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

Digital screening for diabetic retinopathy (DR) is an effective measure recommended by WHO. To implement a modern digital screening program for DR, several important conditions must be met, while the organization of screening at the regional level requires a comprehensive approach that includes compliance with recommended international experience, taking into account the characteristics of the subject. This paper is devoted to identifying the key steps in the implementation and adaptation of such a digital infrastructure in the Tomsk region. Data from federal statistical observation form No. 12, Federal State Statistics Service https://rosstat.gov.ru/, Tomskstat https://70.rosstat.gov.ru/. Methods of statistical analysis: descriptive statistics method, analysis of dynamic series. Data processing was carried out using MSOffice Excel 2010 spreadsheets and the Statistica for Windows 10.0 application package. The key condition for organizing a digital screening system for DR in the region is the creation of the Retinal Pathology Center, the main goal of which is the prevention of blindness and visual impairment in the region. The second important condition is the development and implementation of a telemedicine system with a built-in system for supporting medical decisions, which united the Retinal Pathology Center and medical institutions of the Tomsk Region into a single digital circuit. The third condition is the adaptation of the routing of patients with retinopathy to the current patient routing scheme for the ophthalmology profile. Another important condition was the implementation of a pilot project to adapt the digital structure to the existing scheme for organizing medical care in the ophthalmology profile in the region, identifying first-priority medical organizations, and establishing digital communications. The fifth is making changes at the legislative level. Fulfillment of the above conditions allowed us to successfully implement the digital project in the Tomsk region and create an organizational infrastructure for early detection and timely treatment of patients with DR.