ORDER OF THE MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION

of March 19, 2020 No. 198n

About temporary procedure for the organization of work of the medical organizations for the purpose of implementation of measures for prevention and decrease in risks of spread of new koronavirusny infection of COVID-19

According to the Federal Law of 21.11.2011 No. 323-FZ "About bases of protection of public health in the Russian Federation" (The Russian Federation Code, 2011, No. 48, Art. 6724; 2019, No. 52, the Art. 7836) and Item 5.2.208 of the Regulations on the Ministry of Health of the Russian Federation approved by the order of the Government of the Russian Federation of 19.06.2012 No. 608 (The Russian Federation Code, 2012, 26, of the Art. 3526) and for the purpose of fight against threat of spread of new koronavirusny infection of COVID-19 I order to No.:

1. Create:

The federal remote advisory center of anesthesiology resuscitation for adults concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia (further - FDRKTs for adults) based on federal public autonomous educational institution of the higher education the First Moscow state medical university of name I.M. Sechenova of the Ministry of Health of the Russian Federation (Sechenovsky University);

The federal remote advisory center of anesthesiology resuscitation for children concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia (further - FDRKTs for children) based on the isolated structural division - the Russian children's clinical hospital of federal public autonomous educational institution of the higher education "Russian national research medical university of N. I. Pirogov" of the Ministry of Health of the Russian Federation;

The federal remote advisory center of anesthesiology resuscitation for pregnant women concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia (further - FDRKTs for pregnant women) based on federal state budgetary institution "National medical research center of obstetrics, gynecology and perinatology of name of the academician V. I. Kulakov" of the Ministry of Health of the Russian Federation;

the reserve Federal remote advisory center of anesthesiology resuscitation concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia based on federal state budgetary institution "National medical and surgical center of N. I. Pirogov" of the Ministry of Health of the Russian Federation;

The federal remote advisory center for questions of clinic, pathogenesis and treatment of the heavy and complicated flu forms at adults and children based on federal state budgetary institution "Research institution of flu of name A.A. Smorodintseva" Ministries of Health of the Russian Federation.

The organizational and methodical center for creation and functioning of mobile mobile multidisciplinary teams for the purpose of delivery of health care to patients with new koronavirusny infection of COVID-19 in subjects of the Russian Federation based on federal state budgetary institution "National medical and surgical center of N. I. Pirogov" of the Ministry of Health of the Russian Federation.

2. Determine single number of call center of the federal remote resuscitation advisory centers specified in Item 1 of this order - 8-800-200-46-46.

3. To federal state budgetary institution "National Medical Research Center of Ftiziopulmonologiya and Infectious Diseases" of the Ministry of Health of the Russian Federation:

provide holding remote seminars for health workers on features of clinical current, diagnostics and treatment of new koronavirusny infection of COVID-19;

provide the round-the-clock advisory help of subjects of the Russian Federation to executive bodies in the sphere of health protection in case of identification of persons with suspicion of new koronavirusny infection of COVID-19;

create mobile multidisciplinary teams for the purpose of implementation of organizational and methodical support of subjects of the Russian Federation on the organization of delivery of health care to patients with new koronavirusny infection of COVID-19.

4. To federal state budgetary institution "Central Research and Development Institute of the Organization and Informatization of Health Care" of the Ministry of Health of the Russian Federation:

create exit with new koronavirusny multidisciplinary crews for the purpose of implementation of organizational and methodical support of subjects of the Russian Federation on the organization of delivery of health care to patients COVID-19 infection;

perform operational monitoring of incidence of extra hospital pneumonia and new koronavirusny infection of COVID-19.

4.1. To federal state budgetary institution "National Medical Research Center of Therapy and Preventive Medicine" of the Ministry of Health of the Russian Federation:

create the Federal remote advisory center for questions of vaccination against new koronavirusny infection of COVID-19;

provide holding remote seminars for health workers of the medical organizations subordinated to executive bodies of subjects of the Russian Federation in the sphere of health protection, concerning vaccination against new koronavirusny infection of COVID-19;

provide the advisory help to the medical organizations subordinated to executive bodies of subjects of the Russian Federation in the sphere of health protection, concerning vaccination against new koronavirusny infection of COVID-19;

create "the hot line" for the purpose of informing the population concerning vaccination against new koronavirusny infection of COVID-19.

