Digitalization of healthcare in Russia

Trends

Main article: Medicine of the future

National Project Health Care

Main article: National Project Health Care

Legislative regulation

Federal Project Electronic health care (2016-2025):
Increasing the efficiency of organizing the provision of medical care to citizens through the introduction of information technologies, monitoring the possibility of making an appointment with a doctor, the transition to the maintenance of medical documentation in electronic form of at least 50% of medical organizations by 2018 (80% by 2020), at least 10 electronic services sold (services) in the Personal account of the patient "My Health" at the EPGU, which in 2018 will be used by at least 14 million citizens (30 million in 2020)

Federal Project Primary Health Care (2018-2023):
ensuring optimal accessibility for the population of medical organizations providing primary health care;... optimization of the work of medical organizations providing primary health care, reducing the waiting time in the queue when citizens apply to these medical organizations, simplifying the procedure for making an appointment with a doctor;...

Federal Project Digital Health Circuit (2019-2024):
Improving the efficiency of the health care system by creating a single digital health care circuit and organizing information interaction mechanisms for medical organizations of state and municipal health care systems based on the Uniform State Health Information System in 2022, implementing electronic services (services) in the patient's personal account "My Health" at the EPGU, available to all citizens of the Russian Federation by 2024
Digital Health Project

Increasing the availability of health care to the population

• It is a priority within the framework of the main direction of the strategic development of the Russian Federation "Healthcare" for the period up to 2025,
• approved by the protocol of the meeting of the Presidential Council for Strategic Development and Priority Projects dated March 21, 2017 No. 2
• Making an appointment with a doctor is the most important service to increase the availability of medical care to the population
• Regional doctor's appointment systems have been developing in Russia since 2010 and in fact were the first successful step towards digital transformation
• healthcare - doctor's appointment is faster, easier and available online
• Regional doctor's appointment systems passed the stage of quantitative growth in 2010-2017 and now they need a qualitative leap, which requires primarily the reference digital measurement system - the "reference meter"

Strategic direction of digital transformation of healthcare of the Russian Federation until 2024

• Strategic direction of digital transformation of healthcare of the Russian Federation until 2024

How IT in healthcare is funded and managed

Key systems

Uniform State Health Information System: the main national IT system in health

Main article: Uniform State Health Information System

The Unified State Information System in the field of health care (Uniform State Health Information System) is a national information system created to provide effective information support to bodies and organizations of the health care system, as well as citizens within the framework of the processes of managing medical care and its direct receipt. The development of the system is regulated by the Concept for the Creation of Uniform State Health Information System, approved by order of the Ministry of Health and Social Development of the Russian Federation dated April 28, 2011 No. 364, as well as a number of methodological recommendations and functional requirements for individual components of the system that are appendices to the order.

Uniform State Health Information System is implemented at the level of all constituent entities of the Russian Federation and is a fundamental information system for the entire healthcare industry in Russia.

Single Digital Circuit in Healthcare

Main article: A single digital circuit in healthcare based on Uniform State Health Information System

System of information of sanitary and epidemiological nature

Main article: System of information of sanitary and epidemiological nature

Digital services

Electronic death certificate

Main article: Electronic death certificate

Digital Health Services

Main Article: Digital Health Services (Federal Project)

Digital Health Indicators Used in International Rankings

• National digital health policy or strategy;
• Mobile Health Development Program;
• Telemedicine Development Program;
• Sources of funding for digital health care;
• Regulation of digital data exchange;
• Regulation of means and rules of protection of patients and their personal data;
• Regulation of the use of the patient's electronic medical record (EMR);
• The share of universities teaching the use of ICT in digital health care;
• Proportion of continuing education institutions of health professionals offering courses/continuing education programmes in the use of ICT in health care;
• The presence of a national EMR system and its connection to other information systems in health care;
• The proportion of healthcare organizations of various levels that use EMR;

Use of social media services by medical organizations.

Vendor Map

• Map version for May 2021, PDF

File:Цифровое здравоохранение 2020.png

Digital Healthcare Provider Map (Click to Increase)

2024

Petersburg buys servers worth 1.9 billion rubles to connect to the Moscow IT healthcare system

On October 16, 2024, the Committee on State Order of St. Petersburg published documents on the purchase of equipment for the state needs of the city. We are talking about connecting medical hospitals in St. Petersburg to the unified information and analytical system of Moscow. Read more here

FMBA received 1.4 billion rubles to create a digital health care circuit

At the end of August 2024, it became known that the Russian authorities allocated 1.4 billion rubles to the Federal Medical and Biological Agency (FMBA) to create a digital health care circuit. We are talking, in particular, about the formation of the Unified Departmental Medical Information and Analytical System (EVMIAS). Read more here

The first center for digital design and communications in healthcare in Russia has begun work to develop standards for interfaces of medical services

At the first Moscow State Medical University named after I.M. Sechenov, the first center for digital design and communications in healthcare in Russia began work. This was reported by the press service of the university at the end of May 2024. Read more here.

The Ministry of Health of the Russian Federation for 486 million rubles buys servers for the Center for Medical Data Processing

On April 19, 2024, a tender was announced for the supply of equipment for the development of a medical data storage and processing center (TsOMD), focused on institutions subordinate to the Russian Ministry of Health. The initial cost of the contact is 486.19 million rubles. Read more here.

2023

39 million service users, 1.2 billion electronic documents. Summed up the results of the year in the field of digitalization of healthcare of the Russian Federation

Digital transformation remains one of the key priorities for the development of the health care system in Russia. In 2023, 39 million people used the services of digital medical services in the country, and the number of registered electronic medical documents exceeded 1.2 billion. Such data was published on July 24, 2024 by Deputy Prime Minister Tatyana Golikova.

It is noted that the digitalization of the healthcare sector contributes to both improving the quality of medical services and increasing the coverage of patient care. As of mid-2024, 100% of public health organizations use medical information systems (MIS). In addition, 17 million citizens received an electronic compulsory medical insurance policy without paper media on the basis of the Unified Register of Insured Persons.

In the field of digitalization of healthcare of the Russian Federation, the results of the year were summed up: 39 million users of services and 1.2 billion electronic documents

By the end of 2023, 70 constituent entities of the Russian Federation are using medical devices with AI technology in at least one centralized GIS subsystem. About 1 million automated jobs have been organized, and approximately 522 thousand doctors are provided with electronic signatures. Approximately 50 thousand divisions of clinics have introduced MIS and exchange data with the register of electronic medical documents of the Unified State Information System in the field of health care (Uniform State Health Information System).

In early June 2024, the Minister of Health RFMikhail Murashko announced that more than 30 medical devices with artificial intelligence were registered in the country. Moreover, more than half of them are registered in 2023. It is said that thanks to the accumulation of large amounts of medical data and the rapid development of analytical methods based on machine learning, logical and statistical models, AI tools can fundamentally change the situation in the health sector. As of 2023, 22 million medical records were analyzed in Russia using AI, voice filling services are used in six regions, and virtual assistants with AI are used in 29 to make an appointment with a doctor.^[1]

The government allocated 5 billion rubles to the regions for the digitalization of healthcare in 2024

The Russian government has allocated 5 billion rubles to the regions for the digitalization of healthcare in 2024. Pavel Pugachev, deputy head of the Ministry of Health of the Russian Federation, cited such data at the end of October 2023, speaking at one of the forums in Novosibirsk.

According to the Deputy Minister of Health of the Russian Federation, from January to October 2023, more than 700 million medical documents were registered at the federal level. It is expected that by the end of 2023 this figure will exceed 1 billion.

This is far from the limit, because, according to our estimates, there are about 10 times more of them, "Pugachev emphasized.

He explained that with the help of medical data, it is possible to implement digital services, including systems for supporting the adoption of medical decisions, reduce the number of unnecessary visits of patients, remove the routine from the work of the doctor, optimize the routing of patients.

Pugachev noted that by the end of October 2023, all medical institutions have access to the Internet, 1 million computerized jobs have been created in the state health care system that work with medical InformSystems.

In addition, the deputy head of the Ministry of Health of the Russian Federation said that Russian medical devices with artificial intelligence, which can make a preliminary diagnosis based on the analysis of medical images or medical history, have high competitive and export potential. By the end of 2023, 24 similar products were registered in Russia, of which 17 are products from Russian developers. At the same time, at least 70 regions of Russia are already introducing products with artificial intelligence into the healthcare system, Pugachev noted.

He also recalled that an appointment with a doctor is the most popular service on the State Public services portal, in 2022 the service worked intermittently, the situation with the service was worked out "as part of a federal incident."^[2]

How is the digitalization of healthcare in the Russian Federation. Ministry of Health - on the results of 2019-2023.

In early October 2023, Vadim Vankov, Director of the Department of Digital Development and Information Technologies (DIT) of the Ministry of Health, made a report on the results of digitalization of the health care system in Russia over the past few years. In particular, he noted the growing popularity of remote appointments for medical appointments through the unified portal of Public services.

According to Vankov, by September 2023, the portal recorded 164 million users' requests to record with the doctor, which is three times more than a year earlier. The share of successful records during this time increased from 30 to 49%.

Since last year, work with subjects and analysis at the level of a specific medical organization have been carried out on an ongoing basis. This allowed to increase both the number and quality of this record. The share of successful recordings has grown over the past year by almost 20%, - said Vankov in early October 2023.

He also cited data according to which the number of regions in which the rate of successful medical appointments remotely exceeds 60% increased from 3 to 27. Nevertheless, the bulk of patients, as follows from the presentation, still prefer to sign up through a therapist (39%), a registry (12%) and a call to a call center (30%). During the same period, at least 1 million citizens used the "Registration for vaccination" service on the portal and at least 2 million - the "Call a doctor at home" service.

For nine months of 2023, citizens downloaded 5 million electronic medical documents (EMD) on the public services portal. In total, by October 2023, at least 10 types of EMD are available to users, including: referral and appointment for consultation and medical and social expertise; laboratory, instrumental and consultation protocols; discharge epicrises from the hospital; results of professional examinations and medical examination, as well as electronic prescriptions.

