelsk\u00e9 sc\u00e9n\u00e1\u0159e, zkoum\u00e1 procesy, zji\u0161\u0165uje pot\u0159eby a&nbsp;prov\u00e1d\u00ed simulace. V\u00a0b\u0159eznu by na&nbsp;\u017e\u00e1dost ministra zdravotnictv\u00ed m\u011bla b\u00fdt hotov\u00e1 prvn\u00ed verze N\u00e1rodn\u00edho zdravotnick\u00e9ho informa\u010dn\u00edho port\u00e1lu ur\u010den\u00e9ho ve\u0159ejnosti <a href=\"https:\/\/www.nzip.cz\/\">nzip.cz<\/a>.<\/p>\n<p style=\"text-align: justify;\">Na&nbsp;toto t\u00e9ma pak nav\u00e1zali Martin Komenda a&nbsp;Mat\u011bj Karolyi z\u00e1stupci t\u0159in\u00e1cti\u010dlenn\u00e9ho t\u00fdmu Webstudio zform\u00e1tovan\u00e9ho v&nbsp;r\u00e1mci aktivit pracovi\u0161\u0165 <span class=\"st\">Institutu biostatistiky a&nbsp;anal\u00fdz L\u00e9ka\u0159sk\u00e9 fakulty Masarykovy univerzity (<\/span>IBA LF MU) a&nbsp;<span class=\"st\">\u00dastavu zdravotnick\u00fdch informac\u00ed a&nbsp;statistiky \u010cR (\u00daZIS \u010cR)\u00a0<\/span> a&nbsp;nab\u00edzej\u00edc\u00ed komplexn\u00ed slu\u017eby z&nbsp;oblasti webdesignu a&nbsp;p\u0159\u00edpravy grafick\u00fdch podklad\u016f.<\/p>\n<p style=\"text-align: justify;\">V&nbsp;sou\u010dasnosti jsou informace o&nbsp;zdravotnictv\u00ed a&nbsp;medic\u00edn\u011b zve\u0159ej\u0148ov\u00e1ny prost\u0159ednictv\u00edm mnoha r\u016fzn\u00fdch internetov\u00fdch zdroj\u016f. Problematick\u00e9 se v\u0161ak jev\u00ed rozli\u0161ov\u00e1n\u00ed relevantn\u00edch zdroj\u016f obsahuj\u00edc\u00edch garantovan\u00e9 a&nbsp;spr\u00e1vn\u00e9 informace od&nbsp;t\u011bch nerelevantn\u00edch. Pro n\u00e1vrh koncep\u010dn\u00edch \u0159e\u0161en\u00ed pod garanc\u00ed st\u00e1tn\u00edch organizac\u00ed bylo zapot\u0159eb\u00ed nejprve zmapovat existuj\u00edc\u00ed online zdroje prezentuj\u00edc\u00ed informace z&nbsp;oblasti zdravotnictv\u00ed, a&nbsp;to pod z\u00e1\u0161titou jak st\u00e1tn\u00edch \u010di akademick\u00fdch instituc\u00ed, tak i&nbsp;komer\u010dn\u00edch. Za t\u00edmto \u00fa\u010delem byla zpracov\u00e1na detailn\u00ed re\u0161er\u0161e, jej\u00ed\u017e v\u00fdsledky byly klasifikov\u00e1ny podle sady definovan\u00fdch popisn\u00fdch atribut\u016f. Celkem bylo zahrnuto 190 zdroj\u016f, kter\u00e9 byly pops\u00e1ny pomoc\u00ed sedmi atribut\u016f:<\/p>\n<ul>\n<li>garant obsahu,<\/li>\n<li>typ organizace (st\u00e1tn\u00ed subjekt, akademick\u00fd subjekt, komer\u010dn\u00ed\/soukrom\u00e1 organizace, neziskov\u00e1 organizace\/nada\u010dn\u00ed spolek\/sdru\u017een\u00ed ob\u010dan\u016f),<\/li>\n<li>kategorie obsahu (informace o&nbsp;projektu, novinky\/rozcestn\u00edk, datab\u00e1ze s\u00a0vyhled\u00e1v\u00e1n\u00edm, statick\u00e9 vizualizace dat, interaktivn\u00ed vizualizace dat, otev\u0159en\u00e1 data),<\/li>\n<li>zam\u011b\u0159en\u00ed (ur\u010den\u00ed, zda se port\u00e1l zam\u011b\u0159uje pouze na&nbsp;jedno konkr\u00e9tn\u00ed t\u00e9ma z&nbsp;oblasti zdravotnictv\u00ed nebo poskytuje informace o&nbsp;r\u016fzn\u00fdch t\u00e9matech),<\/li>\n<li>c\u00edlov\u00e1 skupina (odborn\u00edci\/l\u00e9ka\u0159i, ve\u0159ejnost, pracovn\u00edci st\u00e1tn\u00ed spr\u00e1vy\/\u00fa\u0159edn\u00edci, akademi\u010dt\u00ed pracovn\u00edci),<\/li>\n<li>p\u0159\u00edstupnost (\u0161ifrovan\u00e1 komunikace pomoc\u00ed SSL, responzivn\u00ed design u\u017eivatelsk\u00e9ho rozhran\u00ed),<\/li>\n<li>a&nbsp;jazyk (dostupnost jazykov\u00fdch mutac\u00ed &#8211; \u010de\u0161tina, angli\u010dtina) (Karolyi, 2019).<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">Z&nbsp;v\u00fdsledk\u016f re\u0161er\u0161e vypl\u00fdv\u00e1 nap\u0159\u00edklad, \u017ee&nbsp;z&nbsp;hlediska typu organizace jsou nejv\u00edce zastoupeny organizace ze st\u00e1tn\u00edho sektoru (47,9&nbsp;%). Jedn\u00e1 se p\u0159ev\u00e1\u017en\u011b o&nbsp;webov\u00e9 slu\u017eby a&nbsp;informa\u010dn\u00ed port\u00e1ly p\u0159edn\u00edch zdravotnick\u00fdch organizac\u00ed v&nbsp;\u010cesk\u00e9 republice. Z&nbsp;hlediska kategorie obsahu se uk\u00e1zalo, \u017ee&nbsp;v\u011bt\u0161\u00ed \u010d\u00e1st port\u00e1l\u016f (77&nbsp;%) je zam\u011b\u0159ena na&nbsp;specifick\u00e1 t\u00e9mata a&nbsp;men\u0161\u00ed \u010d\u00e1st (23&nbsp;%) informuje sv\u00e9 u\u017eivatele komplexn\u011bji. A&nbsp;z&nbsp;hlediska c\u00edlov\u00e9 skupiny bylo zji\u0161t\u011bno, \u017ee&nbsp;v\u011bt\u0161ina port\u00e1l\u016f (84,7&nbsp;%) se soust\u0159ed\u00ed na&nbsp;\u0161irokou ve\u0159ejnost, pop\u0159\u00edpad\u011b alespo\u0148 obsahuje sekci ur\u010denou \u0161irok\u00e9 ve\u0159ejnosti.