5. Recommend to heads of executive bodies of subjects of the Russian Federation in the sphere of health protection:

a) create and organize functioning:

the remote advisory centers of anesthesiology resuscitation for adults concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia (further - DRKTs for adults) based on the remote advisory centers of anesthesiology resuscitation performing activities according to the order of the Ministry of Health of the Russian Federation of 15.11.2012 No. 919n "About approval of the Procedure for delivery of health care to adult population on the "anesthesiology and resuscitation" profile (29.12.2012, registration No. 26512) with the changes made by the order of the Russian Ministry of Health of 14.09.2018 No. 625n is registered by the Ministry of Justice of the Russian Federation (31.10.2018, registration No. 52591) is registered by the Ministry of Justice of the Russian Federation;

the remote advisory centers of anesthesiology resuscitation for children concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia (further - DRKTs for children) based on the centers of anesthesiology and resuscitation for the children performing activities according to the order of the Ministry of Health of the Russian Federation of 12.11.2012 No. 909n "About approval of the Procedure for delivery of health care to children on the "anesthesiology and resuscitation" profile (29.12.2012, registration No. 26514) is registered by the Ministry of Justice of the Russian Federation, with the change made by the order of the Russian Ministry of Health of 09.07.2013 No. 434n (it is registered by the Ministry of Justice of the Russian Federation 02.08. 2013, registration No. 29236);

the remote advisory centers of anesthesiology resuscitation for pregnant women concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia (further - DRKTs for pregnant women) based on the obstetric remote advisory centers with mobile anesteziologo-resuscitation obstetric teams for rendering emergency and the emergency medical service of the perinatal center and maternity hospital performing activities according to the order of the Ministry of Health of the Russian Federation of 01.11.2012 No. 572n "About approval of the Procedure for delivery of health care on the "obstetrics and gynecology (except for uses of auxiliary reproductive technologies)" profile (it is registered by the Ministry of Justice of the Russian Federation 02.04. 2013, registration No. 27960) with the changes made by orders of the Russian Ministry of Health of 17.01.2014 No. 25n (it is registered by the Ministry of Justice of the Russian Federation 19.03. 2014, registration No. 31644), of 11.06.2015 No. 333n (it is registered by the Ministry of Justice of the Russian Federation 10.07. 2015, registration No. 37983), of 12.01.2016 No. 5n (it is registered by the Ministry of Justice of the Russian Federation 10.02. 2016, registration No. 41053);

directory service for ensuring interaction with service of operational medical care for the purpose of implementation of measures for prevention and decrease in risks of spread of new koronavirusny infection of COVID-19 for single telephone number "122";

b) organize interaction of DRKTs for adults with FDRKTs and Federal state budgetary institution "National Medical Research Center of Ftiziopulmonologiya and Infectious Diseases" of the Ministry of Health of the Russian Federation;

provide the organization of carrying out laboratory researches for the purpose of establishment of the causative agent of extra hospital pneumonia, and in case of impossibility of establishment of the activator - to provide operational informing Department of the organization of the emergency medical care and risk management to health of the Russian Ministry of Health;

c) organize delivery of health care using telemedicine technologies to citizens with the confirmed diagnosis of new koronavirusny infection of COVID-19, the condition of which allows to be observed at home, and also with signs or the confirmed diagnosis of extra hospital pneumonia, acute respiratory viral infections, flu;

organize providing the medical organizations with necessary rooms, means of communication and the equipment for carrying out consultations (consultations of doctors) for implementation of remote interaction of health workers with patients. In case of implementation of consultations using telemedicine technologies by health workers in case of remote operating mode to organize providing the specified health workers with means of communication and the equipment for carrying out consultations;

provide if technically possible and taking into account requirements about information security use of modern information technologies and information systems for the purpose of implementation of measures for prevention and decrease in risks of spread of new koronavirusny infection of COVID-19, including use of technology of artificial intelligence (including the diagnosis of new koronavirusny infection of COVID-19, based on the analysis of images natural language processing and recognition of the speech, intellectual decision support) according to the Presidential decree of the Russian Federation of October 10, 2019 to No. 490 "About development of artificial intelligence in the Russian Federation" (The Russian Federation Code, 2019, No. 41, the Art. 5700);

