Digital medicine

What is digital medicine

Constituent elements of digital medicine:

• Electronic document flow between doctor, patient and medical organization
  • Integration of digital diagnostic equipment
  • Patient Flow Management System
  • Emergency Medical Management System

• Application of telemedicine technologies in the provision of medical care
  • Digital platforms for organizing telemedicine patient-physician consultations
  • Systems for remote monitoring of the state of health of citizens using personal medical devices

• Application of mathematical methods (including artificial intelligence methods, big data processing) in medical data processing
  • Development of information systems for diagnostics using artificial intelligence based on big data
  • Creation of medical decision support systems as an additional module of medical information systems Internet of things Creating systems for continuous monitoring of patients, treatment in honey. Organizations

• Digital model of "lean manufacturing" processes in healthcare

For 2019, researchers at Sechenov University, together with employees of the Research Institute for the Organization and Informatization of Healthcare, identify five main directions for the use of digital technologies in medicine:

• Internet navigation of citizens in the health care system (assistance in finding the necessary specialists, medical institutions or services),
• prevention of diseases and the formation of a healthy lifestyle,
• clinical telemedicine,
• distance education and
• supporting scientific clinical decisions.

Internet navigation of citizens is provided by a program for creating a federal information system, which by 2020 should include medical institutions, insurance companies, pharmacies and sports and recreation centers. Such a system will allow people to receive all the necessary information about the available medical services, medicines and equipment, prevention programs and choose the most suitable for them.

The direction of disease prevention and the spread of a healthy lifestyle requires a lot of attention and effort: it is necessary to work out the procedure for collecting and analyzing data, create a list of mobile devices that can collect data, and develop software for them, ensure the protection of personal data and safe ways of communication between the doctor and the patient.

Telemedicine includes technologies that allow you to remotely monitor the patient's condition, maintain an electronic medical record, conduct consultations and consultations of doctors, and buy medicines from online pharmacies, including electronic prescriptions. In Russia, projects are actively developing that enable doctors from regional hospitals to communicate with the country's leading specialists, exchange experience, and hold consultations. According to the authors of the study, it is possible to significantly improve the work of ambulance teams if they are equipped with telemedicine equipment. In recent years, legislative regulation of telemedicine has also advanced, without which the use of such technologies would be impossible.

Another area, distance education, is designed to serve both students and teachers and practitioners. In medicine, continuing education, constant acquisition of new knowledge are more in demand than in any other field, and digital technologies provide convenient formats for such training: online courses, distance lectures of leading scientists, broadcasts of surgical operations, as well as access to electronic libraries and knowledge bases. This also includes educational projects aimed at improving the literacy of the population in health issues.

Closely related to continuous education is another area of ​ ​ digital medicine - support for scientific clinical decisions. To implement it, it is necessary to ensure that both researchers and practitioners have access to the latest scientific results, publications in scientific journals, databases, information about research support programs and grants, as well as a quick and effective search for them. All this will allow doctors to more easily share the information necessary to make decisions during diagnosis and treatment.

Investment in medical tech

Main article: Investment in medical tech

Mergers and acquisitions in the medical tech industry

Main article: Mergers and acquisitions in the medical tech industry

2022: Top 10 directions in digital in medicine and healthcare in Russia

The Institute for Statistical Research and the Economics of Knowledge (ISIEZ) of the Higher School of Economics on July 15, 2022 shared with Zdrav.Expert the results of its research, according to which digital technologies that are most in demand in medicine and healthcare.

In general, the study showed that the explosive growth of digital medicine is facilitated by new solutions in the field of artificial intelligence, sensorics, robotics, wireless communications, information processing and analysis, augmented and virtual reality. The growth of industry demand for IT solutions is also associated with an increase in the proportion of patients with chronic diseases, the need to provide them with constant monitoring and long-term care. At the same time, the coronavirus pandemic has become a powerful driver for the development of digital medicine. The need to establish prompt mass care for patients, including in a remote format, has led to the mitigation of regulatory restrictions governing the use of certain technologies.

Top 10 Digital Solutions in Medicine and Healthcare
Calculated from an analysis of publications on the Microsoft Academic Graph and in professional media (more than 26 thousand sources).
The technology significance index shows its relative occurrence in the array of sources for 2020-2022, where the 1 corresponds to the maximum number of references. The calculation takes into account the frequency of occurrence of the term, its specificity and vector centrality. The frequency of occurrence in itself is insufficient to reflect the real relevance of the term, it is important that it denotes a specific scientific and technological direction and is not too general (this problem is solved by an indicator of specificity), and vector centrality reflects the degree of its connection with other directions of scientific search. The dynamic index reflects the growth rate of significance, the higher the index, the more dynamic the corresponding topic is. The index can take both positive and negative values.

