B. A. Kobrinskiy, V. A. Kutukov

Basic principles laying the information systems in healthcare: ensuring interoperability, the creation of applied information systems to model SaaS, legacy systems modernization and development of new components to the maximum possible preservation of the existing software and hardware. To create a health information system use technology of "cloud computing» is the most appropriated. The main advantage of using cloud computing technologies is a significant increase in the efficiency of automated processes and reduced costs of creating, supporting and developing information systems. We can distinguish two ways of building architecture - centralized and distributed. The implementation of a distributed architecture is more promising and reasonable. Its main advantages are: 1) a significant reduction in requirements for the reliability of the connection of medical institutions to access network bandwidth and stability bandwidth loop through to the core system, 2) preservation of health facility when disconnected from the network, 3) the ability to use embedded earlier local health information systems, 4) the ability to connect to a centralized system of private medical institutions, and 5) the maintenance of competition between medical in-formation systems, thereby improving their quality. Transition to the new principles of meta-system must be based on the introduction of a single electronic medical record that is generated based on multimodular structure that takes into account the needs of different users. For that should the following problems should be solved: 1) development of personal identity management system of electronic health records (issuing new IDs and keeping current, archive identifiers, issuing temporary IDs, changing device information to be authentic), 2) development of concepts and standards for the construction of maps (single module architecture for all types of medical facilities: obligatory modules - the vital data, diagnoses, treatment information, the provision of services, and others, subsidiary - information, with limited time, general use, for example, to provide emergency, satellite - additional information for the specialized registers; person-centred data integration at the federal level or in regional segment; the all-Russian classifiers of a questionnaire and medical units; information exchange based on open or agreed protocols and formats, and convert charts from databases of different institutional systems, the formation of integrated electronic health records on the basis of association approved fixed-ins), 3) develop a system to control access to electronic medical records (keeping on the federal level, references to maps that are stored at the regional level authentication and authorization of health care worker before going to map the patient; authorized access to keys and / or modules in the cards depending on the position and functional responsibilities; modular exchange to accelerate its transmission / reception, i.e. decrease the load on the channels of communication, a request to the regional data centers to view / receive / transfer of medical data on the link in the federal sector, compulsory registration of patients' rights to view his medical records by other physician).