Vadim Vankov also drew attention to successes in industry electronic document management. If in 2019 clinics formed and sent to Uniform State Health Information System of 4 million structured electronic medical documents (SAMDs) per year, then in 2023 718 million documents have already been formed. The main work, according to the representative of the Ministry of Health of the Russian Federation, is ahead - ideally, the number of SAMDs, taking into account the circulation of patients, should reach about 10 billion.

In addition, it is reported that by the beginning of October 2023, about 70 subjects are using medical devices with AI technology in at least one centralized GIS subsystem. Also in Russia, 1 million automated workplaces, 522 thousand doctors are provided with electronic signatures, and 50 thousand departments of clinics have introduced MIS and exchange data with the register of electronic medical documents of the Uniform State Health Information System, including 20 thousand feldsher-obstetric points.

Digital services for citizens, as well as Uniform State Health Information System and its systems for clinics are developing due to the federal project "Creating a single digital circuit in healthcare," the budget of which in 2019-2024 is 113.8 billion rubles. By 2024, according to the project passport, 38 million people should use at least one of the services of the "My Health" section on the public services portal, and all clinics and regions will allow patients to upload medical documents from the portal.

According to the deputy head of the Ministry of Health of the Russian Federation Pavel Pugachev, by March 2023, 15 regions were already actively introducing artificial intelligence technologies. These are solutions for analyzing medical data, when a risk profile is determined on the basis of a patient's electronic record, preliminary diagnoses are made, and analysis of medical images, when CT, magnetic resonance imaging (MRI), ECG or endoscopy data help doctors diagnose or pay attention to those points that need to be carefully looked at, he said.^[3]

Accounts Chamber - about the problems of digitalization of healthcare: Only 22% of medical institutions transmit data to the Uniform State Health Information System

The Accounts Chamber of the Russian Federation analyzed the current state of informatization of the industry and identified a number of problems that slow down the digital transformation of this sphere. The department disclosed its conclusions at the end of August 2023.

According to the Accounts Chamber, by mid-2023, only 40% of private medical organizations transfer information about health workers and less than 20% of pharmaceutical organizations to Uniform State Health Information System - data on prescribed drugs and medical food products, and state medical organizations connected to Uniform State Health Information System send only 15% of telemedicine consultation protocols to the system. In addition, the volume of information about medical workers providing medical care on an outpatient basis and conducting an independent appointment does not exceed 20%.

The Accounts Chamber came to the conclusion that this level of information interaction does not allow ensuring the integrity and completeness of the data received by the Uniform State Health Information System. According to the department, only 22% of medical institutions from the number approved by the Ministry of Health transmit data to the Unified State Information System in the field of health.

The introduction of information systems without abandoning paper document management significantly reduces the labor productivity of medical personnel, while creating an additional burden for doctors. As a result, the low involvement of participants in the health care system in information interaction, the report says.

As noted in the control department, the burden on doctors increases due to multiple input of information. As the check showed, health workers have to enter patient data simultaneously in several unrelated InformSystems. At the same time, the requirements for their mutual integration are established only for individual components and do not take into account their complete integration.

The Accounts Chamber noted the shortcomings of the methodology for calculating individual indicators, which do not allow a reliable assessment of the effectiveness of the measures being implemented. For example, the indicator "the share of cases of medical care for which electronic medical documents are provided in the Uniform State Health Information System subsystem" does not take into account the fact that up to ten electronic documents can be transferred to the system within one treatment and, as a result, the indicator will be overfulfilled, the report says.

Based on the results of the analysis, the control department gave a number of proposals (recommendations) aimed at improving the processes of digital transformation of the health care system. By the end of August 2023, some of the Accounts Chamber has already been taken into account. Part of the proposals of the control department concerned the adjustment of the indicators of the federal project "Creation of a single digital circuit" and the strategic direction in the field of digital transformation of healthcare. Thus, the Accounts Chamber recommended establishing indicators that characterize:

• reducing the time taken by medical professionals to complete medical records;
• application of the principle of single input and reuse of information for "end-to-end" integration of information systems of all healthcare participants, based on the use of structured electronic medical documents;
• reporting on the basis of data aggregated in the Unified State Information System in the Healthcare Sector (hereinafter referred to as the Uniform State Health Information System Information System);
• formation of digital twins of processes, patients and medical organizations.

These recommendations have been fully implemented. By August 2023, the Ministry of Health of the Russian Federation included the relevant indicators in the federal project "Creation of a single digital circuit" and in the strategic direction in the field of digital transformation of healthcare, and also conducted their synchronization.^[4]

The State Duma Committee on Health has created an expert council on the digitalization of medicine

Under the State Duma Committee on Health Protection, an expert council has been created on issues of modern management and digitalization in the field of health. This became known at the end of May 2023. Read more here.

The Ministry of Health postponed for a year the transition to electronic medical books due to the flaw of GIS

The Ministry of Health of the Russian Federation postponed the transition to electronic medical books for a year due to a flaw in the relevant state information system. This became known in July 2023. Read more here.

The head of the Ministry of Health reported to Putin on the results of digitalization of health care

On July 12, 2023, the President Russia Vladimir Putin and the Minister of Health Mikhail Murashko held a working meeting, one of the topics of which was the digital transformation of Russian medicine.

In particular, Mikhail Murashko also spoke about the Digital FAP program, which allows paramedics to "consult" with the patient. In addition, about 35,000 feldsher-midwife stations (FAP) received licenses according to the instructions of the president.

There were many appeals when the population asked to open a pharmacy, but the population is small, and the pharmacy is simply unprofitable. Therefore, we followed the path of your order, - said the Minister of Health of the Russian Federation.

According to him, thanks to high technologies, the number of visits and hospitalizations of cancer patients has more than doubled.

Rosatom reports that they have more and more technological capabilities, "Putin said.

Earlier, the President of Russia called on the Ministry of Health to pay special attention to digitalization and the use of technological solutions, this work is extremely important in primary healthcare. In 2023, Putin instructed the Ministry of Health to report on the creation of a digital health profile. First Deputy Minister of Health of the Russian Federation Volodymyr Zelenskyy called the creation of a "digital patient profile," a generalized set of medical and non-medical data about him one of the priorities of 2023.

Talking about the conditions in which digitalization takes place, Volodymyr Zelenskyy in mid-April 2023 cited several figures: 1 billion outpatient services are provided in the country per year, more than 20 million hospital hospitalizations and 40 million ambulance calls are registered. 725 million doctor's appointments are made annually and 350 million medical documents are formed.^[5]

The Ministry of Health of the Russian Federation listed cyber threats for its IT systems

In June 2023, the Ministry of Health of the Russian Federation issued a document in which it identified security threats to information systems supervised by the department. In particular, the following threats are attributed to:

• exposure to malicious code, malware;
• unauthorized access to personal data of people with user access rights to state information systems, automated and information systems;
• unauthorized access to the administration of software, software and hardware, information protection tools included in these systems during their creation, operation, maintenance. At the same time, in the latter case, the use of social and psychological impact on such specialists is not excluded.

In addition, risks are presented by unauthorized access to alienated PD media, including portable personal computers of information system users, as well as the possibility of such access using vulnerabilities.

The list of security threats to personal data protected using CIPF is wider. It includes, in particular, the danger of creating methods, preparing and conducting attacks at various stages of the life cycle of cryptographic information protection tools, including by violators outside the zones controlled by the system.

Earlier, the Ministry of Health of the Russian Federation developed the concept of information security in the field of health care. The document, as stated in the department, is aimed at increasing the effectiveness of protecting information processed by medical information systems, including personal data and medical information, as well as ensuring the security of critical information infrastructure facilities in the Russian Federation in the healthcare sector. It defines the directions for the development of the information security system. It also contains draft solutions for implementing information protection measures, architecture and draft solutions for building a system for responding to computer attacks in healthcare information systems.

Draft Order of the Ministry of Health of the Russian federation

Healthcare IT solutions should aim to create a single digital space in the industry

health care Digitalization today is at the peak of the news agenda. The main goals of the project medical are to give specialists the opportunity to quickly and conveniently track the routing of the patient, assess the quality of treatment, consolidate, and in the data future - make medical decisions based on automated ones. algorithms health care Vologda Oblast The boss Digital Development Department Irina Prosviryakova and boss spoke about the digital transformation. Department of Health of the region Alexey Plotnikov Read more here. [1]

Named the main IT problems of obstetric and gynecological institutions in the Russian Federation

In March 2023, specialists of the National Medical Research Center of Obstetrics, Gynecology and Perinatology named after ACOD V.I. Kulakova spoke about the main problems of the development of digital technologies in regional maternity care institutions. Conclusions were made based on the results of visiting events in clinics in 2018-2021.

During these three years, the National Medical Research Center sent more than 6.5 thousand recommendations to the subjects, grouped into 10 sections. Their performance was estimated as a percentage. The lowest indicators in the sections "automation of medical care processes" and "implementation of the" electronic benchmarking "system (17%)," creation of regional programs for monitoring pregnant women "(17%) and" elimination of personnel shortages "(19%). The maximum performance indicator is noted only in the item "internal quality control system and safety of medical activities in the" anchor "medical organization" (36%).

Despite the quantitative success of the introduction of the specialized vertically integrated medical information system (VIMIS) "AKiNEO," there is a problem of the quality of data sent by the regions. There is a low "digital maturity" of some subjects - the lack of automated workplaces and incomplete integration of MIS medical organizations into medical processes. Experts also point to the lack of a system for introducing clinical recommendations, the disunity of the outpatient and inpatient stages, adherence to unreasonable hospitalizations of pregnant women in the departments of pregnancy pathology.