d) organize the out-patient centers of diagnostics and treatment of new koronavirusny infection of COVID-19 (further - the Center);

organize interaction of the Centers with the medical organizations providing emergency medical service and the medical organizations providing medical care in out-patient and stationary conditions;

provide equipment of the Centers road transport for delivery of patients, health workers, and also for transportation of biological materials for researches, delivery of medicines;

e) provide rendering in full to planned medical care to the patients with oncological and oncohematological diseases and also who are on replacement kidney therapy;

e) in case of development of adverse epidemic situation to organize delivery of health care to patients with symptoms of acute respiratory viral infections, extra hospital pneumonia, flu, new koronavirusny infection of COVID-19 in out-patient conditions, including remote method, in the place of departure of mobile medical crew, and stationary conditions, including in the reprofiled or in addition created structural divisions of medical and other organizations (except for structural divisions of the medical and other organizations providing medical care to the patients with oncological and oncohematological diseases and also who are on replacement kidney therapy); in case of reshaping of the medical organizations for treatment of patients with new koronavirusny infection of COVID-19 to provide possibility of treatment of patients with new koronavirusny infection of COVID-19 in combination with somatic pathology; to perform reshaping of the regional vascular centers and primary vascular departments on condition of preserving amounts of bed fund and availability of medical care to patients with sharp coronary syndrome and sharp violation of brain blood circulation;

g) based on the decision of executive body of the subject of the Russian Federation on cancellation of the rationing arrangements entered in the territory of the subject of the Russian Federation in connection with spread of new koronavirusny infection of COVID-19, to organize rendering in full and at the scheduled time of planned medical care to patients, including having provided renewal of activities of the medical organizations (structural divisions of the medical organizations) performing medical care in stationary conditions and which are earlier reorientated for delivery of health care to patients with new koronavirusny infection of COVID-19;

h) provide in case of need medical care to patients with new koronavirusny infection of COVID-19 in the medical organizations (structural divisions of the medical organizations) giving help to patients with noninfectious diseases with observance of sanitary and epidemiologic requirements;

i) provide till July 10, 2022 the step-by-step translation of patients from the medical organizations (structural divisions of the medical organizations) reorientated for delivery of health care to patients with new koronavirusny infection of COVID-19, in the medical organizations providing medical care to patients with infectious diseases in case of sufficient amount of bed fund.

5(1). Recommend to heads of executive bodies of subjects of the Russian Federation in the sphere of health protection and to heads of the medical organizations which take part in delivery of health care for the purpose of implementation of measures for prevention and decrease in risks of spread of new koronavirusny infection of COVID-19, including subordinated to the Ministry of Health of the Russian Federation, to provide duplication of sound and visual information, necessary for disabled people, and also texts, signs and other text and graphical information with the signs executed by relief and dot font of Braille, the admission of the signer and tiflosurdoperevodchik <1>.

Owners of infrastructure facilities of the state, municipal and private health care systems, where medical services (further respectively are provided to disabled people - objects) which cannot be adapted completely for needs of disabled people, accept (before their reconstruction or capital repairs) approved with one of public associations of the disabled people performing the activities in the territory of the settlement, the municipal district, the city district, measure for ensuring access of disabled people to the place of provision of medical services or when it is possible to provide it, for provision of necessary medical services in the residence of disabled people or in remote form.

The bodies and the organizations providing medical services on leasable objects which cannot be adapted completely for needs of disabled people take measures for amendment of agreements with lessors or for inclusion in lease agreements of conditions about execution by the owner of subject of requirements for providing conditions of availability to disabled people of objects and medical services.

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<1> The rules of provision to disabled people of services in the translation of the Russian sign language (sign language translation, tiflosurdoperevod) approved by the order of the Government of the Russian Federation of September 25, 2007 No. 608 "About procedure for provision to disabled people of services in the translation of the Russian sign language (sign language translation, tiflosurdoperevod)" (The Russian Federation Code, 2007, No. 40, Art. 4798; 2021, No. 41, Art. 6967).

