TRENDS IN PROVISION OF TELEMEDICINE SERVICES BY LEADING FEDERAL CENTRES IN THE RUSSIAN FEDERATION
Authors:   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia, Lagutin Maksim , Samofalov Dmitry ,   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia, Tyufilin Denis ,   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia, Chigrina Valeriya ,   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia, Kilnik Andrey ,   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia, Kobyakova Olga ,   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia
Published: August 2024

Significance. Currently, there is a certain heterogeneity in both the number of consultations and medical specialty of "doctor-doctor" telemedicine consultations provided by the national medical research centres to third-level medical organisations in the Russian regions. At the same time, in order to further develop the market of telemedicine services and provide patients with the needed types of consultations, it is important to understand which specialty and ICD codes are much needed. The purpose of the study was to identify trends in care delivery using telemedicine technologies by the leading federal medical centres by specialty in 2021–2023 and most prevalent ICD codes covered by teleconsultations in 2022. Material and methods. The authors have conducted a retrospective analysis of the Federal Telemedicine System data on consultations provided by the national medical research centres to specialists of medical organisations in the Russian regions by medical specialty in 2021-2023. Medical specialties in each region were ranked by the number of telemedicine consultations provided in the reporting period, then three most prevalent specialties were identified. In addition, from 05.10.2023 to 13.10.2023 we surveyed 31 national medical research centres by medical specialty using a questionnaire containing questions about the most prevalent diagnoses covered by "doctor-doctor" telemedicine consultations in 2022. For some specialties, the data of the Federal Telemedicine System on the number of consultations were aggregated to ensure consistent comparison with the survey data. Results. In 2021-2023, the most prevalent medical specialties covered by teleconsultations between federal medical centres and medical organisations in the Russian regions included “Oncology” with a 1.5-fold increase in the number of such consultations during this period. The study has identified a significant decrease in the number of teleconsultations on “Anaesthesiology–Resucitation” and “Infectious Diseases” related to treatment of the new coronavirus infection COVID-19 in 2022. In addition, in 2022-2023, there was a high demand for teleconsultations on “Paediatrics + Anaesthesiology-Resucitation (children)”, “Obstetrics and Gynaecology + Neonatology + Anaesthesiology-Resucitation (pregnant women)”, “Cardiovascular Surgery”, “Paediatric Oncology and Haematology”, with a positive annual growth in the number of consultations on these specialties. Results of the specialty profile ranking in each region of the Russian Federation show that in 2021-2023 the most prevalent specialties included “Oncology” (in Top-3 in 55 regions in 2021 and in 77 regions in 2023) and “Paediatrics” (in 45 and 67 regions, respectively). The aggregated data analysis of the survey of the federal medical centres shows that chronic noncommunicable diseases, including age-associated diseases, topped the list in the majority of medical specialties. In addition, consultations on acute conditions such as myocardial infarction, pneumonia, thermal burns, and acute pancreatitis were also much requested. Conclusion. The study of trends in provision of medical care using telemedicine technologies has identified a heterogenic structure of teleconsultations and demand for consultations with the federal experts on certain medical specialties: first of all, oncology, paediatrics and cardiology. Scope of application. The study results can be used for further development of telemedicine technologies and services, in particular, services of the national medical research centres, so that medical organisations in the Russian regions continue getting quality opinion from the federal experts.