Among the positive practices, an increase in the need of subjects for telemedicine consultations (TMK) with specialists from the National Medical Research Center of Obstetrics and Gynecology over the past three years was noted: according to the profile "Obstetrics and Gynecology" - 5.5 times, up to 5945 in 2022, according to the profile "Neonatology" - 2.3 times (3012).^[6]

2022

Clinics and social organizations in Russia reduced the cost of digitalization by 24.4 billion rubles

At the end of 2022, organizations in the field of health care and the provision of social services in Russia spent approximately 70.3 billion rubles on the introduction and use of digital technologies. For comparison, a year earlier, costs were estimated at 94.7 billion rubles. Thus, on an annualized basis, the cost of digitalization of the industries under consideration decreased by 24.4 billion rubles, or about a quarter. Such data are provided in a report dated January 30, 2024, published by the Institute for Statistical Research and Knowledge Economics of the Higher School of Economics (ISIEZ HSE).

This amount includes both internal (independent) expenses of organizations and external (with the involvement of contractors). It is noted that in 2022, the internal costs of enterprises in the field of health care and the provision of social services amounted to 55.6 billion rubles against 75.3 billion rubles a year earlier. External expenses decreased on an annualized basis from 19.4 billion rubles to 14.7 billion rubles.

Healthcare and social services organizations in Russia spent approximately 70.3 billion rubles on the introduction and use of digital technologies

In 2022, cloud services were among the most popular digital technologies that were introduced in the areas of health and social services, with an indicator of about 36.3% of the total number of industry organizations. In second place were the means of collecting, processing and analyzing big data with a result of 30.6%. This is followed by data centers with 16.6% and digital platforms with 16.1%.

The study says that an electronic appointment with a doctor, as well as a search for information related to health or health services, were included in the Top 10 goals for which Russians used the Internet in 2022. Approximately 40.5% of the population aged 15 to 74 used the appointment service, and 36.9% of citizens were interested in finding health information. It is also noted that in 2022, 63.3% of organizations from the healthcare and social services sectors participated in electronic public procurement.^[7]

Mishustin instructed the Ministry of Health to approve the purchase of foreign information security software for medical institutions

In August 2022, Prime Minister Mikhail Mishustin signed a decree instructing the Ministry of Health to approve the purchase of foreign information security software for medical institutions. In addition, the Government of the Russian Federation approved general requirements for software and rules for the transition to domestic developments.

If it is impossible to purchase domestic IT solutions, state customers must obtain permission to purchase foreign software from a higher federal government agency, the document says. Coordination of purchases of foreign software for healthcare institutions will be carried out by the Ministry of Health.

To obtain permission, the customer must send an application with procurement data to the department, the list of which is established by the certificate. It is also necessary to reflect the reasons why foreign software cannot be replaced with a Russian analogue.

The ministry within five working days assesses the correctness of the application and within another eight working days makes a final decision on approval or refusal. The decision is sent to the applicant within three working days.

Purchases from 100 million rubles will be coordinated by a special commission at. Ministry of Digital Development In-person and absentee meetings of the commission are allowed. After receiving the approval of the government agency, the customer must send the decision to the Ministry of Digital Development within 10 working days.

The Ministry of Health will also have to develop a plan for the transition of the industry to domestic software. The agency should include in the document targets, key deadlines and necessary measures.

Customers, in turn, must analyze the software used to ensure cybersecurity and develop a local import substitution plan. Software replacement activities must be completed by January 1, 2025.

Decree of the Government of the Russian Federation of 22.08.2022 No. 1478 "On Approval of Requirements for Software, Including as Part of Software and Hardware Systems Used by State Authorities, Customers Performing Purchases in Accordance with the Federal Law" On Procurement of Goods, Works, Services by Certain Types of Legal Entities " (with the exception of organizations with municipal participation), at their significant facilities of the critical information infrastructure of the Russian Federation, the Rules for coordinating the procurement of foreign software, including as part of software and hardware systems, for the purpose of its use by customers who carry out purchases in accordance with the Federal Law "On the procurement of goods, works, services by certain types of legal entities" (with the exception of organizations with municipal participation) belonging to them significant facilities of the critical information infrastructure of the Russian Federation, and procuring the services necessary for the use of this software at such facilities, and the Rules for the transition to the predominant use of Russian software, including as part of software and hardware systems, state authorities, customers engaged in procurement in accordance with the Federal Law "On Procurement of Goods, Works, Services by Certain Types of Legal Entities" (with the exception of organizations with municipal participation), at their significant facilities of the critical information infrastructure of the Russian Federation "

Putin instructed to everywhere introduce digital assistants into the health care system

At the end of August 2022, it became known about several instructions from President RFVladimir Putin, which were given to the Government of the Russian Federation following the plenary meeting of the Agency for Strategic Initiatives forum "Strong Ideas for the New Time." One of the instructions concerns the development of medical digital assistants.

As reported on the Kremlin website, the Government of the Russian Federation was instructed until September 15, 2022 "to consider the need to amend the legislation of the Russian Federation, providing for the possibility of collecting information about the patient by the medical organization (questionnaire) with his consent using digital services, processing such information (including using artificial intelligence technologies) and placing it in the patient's electronic medical record before visiting the doctor of this medical organization in order to reduce the administrative burden on medical personnel. "

At the end of August 2022, the Deputy Mayor of Moscow for Social Development Anastasia Rakova said that a digital system for assessing the condition of patients had already been introduced in 30 hospitals in the capital. The same tool will appear in six new fast-moving stationary complexes.

In July 2022, Vladimir Putin discussed with Deputy Prime Ministers and federal officials the implementation of national projects, including in the field of health care. In his opinion, the country has a low percentage of people who can make an appointment with a doctor online, as well as most residents, the function of obtaining an electronic prescription is still not available. The share of these technologies must be increased, "despite all the restrictions," since "technologically [for this] everything is ready," the head of state said.

Here is the same electronic record to the doctor - it all depends on us. We have everything for this, in order to expand this work. Technologically, everything is ready. Well, still there is! - said the Russian leader.[8]

Chernyshenko: A third of the regions of Russia connected to the online attachment service to the clinic on the State Public services portal

On June 29, 2022, the Ministry of Digital Development of the Russian Federation announced the launch of an online attachment service to the clinic on the Public services portal. According to the Deputy Prime Minister of Russia Dmitry Chernyshenko, the service is available in a third of the regions of Russia. Among them:

• Altai Territory
• Belgorod region
• Volgograd region
• Sevastopol
• Kaliningrad region
• Kaluga region
• Karachay-Cherkess Republic
• Kemerovo region
• Kostroma region
• Krasnodar Territory
• Moscow region
• Murmansk region
• Novosibirsk region
• Republic of Bashkortostan
• Republic of Karelia
• Republic of North Ossetia - Alania
• Samara region
• Sakhalin Oblast
• Smolensk region
• Tambov region
• Tver region
• Tomsk region
• Tyumen region
• Ulyanovsk region
• Khanty-Mansiysk Autonomous Okrug - Ugra
• Chechen Republic
• Chuvash Republic
• Yamal-Nenets Autonomous Okrug
• Yaroslavl region.

According to Dmitry Chernyshenko, it is expected that by the end of 2022, residents of all over Russia will be able to remotely attach to the clinic.

To attach to the clinic, you need:

• Check the passport data (they are automatically pulled up from your personal account);
• Check the data of the compulsory medical insurance policy;
• Specify the phone number, address and mail;
• Choose a clinic in your region.

You can change the clinic in your region once a year. When moving to another region, as well as when liquidating an insurance company, such a restriction does not apply.

As noted in the Ministry of Digital Development, online attachment to the clinic saves time and simplifies interaction with the health care system. The agency plans to develop the functionality of the service and has outlined for the third quarter of 2022 the introduction of the possibility of attaching a child to the clinic using a new service.

The Ministry of Health of the Russian Federation unifies the digitalization of regional medicine

As it became known at the end of February 2022, the Ministry of Health of the Russian Federation unifies the digitalization of regional medicine. To do this, the department has prepared changes in the functions and principles of the medical information and analytical center (MIAC).

As Kommersant writes with reference to the corresponding draft resolution developed by the Ministry of Health, the MIAC will be considered a "special type of medical organization" subordinate to the regional Ministry of Health, engaged in the collection, processing and analysis of data in healthcare, medical statistics and digital transformation of the industry.

In a number of regions, MIACs are under the jurisdiction of the Ministry of Digital Development, the newspaper notes. Its source in the industry claims that there will be no disagreements - the departments have distributed powers, and the "internal" digitalization of medicine is left to the Ministry of Health. The department has been engaged in the digitalization of health care since 2011, but regional ministries of health are subordinate to the government of the subject, but due to the specifics of management in the industry (regional ministries are not subordinate to the relevant federal ministry, but to the government of the subject of the Russian Federation) and due to the incompleteness of regulatory documents, the regions launched heterogeneous projects in this area, the publication says.

The main goals of the MIAC are the implementation of a single digital circuit within the framework of the regional component of the national project "Healthcare" and integration with regional state InformSystems (GIS) of territorial CHI funds (MHIF).

As the development director of the Webiomed project, Alexander Gusev, notes, if in a number of regions of the MIAC there are "flagships of digitalization," then somewhere they simply "collect statistical reports."

The industry has long asked the Ministry of Health to unify their activities, and this document will at least give the regions the desired guideline, he stressed.[9]

Digitalization of healthcare in Russia: TAdviser review

In January 2022, TAdviser published a new review on current areas of digital transformation, health care the achievements of this area, its problems and prospects. The review published a rating of the largest participants in this market. Read more here.

Half of Russian medical institutions use equipment with outdated OS

More than half (54%) of Russian medical institutions use equipment with outdated operating systems. Such data were presented on December 8, 2021 at Kaspersky Lab.

This situation in the company was associated with the high cost of updating software and problems with the compatibility of old and new systems. As experts explained, medical organizations can, if necessary, use equipment on which it is no longer possible to update the software, but this may be unsafe. If developers no longer support the system, they stop releasing updates for it. Updates are important because they contain not only improvements, but also patches for vulnerabilities. If the holes are not closed, attackers can use them as an entry point into the corporate infrastructure, Kaspersky Lab noted.

