OPTIMIZATION OF MEDICAL CARE IN REGIONAL HEALTH CARE: PERSPECTIVES AND BARRIERS



Cite item

Full Text

Abstract

The perspectives of Russian health care in the transition to personalized medicine are realized in the formation of an innovative digital health care system. Forming with the use of digital technologies the accessibility of health care provides enormous social advantages in regional conditions and assumes a qualitatively new level of regional health care system.

The problems of the Covid-19 pandemic, requiring isolation, quarantine and social distancing and characterized by the formation of trends of social «atomization», accelerated the dependence on digital health, and served as a «catalyst for the development and implementation of a wide range of remote monitoring technologies in health care delivery». However, the digitalization process is «objectively slow» in Russia. The research establishes a high differentiation of digitalization of regional health systems in the Russian Federation.

The implementation in regional health care of digital technologies, which have a high potential for improving the efficiency of the health system, is limited by institutional barriers.

The article presents a typology of institutional barriers to the digitalization of the regional health system.

Federal level:

- legal barriers,

- organizational and managerial (logistical) and technological barriers.

Regional level:

- Financial barriers.

Level of medical organizations and users (medical staff and patients):

- behavioral barriers,

- organizational and managerial (logistic) and technological barriers.

Modern healthcare is experiencing large-scale digital technology inclusion, which can radically change the healthcare system by determining the accessibility and quality of medical care. However, the provision of cost-effective and quality health care initiated by the regional health care digitalization process is limited by institutional barriers at the federal, regional, medical organization and user levels.

Full Text

Restricted Access

About the authors

Irina L. Krom

Saratov State Medical University named after V.I. Razumovsky

Author for correspondence.
Email: irina.crom@yandex.ru
ORCID iD: 0000-0003-1355-5163
SPIN-code: 4854-1094
Russian Federation, Saratov

Marina V. Erugina

Saratov State Medical University named after V.I. Razumovsky

Email: lab48@yandex.ru
ORCID iD: 0000-0003-4253-5313
SPIN-code: 7016-3160
Russian Federation, Saratov

Maria G. Yeremina

Razumovsky Saratov State Medical University

Email: 913693@mail.ru
ORCID iD: 0000-0001-9752-1352
SPIN-code: 9205-0670
Russian Federation, Saratov

Maria Sapogova

Saratov State Medical University
Health Organization and Public Health
Department (the courses of Law and History of Medicine)

Email: maria.sapogova@mail.ru
ORCID iD: 0000-0001-6495-9884
Russian Federation

Maria M. Orlova

Saratov National Research State University named after N.G. Chernyshevsky

Email: maria2010@mail.ru
ORCID iD: 0000-0003-2340-8343
SPIN-code: 1399-9666

Candidate of Pedagogical Sciences, Associate Professor, Department of General and Consulting Psychology, Saratov National Research State University named after N.G. Chernyshevsky

Russia, 431012, Saratov, 112 B. Kazachya St

Tatiyana P. Lipchanskaya

Saratov State Medical University named after V.I. Razumovsky

Email: tatyanalp@yandex.ru
ORCID iD: 0000-0002-7755-1834
SPIN-code: 5698-6429
Russian Federation, Saratov

