{"title":"医疗保健系统中的“数字悖论”","authors":"Veoletta A. Galitskaya, N. Meshcheryakova","doi":"10.17323/1999-5431-2022-0-4-176-196","DOIUrl":null,"url":null,"abstract":"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reasons for this paradox are lack of confidence in the reliability and efficiency of the unified information system, outdated equipment for the doctor's workplace, and slow Internet connections.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.","PeriodicalId":43338,"journal":{"name":"Voprosy Gosudarstvennogo i Munitsipalnogo Upravleniya-Public Administration Issues","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"«DIGITAL PARADOXES» IN HEALTH CARE SYSTEM\",\"authors\":\"Veoletta A. Galitskaya, N. Meshcheryakova\",\"doi\":\"10.17323/1999-5431-2022-0-4-176-196\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"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.\",\"PeriodicalId\":43338,\"journal\":{\"name\":\"Voprosy Gosudarstvennogo i Munitsipalnogo Upravleniya-Public Administration Issues\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Voprosy Gosudarstvennogo i Munitsipalnogo Upravleniya-Public Administration Issues\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.17323/1999-5431-2022-0-4-176-196\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PUBLIC ADMINISTRATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Voprosy Gosudarstvennogo i Munitsipalnogo Upravleniya-Public Administration Issues","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.17323/1999-5431-2022-0-4-176-196","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PUBLIC ADMINISTRATION","Score":null,"Total":0}
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.
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.