Improving electronic document management in the health protection system for workers

Introduction. Digital transformation is the process of transitioning to a management model based on primary healthcare data. This, in turn, has led to the recognition of the essential role of electronic medical documentation in digital healthcare. The use of structured electronic medical records (SEMR) is integral to the organization of healthcare as a component that ensures uniform standards for the creation and transmission of digital documents for all stakeholders in the healthcare system. One of the current priorities in the area of employee health protection is the development of a unified database system. This system will maximize the effectiveness of mandatory pre-employment and periodic medical exams for employees who work in hazardous or dangerous conditions, as well as those who are exposed to hazardous factors. It will also improve the results of expertise of professional suitability and expertise of the relationship between the disease and the profession. The need for such a system arises from the lack of consistency and continuity in employee health surveys which often necessitates the monitoring of a range of indicators related to health status, work conditions, and preventive measures over time.

The aim of the study is to examine existing structured electronic medical records in occupational health.

Materials and methods. The study was conducted using a combination of expert analytical methods. We analyzed SEMR (103) "Medical report based on the results of a preliminary (periodic) medical examination" Edition 1; SEMR (194) "Medical report based on the results of a preliminary (periodic) medical examination" Edition 2 and SEMR (230) "Medical report regarding employee medical examination for submission to the electronic personal medical record subsystem" Edition 1 for the period from 2023 until the first quarter of 2025. Additionally, and also information from statistical observation form No. 30 "Information about a medical organization" for the year 2023.

Results. From 2023 to the first quarter of 2025 a total of 3,145,512 medical examinations (SEMR) were conducted: 1,175,018 SEMR (103), 984,516 SEMR (194), and 985,978 SEMR (230). In 2023 a total of 412,465 supplementary annual medical examinations were conducted (SEMR): 64,233 SEMR (103) and 348,232 SEMR (194). In 2024 a total of 2,065,738 SEMR was conducted: 752,804 SEMR (103), 636,284 SEMR (194) and 676,650 SEMR (230). On the other side, in 2023 there were 7,932,523 workers in the Russian Federation who underwent mandatory preliminary and periodic medical examinations1, 7,727,117 of them were examined (97.4%). At the same time 412,465 SEMR were registered in 2023, which corresponds to only 5.3% of those examined. In 2024 1,389,088 SEMR were registered (increased by 70.3% compared to 2023). The largest number of SEMR (103) in 2023 was recorded in the Chuvash Republic, Kemerovo Region and Tambov Region: 30,170, 13,178 and 7,821 respectively. At the same time, according to the data from Rosstat, the following figures were obtained: 110,670 employees were examined in the Chuvash Republic, 173,048 employees were examined in the Kemerovo region and 59,051 employees were examined in the Tambov region. In 2023, a total of 348,232 SEMR (194) were formed in the Russian Federation. The largest number of SEMR (194) in 2023 was recorded in the Khanty-Mansiysk autonomous okrug — 42,506, in the Republic of Tatarstan 34,103 and the in Krasnoyarsk region 15,226 respectively. According to the data provided by Rosstat, in the Khanty-Mansiysk autonomous okrug 227,508 employees were examined, in the Republic of Tatarstan 366,318 employees were examined and in the Krasnoyarsk region 161,773 employees were examined.

Limitations. The study analyzed structured electronic medical records for the period from 2023 to the first quarter 2025. The data from Rosstat was used for the year 2023 as information for 2024 is expected to be published in the third quarter of 2025.

Conclusion. The occupational disease monitoring system will contribute to the enhancement of the health status of citizens in the Russian Federation by effectively identifying signs of exposure to hazardous and/or dangerous factors at an early stage. If medical contraindications for work are identified based on the results of mandatory preliminary and periodic medical examinations, or if an occupational disease is suspected, the system will allow for high-quality and timely examinations, and expertise of professional suitability, expertise of the relationship between the disease and the profession. These measures will enable the development of scientifically sound tactics and strategies for preventing occupational, occupation-related, and general morbidity. They will also help reduce employee disability, minimize labor losses due to occupational diseases and preserve long-term health, thereby increasing economic efficiency.

Ethics. During their work, the authors have adhered to the ethical standards for medical research as outlined in the Helsinki Declaration of the World Medical Association's "Ethical Guidelines for Medical Research Involving Human Subjects", the latest edition of which was published in October 2024.

Contributions:
Bukhtiyarov I.V. — editing, making fundamental changes, approving the final version of the article;
Kobyakova O.S. — editing, making fundamental changes, approving the final version of the article;
Kuzmina L.P. — editing, making fundamental changes, approving the final version of the article;
Kulikova I.B. — editing, making fundamental changes;
Nikolaev S.P. — data collection, analysis and interpretation, writing the text;
Zemlyakova S.S. — data analysis and interpretation, writing the text;
Sidorov K.V. — data analysis and interpretation, writing the text.
All authors — concept and design of the study.

Funding. The study had no funding.

Conflict of interest. The authors declare no conflict of interest.

Received: 27.05.2025 / Accepted: 30.05.2025 / Published: 05.07.2025

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