Aim: to evaluate the effectiveness of remote monitoring of patients with spine diseases in the postoperative period using a specialized questionnaire called «Medsenger».

Methods and Materials: 246 patients with spinal disorders were observed at the NMCPF during 2021-2022. Several clinical parameters were assessed and recorded during remote monitoring: severity of pain syndrome, temperature, increase/decrease of muscle strength, sensory disturbances, urinary tract dysfunction and general condition. Patients were divided into 2 groups: 192 patients received standard observation, and 54 patients had remote observation via special messenger.

The follow-up of patients in the postoperative period in the first group was performed at their hospital visit (patientor doctor-initiated  as  required).

Patients in the second group were monitored via the “Medsenger” cloud platform with automated surveys set up.

Results: In the first group 17.71% of patients remained until the end of the follow-up period, while in the second group this proportion was significantly higher — 92.6%. Remote monitoring of patients after surgical intervention on the spine by means of a specialized messenger allowed timely changes in treatment tactics in 13 cases (24% of patients in the second group). The momentary load on the doctor working with patients from the second group during 8 months was 10±2 patients. Constant communication with patients significantly reduced the doctor’s response time to an emerging complication and allowed real-time monitoring of treatment effectiveness.

Background. Development of medical competences is the aim of medical education. Technology of virtual patients has become the main learning tool for these skills as a safe (for real patient), standard digital model. Remote access allows expanding the use, and learning even in case of face-to-face contact limitations.

Aim. Public presentation of the development dynamics and practical results of knowledge engineering during software creation for the formation and assessment of medical decision-making competencies.

Methods. The materials for this research were expert knowledge of skillful clinicians  with  significant  scientific  and teaching experience. Individual and group knowledge engineering methods were used to extract and formalize expert knowledge: survey, brain storm, structured interview, critical review, Delphi method.

Results. Each completed case was considered as a set of textual and multimedia information describing the diagnostic and treatment process (DTP). This information was discretized and represented by a sequence of information nodes in linear trajectory — a model of DTP «as it was.» Subsequently, list of information nodes was determined where DTP trajectory could be changed after another decisions, and additional trajectories that are absent in reality were synthesized. Instead of linear model, the branched graph was created for each case — “how could it be” model that included a certain set of DTP trajectories. Criteria and a scale for evaluating the effectiveness of students’ decisions were formulated, a rating system of evaluation was developed, evidence-based reference materials were prepared for each case. The task specification for programmers was formulated on the basis of obtained results. Software package was developed and implemented for the development and assessment of decision-making competencies of trainees.

Conclusion. The experience of our multidisciplinary team has shown that the engineering of expert knowledge in weakly formalized domains is central to the development software for the development and evaluation of medical decision-making competencies.

Aim. Healthcare is one of the priority sectors for the introduction of artificial intelligence (AI) technologies. The aim of the survey was to assess the awareness and collect opinions of Russian healthcare managers on AI technologies.

Materials and methods. An online survey was conducted in July-August 2022, using the Yandex.Forms service. The survey questionnaire consisted of 24 questions. An invitation to participate was sent to 1,105 Russian healthcare employees registered in the online community “Personnel platform for healthcare organizers”.

Results. 62 healthcare managers took part in the survey (5.6% response rate). Median age was 42.5 years and median work experience was 22 years. 63% (95% CI: 50%-75%) of responders considered themselves as AI-aware, 89% (95% CI: 78%-95%) saw the value of applying AI technologies in healthcare, while 73% (95% CI: 60%-83%) believed that AI would always be used to support healthcare decisions. Only 13% (95% CI 6%-24%) of respondents reported using AI products in their organization. Main areas of AI use were clinical decision support (76%) and optimization of healthcare processes (71%). The most promising areas for the implementation of AI were optimization of managerial decisions (66%), automation of diagnosis (57%), medical care in remote areas (53%) and research in the field of biopharmaceuticals (52%). The biggest concerns about the use of AI were the lack of sufficient universality so that AI can be applied to any patient (52%), unsuitability for use in unexpected situations (44%), limited use in difficult situations (42%). In case of any legal problems arising in connection with the use of AI, doctors (42%) or heads of medical organizations (34%) were likely to be held responsible. Survey participants believed that companies developing AI systems (36%) or regulatory organizations (27%) should bear such responsibility.