According to statistics cited by the antivirus company, due to vulnerabilities, 32% of medical institutions in Russia faced attacks, data breaches 32% - with, DDoS-attacks 30% - with attacks. programs extortioners

The health sector is developing, and it is increasingly using smart devices, that is, connected to the Internet. Their application is associated with certain cybersecurity risks, but there are technologies that can help minimize them. The use of such solutions, as well as regular raising of awareness of employees of medical institutions, can significantly increase the level of security in healthcare, "said Sergey Martsynkyan, head of the product marketing department for corporate business at Kaspersky Lab.

Experts recommend that medical institutions train employees in the basic rules of cyber hygiene, conduct cybersecurity audits of networks and timely fix discovered vulnerabilities, as well as implement services for cyber defense.^[10]

The Ministry of Health of the Russian Federation issued an order to equip nurses' workplaces with computers

In November 2021, the Ministry of Health of the Russian Federation issued a document on the mandatory equipping of nurses' workplaces with computers. We are talking about amending the order on the requirements for the organization and performance of work (services) in nursing.

According to the document, the nurse's workplace must have a computer with access to. Internet

The supply of new computer equipment is carried out within the framework of the implementation of the regional project "Creation of a single digital circuit in healthcare on the basis of a single state health information system (Uniform State Health Information System)" of the national project "Healthcare."

The upgrade of the outdated computer fleet of automated doctors' workplaces began in August this year. New kits, consisting of system units, monitors, keyboards, computer mice, were among the first to receive the Second City Hospital, the Republican Narcological Dispensary, the Republican Skin and Venereological Dispensary, the Republican Clinical Hospital for War Veterans and the City Children's Hospital No. 2. In 2020, more than 6,500 units of technical equipment were purchased, which will go to 48 medical organizations in Chuvashia.

In May 2021, the Minister of Health of Russia of the Ministry of Health Mikhail Murashko called on to support nursing in Russia. Then he said that there are about 1 million nurses in the country, and comfortable working conditions should be created for them.

Also, the head of the Ministry of Health emphasized that internal processes in hospitals should be digitized in order to provide patients with high-quality and safe medical care.

These are checklists, these are standard operating procedures. In any situation, the doctor, nursing staff should act according to the instructions. This is what makes it possible to improve the quality of treatment, "he noted.[11]

Doctors in Russia are forced to duplicate electronic documents on paper

By early October 2021, Russian doctors are forced to duplicate electronic documents in paper form, despite the multi-billion dollar costs of digitalizing healthcare. This problem was raised by the participants of the round table organized by the All-Russian People's Fund (ONF) chaired by the famous doctor and public figure Leonid Roshal.

According to Rossiyskaya Gazeta, since each region was engaged in digitalization independently, and there were no uniform basic rules "on the shore," respectively, the software products used by different medical institutions and regions are seriously different. Until now, the electronic document flow of medical extracts, case histories, examination results does not work in all regions and almost does not work at all between regions.

The fragmentation of information systems remains not only geographically - between regions, but also between departments. For example, schools and kindergartens do not accept electronic certificates and data, and school doctors do not have access to data on their student patients.

To Moscow In April 2021, polyclinics in experimental mode began the transition to the maintenance of electronic medical records without duplication on paper. In at least two children's clinics, medical documents began to be created and stored immediately in electronic form in the Unified Medical Information and Analytical System (). EMIAS The innovation was made possible by a single digital healthcare platform. In October 2021, it was planned to extend the "paperless" practice to a large number of children's clinics in the capital.

Leonid Roshal noted that by October 2021 there are advanced institutions in terms of digitalization, and it is necessary to pair their software products, adding the necessary structures to create a single digital space for the country.

In Russia, the digitalization of health care is carried out within the framework of the federal project "Creation of a single digital health care circuit based on Uniform State Health Information System," it is planned to spend about 170 billion rubles to translate into "digital" until 2024.^[12]

The Ministry of Health is introducing AI to create a unified database of medical knowledge for 150 million rubles

In September 2021, it became known about the creation of a new hardware and software complex (APC) for the situation center of the Ministry of Health of the Russian Federation, which is designed to receive information in real time about various situations, indicators and reports (population incidence, number of patients, etc.) related to healthcare. As part of the update, it is planned to create a single base of medical knowledge using artificial intelligence. Read more here.

83% of pharmaceutical companies in Russia plan to develop digital communication channels with customers

On June 29, 2021, the Digital Laboratory marketing CROC and Bionika Digital reported the results of the Digital Pharma: A New Customer Experience study and highlighted key technology trends pharmaceutical in the industry. The authors of the study found that every second company plans to cooperate with marketplaces, more than a third are already developing their own ecosystem, and client platforms data predictive analytics have become the main trends in the digitalization of the industry.

Technologies have penetrated the sales and communications system of pharmaceutical companies and customers. According to the survey, the site mobile application became the basis of digital hygiene of the farm retail - this was confirmed by 57% and 38% of respondents, respectively. Another important vector is cooperation with marketplaces, integration with which 55% of companies plan. The development of these retail channels e-commerce is a priority for the pharmaceutical business in the next three years.

Using technology in conjunction with a progressive approach to transforming customer experience channels is key to success in existing reality, experts agreed. Respondents identified the following digital tools for effective communication with customers:

• 66% - Customer Data Platform;
• 60% Predictive Analytics;
• 30% - Chat bots based on artificial intelligence;
• 30% - Internet of Things.

The authors of the study note that industry ecosystems in the future can become the basis for spontaneous consumption and improving the quality of customer experience. And this, in turn, will help form a customer-centric approach to the effective promotion of products in the digital world. According to the survey, as early as June 2021, 40% of companies are developing their own ecosystems, and 34% of companies plan to implement them. The main focuses of companies in creating an ecosystem in the near future will be segments of products with a high frequency of consumption (for example, vitamins, dietary supplements, cosmetics), services for doctors and patients, as well as telemedicine.

As part of the study, the Pharma CX Trend Radar trend radar was developed - a map of key trends that could have a significant impact on the development of the pharmaceutical industry in the next 5-10 years. Thus, 83% of companies plan to develop digital communication channels with customers in 2021. Experts note that it is extremely important for pharmaceutical companies to increase the digital literacy of doctors and patients and work with digital channels. In the post-pandemic period, the industry is forced to adapt to a rapidly changing environment and move to using digital tools. At the same time, two-thirds of pharmaceutical companies plan to develop the personalization of client experience using the most flexible and customizable communication channels.

Pharmaceutical companies, especially in a pandemic, actively use digital channels for B2B communication. At the same time, digital gives statistics that differ from the usual offline tools. A platform that will collect data on doctors and pharmacists will help solve this problem. The information obtained will allow you to assess the coverage, frequency and response throughout the advertising campaign. For June 2021, the data is fragmented and accumulates in individual players. Therefore, it is important for everyone to develop uniform requirements and rules for using the master base. After all, a single platform with equal access for representatives of the pharmaceutical industry will solve a large number of tasks of each market participant, - commented Ilya Sankov, director of Bionika Digital.

Respondents note that legislative restrictions (62%), lack of sufficient customer data (52%), lack of qualified personnel in the market (36%) significantly restrain the digitalization of the pharmaceutical industry and the development of e-commerce in Russia. More than half of experts say that regulatory restrictions are the most painful barrier in the issue of effective communication with the end consumer.

Most of the companies surveyed note the market's need for personnel with competencies in data analysis (79%), project management in the field of digital marketing (68%) and mobile development (47%).

Contrary to stereotypes that the industry is considered one of the most conservative on the market, research experts say that pharma is rapidly undergoing a digital transformation and have identified TOP-3 drivers for the development of e-pharma:

• Easing legislative restrictions;
• Implementation of the electronic prescription system;
• Changing customer preferences.

More than 50 manufacturers, distributors and retailers of the pharmaceutical industry took part in the study "Digital Pharma: A New Customer Experience" from April to June 2021. The expert survey's target audience consisted of commercial directors, digital marketing and digital transformation executives, medical representative managers, development directors, product managers, and CEOs.

6 priority goals of healthcare transformation in St. Petersburg are identified

In St. Petersburg, priority goals have been formed for the transformation of the Healthcare direction by 2030. This was announced on April 12, 2021 in the press service of the vice-governor of the city Stanislav Kazarin. Read more here.

Remote medical examinations for taxi drivers are being tested in Moscow

On February 3, 2021, Citymobil announced an offer for partner drivers to undergo free medical examinations at the Taxi House. Read more here.

In the Astrakhan region, Rostelecom's voice assistant helps to call a doctor

Rostelecom on January 21, 2021 announced the implementation of a pilot project to use a voice assistant with artificial intelligence in the health care system of the Astrakhan region. When calling a single number 122, the robot helps to arrange a doctor's call at home, which allows you to significantly reduce the waiting time for an answer. Read more here.

2021: Spending on digitalization of health care has increased in Russia - Rosstat

The costs of healthcare organizations for the creation, distribution and use of digital technologies and related products and services in 2021 reached 2.6% of the total spending among all types of economic activities, compared to 2.2% a year earlier. Such data Rosstat (belatedly) were published in February 2023.

The share of the medical industry in the costs of Russian organizations for digitalization increased to 2.2% in 2020 from 1.6% in 2019. The largest amount of expenses among all industries remained in the field of "Information and Communications" (in 2021 - 29.4%).

The contribution of the information and communication technologies (ICT) sector to the development of the Russian economy in the field of health amounted to 3.4% in 2021 (as a percentage of GDP). This figure has not changed since 2020. The maximum contribution to the development of the economy was recorded in the field of trade (13%), according to Rosstat data.

According to the department's materials, access to broadband Internet from healthcare organizations decreased by 1 percentage point over the year. In 2021, 81.5% of organizations had it. At the same time, high-speed Internet began to be used more widely. 7.8% of organizations are provided with Internet with access speeds above 100 Mbps.

The structure of digital technologies used in healthcare and social services organizations is dominated by cloud services - they are used by about a third of institutions.

