MEDICAL-ORGANIZATIONAL, DIGITAL AND SOCIO-CULTURAL TECHNOLOGIES OF WORKING WITH PATIENTS: CLASSIFICATION, QUALITY
Authors: D.L. Mushnikov , V.A. Kozlov , A.V. Oleynik , E.A. Abrosimov , T.L. Kolobova 
Published: April 2022

Abstract. The introduction of the principles of the socio-cultural approach in the activities of medical organizations requires an emphasis on working with patients as full participants in the treatment and diagnostic process, taking into account their needs, values, psychological status, individual characteristics. The purpose of the study: to propose a classification of technologies for working with patients and to analyze the quality of the practice of their application in health care. The study was conducted on the basis of health care of the subjects of the Central Federal District of the Russian Federation (Ivanovo, Yaroslavl, Kostroma, Vladimir, Moscow regions). Time of the study 2020-2021 Research methods: bibliographic, expert assessments, analytical. The research program included an expert assessment of the quality of technologies for working with patients in 3 components (medical-organizational, digital and socio-cultural). The volume of the sample population formed by random selection amounted to 800 cases of medical care of oncological, pediatric and surgical profile. Under the technologies of working with patients in health care institutions, we understand - the established typical approaches, algorithms for interaction with patients, taking into account the socio-cultural characteristics of patients and with the aim of involving them in the treatment and diagnostic process as full participants, the formation of health-centric behavior and high medical activity. It is proposed to classify the technologies of working with patients into 3 groups: medical and organizational (by phasing, by purpose, by profile, by completeness, by ensuring the rights and interests of the patient, by the interaction of specialists, by timeliness, by technicality), digital (by scientific and technical level of technology, by the level of reflection on the organization's website, by the development of means of digitalization of documentation of technologies, by the development of teleconsultations and monitoring of the patient's condition) and socio-cultural (by value orientation, by the patient's motivation, by taking into account the cultural characteristics of the patient, by comfort, by the implementation of ethical and deontological patterns of interaction). The results of the study showed that the medical and organizational component of patient management technologies was violated most often - in every 10 cases of assistance, the socio-cultural component of patient management technologies was violated in every 4 cases of assistance; digital – in every second case of assistance. It was noted that the frequency of violations was significantly more frequent in the provision of assistance of an oncological and surgical profile than a pediatric one. The basis for the digitalization of patient management technologies is the original automated platform developed by the authors, which consists in the formation of an automated database based on a survey of patients, registration of data on the material and technical and personnel readiness of a medical organization to provide assistance.