Health Care Digitalization 2024 Review

Digitalization of health care received a powerful impetus for development around the world during the Covid-19 pandemic, and Russia was no exception. Have the pace of digitalization decreased today, and what new trends have captured the industry - we talked about all this with market experts.

1 Digitalization Markets Volumes in Medicine

According to feedback from specialists, the amount of funding for the industry around the world continues to grow. Data on the costs of digitalization of healthcare in Russia vary depending on the sources and methodologies of assessment.

As Elvira Gilmanova, Deputy General Director of BARS Group, said, in 2023, the cost of digitalization of medicine worldwide is estimated at $200-250 billion (significant contribution is made by the United States, China, the EU), and in Russia, according to optimistic estimates, at the level of ₽50 billion. In 2024, the world market may reach $300-350 billion, while in the Russian Federation it is expected to grow at the level of 15-20%. The digital healthcare market is expected to grow by 20% in 2025.

Elvira Gilmanova believes that the healthcare industry in the Russian Federation has maintained high growth rates since the launch of the first federal project in 2012 to develop digitalization, and Russian software has been in great demand. Unlike other industries, the healthcare digitalization market today has many serious Russian products in demand both in Russia and in friendly countries.

It is no coincidence that Russian AI services in the direction of analyzing medical images have been actively developing for several years, the expert noted.

According to Andrei Ivashinnikov, Deputy Director of the ICE for Digital Transformation at the Khost Group of Companies, the main injection of funds into the digitalization of healthcare in the Russian Federation in 2023-2024 should be attributed to the federal project to create a single digital circuit on the EGIS platform in the healthcare sector. In accordance with the project passport, the consolidated budget for the project in 2023 amounted to ₽5 830.65 million, and in 2024 - ₽5 778.51 million. At the same time, the total project budget from 2018 to 2024 reached more than ₽88 billion.

In 2025, as part of the implementation of the strategic direction of the digital transformation of healthcare, approved on December 29, 2021 by Decree No. 3980-r of the Government of the Russian Federation, a new key strategic project "Digital Platform" Health "of the national program" Long and Active Life "for 2025-2030 begins, which is a logical continuation of the previous one.

So far, only the federal component of the budget is known, which will be aimed at the development of services and systems of the federal digital platform "Health and GIS OMS." The creation of the digital platform "Health" is laid down by the federal budget in the amount of ₽35 billion and extra-budgetary funding (entirely for GIS OMS services) in the amount of ₽19,44 billion for five years.

Of these funds, ₽29,92 billion from the Fed. the budget will be allocated to the federal digital services of this platform. Also, part of the budget in the amount of ₽2,08 billion will be spent on the industry security system and ensuring the functioning of the industry secure data network.

Investments, both state and private sector, are in the stage of steady growth, - said Alexander Chesnokov, head of the market group at SP.ARM. - More companies that have not previously seen investment attractiveness in healthcare are investing in automation tools, AI-based software products, and services that further digitize healthcare business processes and ultimately influence the improvement of healthcare delivery.

The expert confirmed that the state's interest in digitalizing health care remains high. The topic of digitalization of health care is heard in several national projects. The desire to improve the quality of health services, to make them more accessible to the population, especially in remote and sparsely populated areas, is an important state task. Since the practice suggests that digitalization allows for a significant optimization of resource management processes, reducing administrative costs and improving coordination between medical institutions at the federal and regional levels.

It is important to note that the state is very interested in the digital transformation of healthcare, - said Mikhail Goncharuk, project manager of the voice digital technologies department at BSS.

According to the expert, the state is well aware that the digital infrastructure is able to significantly increase the availability and quality of medical services, reduce costs and improve the overall epidemiological situation. Therefore, the government makes this area a priority, develops and supports digitalization programs, allocates significant funds for the development of infrastructure and the introduction of new technologies. Investments in the digitalization of healthcare remain at a high level. First, the state continues to fund programs to modernize medical facilities and introduce new technologies. Secondly, the private sector is actively investing in startups and companies working in the field of telemedicine, AI development and other areas of digitalization. It is expected that in the coming years the volume of investment in this area will only increase, given its strategic importance and long-term prospects.

As Alexander Gusev, Development Director of Webiomed, said, the global AI market in the healthcare sector grew very quickly, in 2023 it was estimated at $21 billion, and from 2024 to 2030. it is expected to grow by an average of 35%, market capacity should reach $180 billion by 2030. The growth is due to the development of digital technologies, growing demand for personalized medicine, the need to reduce healthcare costs ^[1]. The expert cautiously suggested, based on the dynamics of the revenue of the developers of the relevant solutions, that the volume of the Russian AI market in medicine could range from ₽900 million to ₽1 billion.

Another opinion is Mikhail Goncharuk, project manager of the voice digital technologies department at BSS. Based on various sources, the expert suggests that the volume of the AI market in Russian healthcare is about 10-15% of the total IT market in the country, and here we should already talk about tens of billions of rubles. The main growth drivers are government programs to support the digitalization of healthcare, as well as initiatives by private companies and startups working in this area.

