«DIGITAL PARADOXES» IN HEALTH CARE SYSTEM

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reasons for this paradox are lack of confidence in the reliability and efficiency of the unified information system, outdated equipment for the doctor's workplace, and slow Internet connections.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.