医疗保健系统中的“数字悖论”

Veoletta A. Galitskaya, N. Meshcheryakova
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引用次数: 0

摘要

本文讨论了在不同地区实施联邦项目和计划的具体情况,特别是托木斯克地区的“基于统一的国家卫生信息系统EGISZ创建统一的卫生保健数字电路”区域项目。我们使用了文件分析的方法(行政当局的绩效报告,地区和联邦统计数据);比较分析,深入非正式访谈托木斯克医疗机构的医生。所选择的方法可以将计划的数字化指标与目前的统计数字进行比较;确定滞后的领域,并根据过程的主要参与者-医生的意见;通过单项指标确定数字化滞后的原因,以及医生对流程本身的总体态度。这项研究揭示了一个“数字悖论”,即,尽管电子服务很方便,但医生的工作却离不开纸质病历等实物资料。对访谈的分析表明,造成这种矛盾的主要原因是对统一信息系统的可靠性和效率缺乏信心,医生工作场所的设备过时,互联网连接缓慢。在医疗保健领域,目前尚不存在的单一统一平台问题已变得尤为重要:各个医疗机构正在试验医疗系统,为特定任务选择最合适的系统。然而,私人诊所还没有准备好承担维护医疗信息系统的费用。这导致创建公共数据库的过程变慢,任何医疗机构的医生都可以在其中访问患者的病史。作者得出结论,数字悖论是对数字化过程中困难的一种反应,并将随着数字化进程的发展而失去相关性。这个过程本身受到医生的欢迎,他们看到了它的好处和前景。
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«DIGITAL PARADOXES» IN HEALTH CARE SYSTEM
The article discusses the specifics of implementing federal projects and programs in different regions and the regional project "Creating a unified digital circuit in health care based on the unified state health information system EGISZ" in Tomsk region in particular. We used methods of document analysis (reports on the performance of executive authorities, regional and federal statistics); comparative analysis, in-depth informalized interviews with doctors of medical institutions inTomsk. The selected methods made it possible to compare the planned digitalization indicators with the figures of the current statistics; to identify the lagging areas and, based on opinions of the main actors of the process - doctors; to establish the reasons for the lag in digitalization by individual indicators, as well as the general attitude of doctors to the process itself. The study revealed a "digital paradox" which is that, for all the convenience of electronic services, a physician's work is impossible without their physical counterpart, such as a paper patient record. Analysis of the interviews showed that the main reasons for this paradox are lack of confidence in the reliability and efficiency of the unified information system, outdated equipment for the doctor's workplace, and slow Internet connections. In healthcare, the issue of a single unified platform, which does not yet exist, has become particularly relevant: individual medical institutions are experimenting with medical systems, choosing the most appropriate ones for specific tasks. Private clinics, however, are not yet ready to assume the costs of maintaining medical information systems. This leads to a slowdown in the process of creating a common database in which a doctor from any medical institution could access a patient's medical history. The authors conclude that digital paradoxes arise as a reaction to the difficulties of the digitalization process and will lose their relevance as it develops. The process itself is welcomed by doctors, they see its benefits and prospects.
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来源期刊
CiteScore
1.10
自引率
33.30%
发文量
9
期刊介绍: PUBLIC ADMINISTRATION ISSUES is a scientific peer-reviewed journal published by the National Research University High School of Economics (NRU HSE).The journal is published quarterly in Russian, and contains original articles by Russian and foreign authors. In addition, a special English language issue containing original articles by Russian and foreign authors has been published since 2014. The editorial board consists of leading Russian and foreign scientists in the field of public administration as well as prominent practitioners. The journal is indexed in the international databases: Scopus, RePEc, EBSCOand the Russian Science Citation Index (RSCI) on the platform of Web of Science. In addition, the journal is on the list of key peer-reviewed scientific journals and publications that the Higher Certification (Attestation) Commission in the RF Education Ministry recommends for publishing the main scientific results of theses for PhD and doctoral degrees in Economics, Sociology and Law. The journal focuses on the following subject areas: − Current theories of public administration. − Theoretical fundamentals of economic and social policy − Factors and Assessment of efficiency in public and municipal administration. − Innovations in the system of public and municipal administration. − Planning and forecasting in the system of public and municipal administration. − Staff of the state and municipal service. Management of personnel in public and municipal bodies and in organizations of the public sectors. − Financial, logistical and information resources of the state and municipalities. − Public service. − Functional features of public sector organizations. − Partnership of the state and municipalities with nongovernmental nonprofit organizations. Economic and administrative challenges facing “third sector.” - Development of education programs on public administration.
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