Mikhail Goncharuk suggested that the volume of the global AI market in healthcare in 2020 could be about $6 billion, and by 2027 should reach $45 billion, demonstrating a CAGR of about 40%. According to the expert, such indicators are associated, among other things, with an increase in the volume of medical data, the development of technologies for their processing and analysis, an increase in the effectiveness of diagnostic and therapeutic procedures, the availability of a wide range of AI applications that help to diagnose diseases, develop drugs, manage clinical data and provide support in making medical decisions.

27 companies provided TAdviser with data on revenue from the implementation of IT projects in healthcare. The leader of the rating was the company "Tsifromed" with revenue over 7 billion rubles.

The top three also included RT MIS and BARS Group. The RT MIS company was implementing an important project to introduce a new medical information system in the regions of the Russian Federation. For BARS Group, federal and regional medical digital projects are a key area.

According to the TAdviser project database, among the various classes of IT solutions in the healthcare industry, enterprise resource planning (ERP) systems, video conferencing systems, as well as electronic document management (EDMS) systems and business process management are most in demand. It is these solutions in the TAdviser database that account for the largest number of projects completed in healthcare.

For each class of IT systems implemented in certain industries, the TAdviser database allows you to identify the most popular solutions and vendors of these products. See the charts below for which companies develop the systems most commonly implemented in health care.

Digitalization of the industry retains the potential for growth. In 2023-2024 the following sectors of the Russian digital healthcare market received the greatest development: systems using artificial intelligence (more than half of the products invested); import substitution and own developments in the fields of medical equipment and medical products, domestic wearable gadgets of various directions, ensuring information security.

pandemic Previously, coronavirus infection has become one of the most powerful triggers of deepening digitalization and a new reality. But today digitalization is pushed forward, first of all, by technology. In Russia, the areas in which there was the most close control from the outside developed better. Ministry of Health RUSSIAN FEDERATION

In addition to AI, we are talking about the development of electronic medical records (EMZ), the market for wearable devices and applications for smartphones for self-monitoring of health. Also important is the impact of BI tools that allow you to build analytical panels and analyze data in various sections (for making more informed clinical and management decisions by employees of medical institutions and officials). It is also worth noting digital tools for managing voluntary health insurance, digitalization of medical examination. The development of MIS is relevant in terms of the transition of medical organizations to EDO and much more.

One of the most promising development drivers in the medical industry and pharmaceuticals is the introduction of artificial intelligence technologies and big data analysis. AI, ML and Big Data are used to analyze X-rays, MRI, CT and other medical images to identify latent patterns and predict diseases in the early stages, to analyze large amounts of medical information from sources such as electronic medical records (EMR), in fact laboratory diagnostics, medical research. Systems for supporting medical decision-making (SPMS) with AI, as well as "digital twins" can be promising.

The demand for AI technologies in the digitalization of healthcare, as in other industries, is of interest to customers, said Vladimir Turin, system architect of Netrika Medicine. Whether interest is due only to fashion trends or objective practical necessity, it happens in different ways. But the use of AI technologies in any BI solution is today an undeniable competitive advantage, and tomorrow it will be just a necessity, the expert noted.

It was difficult to call AI promising or mandatory for implementation quite recently, because in 2022 it was impossible to talk about some significant accumulation of structured data for analysis.

According to Alexander Gusev, Development Director of Webiomed, at the moment there are over 60 companies on the Russian market offering various AI systems for medicine and healthcare. Roszdravnadzor issued 37 registration certificates for medical devices with AI, 32 of them are domestic developments. Most of these decisions analyze medical images. At the same time, there are products for analyzing electronic medical records, systems for processing ECG data and video images, solutions for call centers, speech recognition, etc.

In 2023, the healthcare system of the Russian Federation made a significant breakthrough in terms of the practical introduction of medical devices with AI. The implemented procurement and implementation projects are the basis for subsequent industry development. At the end of 2023, 84 constituent entities of the Russian Federation fulfilled the minimum established indicator in terms of the purchase of honey. articles with AI. Within the framework of the state procurement procedures provided for by law, 106 state contracts were concluded for the purchase and implementation of such products for a total amount of 448.43 million rubles^[2]

Alexander Chesnokov, head of the market group of SP.ARM, noted such areas of application of AI: assessment of drug compatibility, construction of forecast models based on Big Data, for example, on the development of the epidemiological situation; using GPT chat inside the IIA: both for the doctor and in the personal account for the patient; identification of risk factors for disease or disease; speech analytics for self-diagnosis of patients; video analytics with forecasting the development of the situation.

As Andrei Ivashinnikov, deputy director of the ICE for digital transformation of the KHOST Group of Companies, said, until recently, the main use of AI was the second opinion in the analysis of DICOM images obtained as a result of instrumental studies. With this, it all started back in "covid" times and even earlier, when the degree of lung damage, the degree of brain damage as a result of acute cerebrovascular accident were determined using AI (ONMC), looked for all kinds of abnormalities in the development of the lungs, heart and vessels in chest images, etc. AI is used as an assistant in determining the diagnosis of the disease, to analyze unstructured medical records by comparing with arrays of reference clinical data of patients. The introduction of speech technologies using AI in internal processes to automate routine operations is becoming popular.