Compared to 2020, in 2021, six of the eight types of technologies presented by Rosstat demonstrated growth in the field of health care and the provision of social services. This is especially noticeable in the field of big data collection, processing and analysis technology - they are in demand among 30.6% of organizations (in 2020 - 27.2%). The use of digital platforms (16.5%) and geoinformation systems (14.3%) decreased.

As software tools in healthcare, electronic document management systems are most often used (64.2%), as well as financial calculations in electronic form (54.3%). There is also a noticeable increase in relation to 2020 in all types of software tools.

In the dynamics of the use of information protection tools in medical organizations, changes are observed only in the use of the spam filter. If in 2020 such protection was used by 40% industry participants, then in 2021 only 23.7%, as a result, among the means of protection, the spam filter moved to the last place in terms of frequency of use. The leader here remains the means of digital electronic signature (82.8%).

At the end of December 2021, Prime Minister Mikhail Mishustin signed a decree approving the strategic direction in the field of digital healthcare transformation. The Ministry of Health of Russia, together with interested federal executive bodies and the Federal Fund for Compulsory Health Insurance, to ensure the implementation of the strategic direction in the field of digital healthcare transformation approved by this document.

The goals of digital transformation are to achieve a high degree of "digital maturity," optimize the working hours of medical workers through the automation of management processes and the introduction of advanced technologies in order to increase the availability of medical care, ensure effective and optimal patient routing, interagency interaction, ensure high quality, the necessary completeness and reliability of patient health information and increase the proportion of early detection of diseases.^[13]

2020

The rating of the digital maturity of the regions in the field of health care is presented

In mid-February 2021 Government of the Russian Federation , it published a rating of the digital maturity of the constituent entities of the Russian Federation health care in the field at the end of 2020. More. here

Approved a roadmap for the introduction of AI in the budgetary health care of Russia

In November 2020, it became known about the approval of the roadmap for the transfer of budgetary health care in Russia to work with artificial intelligence. With the help of such technologies, it is planned to optimize the individual patient treatment plan, Deputy Health Minister Pavel Pugachev told Rossiyskaya Gazeta.

According to him, IT solutions in medicine will help early detection of diseases, prevent their development, and will also become a kind of assistant doctors. For example, the routine work on filling out medical documentation will be able to facilitate special programs that can recognize human speech: they can dictate information, and they themselves will put it into a computer.

This is what visiting the ultrasound diagnostic office looks like now? The doctor does an ultrasound, and a nurse sits next to him, who records him. In the future, he will just need to voice what he sees on the monitor screen, and this will automatically get into the medical information system in the text version, - said Pugachev.

At the end of November 2020, Anastasia Rakova, Deputy Mayor of Moscow for Social Development, at a meeting with developers of artificial intelligence services and representatives of IT companies, announced that as part of an experiment to introduce AI into the capital's healthcare, the number of research areas in which digital technologies will help doctors process will be increased from 4 to 10 in 2021.

We are working on a number of new areas of automated processing of research, including magnetic and resonant computed tomography : the head, brain X-ray of the musculoskeletal system and abdominal organs and others, - she said.

By 2027, it is planned to develop about 50 standards of artificial intelligence in healthcare in certain areas, including general requirements and classification in clinical medicine, radiation and functional diagnostics, remote monitoring systems, histology, etc.^[14]

Neurologist from Yakutia created video games for the rehabilitation of children with cerebral palsy

On November 3, 2020, Kinestika announced the development of rehabilitation video games for children with cerebral palsy, which are available for public use. Read more here.

MegaFon Launches Remote Health Monitoring Solution

MegaFon has launched a solution based on the Internet of Things platform, which will allow public and private medical institutions to offer patients a health monitoring service. This became known on July 23, 2020. Read more here.

Sberbank launches free AI service for recognizing CT images

The SberHealth service and the SberCloud cloud platform, part of the Sberbank ecosystem, launched a joint project on July 14, 2020 to recognize lung computed tomography images. Read more here.

The SVFU is developing the "Pocket Doctor" service to identify the consequences of drug interaction

Master's student of the North-Eastern Federal University Viktor Bialostotsky is developing a multifunctional platform in the form of a web service and a mobile application Pocket medic. "Pocket Doctor" will allow health control thanks to artificial intelligence technologies and big data. This became known on July 10, 2020. Read more here.

CST implements a project on voice filling of medical documentation in Moscow

The group of companies CST (part of the ecosystem) Sberbank optimizes the work of medical institutions, the work of radiation diagnostics doctors using intelligent ones. speech technologies This was announced on June 19, 2020 by Sberbank. More. here

A neural network for ophthalmologists is being tested in Chelyabinsk

On April 28, 2020, it became known that the development team from Chelyabinsk is conducting closed testing of its neural network for ophthalmologists AI-Tonometry. Read more here.

The hospital in Kommunarka is introducing a telemedicine system "doctor-doctor"

On March 31, 2020, TAdviser became aware that LANIT-Integration specialists are working in a hospital in Kommunarka to deploy a system to ensure the safe operation of medical personnel. Read more here.

A chip for automatic dosing of drugs has been developed in Russia

On March 23, 2020, the company RVC announced Zdrav.Expert that the scientists of the Competence Center NTI MIET had been developed on the basis. microfluidic pump chip for drug dosing The development will reduce the cost of research and speed up the development of drugs and does not require animal research. More. here

Central Committee of NTI on the basis of Moscow State University has developed a software project for automated analysis of medical image data

On March 17, 2020, the RVC company announced that a software project has been developed at the NTI Competence Center on the basis of Moscow State University "Big Data Storage and Analysis Technologies," which allows automated analysis of data from fluorography, mammograms and cardiograms based on artificial intelligence with an accuracy of 93%. Read more here.

Softline took part in the development of telemedicine in the Sverdlovsk region

On January 9, 2020, the company Softline announced that it had taken part in the implementation of the project "Creating a Single Digital Circuit health care Based" in UNIFORM STATE HEALTH INFORMATION SYSTEM terms of development in telemedicine. Sverdlovsk region The company delivered and connected equipment for telemedicine complexes, with the help of which doctors Territorial Center for Disaster Medicine will be able to provide online advice to their colleagues from remote areas. More. here

2019

HSE summed up the results of digitalization of health care for 10 years

In 2021, the Institute for Statistical Research and Knowledge Economics (ISIEZ) of the Higher School of Economics issued a report on the development of the digital economy in Russia. One of the areas of the report concerns the digitalization of health care.

According to the study, in 2019, about 97.8% of medical institutions in Russia had Internet access against 86.8% in 2010. The shares of organizations using cloud services and RFID technologies in 2021 amounted to 40.1% and 5.5%, respectively, while 10 years earlier these indicators were zero.

In 42.8% of organizations in the field of health care and the provision of social services in 2019 used the Internet at a speed of more than 100 Mbps. Internet access at speeds from 30 to 100 Mbps was in 25.8% of institutions, and the indicator below 256 Kbps - in 3.6%.

In 2019, 80.9% of health and social organizations had their own websites against 72.5% in 2017. Most often, they use the Internet to conduct correspondence by e-mail (94.8% of institutions did this), to search for information on the Web (93.4%) banking operations (82.7%) and professional training of staff (64.1%).

By 2019, the number of jobs for healthcare workers connected to medical IT systems reached 725.5 thousand, and the next year - already 926 thousand.

According to the Higher School of Economics, in Russia, health services in 2019 remained the most in demand among public electronic services and in terms of the number of users, a third are ahead of the service in the field of taxes and fees (the second in demand).

Russians' access to electronic medical documents in the personal account of the patient "My Health" on the Unified Portal of Public Services in 2019 was provided by 5.3% of medical organizations. 10.3 million people then used the services in their personal account - 2.8 times more than a year earlier.

The full report is here.

Rostec and the Ministry of Health launched an online catalog of drugs

On December 24, 2019, the State Rostec Corporation announced Zdrav.Expert that, together with the Ministry of Health Russia launch of the official and first open in the country, online catalog which contains information about all drugs registered RUSSIAN FEDERATION in the country. A platform that collects data about certified medicines in automatic mode, integrated with systems and. state procurements drug labeling The developer of the system is Rostec State Corporation LLC, NCEM which is part of the structure RT - Design technologies of Rostec State Corporation. More. here

In all pharmacies "Vita" it is planned to provide customers with access to telemedicine

Sberbank, the DocDoc medical service, part of the Sberbank ecosystem, and the Vita pharmacy chain signed a tripartite memorandum of cooperation and cooperation in the implementation of telemedicine services in 2020. This was reported on December 18, 2019 by Sberbank. According to Vita 's expectations, the expansion of the partnership in 2020 will make it possible to fully realize the potential of cooperation in all 1,750 pharmacies of the chain in 37 regions of Russia. Read more here.

RVC chose the fund's management company to invest in high-tech medical projects

On December 18, 2019, RVC told Zdrav.Expert that it had determined the winner of the selection to manage the fund for high-tech medical projects. The largest number of points in the open selection was scored by the Unicorn Capital Partners investment team. The fund is being created by RVC together with the Ministry of Industry and Trade of the Russian Federation for investments in high-tech projects in the production of innovative medicines, medical devices and software. Read more here.

Putin approved a list of instructions for the digitalization of health care

In mid-December 2019, the president Russia Vladimir Putin approved a list of instructions for the digitalization of healthcare. By March 1, 2020, the government and executive authorities of the Russian Federation need to do the following:

• ensure the improvement of the procedure for organizing document management in the field of health protection, including when maintaining medical documentation in the form of electronic documents, providing for a reduction in the burden on medical organizations associated with filling out documentation and reporting. By April 15, 2020, the Ministry of Health must ensure a phased transition to electronic document management in medical institutions, providing for the refusal to keep the specified documentation on paper, subject to the readiness of these organizations and the proper security of information systems in the healthcare sector;

• take measures to provide medical organizations with a private form of ownership of access to a unified state information system in the field of health care and state information systems in the field of health care of subjects, providing for the obligation of such medical organizations to enter information on the medical care provided to citizens into these systems.

The Ministry of Health must submit proposals on attracting citizens who have appropriate education and skills to fulfill certain duties of medical workers. Including we are talking about the maintenance of medical documentation and GIS in the field of health care.