<\/p>\n<p style=\"text-align: justify;\">Mat\u011bj Karolyi pak uk\u00e1zal dva zaj\u00edmav\u00e9 p\u0159\u00edklady port\u00e1l\u016f z&nbsp;produkce Webstudio. Prvn\u00edm byla <a href=\"https:\/\/ztnemocnice.uzis.cz\/\">Mapa zdravotnick\u00e9 techniky<\/a>. Tento webov\u00fd port\u00e1l poskytuje informace o&nbsp;dostupnosti jednotliv\u00fdch kategori\u00ed zdravotnick\u00e9 techniky u&nbsp;v\u0161ech poskytovatel\u016f zdravotnick\u00fdch slu\u017eeb, kte\u0159\u00ed dle z\u00e1kona odevzdali Ro\u010dn\u00ed v\u00fdkaz o&nbsp;p\u0159\u00edstrojov\u00e9m vybaven\u00ed zdravotnick\u00e9ho za\u0159\u00edzen\u00ed. Celkem je evidov\u00e1no 15&nbsp;104 p\u0159\u00edstroj\u016f. Druh\u00fdm port\u00e1lem je <a href=\"https:\/\/drg.uzis.cz\/klasifikace-pripadu\/web\/\">Klasifika\u010dn\u00ed syst\u00e9m DZ-DRG\u00a0<\/a>pracuj\u00edc\u00ed s\u00a0klasifika\u010dn\u00edmi pravidly pro za\u0159azen\u00ed hospitaliza\u010dn\u00edch p\u0159\u00edpad\u016f do&nbsp;jednotliv\u00fdch \u00farovn\u00ed syst\u00e9mu DZ-DRG. Jeho hlavn\u00edm c\u00edlem je snaha zp\u0159\u00edstupnit definovan\u00e1 pravidla \u0161irok\u00e9mu spektru u\u017eivatel\u016f a&nbsp;z\u00e1jemc\u016f.<\/p>\n<p style=\"text-align: justify;\">Hodnocen\u00ed kvality webov\u00fdch str\u00e1nek se tak\u00e9 ve&nbsp;sv\u00e9m p\u0159\u00edsp\u011bvku v\u011bnovali Pavel Kasal a\u00a0\u0160t\u011bp\u00e1n Sva\u010dina. Auto\u0159i v&nbsp;prvn\u00ed polovin\u011b p\u0159\u00edsp\u011bvku pouk\u00e1zali na&nbsp;problematiku alternativn\u00ed medic\u00edny. V\u00a0sou\u010dasnosti nejsou aktivity l\u00e9\u010ditel\u016f pln\u011b legislativn\u011b o\u0161et\u0159eny a&nbsp;naopak jsou sp\u00ed\u0161e podporov\u00e1ny chyb\u011bj\u00edc\u00ed regulac\u00ed klamav\u00e9 reklamy. Na&nbsp;druhou stranu se n\u011bkter\u00e9 alternativn\u00ed praktiky mohou v&nbsp;l\u00e9\u010db\u011b pacient\u016f vhodn\u011b uplatnit. \u0158e\u0161en\u00edm by mohlo b\u00fdt vytvo\u0159en\u00ed port\u00e1lu garantovan\u00e9ho ofici\u00e1ln\u00ed autoritou \u2013 Ministerstvem zdravotnictv\u00ed \u010cR, kter\u00fd by poskytoval objektivn\u00ed, kvalifikovan\u00e9 informace v&nbsp;oblasti alternativn\u00ed medic\u00edny. Moment\u00e1ln\u011b je vypracov\u00e1n n\u00e1vrh port\u00e1lu s&nbsp;n\u00e1zvem ALTMED. Obsahuje seznam praktik, jejich stru\u010dnou definici, indikaci, vyu\u017eit\u00ed, kritiku a&nbsp;odkazy na&nbsp;popul\u00e1rn\u011b odborn\u00e9 \u010dl\u00e1nky o&nbsp;dan\u00e9 problematice.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-large wp-image-4477\" src=\"https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr1-1024x576.png\" alt=\"\" width=\"625\" height=\"352\" srcset=\"https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr1-1024x576.png 1024w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr1-300x169.png 300w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr1-768x432.png 768w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr1-624x351.png 624w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr1.png 1280w\" sizes=\"auto, (max-width: 625px) 100vw, 625px\" \/><\/p>\n<p style=\"text-align: justify;\">V&nbsp;druh\u00e9 polovin\u011b p\u0159edn\u00e1\u0161ky se auto\u0159i zam\u011b\u0159ili na&nbsp;hodnocen\u00ed kvality str\u00e1nek nemocnic. Ukazuje se, \u017ee&nbsp;aktu\u00e1ln\u00ed \u00farove\u0148 webov\u00fdch str\u00e1nek zdravotnick\u00fdch za\u0159\u00edzen\u00ed je velmi rozd\u00edln\u00e1. \u0158ada jejich tv\u016frc\u016f nerespektuje z\u00e1kladn\u00ed pravidla jejich tvorby a&nbsp;v\u00fdsledkem jsou z\u00e1va\u017en\u00e9 nedostatky z&nbsp;hlediska informov\u00e1n\u00ed pacienta. N\u00e1prava situace je podle autor\u016f p\u0159\u00edsp\u011bvku mo\u017en\u00e1 prost\u0159ednictv\u00edm ve\u0159ejn\u00e9ho publikov\u00e1n\u00ed nedostatk\u016f. V&nbsp;r\u00e1mci ji\u017e zanikl\u00e9ho Koordina\u010dn\u00edho st\u0159ediska pro resortn\u00ed zdravotnick\u00e9 informa\u010dn\u00ed syst\u00e9my vznikl port\u00e1l Rankmed, kter\u00fd na&nbsp;z\u00e1klad\u011b hodnocen\u00ed kvality webov\u00fdch str\u00e1nek pravideln\u011b zve\u0159ej\u0148oval jejich po\u0159ad\u00ed v&nbsp;regionech.<\/p>\n<p style=\"text-align: justify;\">Pavel Kasal uvedl p\u0159\u00edklad \u0161patn\u00fdch webov\u00fdch str\u00e1nek nemocnice M\u011bln\u00edk (viz obr\u00e1zek n\u00ed\u017ee).<img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-large wp-image-4475\" src=\"https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr.2-1024x565.png\" alt=\"\" width=\"625\" height=\"345\" srcset=\"https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr.2-1024x565.png 1024w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr.2-300x166.png 300w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr.2-768x424.png 768w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr.2-624x345.png 624w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr.2.png 1219w\" sizes=\"auto, (max-width: 625px) 100vw, 625px\" \/><\/p>\n<p style=\"text-align: justify;\">Na&nbsp;hlavn\u00ed str\u00e1nce je velk\u00e1 fotografie doktora. Nejen, \u017ee&nbsp;jde o&nbsp;n\u011bkoho nezn\u00e1m\u00e9ho, kdo v\u00a0nemocnici ani nepracuje, ale zbyte\u010dn\u011b velk\u00e1 fotografie zab\u00edraj\u00edc\u00ed v\u011bt\u0161inu hlavn\u00ed str\u00e1nky, zp\u016fsobuje pomal\u00e9 na\u010d\u00edt\u00e1n\u00ed str\u00e1nek. Mezi dal\u0161\u00ed \u010dast\u00e9 chyby uvedl \u0161patn\u011b \u010diteln\u00e9 logo nebo zbyte\u010dn\u011b mnoho proklik\u016f, ne\u017e se u\u017eivatel dostane k&nbsp;pot\u0159ebn\u00e9 informaci.