AI significantly reduces the burden on both administrative personnel and medical personnel, which is extremely important both for government agencies (where quality and speed of service are important) and for the commercial sector (where efficiency and personalization of service are in price).

Virtual assistants in voice (virtual assistants) and text (chat bots) channels allow you to seriously automate typical requests and significantly relieve the load on operators, said Mikhail Goncharuk, project manager of the voice digital technologies department at BSS. According to him, the complete automation of patient requests using virtual assistants reaches 70%, and a case in the Tula region is a vivid example .

The voice assistant of the Ministry of Health of the Tula region in its region daily advises citizens on 30 topics of popular issues and independently processes up to 9 thousand incoming and up to 11 thousand outgoing calls. He processes up to 70% of all requests from citizens independently without human participation. This helped to seriously unload operators, reduce the load on them in peak situations.

The expert also cited the Perm Ministry of Health as an example, which, using robotic outgoing calls, was able to free up more than 40% of the busy schedule for doctors. This means that free slots quickly became available for recording to other patients. The use of speech technologies allows you to control the availability of free slots for appointments with specialists, record on freed other patients, regulate the queue of patients from the "waiting list" and increase the availability of medical care.

In addition, speech analytics is being introduced in medical institutions, which helps to improve patient care, detect problem places and growth points, and implement best practices. Outgoing calls make medical examination more effective.

AI is actively used to help in analyzing patient information, to record a history with highlighting critical moments for the patient, promptly provide an appointment/vaccination/medical examination, call a doctor at home at a not very clearly stated address, recognize the "popular" names of LPUs, streets, etc., quickly search for the most convenient slot for the patient, taking into account his preferences and regional features.

Our company leads in this part, providing the opportunity to use large language models and RAG (a method of working with LLM, which does not allow the neural network to invent answers and limits the responses of the neural network to certain content loaded into it) into the customer's loop. This helps to automate the provision of information on any databases, both for internal and external services, - said Mikhail Goncharuk.

AI bots for voice and text channels of the company are able not only to answer standard customer questions, but also to solve much more complex problems without algorithms for building dialog scenarios, based on RAG (Retrieval Augmented Generation) and LLM (Large Language Model) technologies.

Using large language models (LLMs) for comprehensive speech analysis helps determine the emotional temperature and level of customer satisfaction. The Voice Analytics and Automated Quality Control system analyzes operator-customer interactions using neural networks and LLM technologies, helps to find incorrect answers, identify weaknesses in dialogues, and offers scenarios to improve the consulting service.

The "operator prompter" Block implements intelligent hints in real time: based on the analysis of data on the current conversation and the experience of previous interactions, the consultant is offered optimal scenarios.

The use of an intelligent knowledge base also significantly increases the speed, relevance and accuracy of operator responses. Omnichannel automated workstations (AWS) of operators make it possible to significantly increase the efficiency of their work, improve the quality of customer service and optimize processes within the company.

And all these components can be installed in the closed loop of the customer.

As Nikolai Apurin, director of Artwell, said, AI is able to collect and categorize patient appeals, build an all-Russian rating of doctors and even assess the quality of medical care.

And this is not all help from AI in medicine, which is actively used today.

Digitization of classic patient medical records and the formation of fully electronic, integrated data collection and management systems, software products to help physicians make diagnoses (SPTD) - this digitalization front is very important and is designed to optimize patient management, quality control of service delivery, reduce human error, collect and analyze information faster, which can be critical in epidemics, but also useful for "routine" application, conducting research, prompt diagnosis.

EMR have accelerated the paperwork. The implementation of EMZ improves the management of medical data. EMZs provide rapid access to the patient's medical history, which speeds up diagnosis and treatment. EMZs also promote better interactions between different health facilities and specialists, which is particularly important for patients with chronic diseases or complex medical cases. Current EMZ systems include data analysis functions, which helps identify trends and predict disease outbreaks.

The expansion of functionality and the filling of the unified state information system in the field of health care (Uniform State Health Information System) with new arrays of information allows through API and integration buses to automate even more topics of robotic service, as well as make patient care more personalized. Analyzing more customer information allows you to build predictive service models.

The plans of the Ministry of Health of the Russian Federation for the development of Uniform State Health Information System can be found at the disposal of the Government of the Russian Federation No. 959-r^[3] accordance with the strategic direction of digital transformation, it is planned to introduce patient-oriented services on the unified digital platform "Health" aimed at analyzing the primary accumulated data (primarily through SAMD) for disease diagnosis, drug provision planning, proactive health monitoring and remote follow-up of patients with chronic non-communicable diseases.

