«Public Administration Issues» Journal,

Post. address:
National Research University
Higher School of Economics
20 Myasnitskaya Str., Moscow 101000, Russian Federation
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of. 307, 4/2, Slavyanskaya sq., Moscow 109074, Russian Federation

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E-mail: vgmu@hse.ru 


Major Indexing

Research and educational journal
Published quarterly since 2007
ISSN 1999-5431
E-ISSN 2409-5095

Vеoletta Galitskaya1, Nataliya Meshcheryakova2
  • 1 Research assistant, Digital Anthropology Laboratory; Head of International Education Department SibMed, 2 Moskovsky Trakt, 634050 Tomsk, Russia.
  • 2 Dr. in Sociology, Head of Department of Political Sociology and Social Technologies, Russian State University for the Humanitatis, 6 Miusskaya Sq., 125993 Moscow, Russia.


2022. No. 4. P. 176–196 [issue contents]

The article discusses the specifics of implementing federal projects and programs in different regions and the regional project "Creating a unified digital circuit in health care based on the unified state health information system EGISZ" in Tomsk region in particular.  We used methods of document analysis (reports on the performance of executive authorities, regional and federal statistics); comparative analysis, in-depth informalized interviews with doctors of medical institutions inTomsk. The selected methods made it possible to compare the planned digitalization indicators with the figures of the current statistics; to identify the lagging areas and, based on opinions of the main actors of the process - doctors; to establish the reasons for the lag in digitalization by individual indicators, as well as the general attitude of doctors to the process itself. The study revealed a "digital paradox" which is that, for all the convenience of electronic services, a physician's work is impossible without their physical counterpart, such as a paper patient record. Analysis of the interviews showed that the main reasons for this paradox are lack of confidence in the reliability and efficiency of the unified information system, outdated equipment for the doctor's workplace, and slow Internet connections. In healthcare, the issue of a single unified platform, which does not yet exist, has become particularly relevant: individual medical institutions are experimenting with medical systems, choosing the most appropriate ones for specific tasks. Private clinics, however, are not yet ready to assume the costs of maintaining medical information systems. This leads to a slowdown in the process of creating a common database in which a doctor from any medical institution could access a patient's medical history.

The authors conclude that digital paradoxes arise as a reaction to the difficulties of the digitalization process and will lose their relevance as it develops. The process itself is welcomed by doctors, they see its benefits and prospects.

Citation: Galitskaya, V. A. and Meshcheryakova, N. N. (2022) ‘«Digital paradoxes» in health care system’, Public Administration Issues, 4, pp. 176–196. (In Russian). DOI: 10.17323/1999-5431-2022-0-4-176-196
ISSN 1999-5431
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