<\/p>\n<p style=\"text-align: justify;\">Hodnocen\u00ed krit\u00e9ri\u00ed kvality webov\u00fdch str\u00e1nek je definov\u00e1no mezin\u00e1rodn\u011b, ale \u0159ada spole\u010dnost\u00ed vytv\u00e1\u0159ej\u00edc\u00edch str\u00e1nky o&nbsp;nich nev\u00ed. V&nbsp;r\u00e1mci port\u00e1lu Rankmed je hodnoceno celkem 30 aspekt\u016f z\u00a0oblast\u00ed prezentace, navigace, funkce \u010di v\u011brohodnosti,\u00a0nap\u0159.:\u00a0rychlost na\u010dten\u00ed, velikost str\u00e1nky, pokryt\u00ed obrazovky, struktura menu, cizojazy\u010dn\u00e1 verze, vyhled\u00e1v\u00e1n\u00ed, metadata, bezchybnost HTML, aktu\u00e1lnost, datum, neaktivn\u00ed odkazy,\u00a0atd..<span style=\"color: #ff0000;\">\n<\/span><\/p>\n<p style=\"text-align: justify;\">Tematicky na&nbsp;oblast elektronick\u00e9ho zdravotnictv\u00ed nav\u00e1zal tak\u00e9 Ji\u0159\u00ed Kofr\u00e1nek s&nbsp;p\u0159edn\u00e1\u0161kou <em>\u201eModelov\u00e1n\u00ed proces\u016f e-preskripce\u201c<\/em>. Na&nbsp;po\u010d\u00e1tku sv\u00e9 p\u0159edn\u00e1\u0161ky Ji\u0159\u00ed Kofr\u00e1nek vysv\u011btlil v\u00fdvoj profese stavitele. D\u0159\u00edve stavitel\u00e9 budovu navrhli a&nbsp;z\u00e1rove\u0148 ji dok\u00e1zali i&nbsp;postavit. Dnes jsou tyto role rozd\u011bleny na&nbsp;povol\u00e1n\u00ed architekta a&nbsp;stava\u0159e. Podobn\u011b je tomu i&nbsp;u&nbsp;stavitel\u016f informa\u010dn\u00edch syst\u00e9m\u016f, kde vz\u00e1jemn\u011b spolupracuj\u00ed profese n\u00e1vrh\u00e1\u0159i architektury informa\u010dn\u00edch syst\u00e9m\u016f a&nbsp;vlastn\u00ed realiz\u00e1to\u0159i. P\u0159ed vlastn\u00edm budov\u00e1n\u00edm informa\u010dn\u00edho syst\u00e9mu jako je eHealth je pot\u0159eba m\u00edt jasn\u011b vy\u0159e\u0161en\u00fd jeho architektonick\u00fd n\u00e1vrh odpov\u00eddaj\u00edc\u00ed na&nbsp;dv\u011b z\u00e1kladn\u00ed ot\u00e1zky: Co m\u00e1 informa\u010dn\u00ed syst\u00e9m \u0159e\u0161it? Jak to m\u00e1 \u0159e\u0161it?<\/p>\n<p style=\"text-align: justify;\">Pro zaveden\u00ed eReceptu bylo zapot\u0159eb\u00ed urychlen\u011b p\u0159ipravit legislativu \u0159e\u0161\u00edc\u00ed vyu\u017eit\u00ed eReceptu pro tvorbu a&nbsp;nahl\u00ed\u017een\u00ed do&nbsp;l\u00e9kov\u00e9ho z\u00e1znamu (tzn.&nbsp;z\u00e1znam o&nbsp;l\u00e9c\u00edch p\u0159edepsan\u00fdch a&nbsp;vydan\u00fdch pacientovi). Pr\u00e1v\u011b l\u00e9kov\u00fd z\u00e1znam je skute\u010dn\u00fdm re\u00e1ln\u00fdm p\u0159\u00ednosem elektronick\u00e9ho receptu pro kvalitu a&nbsp;bezpe\u010dnost poskytov\u00e1n\u00ed zdravotn\u00ed p\u00e9\u010de. Na&nbsp;p\u0159\u00edprav\u011b legislativy se pod\u00edlelo mnoho akt\u00e9r\u016f, nap\u0159.&nbsp;architekti informa\u010dn\u00ed syst\u00e9mu eHealth, tv\u016frci funk\u010dn\u00edho softwaru St\u00e1tn\u00edho \u00fastavu pro kontrolu l\u00e9\u010div, poji\u0161\u0165ovny, l\u00e9k\u00e1rnick\u00e1 komora, l\u00e9ka\u0159sk\u00e1 komora, \u00da\u0159ad pro ochranu osobn\u00edch \u00fadaj\u016f atd. Pro porozum\u011bn\u00ed a&nbsp;slad\u011bn\u00ed r\u016fzn\u00fdch z\u00e1jm\u016f jednotliv\u00fdch akt\u00e9r\u016f bylo zapot\u0159eb\u00ed p\u0159ehledn\u011b a&nbsp;srozumiteln\u011b popsat v\u0161echny nezbytn\u00e9 procesy t\u00fdkaj\u00edc\u00ed se\u00a0elektronick\u00e9ho receptu. Toho bylo dosa\u017eeno pomoc\u00ed hierarchick\u00fdch stavov\u00fdch diagram\u016f vytvo\u0159en\u00fdch v&nbsp;softwarov\u00e9m n\u00e1stroji vhodn\u00e9m pro n\u00e1vrh procesn\u00ed architektury <a href=\"http:\/\/craftcase.com\/\">Craft.CASE<\/a>. Vytvo\u0159en\u00fd diagram poslou\u017eil jako jedine\u010dn\u00fd diskuzn\u00ed podklad. \u00da\u010dastn\u00edk\u016fm poskytl stru\u010dn\u00fd, jednoduch\u00fd, p\u0159ehledn\u00fd a&nbsp;p\u0159itom ucelen\u00fd n\u00e1hled na&nbsp;to, jak\u00e1 problematika se eReceptem \u0159e\u0161\u00ed, \u010deho v\u0161eho se dot\u00fdk\u00e1, kdo a&nbsp;jak je zapojen a&nbsp;jak\u00e9 situace mohou nastat.<\/p>\n<p style=\"text-align: justify;\">Ji\u0159\u00ed Borej pak ve&nbsp;sv\u00e9 p\u0159edn\u00e1\u0161ce &#8220;<em>Elektronick\u00e1 identita ve&nbsp;zdravotnictv\u00ed&#8221;<\/em> pouk\u00e1zal na\u00a0problematiku identifikace a&nbsp;autentizace subjekt\u016f p\u0159ihla\u0161uj\u00edc\u00edch se k&nbsp;r\u016fzn\u00fdm elektronick\u00fdm slu\u017eb\u00e1m. Na&nbsp;jedn\u00e9 stran\u011b jde o&nbsp;fyzick\u00e9 osoby, jak\u00fdmi jsou: zdravotnick\u00fd pracovn\u00edk, pacient, ve\u0159ejnost, a\u00a0na druh\u00e9 tak\u00e9 poskytovatel slu\u017eeb ru\u010d\u00edc\u00ed za spr\u00e1vnost a\u00a0kvalitu sd\u00edlen\u00fdch dat. Pro vyu\u017e\u00edv\u00e1n\u00ed slu\u017eeb je pot\u0159eba identifikace subjekt\u016f a&nbsp;p\u0159id\u011blen\u00ed n\u00e1vazn\u00fdch opr\u00e1vn\u011bn\u00ed k&nbsp;prov\u00e1d\u011bn\u00ed ur\u010dit\u00fdch \u00fakon\u016f. Snahou ministerstva je, aby bylo p\u0159ihla\u0161ov\u00e1n\u00ed do&nbsp;r\u016fzn\u00fdch slu\u017eeb stejn\u00e9 a&nbsp;co nejm\u00e9n\u011b obt\u011b\u017eovalo jednotliv\u00e9 subjekty. Na&nbsp;druhou stranu mus\u00ed b\u00fdt bezpe\u010dn\u00e9, aby nedo\u0161lo k&nbsp;\u00faniku osobn\u00edch dat.