In 2024, the federal project "Creation of a single digital circuit in healthcare on the basis of a single state information system in the field of healthcare (Uniform State Health Information System)" was completed^[4] The results of its implementation require a comprehensive assessment by specialists, and you need to wait for the results, said Dmitry Zima, General Director of RT MIS. In terms of the subjects operating the GIZ based on the decisions of RT MIS, the expert allowed himself to summarize some of the results.

We ensured the compliance of regional systems with the requirements of the Uniform State Health Information System. IT infrastructure is deployed in all regions of our presence, all medical organizations today can completely abandon paper document management, provide, among other things, interdepartmental electronic interaction, - the expert shared.

According to him, EHR is the basis for building digitalization. In industries health care the regions of operation, the company ensured the entry of complete information on the state of health of patients and the amount of medical care provided. As a result, a huge and conditions have been created database for the further accumulation and analytics of this information. That is, today EMR is already a reality.

We provided access to EMR data for patients. Through regional health portals or a personal account on Public services, each patient can familiarize himself with his EMR: cases of treatment, examination protocols, appointments, clarify the attachment site and make an appointment with a doctor, - confirmed Dmitry Zima.

Further, the direction will develop towards planning and implementing projects to improve EMR data analytics tools, ensure the availability of accumulated information for the patient, ensure the availability and expansion of the range of medical services, and develop the use of AI technologies in the analysis of the accumulated data array in EMR.

Over the past 2 years, digital tools such as electronic medical records (EMZ) have become the most popular classes of IT systems and software in the digitalization of medicine, providing centralized access to patient data and improving treatment coordination, "commented Elvira Gilmanova, Deputy General Director of BARS Group.

A promising world direction in medicine can be called IoT. In the Russian Federation, the name "digital medical assistants" exists: equipment for remote monitoring of the state of patients, functional wearable gadgets, such as smart bracelets, heart rate monitors, glucometers and tonometers, are able to conduct monitoring, collect statistics on the state of the patient, monitor vital signs at home and integrate with medical information systems (MIS).

Their main tasks include observing the clinical indicators of the device owner, responding to critical conditions. Remote health monitoring can be configured to collect data on blood pressure, blood sugar, heart rate, and other parameters. This data can be transmitted in real time to health care providers for immediate response in the event of worsening patients, especially when it comes to diabetes, cardiovascular disease.

The widespread use of medical and "near-medical" devices with the ability to take indications without an appropriate medical specialist is also accompanied by the use of analysis services for a large amount of data obtained using AI. These digital services and systems are designed to assist in medical decision-making.

In addition, the marketing direction is also developing. Healthy lifestyle apps (MyFitnessPal, Welltory and the like) help users monitor physical activity levels, nutrition, sleep, and get recommendations to improve overall health. The market for wearable devices and mobile applications for self-monitoring of health is growing, contributing to increasing patient activity and improving their involvement in the treatment process. IoT systems allow patients to self-monitor their condition and seek medical attention in a timely manner.

In Russia, the need to use technologies of this direction is noted by the national program "Long and Active Life" for 2025-2030, within the framework of which it is planned to purchase and use relevant medical devices, including in the form of digital services working with digital assistants. Financing the implementation of these services and their practical application was initially provided for from the budgets of the constituent entities of the Russian Federation.

According to Andrei Lezin, head of the mobile development department of the IT company SimbirSoft, equipping medical organizations with high-quality mobile devices is partially solved. In 2023, many companies began offering remote monitoring solutions such as CardioQVARK ECG bracelets, Accu-Chek and OneTouch Select Plus glucometers, Omron M7 Intelli IT smart tonometer. However, while the interpretation of data coming from such devices requires software refinement. Automation of the data interpretation process and integration with IIA remain important tasks for the coming years.

As Andrei Ivashinnikov, deputy director of the ICE for digital transformation of the KHOST Group of Companies, said, there is a problem of choosing and equipping medical organizations with mobile devices. The fact is that the supply of medical equipment and the supply of software are often funded by various federal and regional projects. For example, the supply of equipment such as ECG devices is the federal project "Fight in Cardiovascular Diseases," and the development and implementation of remote monitoring programs is the project "Creation of a Single Digital Health Care Circuit on the Uniform State Health Information System Platform." From the point of view of budgeting, it is impossible to jointly purchase and implement complex solutions. As a way out, the expert proposed to establish at the state level requirements for unified data exchange formats for medical devices for monitoring health indicators (such as DICOM for radiology) and create multi-vendor systems for storing and processing readings.

Andrei Ivashinnikov noted that in order to develop the direction of using mobile medical assistants, their methodological support is necessary with the inclusion in the procedures for providing medical care. We are talking, for example, about the use of one or two-channel ECG removal devices, devices with non-invasive measurement of blood glucose levels.

Otherwise, this direction will remain "commercial toys," despite the fact that these devices are undoubtedly progressing in terms of expanding the list of captured data and, more importantly, in terms of developing methods for analyzing captured parameters - such as HRV (heart rate variability), the expert emphasized.

In 2023, costs in the global telemedicine market for emergency care reached $11.1 billion, an increase of 15% year-on-year.

