俄罗斯联邦利用远程医疗技术为患有精神障碍的儿童和青少年提供医疗服务的组织和监管问题

O. Z. Khayretdinov, L. I. Rubakova, E. V. Makushkin
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摘要

背景:由于 COVID-19 大流行,远程提供诊断、治疗和矫治护理的需求大幅增加。与此同时,目前精神科的远程医疗形式在医疗界代表中引起了模棱两可的态度,在提供医疗服务时使用远程医疗技术,特别是在 "病人-医生 "形式中使用远程医疗技术的许多组织、法律和临床方法问题仍未得到充分发展。本综述旨在分析有关在俄罗斯联邦为患有精神障碍的儿童和青少年提供援助时,以 "医生-医生 "和 "患者-医生 "形式进行远程医疗咨询的组织和法律规定的科学出版物。综述材料与方法:根据 "儿童精神病学"、"医疗保健"、"远程医疗技术"、"监管法案 "等关键词,选择并分析了 eLibrary 和 PubMed 数据库中 2016 年 1 月至 2023 年 9 月间发表的俄罗斯科学研究。根据莫斯科卫生局以 G.E. Sukhareva 命名的中心的实践活动,分析了 "医生-患者(法定代表人)"和 "医生-医生 "形式的远程医疗咨询的组织和监管参数。结论:对科学文章的研究证实,利用远程通信技术提供儿童精神病治疗、消除耻辱感和提高医疗质量是有效的。这表明有必要优化监管框架,消除初级远程医疗咨询中相互冲突的监管要求。
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Organizational and Regulatory Aspects of the Telemedicine Technologies Use in Providing Health Care to Children and Adolescents with Mental Disorders in Russian Federation
Background: the need for remote delivery of diagnostic, treatment and correctional care has increased significantly due to the COVID-19 pandemic. At the same time, at present, remote forms of care in psychiatry cause ambiguous attitudes among representatives of the medical community, and many organizational, legal and clinical-methodological issues of the use of telemedicine technologies in the provision of medical care, especially in the “patient–doctor” format, remain insufficiently developed. The purpose of this review is to analyze the scientific publications on the organization and legal regulation of telemedicine consultation in the “doctor–doctor” and “patient–doctor” formats when providing assistance to children and adolescents with mental disorders in the Russian Federation. Material and method of review: according to keywords “child psychiatry”, “health care”, “telemedicine technologies”, “regulatory acts” Russian scientific studies published between January 2016 and September 2023 presented in the databases eLibrary and PubMed were selected and analyzed. An analysis of the organizational and regulatory parameters of telemedicine consultations in the “doctor — patient (legal representative)” format and in the “doctor — doctor” format was made based on the practical activities of the Center named after G.E. Sukhareva of the Moscow Department of Health. Conclusion: the review of scientific articles confirmed the validity of telecommunication technologies use to make accessible the children’s psychiatric care, as well as for destigmatization and improvement the quality of medical care. It was shown the need to optimise the regulatory framework, to eliminate conflicting regulatory requirements for primary telemedicine consultation.
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