Digital healthcare in Russia: the history of three decades of development and trends of transition to patient oriented

Background. The article presents the results of a review study on the origins of systematic healthcare informatization and the formation of digital healthcare in Russia, as it is now commonly called, since the 60s of the last century, and an analysis of how introduction of digital healthcare methods and technologies, and compulsory medical insurance (CMI) progressed over the years. A comprehensive analysis of the formation and development of digital healthcare on a nationwide scale has not been carried out before, and the corresponding periodization of stages has not been developed. Some facts of digitalization of federal significance, specifically in the history of the development of the CMI system in Russia, were either not published at all, or were published in isolation from the digitalization of healthcare in general and were not analyzed in the general context.
Aim. A systematic review of the main developments in the progress of digital healthcare in Russia and the development of a reasonable periodization of this process, as well as a forecast of promising areas of development, the main of which is patient orientation.
Methods. We performed a search for publications in bibliographic database eLibrary over the years, the search engine for the full text of scientific publications, Google Scholar, the analysis of normative legal acts in force in the territory of the Russian Federation, information analysis of open Internet sources with the use of the Yandex search engine. The search was performed using the following keywords: E-health; digital healthcare; digital transformation; digitalization; stages of development; EGISZ; unified digital circuit. Results. As a result of the study, more than 40 of the most important events of the formation and development of digital healthcare in Russia have been identified, the periodization of the process of digitalization of healthcare has been proposed and justified, starting with the creation of systemic prerequisites at the end of 1993 and from the start of digitalization on the scale of Russia in 2006 to the third stage, ending in 2024. The main trends and forecasts in the field of development of digital healthcare methods and technologies at the promising, fourth stage of digitalization of healthcare from 2025 have been formulated.
Conclusion. Digital healthcare in Russia for a unified system of public health protection started only after the creation of the necessary objective conditions – the mass distribution of IT tools, the introduction of a CHI system and the beginning of the digital transformation of the public administration system in Russia. The article proposes and substantiates the periodization of the process of formation and development of digital healthcare in the Russian Federation, including promising areas and key trends until 2030.

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