The research agenda (and the second most important in the market) focuses on biosensors - key elements of wearable devices such as fitness bracelets and smartwatches. They serve for operational monitoring of certain indicators of the body and are especially in demand in patients with chronic diseases, who need to constantly monitor several physiological parameters at once (blood sugar level, blood pressure, etc.). These devices can send health information to a doctor, and even call an ambulance if necessary. They also stimulate more responsible user behavior in relation to their health and the dissemination of the concept of a healthy lifestyle.

The most popular area of ​ ​ application of digital technologies in the market agenda (and the third in the ranking of research priorities) was telemedicine, which is primarily due to the COVID-19 pandemic, the need to comply with quarantine measures and social distance and the transition of a large part of services online. Thanks to telemedicine, it was possible to significantly reduce the burden and costs of health care (according to experts, remote consultation is about 20% cheaper than face-to-face consultation) and increase the availability of medical care, which is especially important for Russia, where part of the population lives in remote areas. Meanwhile, the list of medical services provided remotely, which patients can count on, is still limited: correction of the treatment regimen, obtaining an appointment for additional studies or visiting narrow-profile specialists. The diagnosis can be made only in full-time consultation with a doctor.

The triad of research priorities, simultaneously significant for the market, along with biosensors and telemedicine, includes electronic document management. Solutions used to translate medical records into a digital form increase the convenience of medical services and the speed of transfer of medical information, reduce the routine work of doctors, allowing them to concentrate on the treatment of patients. Moreover, algorithmic intelligence is able to analyze the data of electronic medical records and form timely recommendations: notify about the need to undergo an examination or update the prescription for drugs. The development of this area requires the creation of uniform formalized approaches to the collection, storage and transfer of data, as well as ensuring a higher level of information security.

Large medical data accumulated both within the framework of electronic medical document management and during clinical, genetic and other studies can be used to create systems for supporting clinical decision-making (No. 9 in the research and market agenda). They also use artificial intelligence technologies, thanks to which it is possible to increase the accuracy of diagnosis and prescription of treatment. Also, these systems allow you to instantly check the patient's tolerability of the drugs prescribed to him, their compatibility with medicines that a person already takes.

Named the most popular digital solutions in medicine and healthcare
Illustration: kfund-media.com

Another promising application of artificial intelligence is the analysis of medical images using computer vision algorithms (No. 8 in the research and No. 10 in the market agenda), for example, when detecting pathologies from images of X-rays, computer tomograms or mammograms, which increases the accuracy and speed of diagnosis. To train such algorithms, it will be necessary to form datacets containing a sufficient number of high-quality images.

Thanks to the wide penetration of smartphones and the development of widespread access to the Internet, mHealth applications are increasingly spreading (No. 5 and No. 7). Among them, the most popular are those that help lead a healthy lifestyle (track physical activity, calorie intake, stimulate adherence to healthy habits, etc.). According to the researchers' forecasts, in the medium term, decisions that are especially in demand among people with chronic diseases can become leaders, providing them, including with the help of a wide range of biosensors, the function of constantly monitoring various characteristics of the body (blood glucose, blood pressure, etc.). Patient-oriented services are also developing, allowing you to quickly find the right doctor and make an appointment with him, intelligent chat bots to collect a history, search for medical recommendations. Using such applications, a person is increasingly involved in the process of maintaining his health, his level of compliance (adherence to treatment) increases.

Due to the development ofInternet medical things () IoMT (No. 10 and No. 8), it becomes possible to combine various devices and sensors into an integral ecosystem. The data in it is transmitted in a formalized form to, to cloudy storages which multi-user remote access can be organized. Combining the functions of constant monitoring of human physiological functions and timely tracking of critical changes reduces the number of studies conducted with the participation of medical personnel, the cost of treatment, as well as the possibility of medical error. In the therapy Internet of medical things is used for smart devices:, insulin pumps smart tablets, etc. In addition, such systems are used to optimize and monitor the operation of medical institutions, for example, to assess the state of technology or record medicines.

Various assistant products (No. 7 and No. 4) allow you to compensate for lost functions and organs, help lead an active lifestyle, realize personal and professional ambitions for people with disabilities. There are already about 1 billion of them worldwide, and by 2030 this number could double. Exoskeletons, robotic prostheses are used to restore muscle activity and increase mobility; for training motor skills, systems based on virtual reality technologies are used. Visually impaired people are helped by intelligent voice assistants, robotic assistants, augmented reality smart glasses. Special robots care for the sick, helping them get out of bed, sit in a wheelchair, solve simple household problems. Thanks to assisted technologies, the burden on health and social care systems is reduced, and the need for caregiver and caregiver services is reduced.

