Prospects for the creation of digital medical ecosystems in Russia: digital twins and other technologies, problems and approaches.
Authors:   Ailamazyan Program Systems Institute of RAS, Mikheev A. E. 
Published: January 2025

The efforts of medicine are gradually shifting from combating a specific disease to ensuring the individual well-being of patients with a simultaneous increase in the information capacity of medicine. Information and communication technologies are considered as a key factor in any strategy to improve the quality and cost-effectiveness of medical care. The development of electronic medical records, intelligent healthcare, mobile medicine, and artificial intelligence systems has opened up new opportunities for collaboration and interaction between healthcare providers and patients within the digital ecosystem of medical care, stimulating technological innovations. The medical ecosystem is designed to implement a systematic approach to the processing of clinical data as the basis for improving the effectiveness of medical care through the digital transformation of end-to-end medical technological processes. It focuses on the integration of the work of different providers and consumers of medical care, the exchange of data and information between them to provide comprehensive medical care to patients of a certain association of MO. Medical ecosystems are considered as systems that focus on data and the generation of new health-saving knowledge, that is, as open and loosely connected systems that allow participants to use the acquired knowledge in
their own way, for example, in individual ecosystems of the participants’ MO.
The digital transformation of healthcare is taking place in the wake of the digital economy. We are dealing with the transfer of innovative solutions of business ecosystems to medicine, which implies the need to take into account the specifics of the subject area. The key technology of digital transformation of medicine, following many sectors of the economy, is considered to be the digital twin method, the application of which is impossible without the use and development of other ecosystem technologies: EMC, big data analytics, AI, the
Internet of things and blockchain. An effective and comprehensive implementation of the concept of digital twins for such a subject area as medicine is possible if the problem of combining providers and consumers of medical care into a digital medical ecosystem capable of providing holistic and homogeneous primary data is solved.
The implementation of the concept of joint patient health management within the digital ecosystems of medical care faces obstacles, primarily due to complex issues related to interoperability, confidentiality, security and effective data management. The solution to possible problems lies in ensuring the priority of scientific research in order to strengthen the objectification of the choice of ecosystem technologies and determine the stages in achieving the set goals. The development of the ecosystem must be considered in the form of building blocks, which eventually overlap one another. The first, lower blocks are designed to expand the capabilities of existing technologies, and later ones will require special research in the field of information technology in a broad sense, as well as medical informatics, in particular.
Proactive changes in the regulation of the industry are also needed, taking into account the challenges of the digital economy and the dynamics of changes in the social sphere.