Delivery of health care to the population using mobile telemedicine systems

The approaches to increasing accessibility and improving quality of the medical care provided to inhabitants of hardly accessible and remote settlements of the Russian Federation, realized by means of mobile telemedicine units (MTU) within the project of creation of telemedicine systems (TMS) are considered. The basis of classical TMS is made by two segments interacting among themselves by means of telecommunication lines. The first segment includes a network of stationary telemedicine consulting and diagnostic centers, and the second — a set of MTU performing different functions. The analysis of possible architecture of TMS is carried out. Shortcomings of two-segment TMS, from which the main one is isolation of a system from a network of the out-patient policlinics existing in regions of the Russian Federation, are revealed. It is shown that implementation of such decision results in creation of duplicating circuits of provision of medical services to the population, transmission of a part of functions of policlinics to hospitals of TMS, violation of the rules of medical documents flow, and increase in cost of creation and operation of TMS. The paper proposes three-segment architecture of TMS, which includes existing policlinics as well as MTUs and hospitals of TMS. The proposed solution is free from shortcomings of two-segment TMS, and its functioning conforms to the existing legislation on the organization of delivery of health care to the population of the Russian Federation.