At the same time, the ministry was instructed to determine the procedure for paying for medical care provided using telemedicine technologies by June 1, 2020. The Minister of Health Veronika Skvortsova is responsible for the implementation of all three instructions.^[15]

The number of clinics and doctors using chatbots is extremely insignificant

Virtual assistants are more and more penetrating our lives. According to Gartner, "chatbots are the face of AI, and they contribute in all areas where there is communication between people." According to the 2019 "artificial intelligence hype curve," chatbots are still at their peak, and reaching a productivity plateau is predicted within 2-5 years.

According to Business Insider, in a couple of years, chatbots will be implemented by 80% of companies around the world, including clinics and medical companies. As of December 2019, the number of clinics and doctors using such technologies in their work is extremely insignificant, the research results say.

Sechenov University and Protek agree to create a joint venture for the development of telemedicine

On November 26, 2019, Sechenov Medical University informed TAdviser about the signing of an agreement on the creation of a joint venture on the basis of the university with the Protek Implementation Center. The document was signed by the rector of Sechenov University, academician of the Russian Academy of Sciences Pyotr Glybochko and general director of the PROTEK CV Dmitry Pogrebinsky. Read more here.

DocDoc launches telemedicine services at pharmacies

On November 22, 2019, the DocDoc medical service, part of the Sberbank ecosystem, informed Zdrav.Expert about entering the pharmacy market. According to DocDoc, customers of the Vita Express pharmacy chain (Vita Group of Companies) will be able to receive telemedicine services using a special promotional code. Read more here.

Skoltech and the Center for Neurosurgery named after Academician N.N. Burdenko develop the technology of non-invasive mapping based on AI

On November 17, 2019, it became known that artificial intelligence (AI) technologies could begin to be widely used in planning and conducting neurosurgical operations as early as 2021. The corresponding joint project is being developed by specialists from the Skolkovo Institute of Science and Technology (Skoltech) and the Center for Neurosurgery named after Academician N.N. Burdenko, head of the neurosurgical department of the Center named after Burdenko Professor, Doctor of Medical Sciences David Pizhelauri and Professor Skoltech, Doctor of Physical and Mathematical Sciences Alexander Bernstein. Read more here.

Participation of St. Petersburg NIIF in the development and testing of the Care Mentor AI medical neural network

On November 15, 2019, TAdviser became aware that specialists from St. Petersburg Research Institute of Phthisiopulmonology under the guidance of Professor Pyotr Kazimirovich Yablonsky are participating in the creation of the Care Mentor AI neural network. Read more here.

Launch of an electronic health monitoring and emergency response service in Russia

On November 14, 2019, the European Medical Center announced the launch of a smart health monitoring and emergency response service, which allows 99.99% to determine the occurrence of a threat to life and health, preventing complication after sudden falls. Read more here.

In Russia, it is planned to launch a system for accounting for human biomaterials using AI

Artificial intelligence (AI) will diagnose diseases based on medical analyzes of Russians - such a project is planned to be launched in 2021, RIA Novosti was told on November 4, 2019 in the press service of the CoBrain-Analytics project . Read more here.

Discussion of the creation of the Center of Competence for Telemedicine on the basis of Sechenov University

The competence center for to telemedicine may appear on the base. Sechenov University The university announced this on October 28, 2019. More. here

Opening of the Center for Innovation and the Internet of Things in Healthcare in Skolkovo

On October 22, 2019, AstraZenek announced to TAdviser the opening of the Center for Innovation and the Internet of Things in Healthcare at Skolkovo. The center will become a platform for combining the experience and efforts of business, the state, scientific institutes and startups, health care institutions and medical associations. His work is designed to promote the transformation and development of the health care system in Russia. Read more here.

DocDoc was the first to implement authorization through the public services portal using ESIA

The service DocDoc (part of the ecosystem) providing Sberbank telemedicine advice, on October 18, 2019, announced TAdviser that it was the first to put industrial into operation the possibility of authorization using (UIAS a single system and) identifications through. authentications Public Services Portal More. here

"National Medical Knowledge Base" Promotes Medical Software Registration Bill

On July 12, 2019, it became known that Ministry of Health it refuses to support the draft federal law "On Amendments to the Federal Law" On the Basics of Health Protection of Citizens, "proposing, in particular, to introduce the concept medical software (MPO), a special procedure for its state registration, as well as the possibility of not subjecting it to some types of software included in the MPO and the one ON that is not it. More. here

Deputy Minister of Health Elena Boyko - on the priorities of digitalization of Russian medicine

In May 2019, Deputy Minister of Health Elena Boyko, in an interview with TAdviser Editor-in-Chief Alexander Levashov, spoke about the main directions of the digital development of health care and the role of the Uniform State Health Information System in it. Read more here.

The role of Uniform State Health Information System in the digitalization of Russian healthcare (click to increase)

2 billion rubles over three years

The Ministry of Health of the Russian Federation published in May 2019 a plan for informatization for the current year and the period 2020 and 2021 (order of the Ministry of Health No. 279 of May 8, 2019). Financing of these activities will take place in accordance with the current budget policy. According to the document, in 2019, the Ministry of Health will allocate 727.8 million rubles for these purposes, in 2020 - 683.7 million rubles, and in 2021 - 681.6 million rubles. Thus, in the next three years, the department will allocate more than 2 billion^[16] for informatization^[17].

According to the plan posted on the website of the Ministry of Health, the most capital-intensive event will be the work of the Federal Data Processing Center (the main, test and reserve sites of the Unified State Information System in the field of health care, Uniform State Health Information System). In 2019, 445.5 million rubles are provided for these purposes. And in 2020-2021. - 449.8 million rubles each. 250 million rubles will be spent on the operation of the Uniform State Health Information System itself. and in 2020-2021. - 204 million rubles each. Another block is taking measures to operate regional information support systems, PAC, means and communication networks. In 2019, 32.3 million rubles will be allocated for them, in 2020 - 29.7 million rubles, in 2021 - 27.6 million rubles.

Among the priorities for the current year, the Ministry of Health calls the development and integration of information systems of medical organizations, centralized systems of the constituent entities of the Russian Federation and federal information systems to create a single digital health care circuit. This event is contained in the national project "Health."

To create a single digital health care circuit in 2018, regulatory legal acts were signed, including on the creation, operation and development of information systems in the field of health care, securing the possibility of providing medical care using telemedicine technologies, and the use of electronic services and services in the field of health care by citizens.

In addition, this year the department will control the connection to the Internet of feldsher and feldsher-obstetric points. Recall that according to the passport of the direction "Information Infrastructure" of the national program "Digital Economy of the Russian Federation," in 2019 5,000 feldsher and feldsher-midwife stations should receive standard digital services according to the service model.

The Ministry of Health will also continue to work on the construction of the Federal Telemedicine System, designed to ensure remote interaction of national medical research centers of the Ministry of Health with leading regional medical organizations in the fields of medical care: organization and conduct of consultations with the use of telemedicine technologies in the provision of medical care, medical consultations and conferences, as well as knowledge translation.

Since January 1, 2018, an information and analytical system for monitoring and control in the field of procurement of drugs to meet state and municipal needs has been operating in industrial mode. The system is integrated with a unified information system in the field of procurement, an array of data on contracts for the purchase of medicines is formed using a single structured directory of medicines for human use. Since July 1, 2018, an automated calculation of weighted average prices for purchased drugs has been carried out. In order to ensure quality control of medicinal products in circulation and combat their falsification, information is entered into the system for monitoring the movement of medicinal products using identification means applied to the packaging of medicinal products.

The Accounts Chamber criticized the work of officials to connect hospitals and clinics to the Internet

The president's order to connect all medical institutions of the country to the high-speed Internet in 2017-2018 was generally fulfilled, but the management of the project was ineffective, the Accounts Chamber said in April 2019. The auditors came to this conclusion following an audit of the targeted and effective use of federal budget funds for connecting medical organizations to the Internet in 2018-2019. and monitoring the connection in 2018 of hospitals and clinics to the high-speed Internet.

According to the Accounts Chamber, the Ministry of Telecom and Mass Communications delayed the approval of the schedule for the provision of services for connecting hospitals and clinics to the Internet. It was originally supposed to be ready in 2017. Then the dates were postponed several times, the last date was July 1, 2018. But by this time the department had not had time.

It approved the schedule 3 months later and only after the Accounts Chamber sent a submission to the Minister of Digital Development. The Ministry of Health also did not develop recommendations for the data transfer rate on time.

As of March 5, 2019, the corresponding order was not registered with the Ministry of Justice, although all constituent entities of the Russian Federation have already adopted it, are guided by the requirements of the Ministry of Health, the Accounts Chamber notes.

By decision of the government, the organization of communication channels for hospitals and polyclinics was carried out in two ways: at least 1 Mbit/s using a satellite for hard-to-reach areas and from 10 Mbit/s through fiber-optic communication lines (FOCL). These two methods did not take into account connections in other ways existing in the market, which made it possible to provide a communication channel with sufficient speed and a lower tariff.

The office of a general practitioner in the city of Voronezh was connected to the FOCL back in 2017, but almost from the very moment the equipment was installed by Rostelecom, it is not actually used. The building, where the doctor's office is installed, is also connected by another operator via fiber optic fiber. At the same time, the tariff at a speed of 10 Mbps amounted to only 2 thousand rubles, while Rostelecom requested 7 thousand rubles a month for this speed, - such an example was cited in the Accounts Chamber.

This is a fairly common situation and is caused by the interpretation of the conditions of orders to determine the sole executor: "The connection via the fiber optic network should be organized to the premises where the medical organization is located, it does not matter that the building itself, where it is located, is already connected to the Internet." Connecting only one such office of a general practitioner in Voronezh cost the budget more than 450 thousand rubles.

Since 2017, the trend of loading communication channels has remained low, which indicates the low demand of the provided resource by medical organizations at the moment, the Accounts Chamber states. According to Deputy Minister of Health Elena Boyko, the entire infrastructure and system is being done not for today, but for the future.

