Pavel Kraynyukov, V. Tolstosheev, Р Н Гузеев, R LEMESHKIN
The article continues analyzing of the problem of provision of medical assistance to forced migrants, which began in the issue No.6, 2025 and presents a conceptual model of the use of distributed ledger technology (blockchain) for creation of a decentralized secured and interoperable system for the management of medical data.
В статье описан процесс реформирования системы здравоохранения, который привел к созданию децентрализованной системы, в которой существуют автономные медицинские организации разных форм собственности, обладающие правом оказания платных медицинских услуг населению, но выполняющие единые регламенты и стандарты оказания медицинской помощи. Эти преобразования создали условия для формирования новой модели бизнес-процессов, основанной на информационных и цифровых технологиях. В статья перечислены выгоды и риски, которые создает едина платформенная система для пациентов. The article describes the process of reforming the healthcare system, which led to the creation of a decentralized system in which there are autonomous medical organizations of various forms of ownership that have the right to provide paid medical services to the population, but that follow unified regulations and standards for providing medical care. These transformations have created conditions for the formation of a new model of business processes based on information and digital technologies. The article lists the benefits and risks that a single platform system creates for patients.
Health care is the most important activity and human kind is dealing with its organization for centuries. Public health policies and functional health care systems have as their primary objectives the preservation and improvement of public health. Problems of intensive aging of the population, continuous growth of health spending, ensuring sustainable financing of health systems and efficient use of resources are present in all world health systems. Health care system reforms have become a global phenomenon for the last twenty years of the last century. The goal of this review paper is to point out the importance and need for timely modifications of the strategy of the health care optimization plan in Serbia by 2035, so that the health care system of Serbia would be ready to respond to potential global health crises in the future. The Plan for optimizing the health care institutions network by 2035 as a key document of the Master Plan will be briefly presented with an analysis of key parameters of health care effectiveness and above all improvement of the implementation of basic principles of health care - uniformity and availability of health services on the territory of Republic of Serbia. In order to present future key changes in the health system, it is necessary to take into account the current situation, as well as the potential consequences of the global pandemic of COVID-19 virus on health systems. Databases were used for analysis: WHO, OECD, World Bank Reports. The tendency of increasing the share of health care costs in GDP, with the problems of efficient use of health care resources, is becoming the most important reason for reforming health insurance and health care in almost all countries in the world. Numerous researches of eminent experts in the field of economy and finance indicate that the introduction of compulsory health insurance with a clearly defined package of health conditions is the most rational choice in the implementation of the World Health Organization project: "Health for all in the 21st century". A health system could be said to be effective if it provides health care of maximum quality in terms of medical outcome, with minimal costs in relation to the allocated funds. Health care systems around the world today face very similar problems, and the COVID-19 pandemic has shown how "vulnerable" it is not only the health system but all of humanity when faced with such challenges.
A c t u a l i t y . The role of “patient experience” in assessing quality of medical services is growing as a global trend to value-based healthcare. Currently, only 11% of the Russian population positively assess the quality of medical services. Federal law No. 256-FZ requires all public healthcare providers to conduct an independent assessment of the provision of services, but 44% of organizations do not have such assessment, that can be caused by methodological and organizational reasons. P u r p o s e o f t h e s t u d y to evaluate the prospects for digital improvement of measuring patient satisfaction using distributed ledger technology. To analyze the literature on the topic of independent assessment of the quality of services provided by medical organizations; to analyze modern approaches to assessing patient satisfaction with healthcare providers; to assess the opportunities of improving the processes and results of satisfaction assessment using distributed ledger technology. M a t e r i a l s a n d m e t h o d s . To achieve the purpose, the authors analyzed numerous relevant Russian and foreign sources of literature. Literature review was carried out across scientific libraries as eLIBRARY, PubMed by key words. The search in open sources in Google and Yandex was used. R e s u l t s . The complexity of “patient experience” measurement, biased assessment, ambiguity of the results obtained and the difficulty of correct interpretation require more transparent methods of measuring the value of healthcare. A decentralized platform based on distributed ledge technology may become one of the possible solutions to the problem of objective assessment of patients ‘ satisfaction with the quality of medical services. Such approach allows to form an objective dynamic multi-factor rating of processes and all other components of healthcare services. Conclusion. The existing mechanisms for independent assessment of the quality of medical services need to be improved. Confidence in the results of the patient satisfaction measurement is one of core requirement. To make managerial decision evidence-based, it is important to evaluate the processes and patient experience along with results of healthcare services. Distributed ledger technology implemented as a dynamic multi-factor rating platform can be a logical solution for improving the quality of services and could become a part of a comprehensive IT ecosystem based on value-based approach.
Andrey Litvin, С. В. Коренев, Ekaterina Gennadevna Knyazeva, V. Litvin
A blockchain technology representing a tool for data storage and transmission is briefly described in this review. Current trends of its development are also shown as well as currently known specific features and advantages of using the blockchain technology in medicine. The possibilities and prospects of applying the blockchain for solving some tasks in healthcare are analyzed. In addition, shortcomings and problems associated with the employment of this technology in medicine are also highlighted.
Konstantin Koshechkin, G.S. Klimenko, Ilya Ryabkov, Pavel Kozhin
Blockchain as technology described to be used in closed systems to conduct registers of official data in public healthcare. Also this technology had found its use in different other ways, for example it is education of medical staff, control of the contracts for healthcare services. And the role of Blockchain in CALS / PLM-technologies suggested.
Marina Laktaeva, E.A. Laktaeva, Василий Григорьевич Иванов
The article examines the problems of modernizing Russian health care at the regional level, investigates the issues arising in the course of implementing the Concept of Health Development in the Russian Federation, and identifies approaches to their solution. The authors point out that the Russian National Security Strategy defines the main priorities for the development of the health care system in our country, in particular, it has been established that development the healthcare system, as well as strengthening the health of the country's population, is one of the most important directions to ensure national security, which requires the development and consistent implementation of the long-term state policy in the sphere of health protection of citizens At the same time, there is an understanding of the main problems in the way of implementing state guarantees for the provision of free medical care to Russian citizens, which include: traditionally insufficient financial support for these guarantees, differentiation of the subjects of the Russian Federation in terms of implementing programs in this area, as well as well-known fragmentation of the sources of financing medical care, preventing the development and full implementation of the mandatory system of compulsory medical insurance for the population. Now the health financing system is fragmented and decentralized to a much greater extent than, for example, in most European countries.
There are three main problems at present in the area of health care: — an imbalance between the amounts of state financing for health care and the guarantees offurnishing medical assistanceto the citizenry at no charge; — a lack of coordination in the activities and contradictions in the mutual relations of the entities receiving state financing for health care, engendered by the decentralization of management and transition to a system of mandatory medical insurance; — an absence of competitive behavior among insurance organizations and medical institutions, despite the adoption of the institutions of a market economy into the system of health care.
The introduction of health insurance system has been the core of the Russian health care reform. It has coincided with the decentralization of the state administration. The reform has thus been decentralized, and the transition has been fragmentary and incomplete. As a result, the existing health financing system is eclectic and contradictory. Meanwhile, the reform has had a positive stabilizing influence on financing of health care under conditions of continued economic crisis. The new priorities of the reform should be to balance the financial flows and the state's obligations, and to increase the efficiency of the use of resources through encouragement of competition, assurance of transparency of public funding, development of health care planning, and shift from inpatient to outpatient care.