Historical aspects and current trends in the organization of the laboratory service of the Russian Federation (literature review)

Trends in the development of modern healthcare and medical science led to a paradigm shift in medicine, which could not but affect the activities of the laboratory service. Currently, the introduction of new technologies and organizational issues of laboratory activities are largely solved autonomously and not everywhere in the same way. A systematic approach is needed to understand the changes taking place, and from this point of view, a review of trends in the development of clinical laboratory diagnostics and the organization of laboratory services in the Russian Federation is relevant and scientifically significant for the further development of the industry. The purpose of the study is to analyze the historical aspects of the organization of laboratory services in the Russian Federation and review current trends in its development. The paper uses a selective literature review. The normative documentation on the organization of laboratory services, publications by various authors on the development of laboratory diagnostics and the organization of laboratory work in Russia, as well as on the experience of various subjects of the Russian Federation in this field have been studied. These studies indicate that the laboratory service of Russia has gone a long way in development, starting from simple devices for research and manual preparation of reagents to the creation of complex closed-loop diagnostic systems integrated with laboratory information systems embedded in the contour of medical information systems at the level of territories and subjects of the Russian Federation. The organizational basis of the laboratory service has also changed significantly: from individual low-power disparate laboratories to large centralized high-tech laboratory complexes of various forms of ownership. The analysis made it possible to identify several periods (stages) in the development of the laboratory service, each of which was characterized by the emergence and introduction of new laboratory diagnostic technologies and/or research methods, regulatory and legal regulation, and typical practical implementation on the ground. It can be assumed that the further development of the laboratory service will go in several main directions: 1) centralization, creation of large laboratory complexes, integration of information systems at the level of territories and subjects of the Russian Federation, using the capabilities of large amounts of data and artificial intelligence; 2) deepening and further development of specialization; 3) further miniaturization of devices and expanding the possibility of diagnosis at the bedside. Due to the continuing biological threats, it will obviously be necessary to maintain horizontal integration as the basis of the organization for specialized virological, bacteriological, microbiological laboratories.