<\/p>\n<p style=\"text-align: justify;\">S&nbsp;digitalizac\u00ed p\u0159ich\u00e1z\u00ed nutnost klasifikace. Na&nbsp;tuto problematiku pouk\u00e1zal hlavn\u011b p\u0159\u00edsp\u011bvek Tom\u00e1\u0161e Mach\u00e1\u010dka, l\u00e9ka\u0159e v\u011bnuj\u00edc\u00edho se od&nbsp;roku 1995 \u0159\u00edzen\u00e9 p\u00e9\u010di, kter\u00e1 zahrnuje organizaci, poskytov\u00e1n\u00ed a&nbsp;financov\u00e1n\u00ed zdravotn\u00ed p\u00e9\u010de s&nbsp;c\u00edlem zvy\u0161ovat \u00fa\u010delnost n\u00e1klad\u016f vynalo\u017een\u00fdch na&nbsp;zdravotn\u00ed p\u00e9\u010di a&nbsp;sou\u010dasn\u011b zachovat nebo zlep\u0161it jej\u00ed kvalitu (Z\u00e1kladn\u00ed principy \u0159\u00edzen\u00e9 p\u00e9\u010de, 2018). P\u0159i snaze o&nbsp;vytvo\u0159en\u00ed robustn\u00edho pl\u00e1nu na&nbsp;podporu \u0159\u00edzen\u00e9 p\u00e9\u010de narazil na&nbsp;probl\u00e9my klinick\u00e9ho jazyka a&nbsp;klinick\u00e9 komunikace. Klinick\u00fd jazyk je zalo\u017een nikoli na&nbsp;\u00fa\u0159edn\u011b definovan\u00fdch term\u00ednech, ale na&nbsp;p\u0159enesen\u00fdch v\u00fdznamech. Jako p\u0159\u00edklad uvedl b\u011b\u017en\u011b pou\u017e\u00edvan\u00fd term\u00edn \u201evy\u0161\u0161\u00ed pH mo\u010di\u201c. O&nbsp;kolik? Co to vlastn\u011b znamen\u00e1 a&nbsp;jak\u00fd to m\u00e1 v\u00fdznam? Nav\u00edc uv\u00e1d\u00ed, \u017ee&nbsp;se vytv\u00e1\u0159ej\u00ed lok\u00e1ln\u00ed \u017eargony, proto si l\u00e9ka\u0159i v&nbsp;r\u016fzn\u00fdch specializac\u00edch mezi sebou nerozum\u00ed. Ukazuje se, \u017ee&nbsp;konceptualizace pomoc\u00ed \u017eiv\u00e9ho jazyka je probl\u00e9mov\u00e1. Pro \u00fa\u010dely p\u0159\u00edpravy projektu \u0159\u00edzen\u00e9 p\u00e9\u010de byl vytvo\u0159en s\u00e9mantick\u00fd slovn\u00edk. V&nbsp;sou\u010dasnosti obsahuje 120 koncept\u016f ulo\u017een\u00fdch v&nbsp;datab\u00e1zi RDF Store.<\/p>\n<p style=\"text-align: justify;\">Probl\u00e9my komunikace l\u00e9ka\u0159\u016f s&nbsp;pacienty hluboce souvis\u00ed s&nbsp;tradic\u00ed l\u00e9ka\u0159sk\u00e9 profese, kdy l\u00e9ka\u0159 dlouhou dobu nebyl zodpov\u011bdn\u00fd sv\u00e9mu pacientovi ve&nbsp;smyslu dokumentace. Pro l\u00e9ka\u0159e je pacient biologick\u00fdm objektem, na&nbsp;n\u011bm\u017e ode\u010d\u00edtal hodnoty. Komunikovat musel pouze p\u0159i konzultaci nebo p\u0159i p\u0159ed\u00e1v\u00e1n\u00ed zpr\u00e1vy jin\u00e9mu l\u00e9ka\u0159i, ve&nbsp;kter\u00e9 nav\u00edc popisoval pouze, co si myslel, \u017ee&nbsp;jin\u00fd l\u00e9ka\u0159 bude pot\u0159ebovat. K&nbsp;tomu se navazuje problematika veden\u00ed prozat\u00edm nestrukturovan\u00e9 zdravotn\u00ed dokumentace. V&nbsp;sou\u010dasnosti neexistuje kontext, v&nbsp;n\u011bm\u017e by byla struktura dokumentace vy\u017eadov\u00e1na. L\u00e9ka\u0159i nav\u00edc p\u0159i v\u00fdm\u011bn\u011b dokumentace nejsou schopni komunikovat sv\u00e9 intuitivn\u00ed n\u00e1zory.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-4476\" src=\"https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr.3.png\" alt=\"\" width=\"920\" height=\"518\" srcset=\"https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr.3.png 920w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr.3-300x169.png 300w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr.3-768x432.png 768w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr.3-624x351.png 624w\" sizes=\"auto, (max-width: 920px) 100vw, 920px\" \/><\/p>\n<p style=\"text-align: justify;\">O&nbsp;klasifikaci mluvila ve&nbsp;sv\u00e9m p\u0159\u00edsp\u011bvku tak\u00e9 Irena Rube\u0161ov\u00e1. \u00daZIS \u010cR v&nbsp;r\u00e1mci projektu Metodick\u00e1 optimalizace a&nbsp;zefektivn\u011bn\u00ed syst\u00e9mu \u00fahrad nemocni\u010dn\u00ed p\u00e9\u010de v&nbsp;\u010cR (DRG Restart) od&nbsp;srpna 2015 vyv\u00edj\u00ed novou Klasifikaci hospitaliza\u010dn\u00edch procedur. Jedn\u00edm z&nbsp;d\u00edl\u010d\u00edch c\u00edl\u016f projektu je vytvo\u0159it funk\u010dn\u00ed klasifika\u010dn\u00ed syst\u00e9m hospitaliza\u010dn\u00edch procedur umo\u017e\u0148uj\u00edc\u00ed standardizovan\u00fd popis zdravotnick\u00fdch intervenc\u00ed. Mezi z\u00e1kladn\u00ed principy klasifikace pat\u0159\u00ed v\u00edcerozm\u011brnost, logick\u00e1 struktura a&nbsp;modul\u00e1rnost. Aktu\u00e1ln\u00ed testovac\u00ed verze je dostupn\u00e1 na\u00a0webu <a href=\"https:\/\/drg.uzis.cz\/khp\">https:\/\/drg.uzis.cz\/khp<\/a>.