In Russia, remote communications between employees of medical institutions, who received a powerful impetus during the pandemic period, took root so much that they became familiar.

Today we are talking about a slightly broader task: providing remote access for employees of medical institutions to all key information systems that are necessary for field work. Providing advice to patients who are in other regions or unable to physically visit a treatment facility is particularly relevant. Patients appreciated the convenience, and medical institutions were able to expand access to their services without the need for a face-to-face visit.

After the transition from a pandemic to a seasonal period with the transformation of the Covid-19 virus into softer forms, in addition to remote monitoring of patients, such digital solutions as remote rehabilitation programs for patients have become in demand, since the consequences of a pandemic are complications of chronic diseases in a large number of comorbid patients who have undergone covid and, as a result, increased "delayed" mortality. All this dictates the application of modern digital solutions related to the mass observation of patients in certain risk groups.

In addition, in connection with the SVO, there is a need for consultations with psychotherapists, psychologists, primarily related to post-traumatic syndrome, which can be implemented, including through telemedicine consultation services, - said Andrei Ivashinnikov, Deputy Director of the ICE for Digital Transformation of the KHOST Group of Companies.

Telemedicine is convenient for people with disabilities, reduces the burden on health facilities and allows doctors to serve more patients in less time. Its development includes improved video conferencing, the development of specialized applications and integration with electronic medical records systems.

Since the pandemic, telemedicine has greatly expanded its impact. Along with state initiatives, private telemedicine platforms appeared on the market: SberHealth, Doctor Nearby and others.

To date, we can say that telemedicine has firmly entered the toolkit of doctors. It "substitutes the shoulder" with a lack of competencies and allows you to get a "second opinion" if there is a need for this.

In the face of growing demand for remote consultations, telemedicine platforms have become a key tool in medical practice, "said Andrei Lezin, head of mobile development at IT company SimbirSoft.

As Andrei Ivashinnikov said, in 2023-2024, telemedicine practically did not develop functionally. The medical community uses telemedicine technologies in the same way as 5 years ago, and the idea even sounds that in the current implementation telemedicine consultations should completely "leave the stage," giving way to proactive remote monitoring of health indicators.

An analysis of the use of telemedicine consultation systems conducted by us in the regions where solutions are present on our Medvedev platform shows that state health care mainly prefers the interests of the doctor to the interests of the patient - therefore, at the teleconsultation "doctor-patient" compared to face-to-face reception, little time is allocated, compulsory medical insurance tariffs do not motivate remote interaction, not all telemedicine services available from the regions are used, the expert emphasized.

According to him, commercial teleconsultations with narrow specialists to obtain a second opinion seem to be a rather promising direction. The Ministry of Health of the Russian Federation pays little attention to the development of paid services services in state health care, leaving this at the mercy of the medical organizations themselves, depriving citizens of a convenient choice of receiving medical care on the one hand, and leaving these services in a "gray," poorly controlled zone on the other.

The departure of world software and equipment manufacturers, as well as sanctions, did not significantly affect the automation of citizen services, said Mikhail Goncharuk, project manager of the BSS voice digital technology department. In his opinion, domestic solutions have become much more in demand, and the departure of world software manufacturers has seriously stimulated the growth of local vendors, especially since domestic solutions for digitalizing patient care have not previously been inferior in quality and manufacturability to foreign counterparts.

When discussing projects, customers are necessarily interested in whether the product is domestic, the expert shared.

The process of switching to domestic software is very laborious, said Vladimir Turin, system architect of Netrika Medicine. In the field of digital transformation of public health, the company's specialists faced the need to replace the components of BI systems.

All technologies, database management systems, operating systems shall be Russian. And this is the main difficulty of import substitution - all services related to BI have to be changed, - the expert noted.

Of course, the sanctions influenced the Russian IT industry, as well as the medical sector and the pharmaceutical sector. This challenge accelerated import substitution, which began much earlier. Under the conditions of sanctions pressure, companies began to actively revise their IT strategies, replacing foreign solutions with domestic counterparts, and also pay great attention to the safety of internal systems and data storage. Requirements for the organization of CII facilities push manufacturers of domestic software to active technological partnership.

Pharmaceutical companies were forced to look for new ways to maintain the stability of their IT infrastructures. This gave impetus to the introduction of domestic software solutions in production management, logistics, distribution and research projects.

We see in this industry an increase in interest in Russian manufacturers of server and network equipment: almost every large company has already tested equipment options from Russian vendors, and some have already begun large-scale replacement projects, "said Vladimir Eronin, director of business development at Kraion.

The expert noted a significant increase in the number of Russian IT developers who offer competitive solutions for the pharmaceutical sector, including laboratory management systems, quality control solutions, electronic document management and big data analytics. Vladimir Eronin also emphasized the important role of state programs to support the IT sector and the active development of import-substituting products.

