A.R. Dabagov

The review considers a number of aspects of modern medical informatics, its achievements and some immediate problems. The role of system theory as the most universal methods of solving the problems is briefly shown. The importance of approaches based on open systems theory and open systems architectures is depicted. In modern medicine, the transition to modern IT provides a range of new features and integration with digital diagnostics. This improves the quality of service, reduces the survey time, increases diagnostic accuracy, allows for remote consultations, surveys, analysis, and remote processing of primary information in highly specialized centers, but also offers the possibility of long-term storage of patient information in digital form. The creation and development of integrated computerized corporate-level MIS, their integration into regional, departmental, and public health is a complex, multi-level and complicated task. Moreover, some issues are so complex that they require the use of close attention of leading scientists and specialists. In the review, the systemic nature of problems is emphasized in its historical scope. Approaches based on open systems theory and open systems architecture are discussed; in such a way is shown to provide significant cost savings and improved quality and functionality, which also applies to a number of software development. The questions of building of a rather sophisticated systems, ensuring openness properties in the broadest sense of the word and building the optimal architecture of interoperable systems define a number of fundamental and applied problems and research methods. Problems of optimization of architectures of such systems, both interaction of "human-machine" and several others are in the foreground, which is associated primarily with a low-predictable behavior of suboptimal models and the resulting large commercial and others risks. It is noted that despite the rather significant input on health care in the world as a whole, there are billion dollars losses for a number of IT projects in the integration of medical systems. Much of the losses associated with the problems of complexity, they all are, as a rule, interdisciplinary, and emerging as the expansion and integration of systems and in the process of developing common standards, architectural models and methodologies for their analysis and design. On the basis of the considered material some conclusions and recommendations have been made on large-level MIS development, as well as point to some fundamental difficulties.