<\/p>\n<p style=\"text-align: justify;\">Petra Kr\u00e1lov\u00e1 m\u011bla vystoupit s&nbsp;p\u0159\u00edsp\u011bvkem \u201e<em>Kurz k\u00f3dov\u00e1n\u00ed zdravotn\u00edch slu\u017eeb &#8211; referen\u010dn\u00ed k\u00f3dov\u00e1n\u00ed v&nbsp;syst\u00e9mu CZ-DRG<\/em>\u201c, bohu\u017eel na&nbsp;semin\u00e1\u0159 se nemohla dostavit. Z&nbsp;anotace p\u0159\u00edsp\u011bvku v\u0161ak vypl\u00fdv\u00e1, \u017ee&nbsp;\u00daZIS \u010cR ve&nbsp;spolupr\u00e1ci s&nbsp;Institutem postgradu\u00e1ln\u00edho vzd\u011bl\u00e1v\u00e1n\u00ed ve&nbsp;zdravotnictv\u00ed (IPVZ) vytvo\u0159ili t\u0159\u00eddenn\u00ed kurz pro vzd\u011bl\u00e1v\u00e1n\u00ed kod\u00e9r\u016f pro nov\u011b vyv\u00edjen\u00fd syst\u00e9m CZ-DRG. Snahou je aplikovat v\u00fdstupy projektu do&nbsp;praxe, co\u017e by m\u011blo v\u00e9st k&nbsp;dostupnosti kapacit profesion\u00e1l\u016f a&nbsp;k&nbsp;zlep\u0161en\u00ed kvality dat produkovan\u00fdch ve&nbsp;zdravotnictv\u00ed (vykazov\u00e1n\u00ed pro administrativn\u00ed a&nbsp;statistick\u00e9 \u00fa\u010dely, syst\u00e9my \u00fahrad, business intelligence, data mining a&nbsp;mana\u017eersk\u00e9 rozhodov\u00e1n\u00ed, v\u011bda a&nbsp;v\u00fdzkum atd.).<\/p>\n<p style=\"text-align: justify;\">A&nbsp;pr\u00e1v\u011b pr\u00e1ce s&nbsp;daty je z\u00e1kladn\u00ed slo\u017ekou cel\u00e9ho elektronick\u00e9ho zdravotnictv\u00ed. Jan Hendl svou teoretickou p\u0159edn\u00e1\u0161kou \u201e<em>Metody anal\u00fdzy velk\u00fdch dat<\/em>\u201c zd\u016fraznil, \u017ee&nbsp;data jsou v\u0161ude kolem n\u00e1s a&nbsp;organizace a&nbsp;anal\u00fdza dat n\u00e1m m\u016f\u017ee napomoci k&nbsp;lep\u0161\u00edmu rozhodov\u00e1n\u00ed.<\/p>\n<p style=\"text-align: justify;\">Pojem velk\u00e1 data (big data) lze charakterizovat t\u0159emi vlastnostmi \u2013 jsou objemn\u00e1, r\u016fznorod\u00e1 a&nbsp;rychle se\u00a0m\u011bn\u00edc\u00ed. Velk\u00fdch dat je tolik, \u017ee&nbsp;jejich anal\u00fdzu nen\u00ed lidsk\u00e1 s\u00edla schopna zvl\u00e1dnout. Lze v\u0161ak vyu\u017e\u00edt automatizovan\u00e9ho prost\u0159edku vyu\u017e\u00edvaj\u00edc\u00edho metod um\u011bl\u00e9 inteligence. Jde o&nbsp;simulaci racion\u00e1ln\u00edho chov\u00e1n\u00ed v&nbsp;r\u00e1mci n\u011bjak\u00e9ho \u00fakolu. Syst\u00e9m je v\u0161ak nejprve nutno nau\u010dit, jak m\u00e1 analyzovat. Existuj\u00ed dva zp\u016fsoby: u\u010den\u00ed s&nbsp;u\u010ditelem (hled\u00e1n\u00ed funkce, kter\u00e1 nejl\u00e9pe predikuje c\u00edlovou prom\u011bnnou) a&nbsp;u\u010den\u00ed bez u\u010ditele (nen\u00ed k&nbsp;dispozici c\u00edlov\u00e1 prom\u011bnn\u00e1 \u2013 je pot\u0159eba porozum\u011bt p\u0159irozen\u011b dan\u00fdm struktur\u00e1m).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-4478\" src=\"https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr4.png\" alt=\"\" width=\"920\" height=\"518\" srcset=\"https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr4.png 920w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr4-300x169.png 300w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr4-768x432.png 768w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr4-624x351.png 624w\" sizes=\"auto, (max-width: 920px) 100vw, 920px\" \/><\/p>\n<p style=\"text-align: justify;\">Velmi d\u016fle\u017eitou oblast\u00ed velk\u00fdch dat je data mining neboli dolov\u00e1n\u00ed dat, <span class=\"st\">analytick\u00e1 metoda, jak z\u00edskat z&nbsp;velk\u00e9ho mno\u017estv\u00ed dat u\u017eite\u010dn\u00e9 a&nbsp;netrivi\u00e1ln\u00ed informace<\/span>. Existuj\u00ed dva zp\u016fsoby: prediktivn\u00ed dolov\u00e1n\u00ed dat (vytvo\u0159en\u00ed modelu syst\u00e9mu popsan\u00e9ho daty &#8211; vyu\u017eit\u00ed k&nbsp;predikci nezn\u00e1m\u00fdch hodnot nebo budouc\u00edch hodnot) a&nbsp;popisn\u00e9 dolov\u00e1n\u00ed dat (z\u00edsk\u00e1n\u00ed nov\u00fdch a&nbsp;netrivi\u00e1ln\u00edch informac\u00ed o&nbsp;datech interpretovateln\u00fd lidmi).<\/p>\n<p style=\"text-align: justify;\">Jedn\u00edm ze z\u00e1kladn\u00edch c\u00edl\u016f anal\u00fdzy velk\u00fdch datov\u00fdch soubor\u016f je um\u011bt klasifikovat z\u00e1znamy, tedy p\u0159i\u0159adit k&nbsp;nim pat\u0159i\u010dnou klasifika\u010dn\u00ed t\u0159\u00eddu. K&nbsp;tomu je zapot\u0159eb\u00ed nau\u010dit syst\u00e9m jak data rozd\u011blit. To lze prov\u00e9st hned n\u011bkolika zp\u016fsoby, nap\u0159.&nbsp;pomoc\u00ed klasifika\u010dn\u00edch strom\u016f, Bayesovy metody, klasifikace K, genetick\u00fdch algoritm\u016f atd.<\/p>\n<p style=\"text-align: justify;\">Pro odhalen\u00ed podrobnost\u00ed v&nbsp;mno\u017ein\u011b objekt\u016f je typickou procedurou shlukov\u00e1n\u00ed. Jde o\u00a0popisnou proceduru zprost\u0159edkov\u00e1vaj\u00edc\u00ed u\u017eivateli informace, co by v&nbsp;datech mohlo b\u00fdt d\u016fle\u017eit\u00e9ho. Mezi daty se tak\u00e9 hledaj\u00ed asociace a&nbsp;korelace. Generuj\u00ed se tak spoje mezi jednotliv\u00fdmi prom\u011bnn\u00fdmi.<\/p>\n<p style=\"text-align: justify;\">Jan Hendl svou p\u0159edn\u00e1\u0161kou zd\u016fraznil pot\u0159ebu zpracov\u00e1n\u00ed velk\u00fdch dat a&nbsp;upozornil na\u00a0program Big Data to Knowledge (BD2K) maj\u00edc\u00ed za c\u00edl urychlen\u00ed integrace velk\u00fdch dat do&nbsp;biomedic\u00ednsk\u00e9ho v\u00fdzkumu.