As for the situation with the Russian MedTech, it is obvious that every year the share of domestic software is growing. And it can be noted that the state is playing an increasingly active role in the development of the Russian MedTech sector. This gives new opportunities not only to the main players in the market, but also to various startups, - said Alexander Chesnokov, head of the market group at SP.ARM.

Our customer requires the construction of unified business processes with a high level of information security based on import-independent solutions. The norm is a solution in which the result is products already tested for compatibility, without experiments at the customer's facility, - said Dmitry Zima, General Director of RT MIS.

According to the expert, the ECP.MIS solution was modernized in advance and tested for compatibility with the operating system from Red Software and the Postgres Pro Certified DBMS. Today, customers have the opportunity to operate systems based on ECP.MIS, subject to full compliance with the requirements of Presidential Decree^[5] of the ^[6]."

For the first time, import substitution, including software, began to be actively talked about in 2015, when federal law No. 149-FZ "On Information, Information Technologies and Information Protection" was supplemented with Article 12.1 on the unified register of Russian software.

At the same time, by the Decree of the Government of the Russian Federation of November 16, 2015 No. 1236, a ban was established on the admission from January 1, 2016 of software from foreign countries for procurement to meet state and municipal needs. The ban worked if the purchased software had an analogue included in the registers of Russian or Eurasian software maintained by the Ministry of Digital Engineering of the Russian Federation. Therefore, in the pre-prepared public sector, the care of foreign software is not as tangible as in private.

In terms of imported hardware, the situation is significantly worse, since its own production of computing and communication capacities requires the development of related domestic technologies.

In the meantime, we are getting out of the situation due to imported products and components from friendly countries and with the help of parallel imports, - said Andrey Ivashinnikov, Deputy Director of the ICE for Digital Transformation of the KHOST Group of Companies.

If we talk about import substitution of the medical products themselves in a broad sense, in November, with reference to the Ministry of Industry and Trade, Izvestia reported that at the beginning of 2024, only about 25% of products were replaced in medicine, progress is being undermined by personnel shortages and other barriers^[7].

Despite this, relatively modest, indicator, changes still occur. So, for example, in 2024, a factory for the production of medical devices was launched in the Sverdlovsk region.

If we talk about the domestic market for medical equipment and medical products, it is at a stage when the share of Russian production and adaptation has been growing steadily for several years. It is predicted that this trend will continue for some time, - commented on this issue Alexander Chesnokov, head of the market group of SP.ARM.

One of the modern constants of Russian reality is the factor of various threats to digital security. In this context, today Russian companies are the most attacked in the world. The main driver that activates the emergence of more and more new projects is not so much a trend towards import substitution as just an unprecedented level of threats in the field of cybersecurity.

We constantly see the manifestations of these attacks from our customers and help them protect themselves from them, "said Vladimir Eronin, director of business development at Kraion.

Ensuring the protection of personal data of patients, large amounts of medical data, and simply maintaining the availability and operability of information systems of medical institutions has become a priority for medical organizations and providers of digital solutions.

Information security is an area in which previously the positions of Russian vendors were very strong: Kaspersky, Positive Technologies and other companies are known not only in the Russian market.

The development of digital tools for the management of voluntary health insurance (VHI) allows for improved access to insurance services and simplifies the process of obtaining medical care. In terms of digitalization of health insurance, there is a large demand for speech technologies for customer service, as Mikhail Goncharuk, project manager of the voice digital technologies department at BSS, spoke about.

I will say from my experience that we, for example, have actively introduced virtual assistants in the text channel in leading insurance companies to provide integration services to subscribers both in the mobile application and on official websites, the expert noted.

From interesting and promising areas, he noted solutions for managing supply chains and logistics in healthcare, platforms for managing the quality of medical care, robotic surgical systems.

According to Alexander Chesnokov, head of the market group of SP.ARM, the processes of digitalization in the field of medical insurance are deepening, there is a simplification of business processes and departure to electronic document management.

According to the specialist's forecast, in 2025 the following IT systems will be the most developing and in demand in medicine: AI-based solutions for analyzing medical images and EMR data, assessing drug compatibility, predicting the epidemiological situation, using drugs in development; medical wearables synchronized with the MIS; telemedicine services; mobile health apps; MIS and its components; Various analytics services and tools cloud technologies; information security.

Among other trends, Alexander Chesnokov noted that biotechnology and demanded pharmaceuticals received obvious development.

According to Andrei Lezin, head of the mobile development department at IT company SimbirSoft, blockchain technologies and quantum computing are beginning to attract attention in healthcare. For example, MedRec is one of the first blockchain-based platforms designed to store and manage electronic medical records; secures data, protecting it from hacking and unauthorized access.

Andrey Ivashinnikov, Deputy Director of ICE for Digital Transformation of KHOST Group of Companies, noted the promise of resource management and planning systems - ERP. First of all, the emphasis in the development of systems concerns the optimization of patient admission planning and examination, accounting and planning of preferential drug provision and medical products and components. Also, according to the expert, EDMS systems were developed, primarily in terms of medical documentation management, including at the federal level.

