Key stages of implementation and adaptation of digital infrastructure for medical care for patients with diabetic retinopathy in the Tomsk region

INTRODUCTION. One of the serious complications of diabetes is diabetic retinopathy, which is the leading cause of blindness and disability. Digital screening for diabetic retinopathy is one of the effective measures recommended by the WHO. To implement an effective digital screening program for DR, several important conditions must be met. At the same time, the organization of the disease screening at the regional level requires a comprehensive approach, which includes compliance with the recommended international experience, taking into account the characteristics of the subject. This work is devoted to determining the key steps for the implementation and adaptation of such a digital infrastructure in the Tomsk region.

MATERIALS AND METHODS: the data of the federal statistical observation form No. 12, the Federal State Statistics Service https://rosstat.gov.ru/, Tomskstat https://70.rosstat.gov.ru/. Statistical analysis methods: descriptive statistics method, time series analysis. Data processing was carried out using the «MS Office Excel 2010» spreadsheets and the «Statistica» software package for Windows 10.0.

RESULTS. The key element of the digital screening system for diabetic retinopathy in the subject was the organization of the Retinal Pathology Center, the main goal of which is the prevention of blindness and severe visual impairments in the subject. The second important condition was the development and implementation of a telemedicine system with an embedded decision support system, which united the Retinal Pathology Center and medical institutions of the Tomsk region into a single digital circuit. The third condition was the adaptation of the routing of patients with retinopathy into the existing routing scheme for patients in the «ophthalmology» profile. Another condition was the implementation of a pilot project to adapt the digital structure to the existing scheme of medical care organization in the «ophthalmology» profile in the region, the identification of first-line medical organizations, and the establishment of digital communication. The final condition was the introduction of changes at the legislative level.

CONCLUSION. The fulfillment of the above conditions allowed the successful implementation of the digital project in the Tomsk region and the creation of an organizational infrastructure for the early detection and timely treatment of patients with diabetic retinopathy.

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