6. Approve:

order of interaction of the federal remote advisory centers of anesthesiology resuscitation concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia with the remote advisory centers of anesthesiology resuscitation in subjects of the Russian Federation concerning diagnostics and treatment of new koronavirusny infection of COVID-19 and pneumonia according to appendix No. 1;

temporary procedure for the organization of rendering the ambulance, including fast specialized, medical care for the purpose of implementation of measures for prevention and decrease in risks of spread of new koronavirusny infection of COVID-19 according to appendix No. 2;

temporary procedure for the organization of work of the medical organizations providing medical care in out-patient conditions for the purpose of implementation of measures for prevention and decrease in risks of spread of new koronavirusny infection of COVID-19, according to appendix No. 3;

algorithm of actions of the health workers providing medical care in out-patient conditions, including at home, to patients with acute respiratory viral infections, flu and extra hospital pneumonia according to appendix No. 4;

the basic principles of the organization of medical care to patients with acute respiratory viral infections of medium-weight or heavy current, the heavy and (or) complicated forms of flu and extra hospital pneumonia in case of suspicion of new koronavirusny infection of COVID-19 in the medical organizations and their structural divisions providing medical care in stationary conditions according to appendix No. 5;

algorithm of actions of the health workers providing medical care in stationary conditions according to appendix No. 6;

the protocol of the events held by health workers for non-admission of intrahospital spread of new koronavirusny infection of COVID-19 in the medical organization providing medical care in stationary conditions according to appendix No. 7;

the basic principles of delivery of health care in out-patient conditions (at home) to patients with the established diagnosis of new koronavirusny infection of COVID-19 according to appendix No. 8;

procedure for the organization of additional training of health workers for the purpose of implementation of measures for prevention and decrease in risks of spread of new koronavirusny infection of COVID-19 according to appendix No. 9;

the minimum requirements to implementation of the medical activities directed to prevention, diagnostics and treatment of new koronavirusny infection of COVID-19, according to appendix No. 10;

temporary procedure for the organization of work of the medical organizations which are carrying out works on procurement, storage, transportation and safety of donor blood and (or) its components for the purpose of implementation of measures for prevention and decrease in risks of spread of new koronavirusny infection of COVID-19 among donors of donor blood and (or) its components according to appendix No. 11;

procedure for hospitalization in the medical organizations of patients with the established diagnosis of new koronavirusny infection of COVID-19 depending on severity of disease according to appendix No. 12;

procedure for the statement (translation) from the medical organization and criteria of recovery of patients with the established diagnosis of new koronavirusny infection of COVID-19 according to appendix No. 13;

temporary procedure for acceptance of patients by the medical organizations rendering specialized, including high-technology, medical care in planned form in the conditions of preserving risk of spread of new koronavirusny infection of COVID-19 according to appendix No. 14;

paragraph sixteenth ceased to be valid

temporary regular standard rates of the structural divisions of the medical organization providing medical care to adult population with new koronavirusny infection of COVID-19 in stationary conditions according to appendix No. 16;

temporary regular standard rates of the structural divisions of the medical organization providing medical care to children with new koronavirusny infection of COVID-19 in stationary conditions according to appendix No. 17;

temporary regulations of the organization and rendering advisory medical care using telemedicine technologies to citizens with the confirmed diagnosis of new koronavirusny infection of COVID-19, and also with signs or the confirmed diagnosis of extra hospital pneumonia, acute respiratory viral infection, flu, receiving medical care in out-patient conditions (at home), according to appendix No. 18;

regulations on the organization of work of the out-patient center of diagnostics and treatment of new koronavirusny infection of COVID-19 according to appendix No. 19;

rules of the organization of delivery of health care by mobile mobile multidisciplinary teams according to appendix No. 20;

temporary procedure for the organization of carrying out preventive inoculations against new koronavirusny infection of COVID-19, according to appendix No. 21.

7. This order is effective till January 1, 2023.

8. Subitem 1.9 of Item 1, subitems 2.19 and 2.27 of Item 2 of appendix No. 3 to this order, paragraph one of the column "Maintaining Tactics" of Item 1 of appendix No. 4 to this order, subitem 4.7 of item 4 and subitem 7.4.1 of Item 7 of appendix No. 18 to this order are effective till March 15, 2022.

Appendix No. 1

to the Order of the Ministry of Health of the Russian Federation of March 19, 2020 No. 198n

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