Marina V. Vlasova

Email: vmv-22@yandex.ru
ORCID iD: 0000-0002-5813-4154
SPIN-code: 4939-6247

References

  1. Prysyazhnaya NV Medicine in the World of the Future: Load of Traditions and Press of Innovations? Sociology and society: traditions and innovations in the social development of the regions [Electronic resource]: Collection of reports of the VI All-Russian Sociological Congress (Tyumen, 14-16 October 2020) Moscow: ROS; FNISC RAS, 2020;5916. (In Russ).
  2. Egorova AV. Digitalization of Regional Health System in the Digital Economy. Scientific Yearbook of the Center for Analysis and Forecasting. 2018;1(2):256-261. (In Russ).
  3. Alimbayev AA, Bitenova BS, Yesenbekova TI. Methodology of Assessment of Social and Economic Efficiency of Digitalization of Health System. Economics: Strategy and Practice. 2020;(15):25-37. (In Russ).
  4. Prysyazhnaya NV, Reshetnikov AV. Education in Conditions of Pandemic: Vectors of Digital Transformation. Sociological Studies. 2022;(4):149-151. (In Russ).
  5. World Health Organization, 2018, web – Digital Health. Resolution WHA71. 7. Seventy-First World Health Assembly, World Health Organization, 2018. Available from: https://apps.who.int/gb/ebwha/pdf_files/WHA71/A71_R7-en. pdf.
  6. Seljelid B, Varsi C, Nes LS, et al. A Digital Patient-Provider Communication Intervention (InvolveMe): Qualitative Study on the Implementation Preparation Based on Identified Facilitators and Barriers. Journal of medical internet research. 2021; 23(4):e22399.
  7. Morozov VV, Seryapina YuV, Bessmeltsev VP, et al. Problematics of telemedicine in domestic health care. Fundamental research. 2014;(10-7):1365-1368. (In Russ).
  8. Svetkova GS, Groznova OS. Theory and Practice of Institutional Risks. Bulletin of Chuvash University. 2012;(1):476-480. (In Russ).
  9. Myzrova KA., Tuganova EA. Digitalization of healthcare as a promising direction of development. Questions of Innovative Economics. 2018;8(3):479-486. (In Russ).
  10. Puzin SN, Sertakova OV, Reshetov DN. Telemedicine as a vector for the innovative development of the system of service delivery in health care. Bulletin of the All-Russian Society of Specialists in Medical and Social Expertise, Rehabilitation and Rehabilitation Industry. 2018;(2):65-73. (In Russ).
  11. Digitalization of medicine will change the usual way of working in the industry. Analytical Center under the Government of the Russian Federation. Available from: http://ac.gov.ru/events/014209.html. (In Russ).
  12. Rusanovsky GA, Bylina SG. Problems of digitalization of rural health in Russia in terms of regional differentiation. Economic security and quality. 2019;2(35):27-33. (In Russ).
  13. Kim D, Alanazi H, Daim T. Prospects for Telemedicine Diffusion: Foresight Modeling Using Rural US Examples. Foresight. 2015;9(4):32-41. (In Russ).
  14. Tsvetkova GS, Groznova OS. Theory and Practice of Institutional Risks. Bulletin of Chuvash University. 2012;(1):476-480. (In Russ).
  15. Lebedeva-Nesevrya NA. Theory, Methodology and Practice of the Analysis of Socially Determined Risks of Population Health: dissertation.... Doctor of Sociology: 14.02.05. Volgograd. 2014;369. (In Russ).
  16. Korobkova OK. Digitalization as a new stage in the genesis of health services. Business. Education. Law. 2020;1(50):255-261. (In Russ).
  17. Barashkov GM, Eremina MG, Subbotina VG. Telemedicine in solving the problem of limited access to medical care in remote areas: legal barriers to implementation and operation (review). Saratov Scientific Medical Journal. 2021;17(4):755-760. (In Russ).
  18. Kundryukov VA. Digitalization of healthcare: achievements and challenges. National concept of quality: state and public protection of consumer rights: collected theses of reports of International scientific and practical conference (Saint Petersburg, September 30 - October 01. 2019. St. Petersburg. 2019;197-200. Available from: https://www.elibrary.ru/download/elibrary_41546925_68159921.pdf. (In Russ).
  19. Baranov AA, Vishneva EA, Namazova-Baranova LS. Telemedicine - prospects and challenges before a new stage of development. Pediatric Pharmacology. 2013;10(3):6-11. (In Russ).
  20. Zaidan BB., Zaidan AA, Mat Kiah ML. Impact of data privacy and confidentiality on developing telemedicine applications: a review participates opinion and expert concerns. Pharmacology. 2011;7:382-387.
  21. Palacholla RS, Fischer N, Coleman A, et al. Provider- and patient-related barriers to and facilitators of digital health technology adoption for hypertension management: scoping review. Mir Cardio. 2019;3:e11951. doi: 10.2196/11951
  22. Nohl-Deryk P, Brinkmann J, Gerlach F, et al. Hürden bei der Digitalisierung der Medizinin Deutschland (Barriers for Digitalization in the German Medicine Sector. Gesundheitswesen. 2018;80(11):939-945. doi: 10.1055/s-0043-121010
  23. Maksimov IB, Diashev AN, Sinopalnikov VI, et al. History, analysis of the state and prospects for the development of telemedicine. Journal of telemedicine and e-health. 2018;(3(8)):103-110. (In Russ).