The Accounts Chamber especially noted the insufficient planning of allocations by the Ministry of Communications and the Ministry of Finance. Of the 20.4 billion rubles allocated by the budget, at the time of the end of the audit in March 2019, only 6 billion rubles were spent.

At the end of 2019, they will be paid, most likely, to date, have already been paid, another 6.5 billion rubles of the work performed. At the same time, we can already say that 7.8 billion rubles will be underutilized, which once again confirms the insufficient quality of planning both from the Ministry of Communications and the Ministry of Finance, the auditors say.

Deputy Minister of Digital Development Oleg Ivanov, who was present at the board of the Accounts Chamber, where the results of the audit were announced, agreed with its conclusions, the website of the Accounts Chamber reports. In addition, he said that in order to implement new projects to connect objects to the Internet, "the terms of reference spell out other alternative methods of connection that the contractor of this contract can use."

The National Program "Digital Economy" provides for a number of projects to connect social facilities to the Internet, including feldsher points and schools. Risks in the implementation of these projects will be monitored by the Accounts Chamber.

The board decided to send information letters to the President of the Russian Federation, to the Ministry of Digital Development, Communications and Mass Media, to the Ministry of Health and the Governor of the Voronezh Region. The appeal will be sent to the Prosecutor General's Office, and the report to the chambers of the Federal Assembly.

2018

A single biomedical data operator is being created in Russia

On September 26, 2018, it became known about the start of a large-scale project in Russia to create a national operator of biomedical data of citizens. Read more here.

All medical records in Moscow polyclinics will be equipped with RFID tags

On September 24, 2018, it became known that all medical records in Moscow polyclinics were equipped with radio tags. Thanks to the introduction of technology, patient cards can be searched faster, and the risks of their loss will decrease. Read more here.

The Ministry of Health proposed to streamline the interaction of state and non-state MIS

Governments of the Russian Federation Dmitry Medvedev On April 12, 2018, the chairman signed Decree No. 447 on the procedure for interaction between state and non-state information systems in the field. health care The document was prepared by Ministry of Health the Russian Federation. It is expected that the rules approved by the document will allow commercial organizations to create high-quality services for citizens, doctors and medical organizations.

Including the rules establish technical requirements for the information systems of non-governmental organizations that provide services to citizens and medical organizations. According to the decree, at least one of the following functions should be implemented in such systems: organizing an appointment with a doctor and calling a doctor at home; providing medical care using telemedicine technologies; organization of medical services received by citizens of the Russian Federation outside Russia, and by foreign citizens - on the territory of the Russian Federation; organization and maintenance of information exchange in the field of health care; providing analytical information on the services provided by medical organizations; reception of complaints, applications and proposals from citizens and health workers on the provision of medical care; et al.

The decree also defines the procedure for connecting and conditions for interaction of such systems with the Unified State Information System in the field of health care (Uniform State Health Information System), with the information systems of health management bodies of the constituent entities of the Federation, territorial funds of compulsory medical insurance, medical organizations, as well as the conditions for connecting to information systems "electronic government."

Thus, the software, technical and linguistic means of non-state information systems in the field of healthcare should be located in Russia, while compliance with the terms of storage of medical documentation in the form of electronic documents established by law should be guaranteed and the uninterrupted operation of databases should be ensured.

Particular attention is paid to the issue of compliance of such systems with information security requirements enshrined in Russian legislation, including in terms of the protection of personal data and information constituting a medical secret.

In particular, operators of non-state information systems in the healthcare sector will need to ensure: protection of information from unauthorized access, including when it is transmitted via information and telecommunication networks; timely detection of facts of unauthorized access; control over access to documents by logging; automatic verification of qualified electronic signatures of organizations or officials participating in information interaction; interaction with Uniform State Health Information System and state information systems using a secure channel.

As follows from the document, the process of connecting non-state information systems to the Uniform State Health Information System and ESIA will be declarative in nature. Applications from operators will be accepted by the Ministry of Health of the Russian Federation and then sent for consideration to the Government Commission on the use of information technologies to improve the quality of life and conditions for doing business.

You can get acquainted with the text of Government Decree No. 447 here.

Rostelecom became the only Internet provider for healthcare

In March 2018, Prime Minister Dmitry Medvedev signed an order according to which Rostelecom was chosen as the only provider of Internet access services for medical organizations of state and municipal health care systems. 

According to the document published on the website of the Cabinet of Ministers, medical institutions must gain access to high-speed Internet at a speed of at least 10 Mbps using fiber-optic communication lines or at a speed of at least 1 Mbps using satellite lines.

High-speed Internet is needed by medical organizations to develop telemedicine and advise patients by specialists from leading federal and regional medical institutions, the Cabinet of Ministers said.

The list of medical organizations and their structural divisions for connecting them to the World Wide Web will be formed by the Ministry of Health together with the authorities of the constituent entities of the Russian Federation.

The authorities of the constituent entities of the Russian Federation and local governments are recommended to identify responsible persons for coordinating measures to ensure connections, take the necessary measures to ensure the safety of the installed equipment, and assist Rostelecom in the provision of services.

The connection of medical organizations takes place within the framework of the state program "Information Society" (2011-2020), according to which  16.6 billion rubles will be required to connect medical institutions to the Internet: 6.6 billion rubles will be sent from the federal budget, and 10 billion rubles will be extra-budgetary funds.

Back in 2017, Rostelecom was appointed the sole executor of the contract for connecting medical institutions to the Internet throughout. Russia Under the terms of the contract, the operator was supposed to conduct the Internet in 3134 hospitals and clinics by the end of 2017, and, as indicated on the public procurement website, the contract was executed. Thus, Rostelecom remained an exclusive supplier Internet for healthcare for 2018.^[18]

2017: Medical cards of Russians will be transferred to blockchain

In September 2017, it became known about the plans of the Ministry of Health of the Russian Federation to transfer electronic patient cards in Russian medical institutions to a blockchain-based system. Citizens will be able to independently choose with whom they will share personal information. Read more here.

2016: Detailed analysis of public procurement of MIS in Russia for three years

A detailed analysis of public procurement of software and IT services for healthcare is contained in the study of public procurement of software and services for informatization of healthcare in 2013-2016.

2014

Approved "Concept of informatization of regions"

In December 2014, the Government of the Russian Federation approved the "Concept of Informatization of Regions," calculated until 2018. According to her, in the field of health care, regional informatization is carried out taking into account the state program of the Russian Federation "Development of Healthcare," approved by Decree of the Government of the Russian Federation of April 15, 2014 No. 294 "On the approval of the state program of the Russian Federation" Development of health care, "and decrees of the President of the Russian Federation dated May 7, 2012 No. 598"On Improving Public Health Policy "and No. 606 of May 7, 2012"On measures to implement the demographic policy of the Russian Federation "and aims to improve the quality of medical care, including high-tech, the development and introduction of modern methods of diagnosis, prevention and treatment, and increase the efficiency of management of the health care system.

To do this, it is recommended to create and develop at the regional level information systems for supporting medical decision-making and monitoring the implementation of medical care standards, including receiving remote medical advice by medical professionals and patients, information systems for recording medical care provided to patients, information systems that provide remote appointment with a doctor and provide patients with remote access to their medical information (history) and information on received medical services.

It is advisable to provide citizens with access to information on health services provided in the subject of the Russian Federation, on the qualifications of medical workers, the results of the activities of medical and preventive institutions in the region. An effective mechanism for monitoring the volume of medical services provided is to inform citizens through their personal accounts on the Unified Portal about the facts of citizens receiving medical services received by health authorities, as well as to compare, within the framework of the current legislation, the data of medical records, which are maintained in electronic form, with the data of the compulsory health insurance system and the reporting data of medical and preventive institutions.

It is recommended to achieve the efficiency of management decisions by developing analytical tools based on the information contained in the regional component of the unified state information system in the field of health care. To improve the efficiency of medical personnel, it is advisable to create ergonomic automated workplaces that reduce the number of manual operations that take up significant time. In particular, it is recommended to implement electronic prescribing systems integrated with decision support systems in the field of rational pharmacotherapy, maintenance of the patient's electronic medical record and electronic medical history.

In medical institutions of the constituent entities of the Russian Federation, it is advisable to ensure comprehensive automation of the processes of managing a medical institution and providing medical services, as well as the integration of information systems of medical institutions with regional and federal information systems in the field of health care, including providing medical personnel with certificates of electronic signature verification keys necessary for maintaining medical documentation in electronic form.

To reduce the cost of creating and operating information systems in the healthcare sector, the use of "cloud" technologies is recommended, taking into account the requirements of the legislation of the Russian Federation, including the protection of personal data and medical secrecy.

It is advisable for the Ministry of Health of the Russian Federation to ensure the approval of formats for the provision of medical information and documents in electronic form, the procedure for the exchange of such information, as well as the adjustment of the provisions of legal acts in order to ensure the maintenance of medical documentation, accounting for medical information and the formation of reporting forms in electronic form, as well as the exclusion of duplicate submission of these information on paper.

The problem of protecting personal data of patients

According to the experts of InfoTechnoProekt, a number of problems may arise in the implementation of the concept^[19].

One of the main requirements for the system is to ensure the confidentiality of information that is accumulated in large volumes in medical organizations. At the same time, information security issues in the design and operation of health information systems have not previously been a priority, but require close attention when creating a system. In particular, paragraph 8 of the Concept directly defines the need to protect personal data of citizens in the system, which should be provided in accordance with the requirements of the legislation of the Russian Federation, but the authors did not disclose how they intend to do so. The implementation of the above paragraph of the concept will require the resolution of previously accumulated problems of regulatory legal regulation in the field of information security.

The conceptual problem is the implementation of a single regime for the processing and protection of personal data and information constituting a medical secret within the framework of a single state information system. Legal institutions of personal data and medical secrecy have a similar legal nature, but contain slightly different regimes of legal regulation and requirements for the processing and protection of information.