Conclusions. Most of Russian healthcare managers are generally familiar with AI technologies and favor their implementation in domestic medicine, although the actual implementation of AI systems is still relatively rare. Thus, healthcare managers are potential supporters and customers for the implementation of AI products in their organizations.

A fundamental increase in the effectiveness of measures aimed at overcoming the problem of chronic noncommunicable diseases (CNCDs) can only be achieved through the digital transformation of healthcare. An Integrative Digital Strategy to Combat NCDs has been developed, which not only solves the problems of developing the healthcare system, but also stimulates the development of the national economy in the field of high technologies in full accordance with the Ashgabat Declaration on the Prevention and Control of Noncommunicable Diseases. The key message of this paper is that prevention and control of NCDs can provide a platform for investment in research and development for health innovation as a means to generate knowledge and wealth, and to improve the performance of health systems. The integrative strategy aims at strengthening interaction between government agencies, public associations, civil society and the private sector to promote cooperation at all levels in order to intensify efforts to prevent non-communicable diseases, which is the direction of the state policy of Turkmenistan.

The article describes the landscape of innovations in the field of medicine in general and start-ups of digital solutions in particular, presents the experience of the Pirogov National Medical and Surgical Center in organization and performing of acceleration program for medical start-ups, proposals are formulated for creating effective translating mechanisms of innovative technologies and products into clinical practice.

Aim. To optimize the process of receiving and processing federal statistical observation forms.

Materials and methods. The MEDSTAT-WEB software, previously used by the Russian Research Institute of Health, was used as the basis. Innovative elements of third-party software were integrated into the process of providing primary statistical data.

Results. A functional has been developed that provides prompt online interaction between specialists of the Subjects of the Russian Federation and specialized experts of Russian Research Institute of Health. To confirm the legal significance of the provided information the reinforced qualified electronic signature was introduced. The video conferencing module was implemented by means of software from the Russian company TrueConf. The reporting status monitoring module was based on the Telegram messenger. The secure access module for remote form-taking experts of specialized national medical research centers was implemented on the basis of VPN system introduction into the closed segment of the Russian Research Institute of Health local network. A certification centre module has been integrated to perform information security tasks and to provide mechanisms for protecting data from unauthorized access and illegal data modification.

Conclusions. The re-engineering of the Federal Tax Service data transmission service contributes to optimizing the process of receiving and processing of electronic documents, increases the reliability of data and significantly increases the speed of information  acquisition.

Background. Assessment of medical services quality from the patient’s point of view is an integral part of the management process of medical organizations within the widely adapted concept of patient-oriented healthcare.

Aim. To evaluate the effectiveness of using an information and analytical system for collecting and analyzing the results of patient satisfaction surveys on medical care provided in a round-the-clock hospital

Methods. Patient questionnaires were the primary research instrument. The study used 23-item questionnaire with the answers supposedly expressing patients opinion on the quality of medical staff work, the comfort of the conditions of stay in the admissions department, as well as the overall assessment of the work of the hospital stay. To implement the study, we developed an information and analytical system used to collect and analyze the results of the survey. Mathematical analysis of the results was carried out quarterly and at the end of the year according to five satisfaction rates for assessing the quality of the conditions for providing medical care.

Results. A survey of patients admitted to the hospital was carried out in 2021-2022, with 612 patients participating in 2021, and 279 patients — in 2022. The use of information technologies in patient surveys and analysis of results allowed for prompt monitoring of patient satisfaction indicators and created a basis for assessing most aspects of the hospital’s activities from the perspective of patients: the quality of medical services and their outcomes, interaction with staff, infrastructure and service components.

Conclusion. Patients survey is able to do both: fulfill the requirements of the Ministry of Healthcare of Russia on mandatory participation in an independent quality assessment, and to identify weak spots in the organization of medical care provision. The patients perspective helps to focus on problematic areas in the activities of a medical organization, often overlooked by medical personnel, gives an understanding of the effectiveness of innovations and reforms. The results of a survey carried out at least once every six months can be a rationale for making managerial decisions, rational allocation of resources to achieve the main goal of a medical organization — to provide high-quality and affordable medical care.