  24. Gajarawala SN, Pelkowski JN. Telehealth benefits and barriers. J. Nurse Pract. 2020;17(2):218-221. doi: 10.1016/j.nurpra.2020.09.013
  25. Bally ELS, Cesuroglu T. Toward Integration of mHealth in Primary Care in the Netherlands: A Qualitative Analysis of Stakeholder Perspectives. Frontiers in public health. 2020; 7:407.
  26. Nohl-Deryk P, Brinkmann JK, Gerlach FM, et al. Barriers to Digitalisation of Healthcare in Germany: A Survey of Experts. Gesundheitswesen. 2018;80(11):939-945.
  27. Versluis A, van Luenen S, Meijer E, et al. Series: eHealth in primary care. Part 4: Addressing the challenges of implementation. European journal of general practice. 2020;26(1):140-145.
  28. Gleiss A, Lewandowski S. Removing barriers for digital health through organizing ambidexterity in hospitals. Journal of public health-heidelberg. 2021. doi: 10.1007/s10389-021-01532-y
  29. Prysyazhnaya NV, Koryagin MO. Perception of the results of modernization of the health care system by medical professionals. Sociology of Medicine. 2019; 18 (2): 122–127. .doi http://dx.doi.org/10.18821/1728-2810-2019-18-2-122-127. (In Russ).
  30. Harst L, Timpel P, Otto L, et al. Identifying barriers in telemedicine-supported integrated care research: scoping reviews and qualitative content analysis. Public Health. 2019; 28: 583-559. doi 10.1007/ s10389-019-01065-5
  31. Glock H, Nymberg VM, Bolmsjo BB, et al. Attitudes, Barriers, and Concerns Regarding Telemedicine Among Swedish Primary Care Physicians: A Qualitative Study. International journal of general medicine. 2021; 14: 9237-9246. doi: 10.2147/IJGM.S334782
  32. Shchupak AYu, Ostrogolovy V M, Lunin A D, Voronov A I. Side effects of digitalization of educational technologies in health care. Methodological support of pedagogical process in medical university in the conditions of competence approach realization: collection: Materials of inter-regional educational-methodical conference for higher school teachers Khabarovsk: Far-Eastern State Medical University. 2020;125-128. (In Russ).
  33. Lyadova AV. Digital Health: Myth or Reality. XXI International Conference in memory of Professor L. N. Kogan "Culture, personality, society in the modern world: methodology, empirical research experience", March 22-23, 2018, Ekaterinburg. Ekaterinburg: UrFU. 2018;1451-1461. Available from: http://elar.urfu.ru/bitstream/10995/58996/1/978-5-91256-403-1_2018_154.pdf. (In Russ).
  34. Noskova MV. Cognitive component of psychological readiness of doctors to digitalization in health care. Innovative potential of science development in the modern world: achievements and innovations. Collection of scientific articles on the materials of the III International Scientific-Practical Conference. Ufa. 2020;280-285. (In Russ).
  35. Chistyakov AV, Tretyakov MA. Perception of digitalization of health care as a trend to reduce the quality of medical care. Modern Applied Research: Proceedings of the Fourth National Scientific and Practical Conference. Novocherkassk: Southern-Russian State Pedagogical University (NPI). 2020;266-270. (In Russ).
  36. Vladzimirsky AV. Primary patient-physician telemedicine consultation: first systematization of methodology. Journal of Telemedicine and e-health. 2017;(2(4)):109-120. (In Russ).
  37. Ali MA, Alam K, Taylor B, et al. Examining the determinants of eHealth usage among elderly people with disability: The moderating role of behavioural aspects. International journal of medical informatics. 2021; 14: 104411.
  38. McLachlan S, Dube K, Johnson O, et al. A framework for analysing learning health systems: Are we removing the most impactful barriers? Learning Health Systems. 2019;3(4): e10189. doi: 10.1002/lrh2.10189
  39. Graetz I. The health IT special issue: enduring barriers to adoption and innovative predictive methods. American Journal of Managed Care. 2020;26(1):19.м doi: 10.37765/ajmc.2020.42140
  40. Muller AE, Berg RC, Jardim PSJ, et al. Can Remote Patient Monitoring Be the New Standard in Primary Care of Chronic Diseases, Post-COVID-19? Telemedicine and e-health. 2021. doi: 10.1089/tmj.2021.0399
  41. Reshetnikov AV, Prisyazhnaya NV, Pavlov SV, Vyatkina NV. Perception of the covid-19 pandemic by Moscow residents. Sociological Research. 2020;(7):138-143. (In Russ).
  42. Houlding E, Mate KKV, Engler K, et al. Barriers to Use of Remote Monitoring Technologies Used to Support Patients With COVID-19: Rapid Review. JMIR mhealth and uhealth. 2021;9(4): e24743. doi: 10.2196/24743
  43. Christensen C, Waldeck A, Fogg R. How disruptive innovation can finally revolutionize healthcare. Innosight & The Christensen Institute. 2017. Available from: https://www.christenseninstitute.org/publications/how-disruption-can-finally-revolutionize-healthcare

Supplementary files

There are no supplementary files to display.


Copyright (c) Eco-Vector


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № 77 - 12391 от 19.04.2002 г. 
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ЭЛ № ФС 77 - 80649 от 15.03.2021 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies