Moscow Vice-Mayor Anastasia Rakova on the Future of the Capital`s Hospitals, Polyclinics, Schools, and Colleges
Moscow`s healthcare and education systems are undergoing extensive reforms, transitioning to a fundamentally new operational model. In an exclusive interview, Deputy Mayor of Moscow Anastasia Rakova discussed the ambitious program for modernizing city hospitals, the new standard for oncology treatment, the development of international medical tourism, and the prospective application of artificial intelligence in healthcare. She also addressed the challenges Moscow schoolchildren face in university admissions, how the city is tackling the shortage of college places, and the rising demand for vocational education.
On the Future of Moscow Hospitals
— Mayor Sergey Sobyanin recently announced the completion of the Moscow polyclinic modernization program. What`s next for the healthcare system?
— The renovation of outpatient clinics was just one phase; the modernization of Moscow`s healthcare system continues. We are now actively upgrading city hospitals. This work is less visible because, fortunately, people don`t visit hospitals as frequently. To date, approximately 100 facilities, including major ones like Kommunarka Hospital, Loginov Hospital, and St. Vladimir Children`s Hospital, have been renovated or newly constructed.
Last year, we completed the renovation of all hospital emergency departments and built six flagship centers, establishing a new emergency care system. By implementing unified modern approaches, innovative technologies, clear algorithms, and equipping facilities with advanced equipment, we`ve significantly improved the speed and quality of urgent medical assistance. Now, regardless of which clinic a patient is taken to, they can be confident of receiving consistently high-quality medical care in equally comfortable conditions.
Our second major initiative, nearing completion, is the development of a new standard for oncological care. All resources are concentrated in five large multidisciplinary hospitals: Loginov Center, Kommunarka, Botkin Hospital, Yudin Hospital, and Hospital No. 62.
These centers are equipped with everything necessary for accurate diagnosis, treatment (including repeat cycles), and subsequent lifelong dispensary observation.
These are not merely new clinics; they represent a new standard for oncological patient care, ensuring a clear patient journey and the full responsibility of a unified medical team from diagnosis through all stages of treatment.
The final step in establishing Moscow`s oncological service will be the opening of a new complex for Oncological Hospital No. 62 in Skolkovo early next year. Here, Muscovites will receive a complete cycle of medical care on one site, from initial consultation to all types of treatment and long-term follow-up.
— What is planned for the future?
— We recognize that to create the medicine of the future and become global leaders, we must focus on constructing entirely new medical institutions – «clinics of tomorrow.» This is a complex undertaking that goes beyond simply erecting buildings. It involves designing facilities that consider not only current medical capabilities but also future developments, integrating advanced medical standards, aesthetic space, a healing environment concept, and innovative construction technologies and materials.
For several years, interdisciplinary teams comprising medical professionals, architects, designers, and business analysts have been developing concepts for future large medical centers, each exceeding 100,000 square meters. The new Hospital No. 52 will be the first embodiment of this approach, followed by the Sklifosovsky Institute, Demikhov Hospital, and a multidisciplinary children`s hospital in the west. These projects are unprecedented in scale for our practice.
Currently, we are also developing concepts for the second phases of Kommunarka Hospital, St. Vladimir Hospital, and a new hospital in Troitsk.
— What is the fundamental difference from previously built clinics?
— Most existing hospital buildings were constructed in the 1970s and focused solely on inpatient care.
A modern medical center today represents a fundamentally different format: it`s a competence center offering outpatient appointments, day hospitals, and one-day surgeries, as many modern treatments no longer require overnight stays.
It involves equipping facilities with the most advanced technology: modern CT and MRI scanners, linear accelerators for oncology hospitals, and robotic systems. Last year, we acquired seven new robot-assisted surgical systems for the city`s leading clinics. The number of robotic surgeries has nearly doubled compared to 2023.
It`s about transparent, highly efficient, and clear patient pathways for all medical profiles, both for doctors and patients. This ensures patients don`t have to navigate between different institutions to find who will treat them. Instead, doctors seamlessly transfer them and remain responsible for the patient`s condition.
Crucially, there must be clear interaction between polyclinics and hospitals, ensuring they complement each other and each takes over when necessary. These clinics must not only be digital but also widely adopt all cutting-edge technologies, such as artificial intelligence and cellular technologies in medical practice.
And, of course, the service environment is vital. We pay special attention to the comfort of both medical staff and patients. For doctors, this means not only modernly equipped workplaces but also new common rooms, meeting rooms for discussing clinical cases, and changing facilities. For patients, we`ve developed a new balanced menu in all hospitals – it`s not only healthy but genuinely tasty, served on new modern tableware. We are currently replacing bed linen. For relatives of patients in intensive care, special lounge rooms are provided where they can relax, shower, and rest.
On Medical Tourism
— Is Moscow`s medicine ready to receive regional patients?
— Our goal is to treat not only residents from other regions of Russia but also patients from all over the world. We plan to develop medical tourism in Moscow. I am confident that the capital already possesses all the necessary capabilities for this. Primarily, we are focusing on countries in the near abroad, as organizing cooperation with them is simpler, but we will also actively work with more distant countries, inviting them to collaborate.
— It`s clear that international tourism will be commercial. What about interregional tourism — will it be under mandatory health insurance (OMC)?
— We plan to develop medical tourism within both the OMC system and the sphere of paid services. Today, people are willing to invest in their health and pay extra for a high level of service. We are ready to provide such services on par with private clinics, while remaining open to working within the OMC framework. Thus, we are prepared for cooperation in all areas — both under mandatory insurance and on a commercial basis.
— How will you attract tourists from abroad?
— Across most medical specialties, we demonstrate a higher level of competence compared to many countries in the near abroad. This is our first key advantage.
The second significant advantage is the cost of treatment. Medical services in Moscow are considerably more affordable than, for example, in Korea or Turkey. At the same time, the quality, for instance in oncology — the level of diagnostics, surgical intervention, chemotherapy, and radiotherapy — meets the highest global standards. Thus, patients receive world-class treatment at a much lower cost.
This competitiveness extends to other areas such as cardiology, nephrology, neurosurgery, ophthalmology, hematology, and others, where we confidently hold a strong position on the international stage.
On Operations During Seasonal Illness Outbreaks
— How has the infectious disease service changed in recent years, considering the experience gained during the pandemic?
— The pandemic taught us a great deal, and today we have a clear understanding of how to quickly, effectively, and proactively reorganize the work of our outpatient and inpatient networks during seasonal outbreaks and potential epidemics – ensuring that medical care is provided to everyone and exactly to the required extent.
— We are currently experiencing a seasonal increase in acute respiratory viral infections (ARVI). How is the network`s work being restructured today?
— During the COVID-19 pandemic, we clearly understood that in a megalopolis like Moscow, the risk of infection spread is always extremely high. The city is integrated into global transport flows, with a constant movement of many people from different regions and countries. Therefore, to understand, predict, and, most importantly, manage the epidemiological situation, we continuously monitor the viruses circulating in the city. We not only identify them but also perform real-time whole-genome sequencing to understand the properties of each strain. This allows us to see which virus is dominant, which is gaining strength, and which is fading, as well as to predict the level of incidence. By analyzing this data daily, we can plan for the development of a seasonal wave or timely identify the start of an epidemic, predicting its scale with accuracy down to dozens of cases per day.
Every day, we compare the forecast with actual indicators and, based on this, deploy the necessary medical capacities. If, for example, we see that rhinovirus accounts for 70% of morbidity (it usually presents mildly and is mainly active among children), we increase the number of on-duty doctors in pediatric polyclinics.
Further, depending on the situation`s development, we adjust resources daily. If the forecast shows that the wave is subsiding and, for example, the deployed examination rooms with on-duty doctors (no appointment needed, working on a live queue basis) in each polyclinic are sufficient, we reduce them, returning doctors to their regular appointments.
Conversely, if an increase in incidence is predicted, which could lead to a rise in hospitalizations (considering the virus`s properties), we separate the forecast for adults and children and begin organizing the work of hospitals. We distribute patient flows, deploy additional departments and beds. Temporarily, for two to three weeks, we increase the workload on staff and reactivate reserve departments that are usually idle in summer. We have clear schedules for deploying bed capacity and placing hospitals on heightened alert. Personnel receive necessary training in advance during the summer. When the wave of illness passes, we similarly and systematically scale back the additional capacities.
On Women`s Reproductive Health Screening
— Moscow recently launched a program allowing women aged 18 to 40 to undergo a free reproductive health check, including an Anti-Müllerian Hormone (AMH) test. What are the results of this testing?
— We often live under the illusion that modern medicine can do anything and that planning children can be postponed indefinitely. Some believe it`s fine to consider it closer to 40. Undoubtedly, medicine can do a lot today, but not everything. It`s important to try and do things at the right time. That`s why, in addition to existing reproductive health screening programs, we have provided every woman aged 18 to 39 with the opportunity to take an AMH test and assess her ovarian reserve. Of course, this test is not the sole component of reproductive health screening. The «I Will Become a Mom» program includes a comprehensive set of measures: from the initial AMH test to full diagnostics, IVF procedures, the possibility of cryopreservation of oocytes or embryos with subsequent storage. For women at risk of hereditary diseases, free preimplantation genetic testing of embryos is offered.
The program proved highly popular: 270,000 women have undergone the test in a year. This allowed us to obtain unique population data that was previously unavailable.
The results revealed trends worth noting. For example, 10% of women aged 24–29 who took the test already showed a reduced ovarian reserve. This indicates a high probability of difficulties with future family planning, meaning this issue needs to be addressed now, without even postponing for two or three years. In the 29–34 age group, this figure rises to 20%, and among women aged 35–39, it`s 40%. This vividly demonstrates the importance of acting promptly.
On the other hand, we were pleased that many women, upon receiving less than optimal AMH results, begin to consider planning and do not delay it. Over 8,000 women will soon become mothers. This is a positive psychological effect of the program.
There`s also a direct medical outcome. In 500 women, excessively high AMH levels were detected, which in certain cases is not a good but rather an alarming sign, indicating diseases, including oncological ones. All these patients were immediately placed under medical observation. Thanks to timely organized treatment, many of them will not only be able to become mothers but, in essence, save their lives.
— How many women have taken advantage of the opportunity for genetic material cryopreservation?
— Around 200. It`s important to understand that people`s consciousness and behavior change very slowly. All the programs we implement are designed not for immediate results but for a long-term perspective. Those who freeze their biomaterial today may only realize its value much later.
— Is there a shortage of personnel in the healthcare system?
— There is no shortage of staff overall, but there is always a shortage of good staff. Therefore, we are open to talented specialists and strive to ensure that the best doctors want to work specifically in Moscow`s polyclinics and hospitals and see their professional future here, rather than moving to the private sector.
On one hand, we offer work in modern clinics with the most advanced equipment and guarantee competitive salaries, create comfortable working conditions (including places to rest and eat), and ensure optimal workload.
On the other hand, we create opportunities for professional growth. Several years ago, a unique HR center began operating in Moscow. It helps every doctor build an individual educational track, for example, to fill knowledge gaps, master new technologies, and develop in science.
A separate area is supporting innovator doctors. We strive to motivate doctors to move forward and implement new solutions in daily practice. Any Moscow specialist or team can propose new treatment methods or scientific developments. The Mayor of Moscow allocates grants totaling over 1 billion rubles annually for this purpose.
To provide Muscovites with high-quality medical care, we must demand high standards from doctors, especially now that we have created all the necessary conditions for their work.
For example, a doctor cannot simply come to a polyclinic and get a job; they must first pass a corresponding test at the HR center.
Starting this year, by decision of the Council of Chief Physicians, all heads of departments in our hospitals must pass an exam and obtain the «Moscow Doctor» status. I won`t hide it – not everyone passes on the first try; the exam is difficult and multi-staged. But this is very important because the best of the best, leaders who will move the team forward, must be at the helm of medical departments. To be such a leader, it is important to constantly learn, improve one`s knowledge, and be able to cope with difficulties. Today, over 1,500 department heads have passed the exam and received the Moscow Doctor status, which is 80% of all leaders.
This comprehensive work aims to ensure that the Moscow medical team comprises the strongest specialists capable of providing the highest level of medical care.
On Technologies in Moscow`s Healthcare System
— How is Moscow`s Unified Medical Information and Analytical System (EMIASS) developing?
— Development is proceeding in several directions. First and foremost is data management. Today, patients have complete freedom to manage their medical information. They can independently grant access to their electronic medical record to any doctor – both in private and federal healthcare systems. Moreover, they can configure the access level, for example, opening it only for a specific period. Patients can also independently upload medical documents to their medical record for storage in a unified digital environment. Additionally, it`s possible to grant access to children`s health information: parents can not only view their child`s medical history but also use the video surveillance function for newborns in intensive care.
In parallel, we are scaling our experience. A number of federal clinics are already using our software product in their hospitals. Currently, EMIASS is being implemented in St. Petersburg clinics. We are open to cooperation with other regions as well.
I want to emphasize that this is a unique system, with virtually no analogues in the world yet. EMIASS accumulates all patient medical information from all city medical organizations. For example, if a patient visited different doctors in a polyclinic last week, received emergency care yesterday, will be in an oncology dispensary today, and will be hospitalized tomorrow – all this data is recorded in real-time in one electronic medical record. This data has a retrospective of several years and will accumulate throughout the patient`s life.
The main advantage is that this information is instantly available to any doctor. For instance, when a patient is brought to the N.V. Sklifosovsky Research Institute of Emergency Medicine, the doctor immediately sees a complete picture of what happened with the patient previously. This dramatically increases the speed and quality of medical care.
— Data from private and federal clinics are not automatically uploaded to EMIASS. Are you considering allowing these medical institutions access to the system?
