Телемедицина как инструмент межрегионального дистанционного взаимодействия с профильными медицинскими организациями субъектов Российской Федерации: опыт Чебок- сарского филиала ФГАУ «НМИЦ «МНТК «Микрохирургия глаза» им. акад. С. Н. Федорова» Минздрава России

Abstract

At present, the possibility of providing qualified medical care anywhere in the world has become a reality thanks to the development of telemedicine technologies. The development and improvement of telemedicine technologies is due to the regulatory and legal regulation and implementation of the national project «Health Care», which was developed on the basis of the Presidential Decree № 204 of 07.05.2018 «On the national goals and strategic objectives of the Russian Federation for the period until 2024». (hereinafter – the Decree of the President of the Russian Federation of 07.05.2018 № 204) [9]. The National Medical Research Centers (NMRCs) were tasked with organizing advisory and methodological expert support for specialized regional medical organizations of the 3rd level of RF subjects. Cheboksary branch «The S. Fyodorov Eye Microsurgery Federal State Institution» supervises ophthalmological service of 8 subjects of the Russian Federation: Nizhny Novgorod, Kirov, Ulyanovsk regions, Republics of Mordovia, Udmurtia, Mari-El, Tatarstan and Chuvashia. The article presents the experience of Cheboksary branch «The S. Fyodorov Eye Microsurgery Federal State Institution» of Health of Russia on the use of telemedicine technologies to improve the provision of specialized, including high-tech medical care in the profile «Ophthalmology». Over the 3-year period of operation, the number of requests for telemedicine consultations at the «doctor-physician» level has increased significantly. In addition, from January 2021, Cheboksary branch «The S. Fyodorov Eye Microsurgery Federal State Institution» provides consultative care at the «doctor-patient» level. Purpose of the study is to present the experience of Cheboksary branch «The S. Fyodorov Eye Microsurgery Federal State Institution» of Health of Russia on the use of telemedicine consultations (TMC) performed using the «Telemedicine consultations» component of the federal electronic registry subsystem of the unified state information system in healthcare (USGISZ FER TMC component) from 2019 to 2021 and the «MEDTERA Telemedicine» unified secure technological platform from 2021. Material and Methods. Telemedical consultations on the basis of the Cheboksary branch «The S. Fyodorov Eye Microsurgery Federal State Institution» are performed by highly qualified specialists – heads of the departments, research workers, leading specialists in different fields of ophthalmology. Telemedical consultations at the «doctor-physician» level are performed as follows: at the initial stage, a request for a consultation is received from specialized medical organizations of the subjects of the Russian Federation, which is processed by the employees of the Department of Telemedical Consultations. Information about the request is registered in the database, its profile is evaluated, as well as the quality, completeness and relevance of the data of the attached medical documentation. For real-time consultation «doctor-patient» through video or audio conferencing, the patient makes an independent appointment for a convenient date and time with a particular specialist. Results. During 3 years of the TMC functioning at the Cheboksary branch «The S. Fyodorov Eye Microsurgery Federal State Institution» the number of requests for telemedicine consultations at the “doctor-physician” level in the field of ophthalmology from 8 subjects of the Russian Federation of the Volga Federal District is progressively increasing. The bulk of telemedicine consultations are scheduled requests. During the 3-year period of telemedicine consultations at the Cheboksary branch «The S. Fyodorov Eye Microsurgery Federal State Institution» there were 94 TMK from the Republic of Tatarstan, 79 TMK from the Chuvash Republic, 61 TMK from the Republic of Mariy-El, 53 TMK from the Republic of Udmurtia, 46 TMK from the Kirov region, 37 TMK from the Nizhny Novgorod region, 36 TMK from the Ulyanovsk region, 23 TMK from the Republic of Mordovia. Findings. Summarizing the results of the analysis of the structure of telemedicine consultations performed using the IGISZ FER TMC component, it can be summarized that the IGISZ FER TMC component is a convenient, effective tool, which allows to comply with the Russian legislation in conducting telemedicine consultations, as well as to analyze the structure of telemedicine consultations conducted with its use.