The imperfection of legal regulation in the field of personal data creates a whole range of problems and contradictions that will have to be encountered in the implementation of the concept. There is a clear "lag" of the existing regulatory framework from the intensively developing IT field.

The authors of the concept propose the widespread use of virtualization and cloud computing technologies, in particular, the implementation of infrastructure-as-a-service (IaaS) and software-as-a-service (SaaS) models. The complete or partial transfer of the IT infrastructure of healthcare organizations to the virtual environment of the proposed system, followed by remote processing of data in this environment, promises both advantages and problems of various types.

The absolute advantage of this approach from the point of view of ensuring information security is the possibility of using a single and integrated approach in the implementation of the requirements of the legislation on the confidentiality of personal data and information constituting a medical and other secret. In addition, centralized information protection will significantly reduce the severity of the "chronic" problem of medical organizations, which consists in obtaining licenses for activities for the technical protection of confidential information and activities in the field of information encryption, the use of certified information protection tools and certification of personal data information systems according to information security requirements.

On the other hand, the flexibility and scalability of IT virtual infrastructure makes it difficult to maintain the technical and legal confidentiality of the data being processed. The existing regulatory framework does not meet modern information security requirements. Quite clearly, this discrepancy can be seen on the example of the legal institute for the processing and protection of personal data, the main regulatory legal act of which - Federal Law No. 152-FZ "On Personal Data" (hereinafter FZ-152) - is largely based on the concept of "personal data information system" (ISDS). At the same time, the application of the ISDS definition to the components of the System being created faces many obstacles of a conceptual, technological and technical nature. The current situation is further aggravated by the "backwardness" of requirements in the field of information protection of state supervisory authorities (FSTEC Russia and the FSB of Russia), which, for the most part, rely on the guidelines developed 15-20 years ago by the State Technical Commission and FAPSI, which do not take into account modern realities and development trends. information technology

A similar fate befell the "Methodological Recommendations for Organizing the Protection of Information when Processing Personal Data in Health, Social, Labor and Employment Institutions" of the Ministry of Health and Social Development of Russia, developed in accordance with the requirements of state regulations.

Additional problems are created by the imperfection of the legal tools inherent in the FZ-152. The concept provides for the possibility of using the mechanism for depersonification of personal data by depersonalizing data obtained from medical information systems for centralized processing and storage, as well as when transmitting them via communication channels. Paragraph 8 of Article 3 FZ-152 establishes the concept of personal data depersonalization - these are actions as a result of which it is impossible to determine the ownership of personal data to a specific subject of personal data, which, in turn, allows personal data operators not to ensure one of the mandatory conditions for the processing of personal data - the confidentiality of the data being processed.

Based on the legal definition, impersonation of personal data is an irreversible process, therefore, impersonal personal data cannot be inversely compared with a specific individual and cannot be used to identify the subject of personal data. The impossibility of inverse matching limits the scope of impersonal data to statistical or other scientific purposes. A way out of this situation could be another mechanism of depersonification, different from depersonalization, - data psvedonymization, which allows you to maintain the ability to reverse match pseudonized personal data with a specific person.

The content of paragraph 10 of the Concept - "Main Stages of the System Creation," which lacks the stage of identifying the existing problems of regulatory regulation of relations within the framework of the System being created and finding solutions to the identified problems by improving the regulatory framework, is ambiguous. Which, most likely, will lead to an increase in the time for the development and implementation of the system, the inconsistency of the legal regime of the system, and as a result, an increase in the cost of work.

2013: Review of large contracts worth 4 billion rubles

According to the TAdviser Center, based on the information of the portal of public procurement of the Russian Federation from January 2012 to June 2013, 15 large contracts worth more than 4.415 billion rubles were concluded in the field of informatization of health care in the regions of the country. Most of them concerned the creation and development of regional segments of the Unified State Automated Health System (EGAIS).

15 largest healthcare informatization projects in the regions 2012-first ½ of 2013

№	Project Name	Contract value, rubles	Customer	Signing and Ending Dates	Contractor
1	Automation of regional fragment of EGIS Zdrav	848 130 246	St. Petersburg Informatization and Communications Committee	09.2012 - Completed	Rostelecom
2	AWS supply for medical institutions in Moscow	822 361 885	DIT of Moscow	11.2012-Completed	Technoprogress
3	Ensuring the work of the Moscow EMIAS in 2012	399 900 000	DIT of Moscow	08.2012-08.2013	Electronic Moscow Certification Center
4	Unified Information System in the Healthcare Sector of the Rostov Region	362 020 489	Ministry of Health of Rostov Region	11.2012-12.2012	Rostelecom
5	Support of the implemented components of the first stage of the creation of the Moscow EMIAS Health Care	349 005 265	DIT of Moscow	07.2013-11.2013	CROC
6	Building a regional resource access infrastructure for health facilities	315 580 000	Ministry of Health of the Moscow Region	10.2012-12.2012	Rostelecom
7	Delivery of information and communication system to medical institutions	210 741 302	Altai Krai Main Directorate for Health	05.2012-12.2012	Rostelecom
8	Creation of the citywide information service SIMI EMIAS	205 000 000	DIT of Moscow	09.2012-12.2013 |IBS
9	Creation of the city-wide information service SPU EMIAS	180 000 000	DIT of Moscow	09.2012-10.2013	Medlinsoft
10	Creation of regional segment of EGIS Zdrav	137 442 600	Administration of the Pskov Region	07.2012-12.2012	Pskov GTS
11	Creation of regional segment of EGIS Zdrav	133 804 200	Department of Health and Social Development of Oryol Oblast	09.2012-12.2012	Rostelecom
12	Laying of LAN in medical and preventive institutions of the region]	132 605 063	Department of Health of the Krasnodar Territory	07.2012-12.2012	Technoserv
13	Delivery of computer equipment with software for healthcare institutions	109 954 465	Ministry of Health of Samara Region	09.2012-12.2012	Open Source
14	Delivery of computer equipment	107 807 912	Ministry of Health of Irkutsk Region	09.2012-12.2012	Atis
15	Purchase of Software License Rights	101 000 000	Ministry of Health of Kamchatka Krai	06.2012-06.2012	AWS JV

TAdviser Center, 2013

2012

Criticism of the progress of health informatization

According to A.V. Gusev, Ph.D., Deputy Director for Development "Complex Information Systems" and M.M. Elyanov, Ph.D., President of ARMIT^[20]2012^[20] implementation of the program actually begins with the following results:

• Of the 2 years allotted for informatization (2011-2012), 9 months (i.e. 37.5%) were spent on the development of guidance documents and the coordination of work plans by the relevant ministry, although initially management decisions at the level of the President and the Chairman of the Government, apparently, were adopted in the spring of 2010.

• The initially formulated task of introducing electronic medical histories, telemedicine, reference systems, and electronic registrars, which was formulated by the president at a meeting of the Council for the Development of the Information Society in Tver on July 8, 2010, for 2010-2011, was transformed into the introduction of statistical accounting systems for the internal needs of the Ministry of Health and Social Development related to the health department .

• Work on the project went on and continues to go exclusively in the bowels of the Ministry of Health and Social Development: there was no full-fledged public discussion and involvement of experienced specialists in the development of the "Concept" and "Methodological Recommendations."

• The informatization of the regions began in the absence of official and full-fledged guiding documents: there was no intelligible program for creating a federal segment of the system, "Methodological Recommendations" were not officially approved and in mid-November had the status of a "project."

Which regions are lagging behind in mastering IT budgets in health

Moscow ranks first among the regions of the country in which funds from the federal budget allocated for the modernization of health care are poorly mastered. Over the year, the capital spent only 9% of the allocated amounts on the implementation of the program. This was stated on June 26, 2012 at a parliamentary hearing on the modernization of healthcare, the auditor of the Accounts Chamber of the Russian Federation Vladimir Katrenko^[21]

After Moscow, Kaliningrad, Sverdlovsk, Tula regions, as well as Kabardino-Balkaria are on this list. In these regions, budget money is spent by 23-25%. In general, according to the Accounts Chamber, all subjects of the Russian Federation could not fully implement the measures provided for by the program. In 2011, the regions spent only 59.4% of the total planned funds. At the same time, the smallest amount of expenses falls on the introduction of modern information systems.

Thus, in 12 regions, including Amur, Astrakhan, Belgorod, Vladimir regions and St. Petersburg, during 2011, the construction of not a single planned facility was completed, and in 14 regions less than 30% of the planned areas were repaired. As Katrenko noted, violation of the deadlines led to a long-term exclusion from the medical process of medical premises, an increase in the waiting period for patients for planned hospitalizations and a restriction on the availability of medical care.

In addition, the amount of additional payments to specialist doctors lagged behind the planned level by more than a quarter. At the same time, the increase in wages occurs unevenly across regions and institutions. According to Katrenko, quoted by RBC, such a trend could cause personnel migration, which, in turn, will lead to a decrease in the level of medical care for the population.

The implementation of the healthcare modernization program began in April-May 2011, when the process of signing relevant agreements with the regions was completed. The main provisions of the proposed modernization were enshrined in the federal law "On Compulsory Medical Insurance." Funds of the MHIF, funds of the federal budget, as well as funds of territorial funds were fixed as sources of financing. At the same time, the main share in financing the program, about 64%, falls on the funds of the MHIF. In total, 625 billion rubles are supposed to be spent on the modernization of healthcare.

In March 2012, representatives of the Ministry of Health and Social Development announced that they plan to introduce strict control over IT projects^[22]. The increased attention of the Ministry of Health is guaranteed by comprehensive procurement, where, within the framework of one procedure, services are ordered to create regional segments of the Uniform State Health Information System, including at the same time the construction of data centers and SCS, and equipping medical institutions with computer equipment, and the development and implementation of MIS.

2011: MHIF plans to spend 24 billion rubles on IT in health within two years

As it became known in May 2011, it is planned to allocate 24 billion rubles to the program of informatization of health care only from the Federal Fund for Compulsory Health Insurance within two years. In addition, the regions also plan to allocate about 10 billion for these purposes^[23].

Notes