Serious potential for the restoration of lost body functions has interfaces brain "-" computer(No. 4 and No. 6). In particular, they are used to treat neurodegenerative mental illness and neurorehabilitation. So, on the basis of such devices are created neurocontrol prostheses for movement with limbs and fingers. Completely paralyzed people can communicate with the outside world using such interfaces, controlling the smartphone with the "power of thought." The development of neurotechnologies and a deeper understanding of the principles of the brain will allow the development of future interfaces to expand a person's capabilities, for example, stimulating his cognitive abilities or controlling the emotional background.

Robotic surgeons (# 6 and# 5) appeared in the early 2000s. As of 2022, robotic systems are actively developing, are used in almost all areas of surgery, are becoming more complex, acquire new functions (flexible robotics, 3D imaging , voice control, etc.). As a result, the accuracy of surgical interventions is increased, the level of injuries during operations is reduced, and the recovery time for patients is reduced.

According to the conclusion of researchers at the Higher School of Economics, the digital transformation in the field of medicine determines its transition to a 4-P model, which implies the prediction and prevention of the development of diseases, the personalization of therapy and patient participation, and at the same time guarantees the availability and high standards of medical care. Thus, the development of wearable biomonitoring devices allows you to shift the focus from treating diseases to preventing them or preclinical detection. Based on the analysis of a large accumulated amount of medical data, it becomes possible to personalize the approach to treatment. Patients are increasingly involved in this process, in particular, with the help of various kinds of applications, they can independently monitor the most important parameters of the body.

The HSE NIEZ study was conducted using the iFORA big data analysis system. In total, the study analyzed more than 26 thousand sources reflecting the current agenda of science and business.^[1]

2020: Google, HP and Philips set about developing digital medicine standards

At the end of August 2020, large companies operating in the region medical technology, including Philips, Google and HP, joined the new initiative of the organization Consumer Technology Association to develop digital medicine standards. Project should provide clear definitions and establish understandable terminology, which can be used to describe digital medicine. Except moreover, the initiative will include consumer education.

Against the backdrop of the COVID-19 pandemic, innovative growth has intensified in all aspects of digital health care, including digital therapy, "explained Gary Shapiro, CEO of the Consumer Technology Association.

Google, HP and Philips begin developing digital medicine standards

Experts note that the possibilities of this areas are almost limitless, but for further development to experts it is necessary to define and document general concepts and language, on to which they will be able to further discuss their innovations.

Need for consistent and meaningful terminology becomes more pressing as state-run organizations develop regulatory requirements, and pharmaceutical companies - forms and reimbursement programs. Interested the parties also warned experts that without agreed standards the term "digital medicine" may become a fashionable marketing label. The panel of experts should also draw a line between shared digital health care technologies and technologies used for interventions.

The following companies took part in the initiative:

• Activbody;
• Akili;
• Rx;
• Amptify;
• AudioCardio;
• Awarables;
• Bose;
• CareWear;
• Doctor on Demand;
• Ginger;
• GlucoseZone;
• Google Health;
• HP;
• Livongo;
• MagicLeap;
• MindMaze;
• MyndVR;
• Oova;
• Philips;
• Propeller Health;
• RapidSOS;
• ResMed;
• Omega;
• Concern;
• Tivic Health Systems;
• Validic.^[2]

2018: Federal project Uniform State Health Information System

Main article: Uniform State Health Information System

As part of the implementation of the state Development program, since health care 2018, the federal project "Creation of a single digital circuit in healthcare on the basis of a single state health information system ()" has been implemented. UNIFORM STATE HEALTH INFORMATION SYSTEM

Electronic health care involves the translation into digital format and the integration into a single database of a significant part of information about the patient and the course of his treatment (the history of requests for medical help, data from wearable devices and gadgets), as well as an electronic document flow assessment of the quality of medical services, distance education and the sale of drugs and equipment,. telemedicine Digital health includes all of the listed measures plus the introduction of analytical and mathematical methods of data processing, including to help make medical decisions.

2017: Relevance of the introduction of intelligent data processing technologies in medicine

In the Digital Economy program, approved by order of the Government of the Russian Federation of July 28, 2017 No. 1632-r, neurotechnology and artificial intelligence are identified as one of the priority areas.

Improving the quality of medicine is largely achieved through the use of modern diagnostic methods and means, characterized, in turn, by a sharp increase in the amount of medical data generated. Such arrays of information can no longer be processed manually, but involve the use of automated systems that fully implement the requirements for the efficiency, continuity and versatility of the provision of medical services, as well as for the independence of the quality of services from the patient's location.

The use of THIOD in medicine will allow:

• Ensure that a sound, consistent, evidence-based decision is made
• Ensure decision-making within the shortest possible time, in conditions of stress and incompleteness of information
• Ensure required completeness of patient examinations by evidence-based exclusion of suspected diagnoses
• Ensure that the maximum amount of data on the patient's health and data on such cases of seeking medical care is processed

2016: Launch of E-Health Priority Project

Main article: Priority project E-Health

In 2016, the priority project "Electronic Health" was launched in Russia.

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