As for the future development, then, of course, I want to see the transition of state medical organizations to CRM systems, as a more patient-oriented class of systems to support the effective provision of medical services, "said Andrei Ivashinnikov.

According to Elvira Gilmanova, Deputy General Director of BARS Group, organizational approaches are changing in healthcare today. Previously, the system worked around a medical organization and a doctor, but now there has been a transitionto a "patient-centric" approach. The next step is to organize health care around the patient and his family. The development of digital services parallels this trend.

Services will be actively developed to identify risks and prevent diseases, as well as a person's conscious attitude to his health. The growth of data and the assessment of their quality will allow not only to improve predictive health analysis, but to find the most effective economic routes for the health care system.

Statistical reporting will become more transparent, allowing you to "go down" to the primary data, and each indicator will be formed from a clear methodology and understanding of the sources of information. It is this that can become the basis for the formation of a data economy.

At the moment, it is critical to work on the quality of data that is aggregated in large numbers in various information systems (MIS, LIS, etc.), and on the basis of which, among other things, various innovative services are built (for example, using AI).

It is the quality of data today that is the main driver of development. How can data quality be assessed? Through digital routing. The digital route is the automated construction of the patient's clinical route, based on the orders of WMD (provision of medical care) and clinical recommendations; and control of deviations of these orders and recommendations, - said the expert.

Further, on the basis of "clean" data, SPTPR and AI-based services should be developed to improve the quality of medical care, Elvira Gilmanova believes.

Also, according to the expert, the industrial medicine market is currently actively developing. Approaches and even definitions are changing. If earlier industrial medicine was more related to the system of labor protection and safety, now more and more talk about models of "health saving" and risk-oriented approaches to employee health.

Alexander Gusev, Development Director of Webiomed, said that since 2018, his company has been developing the Webiomed predictive analytics platform, which is designed to collect, validate and analyze impersonal medical data in order to support medical and management decision-making in the healthcare sector. The solution was introduced in 38 constituent entities of the Russian Federation and is a leader in the Russian AI market for healthcare. The platform's functionality includes the collection and processing of impersonal medical data, the extraction of features using AI technologies and their automatic verification and cleaning, the formation of a patient's digital profile, the creation of datasets based on profiles based on specified parameters, as well as functionality for the automatic interpretation and analysis of formed profiles, including using AI technologies and predictive analytics.

Alexander Chesnokov, head of the SP.ARM market group, noted that SP.ARM is constantly working not only to improve service and increase market share, but also constantly develops and improves its multifunctional medical system qMS, many of its components and integration solutions. In addition, the company is doing a lot of work to expand its partner portfolio and find new product applications.

The qMS medical information system includes, as an independent unit, a full-fledged laboratory InformSystem (LIS), which, according to market representatives, is one of the most fully functional for specialized institutions. The product is able to simultaneously close the tasks of medical and comprehensive rehabilitation, including early assistance to children and their families. At the same time, health care, social and educational spheres are included in interdepartmental interaction at the regional level and joint work. The portfolio of integrated services contains solutions based on artificial intelligence: SPVR, prediction of hospitalization, speech analytics. Work is underway to implement and use GPT chat. Much attention is paid to various summary and point analytics and the construction of analytical slices and dashboards. MIS qMS uses its own DBMS M.Base (both products are included in the register of domestic software). On an ongoing basis, SP.ARM specialists update and supplement the technological stack. New software modules and services (for example, IT monitoring) are developed, packaged and offered to the market.

Ultimately, through the instrumental environment that underpins the product, the system is a high-tech tool for digital healthcare transformation and helps improve the quality of care delivery.

Andrei Ivashinnikov, Deputy Director of the ICE for Digital Transformation of the KHOST Group of Companies, said that the group is engaged in the design IT infrastructures and supply of communication and computing equipment, as well as the development and implementation. software In terms of development ON , the main direction is digital solutions in the field. health care At the moment, the company considers the most promising areas to be telemedicine consultation systems, remote monitoring of health indicators on its own platform "Medved.Telemed." as well as solutions for organizing information interaction UNIFORM STATE HEALTH INFORMATION SYSTEM with private clinics - this is the IS " cloud service Medved" to form and send EMD to the federal register. Several more pilot directions related to the use and AI are being considered - IoT also in healthcare.

Elvira Gilmanova, Deputy General Director of BARS Group, said that the company is developing MIS, laboratory information systems, solutions designed to monitor and control the process of providing medical care to patients of the constituent entities of the Russian Federation in the profiles of "Oncology," "Obstetrics and Gynecology" and "Neonatology," "Cardiovascular Diseases," "Preventive Medicine." The company has an information and analytical system for health monitoring, which is designed to collect and analyze indicators of the health sector in the constituent entities and municipalities of the Russian Federation. The company also has the development of data analytics platforms in medicine, developments in the field of monitoring health insurance, digital platforms for processing information of personalized accounting of medical care provided by medical organizations of the constituent entities of the Russian Federation within the framework of compulsory medical insurance.