<\/p>\n<p style=\"text-align: justify;\">Vyu\u017eit\u00ed dat v&nbsp;praxi p\u0159edstavil Mat\u011bj Adam (IBM \u010cesk\u00e1 republika, spol. s.r.o.) v&nbsp;p\u0159\u00edsp\u011bvku \u201e<em>Vyu\u017eit\u00ed AI v&nbsp;klinick\u00e9m rozhodov\u00e1n\u00ed<\/em>\u201c. V&nbsp;posledn\u00edch letech se\u00a0klientsk\u00e9 rozhodov\u00e1n\u00ed s&nbsp;podporou po\u010d\u00edta\u010d\u016f zav\u00e1d\u00ed do&nbsp;praxe. Je\u0161t\u011b p\u0159ed p\u00e1r lety by vyu\u017eit\u00ed um\u011bl\u00e9 inteligence v&nbsp;medic\u00edn\u011b bylo nemysliteln\u00e9, ale dnes se podm\u00ednky m\u011bn\u00ed: dostatek dat dostupn\u00fdch odkudkoli, digitalizace, zav\u00e1d\u011bn\u00ed eHealth \u010di znalost u\u017eivatel\u016f. P\u0159ib\u00fdvaj\u00ed nov\u00e9 informace u&nbsp;v\u00fdzkum\u016f a&nbsp;lidsk\u00e9 kognitivn\u00ed schopnosti za\u010d\u00ednaj\u00ed nar\u00e1\u017eet na&nbsp;limity.<\/p>\n<p style=\"text-align: justify;\">Navrhovan\u00fd syst\u00e9m vyu\u017e\u00edvaj\u00edc\u00ed um\u011bl\u00e9 inteligence funguje tak, \u017ee&nbsp;nejprve je pacient diagnostikov\u00e1n tak, aby byly dostupn\u00e9 ve\u0161ker\u00e9 informace z&nbsp;v\u00fdsledk\u016f vy\u0161et\u0159en\u00ed. Pot\u00e9 syst\u00e9m na&nbsp;z\u00e1klad\u011b tr\u00e9ninku um\u011bl\u00e9 inteligence \u0159\u00edzen\u00e9ho odborn\u00edky navrhne ke&nbsp;zv\u00e1\u017een\u00ed seznam doporu\u010den\u00fdch postup\u016f pro pacientovu l\u00e9\u010dbu a&nbsp;to s&nbsp;p\u0159ihl\u00e9dnut\u00edm k&nbsp;jeho individu\u00e1ln\u00edm hodnot\u00e1m. L\u00e9ka\u0159 se pak p\u0159edlo\u017een\u00fdmi doporu\u010den\u00edmi m\u016f\u017ee i&nbsp;nemus\u00ed \u0159\u00eddit. Tento syst\u00e9m je vhodn\u00fd pro podporu personalizovan\u00e9 medic\u00edny, ale tak\u00e9 napom\u00e1h\u00e1 k&nbsp;hled\u00e1n\u00ed pacient\u016f pro klinick\u00e9 studie, kter\u00e9 by jinak kv\u016fli nedostatku vzork\u016f nemohly b\u00fdt provediteln\u00e9.<\/p>\n<p style=\"text-align: justify;\">Navrhovan\u00fd syst\u00e9m byl zat\u00edm testov\u00e1n v&nbsp;USA na&nbsp;onkologick\u00fdch pacientech. Prob\u011bhla klinick\u00e1 studie srovn\u00e1vaj\u00edc\u00ed, nakolik jsou stejn\u00e1 \u010di rozd\u00edln\u00e1 doporu\u010den\u00ed expert\u016f s&nbsp;expertn\u00edm syst\u00e9mem. Shoda byla 89 %, co\u017e je velmi pozitivn\u00ed v\u00fdsledek, proto\u017ee ani sami onkologov\u00e9 mezi sebou nemaj\u00ed vy\u0161\u0161\u00ed procento shody.<\/p>\n<p style=\"text-align: justify;\">Mat\u011bj Adam upozornil na&nbsp;to, \u017ee&nbsp;firmy si uv\u011bdomuj\u00ed rizika p\u0159i zav\u00e1d\u011bn\u00ed um\u011bl\u00e9 inteligence, a\u00a0proto je nezbytn\u00e9 nastavit regule. Jedn\u00edm z&nbsp;hlavn\u00edch princip\u016f je transparentnost, tzn., \u017ee&nbsp;v\u00a0ka\u017ed\u00e9m okam\u017eiku mus\u00ed b\u00fdt schopni rozpoznat, jak je syst\u00e9m nastaven, podle \u010deho se\u00a0tr\u00e9nuje, tedy na&nbsp;jak\u00fdch datech a&nbsp;kdo ho tr\u00e9nuje.<\/p>\n<p style=\"text-align: justify;\">Dosud jsem zmi\u0148ovala pouze p\u0159\u00edsp\u011bvky zam\u011b\u0159en\u00e9 sp\u00ed\u0161e na&nbsp;zdravotn\u00ed informatiku. Semin\u00e1\u0159e se v\u0161ak z\u00fa\u010dastnili i&nbsp;profesion\u00e1ln\u00ed knihovn\u00edci. Richard Pap\u00edk p\u0159ednesl p\u0159edn\u00e1\u0161ku na&nbsp;t\u00e9ma \u201e<em>Obecn\u00e9 a&nbsp;speci\u00e1ln\u00ed re\u0161er\u0161n\u00ed strategie<\/em>\u201c. Re\u0161er\u0161n\u00ed strategie se zm\u011bnily kv\u016fli u\u017eivatelsk\u00e9mu prost\u0159ed\u00ed. Nast\u00e1v\u00e1 tedy ot\u00e1zka, zda je st\u00e1le pot\u0159eba re\u0161er\u0161\u00ed? Podle Pap\u00edka mnoho u\u017eivatel\u016f ani nev\u00ed, jak\u00e9 zdroje jsou dostupn\u00e9 a&nbsp;neznaj\u00ed jejich mo\u017enosti. Dle jeho zku\u0161enost\u00ed studenti \u010dasto nejsou vedeni \u00a0k vyu\u017e\u00edv\u00e1n\u00ed jin\u00fdch ne\u017e voln\u011b dostupn\u00fdch zdroj\u016f. Jejich vyhled\u00e1vac\u00ed syst\u00e9my jsou sice p\u0159\u00e1telsk\u00e9, ale nejsou \u201ep\u0159\u00edtuln\u00e9\u201c. Kdy\u017e v&nbsp;nich u\u017eivatel hled\u00e1 informace m\u00edsto procesu vyhled\u00e1v\u00e1n\u00ed, je veden k&nbsp;prohl\u00ed\u017eec\u00ed strategii. To vede k&nbsp;informa\u010dn\u00edmu p\u0159et\u00ed\u017een\u00ed. U\u017eivatel dost\u00e1v\u00e1 stovky a\u017e tis\u00edce dokument\u016f, ale p\u0159i tom by mu sta\u010dilo pouze n\u011bkolik vybran\u00fdch.