Telemedicine technology management: strategic priorities and institutional barriers[Менеджмент Телемедицинских Технологий: Стратегические Приоритеты И Институциональные Барьеры]

Purpose. A comprehensive analysis of strategic priorities in the development of telemedicine technologies in the Russian Federation, contributing to the integration of innovative approaches in the medical care system, and identifying institutional barriers affecting the scaling of remote medical services. Methods. The research is based on the integrated use of systemic and institutional methods to assess the factors determining the development of telemedicine in the existing socio-economic and regulatory environment. The use of the structural and functional method made it possible to identify the main elements of telemedicine, identify their features and assess the degree of adaptation to the institutional environment. The analysis is based on data from Russian medical platforms that include elements of artificial intelligence, cloud technologies, and big data. Results. The main drivers of technological progressive telemedicine have been identified, including the entire range of end-to-end technologies and integration of artificial intelligence technologies, cloud technologies, interoperable medical platforms, etc. into the implementation of medical services. The typologization of digital services in healthcare has been carried out, based on an assessment of existing ecosystems for the implementation of medical services. An analysis of the effectiveness of telemedicine technologies has been carried out, demonstrating a reduction in significant healthcare costs by minimizing the cost of transporting patients, optimizing human resources and increasing the availability of highly qualified medical care. Institutional constraints have been identified due to regulatory imbalances, imperfect financing of telemedicine services, and insufficient digital literacy of medical personnel and patients. Conclusions. The results of the study confirm that the strategic development of telemedicine technologies in Russia is determined by the synergy of technological innovations and institutional reforms aimed at improving the quality and accessibility of medical services. The identified drivers of healthcare digitalization, such as the introduction of artificial intelligence, the use of cloud technologies and big data, portable devices (IoT), lead to the emergence of new digital ecosystems for the implementation of medical services that can transform the economy of social reproduction. The economic efficiency of telemedicine is associated with reducing the total costs of the healthcare system by optimizing the logistics of medical services and reducing the cost of inpatient treatment. The analyzed models of telemedicine services demonstrate high adaptability to the institutional environment. At the same time, the successful integration of telemedicine technologies into the healthcare system requires an integrated approach, including institutional reforms, the development of digitalization processes, standardization of medical data, and increased innovation. Overcoming the described institutional barriers will make it possible to create a sustainable healthcare model that ensures high economic efficiency and quality of services provided.