Mikhail Goncharuk, project manager of the company's voice digital technologies BSS department, stressed that the company provides a full range of voice and text service solutions based on a single stack of Russian-developed technologies. All these solutions are combined in an intelligent dialog platform that Digital2Speech allows you to expand the capabilities of contact centers with modern speech technologies using ML, AI and LLM algorithms.

Already, virtual assistants of line 122 from BSS serve more than 22 million citizens in 18 regions of the Russian Federation. The average level of automation is 60% - these are calls independently processed by the robot, without the help of line 122 specialists. The level of automation continues to grow due to the refinement of scenarios, updating models and, in general, increasing the maturity of the technologies used based on artificial intelligence. Automation also increases due to the no-code approach - a tool for the independent development of virtual assistants without the involvement of external developers.

As Vladimir Turin, the system architect of Netrika Medicine, said, in 2024 the company supplemented the self-service of its platform with a new development - parser. With its help, users, without special technical knowledge, can analyze primary data from their large collections of semi-structured electronic medical documents. Thus, one of the key tasks of the analysis of clinical documents (HL7 CDA, Health level 7 Clinical Documents Architecture) is solved. During operation, the parser showed its viability and effectiveness in working with other electronic documents - for example, with financial documents by the State Information System of Compulsory Health Insurance (GIS Compulsory Medical Insurance).

In N3.Analitika, the company has launched two new areas related to AI technologies: a digital assistant and an intelligent analyzer for the quality of medical data. Experts plan to share the first results as early as 2025.

At the congress "National Health 2024" within the framework of the session "EDS" Health ": a step into the future of medicine" on October 28, the chairman of the FOMSI Balanin spoke about the development of GIS compulsory medical insurance, which began at the end of 2022, when a single register of insured persons (ERZ) was created and federal information systems such as tax, registry office, Ministry of Internal Affairs were able to interact with the relevant data on citizens. At the moment, the ERZ is being updated online.

The expert also spoke about plans for the development of a digital medical profile - a hybrid data storage filled from different medical systems. It is planned that information on the provided medical care will first be loaded from the registers of accounts of territorial funds, and in the future from the system of personalized accounting of information about medical care, the data will come from various sources, institutions where the medical service was provided to the insured (from commercial clinics, institutions in other regions, and not only from the clinic at the place of registration). This system will not only show insurers events in the provision of medical care, the presence of chronic diseases, but also related insurance and even behavioral risks.

At the same session, Academician of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor Yevgeny Shlyakhto spoke about the main directions of work with artificial intelligence. According to the expert, soon there will not be a single doctor who does not work with AI.

The Minister of Health of the Tula Region, Mikhail Malishevsky, showed what modern processes of digitalization in medicine in regional practice are, when absolutely all medical statistical indicators are collected in a BI or CRM interface convenient for the governor, minister, chief doctors for making management decisions that increase the efficiency of health saving the population^[8].

On the same day, at the session "Innovations in Action: How Technologies Change Medicine," Igor Korobko, Director of the Department of Science and Innovative Health Development of the Ministry of Health of the Russian Federation, stated that the medical sector is moving into a qualitatively new state - to prioritize prevention, to prevent diseases, thanks to new technologies, many of which are cross-cutting, affecting not only medicine.

From the point of view of science and technology, the expert outlined such trends in the digitalization of the industry: genomic and other omix technologies, AI, personalization of medical care, remote monitoring technologies. This is no longer so much about the detection of risk factors for the patient's health as about risk management to prevent the onset of adverse consequences.

As an example, Igor Korobko cited the development of the National Medical Research Center named after V.I. Kulakova, made within the framework of the target project "Medical Science for Humans" - a approved medical device, which allows diagnosing more than 2 thousand hereditary monogenic diseases in one analysis^[9][10]. And since 2024, a pilot project for the early detection (immediately after birth) of such diseases in risk groups has been taking place in several regions of the Russian Federation. The speaker also cited an example of early non-invasive diagnosis in oncology of various types of tumor diseases based on characteristic methylation patterns. This solution became possible thanks to the synthesis of genetic technologies, Big Data and AI.

Genomic data are increasingly used to identify individual risks. Personalized approaches are developing very quickly in cell and gene therapy, oncology (in particular, we are talking about oncovaccins^[11]).

The expert mentioned new medical devices and medicines, the creation of which is based on innovative technologies. High-throughput sequencing provides a glimpse into the human exome or genome. Technologies based on template RNAs are actively developing. Viral delivery allows the delivery of gene therapy drugs for previously incurable diseases.

According to the expert, today progress in medicine and changes in the human lifestyle are changing the landscape of medical problems. The most promising areas of work: oncology, cardiovascular pathologies, issues of aging and active longevity, metabolic syndrome, autoimmune diseases, neuro-cognitive aspects. The key tool for solving these problems in the coming years should be the national project "New Health Saving Technologies," within the framework of which not only new solutions for key technologies will be developed, which are determined by decree of the President of the Russian Federation No. 529, but the project should become a catalyst for the technological development of the industry as a whole.

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