<\/p>\n<p style=\"text-align: justify;\">Richard Pap\u00edk ve&nbsp;sv\u00e9 p\u0159edn\u00e1\u0161ce rozli\u0161il dv\u011b z\u00e1kladn\u00ed re\u0161er\u0161n\u00ed strategie: intuitivn\u00ed a\u00a0analytickou. Prost\u0159ednictv\u00edm u\u017eivatelsk\u00e9ho prost\u0159ed\u00ed je u\u017eivatel \u010dasto veden k&nbsp;intuitivn\u00ed strategii, ale \u010dasto zaost\u00e1v\u00e1 v&nbsp;t\u00e9 analytick\u00e9. V\u00fdsledky vyhled\u00e1v\u00e1n\u00ed mohou b\u00fdt bu\u010f \u00fapln\u00e9 anebo p\u0159esn\u00e9. Nikdy oboj\u00ed, a&nbsp;proto je pot\u0159eba re\u0161er\u0161n\u00ed strategie st\u0159\u00eddat. <img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-large wp-image-4479\" src=\"https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr5-1024x576.png\" alt=\"\" width=\"625\" height=\"352\" srcset=\"https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr5-1024x576.png 1024w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr5-300x169.png 300w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr5-768x432.png 768w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr5-624x351.png 624w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr5.png 1280w\" sizes=\"auto, (max-width: 625px) 100vw, 625px\" \/><\/p>\n<p style=\"text-align: justify;\">Bylo tak\u00e9 zd\u016frazn\u011bno, \u017ee&nbsp;je pot\u0159eba m\u00edt p\u0159ehled o&nbsp;dostupn\u00fdch zdroj\u00edch. \u010c\u00e1ste\u010dn\u011b n\u00e1m v\u00a0tomto probl\u00e9mu pom\u00e1h\u00e1 Google Scholar, ale st\u00e1le existuj\u00ed dokumenty, kter\u00e9 prost\u0159ednictv\u00edm vyhled\u00e1va\u010de vyhledat nelze. P\u0159\u00edkladem uvedl Research Gate.<\/p>\n<p style=\"text-align: justify;\">Je tak\u00e9 dobr\u00e9 zn\u00e1t z\u00e1kladn\u00ed re\u0161er\u0161n\u00ed strategie. Mnoho u\u017eivatel\u016f si mysl\u00ed, \u017ee&nbsp;sta\u010d\u00ed do\u00a0vyhled\u00e1vac\u00edho pol\u00ed\u010dka zadat kl\u00ed\u010dov\u00e1 slova, ale \u010dasto zapom\u00ednaj\u00ed do&nbsp;sv\u00e9ho dotazu implementovat tak\u00e9 jejich synonyma. Richard Pap\u00edk sv\u00fdm student\u016fm doporu\u010duje pou\u017eit\u00ed \u201cre\u0161er\u0161n\u00edho den\u00edku\u201d, pomoc\u00ed kter\u00e9ho si studenti mohou ujasnit svou re\u0161er\u0161n\u00ed strategii (viz obr\u00e1zek).<img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-4480\" src=\"https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr6.png\" alt=\"\" width=\"920\" height=\"518\" srcset=\"https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr6.png 920w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr6-300x169.png 300w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr6-768x432.png 768w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr6-624x351.png 624w\" sizes=\"auto, (max-width: 920px) 100vw, 920px\" \/><\/p>\n<p style=\"text-align: justify;\">Co se t\u00fdk\u00e1 dostupnosti jednotliv\u00fdch zdroj\u016f, tak Lenka Maixnerov\u00e1 ve&nbsp;sv\u00e9m p\u0159\u00edsp\u011bvku p\u0159edstavila technologick\u00e9 n\u00e1stroje a&nbsp;postupy pro vytv\u00e1\u0159en\u00ed a&nbsp;zp\u0159\u00edstup\u0148ov\u00e1n\u00ed informa\u010dn\u00edch zdroj\u016f v&nbsp;N\u00e1rodn\u00ed l\u00e9ka\u0159sk\u00e9 knihovn\u011b (d\u00e1le NLK). Zaj\u00edmav\u00fdm se jev\u00ed port\u00e1l <a href=\"http:\/\/www.medlike.cz\">MedLike<\/a> poskytuj\u00edc\u00ed p\u0159\u00edstup k&nbsp;d\u016fv\u011bryhodn\u00fdm informa\u010dn\u00edm zdroj\u016fm o&nbsp;zdrav\u00ed a&nbsp;nemoci pro podporu zdravotn\u00ed gramotnosti. Port\u00e1l je vytv\u00e1\u0159en od&nbsp;roku 2016. Jeho auto\u0159i vyb\u00edraj\u00ed z&nbsp;fondu NLK a&nbsp;z&nbsp;voln\u00e9ho internetu d\u016fv\u011bryhodn\u00e9 zdroje a&nbsp;to podle vlastn\u00ed <a href=\"https:\/\/nlk.cz\/zdroje\/medlike\/metodika-hodnoceni-kvality-zdroju\/\">metodiky hodnocen\u00ed kvality<\/a>.<\/p>\n<p style=\"text-align: justify;\">Z&nbsp;oblasti vzd\u011bl\u00e1v\u00e1n\u00ed knihovn\u00edk\u016f vystupovali se sv\u00fdmi p\u0159\u00edsp\u011bvky knihovn\u00edci z&nbsp;N\u00e1rodn\u00ed l\u00e9ka\u0159sk\u00e9 knihovny, kte\u0159\u00ed se dlouhodob\u011b v\u011bnuj\u00ed celo\u017eivotn\u00edmu vzd\u011bl\u00e1v\u00e1n\u00ed zdravotnick\u00fdch knihovn\u00edk\u016f. Jitka Feberov\u00e1 (1.&nbsp;l\u00e9ka\u0159sk\u00e1 fakulta Univerzity Karlovy) zas p\u0159edstavila nov\u00fd koncept vyu\u017eit\u00ed e-learningov\u00e9ho syst\u00e9mu Moodle v&nbsp;l\u00e9ka\u0159sk\u00e9 v\u00fduce.<\/p>\n<p style=\"text-align: justify;\">Leto\u0161n\u00ed semin\u00e1\u0159 Medsoft byl tematicky velmi nabit\u00fd. Jeho obsah poukazuje na&nbsp;moment\u00e1ln\u011b \u0159e\u0161en\u00e9 probl\u00e9my v&nbsp;oblasti elektronick\u00e9ho zdravotnictv\u00ed. Sou\u010d\u00e1st\u00ed semin\u00e1\u0159e byl tak\u00e9 kulat\u00fd st\u016fl, kde se diskutovalo nad budoucnost\u00ed e-Health a&nbsp;jeho strukturou v&nbsp;\u010cR.<\/p>\n<p style=\"text-align: justify;\">Diskuze se tak\u00e9 z\u00fa\u010dastnil ministr zdravotnictv\u00ed Adam Vojt\u011bch. Ukazuje se, \u017ee&nbsp;ve&nbsp;zdravotnictv\u00ed velmi chyb\u00ed finance. Elektronick\u00e9 zdravotnictv\u00ed by mohlo b\u00fdt cestou, kter\u00e1 pom\u016f\u017ee u\u0161et\u0159it finance na&nbsp;spr\u00e1vn\u00fdch m\u00edstech. V&nbsp;pr\u016fb\u011bhu cel\u00e9ho semin\u00e1\u0159e bylo n\u011bkolikr\u00e1t zm\u00edn\u011bno, \u017ee&nbsp;pacienti s&nbsp;chronick\u00fdmi chorobami jsou zodpov\u011bdn\u00ed za 75&nbsp;% n\u00e1klad\u016f ve&nbsp;zdravotnictv\u00ed. Podle ministra v&nbsp;sou\u010dasn\u00e9m zdravotnictv\u00ed velmi chyb\u00ed dostupnost zdravotnick\u00e9 dokumentace. Probl\u00e9mov\u00e1 se tak\u00e9 jev\u00ed dlouh\u00e1 objednac\u00ed doba k&nbsp;vy\u0161et\u0159en\u00ed. Ta vede k&nbsp;prome\u0161k\u00e1n\u00ed v\u010dasn\u00e9ho l\u00e9\u010den\u00ed, co\u017e ve&nbsp;v\u00fdsledku stoj\u00ed st\u00e1le daleko v\u00edce pen\u011bz. Elektronick\u00e9 zdravotnictv\u00ed m\u016f\u017ee napomoci \u0159e\u0161en\u00ed mnoha probl\u00e9m\u016f, ale tak\u00e9 m\u00e1 sv\u00e1 slab\u00e1 m\u00edsta. P\u0159\u00edkladem m\u016f\u017ee b\u00fdt ochota samotn\u00fdch doktor\u016f zapojit se a&nbsp;pracovat se syst\u00e9mem. Neochota nau\u010dit se pou\u017e\u00edvat nov\u00e9 technologie m\u016f\u017ee v\u00fdrazn\u011b zpomalit n\u00e1stup elektronick\u00e9ho zdravotnictv\u00ed.<img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-large wp-image-4482\" src=\"https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr8-1024x576.png\" alt=\"\" width=\"625\" height=\"352\" srcset=\"https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr8-1024x576.png 1024w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr8-300x169.png 300w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr8-768x432.png 768w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr8-624x351.png 624w, https:\/\/casopis.nlk.cz\/wp-content\/uploads\/sites\/6\/2019\/06\/Obr8.png 1280w\" sizes=\"auto, (max-width: 625px) 100vw, 625px\" \/><\/p>\n<p style=\"text-align: justify;\">N\u011bkter\u00e9 ze zmi\u0148ovan\u00fdch p\u0159\u00edsp\u011bvk\u016f a&nbsp;i&nbsp;jin\u00e9 jsou dostupn\u00e9 online ve&nbsp;sborn\u00edku na&nbsp;<a href=\"http:\/\/medsoft.creativeconnections.cz\">http:\/\/medsoft.creativeconnections.cz<\/a><\/p>\n<p style=\"text-align: justify;\">Literatura:<\/p>\n<p style=\"text-align: justify;\">KAROLYI, Mat\u011bj a&nbsp;Martin KOMENDA, 2019. P\u0159ehled elektronick\u00fdch informa\u010dn\u00edch zdroj\u016f ve&nbsp;zdravotnictv\u00ed \u010cR. In: <em>MEDSOFT 2019<\/em>. Praha: Creative Cinnection, s. 40-49. ISBN 978-80-86742-51-9. ISSN 1803-8115. Dostupn\u00e9 tak\u00e9 z: <a href=\"http:\/\/www.creativeconnections.cz\/medsoft\/\">http:\/\/www.creativeconnections.cz\/medsoft\/<\/a><\/p>\n<p style=\"text-align: justify;\">Z\u00e1kladn\u00ed principy \u0159\u00edzen\u00e9 p\u00e9\u010de, 2018. K<em>lientPRO: Inteligentn\u00ed \u0159e\u0161en\u00ed pro zdravotnictv\u00ed<\/em> [online]. KlientPRO [cit. 2019-04-18]. Dostupn\u00e9 z: <a href=\"https:\/\/www.klientpro.cz\/principy-rizene-pece\">https:\/\/www.klientpro.cz\/principy-rizene-pece<\/a><\/p>\n<p><hr \/>\r\n<h2>Citace<\/h2>\r\n<p>MA\u0160KOV\u00c1, Kl\u00e1ra. . <i>L\u00e9ka\u0159sk\u00e1 knihovna<\/i> [online]. 2019, ro\u010d. 24, \u010d. 1-2 [cit. 05.11.2026]. Dostupn\u00e9 z: <a href=\"https:\/\/casopis.nlk.cz\/en\/wp-json\/wp\/v2\/pages\/4470\">https:\/\/casopis.nlk.cz\/en\/wp-json\/wp\/v2\/pages\/4470<\/a>. ISSN 1804-2031.<\/p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Bc. Kl\u00e1ra MA\u0160KOV\u00c1, NLK Dvoudenn\u00ed semin\u00e1\u0159 Medsoft u\u017e podes\u00e1t\u00e9 hostil hotel Academic v&nbsp;Roztok\u00e1ch u&nbsp;Prahy, kde se se\u0161ly p\u0159es \u010dty\u0159i des\u00edtky \u00fa\u010dastn\u00edk\u016f. Leto\u0161n\u00ed 31.&nbsp;ro\u010dn\u00edk byl zah\u00e1jen vzpom\u00ednkou na&nbsp;RNDr. Josefa Cir\u00fdna, spoluzakladatele semin\u00e1\u0159e, kter\u00fd zesnul 8.\u00a0b\u0159ezna.<\/p>\n","protected":false},"author":12,"featured_media":0,"parent":4143,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-4470","page","type-page","status-publish","hentry"],"translation":{"provider":"WPGlobus","version":"3.0.6","language":"en","enabled_languages":["cs","en"],"languages":{"cs":{"title":true,"content":true,"excerpt":false},"en":{"title":false,"content":false,"excerpt":false}}},"_links":{"self":[{"href":"https:\/\/casopis.nlk.cz\/en\/wp-json\/wp\/v2\/pages\/4470","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/casopis.nlk.cz\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/casopis.nlk.cz\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/casopis.nlk.cz\/en\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/casopis.nlk.cz\/en\/wp-json\/wp\/v2\/comments?post=4470"}],"version-history":[{"count":15,"href":"https:\/\/casopis.nlk.cz\/en\/wp-json\/wp\/v2\/pages\/4470\/revisions"}],"predecessor-version":[{"id":4630,"href":"https:\/\/casopis.nlk.cz\/en\/wp-json\/wp\/v2\/pages\/4470\/revisions\/4630"}],"up":[{"embeddable":true,"href":"https:\/\/casopis.nlk.cz\/en\/wp-json\/wp\/v2\/pages\/4143"}],"wp:attachment":[{"href":"https:\/\/casopis.nlk.cz\/en\/wp-json\/wp\/v2\/media?parent=4470"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/casopis.nlk.cz\/en\/wp-json\/wp\/v2\/categories?post=4470"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/casopis.nlk.cz\/en\/wp-json\/wp\/v2\/tags?post=4470"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}