The electronic (public) health (EH) in the regions should be constructed, in accordance with the demographic - medically characteristics, specific features and the peculiarities of the territories, the safeguarding (public) health challenges, and to be included the evolutionary phase-by-phase development of the electronic services (ES) with the priority directions definition of the region (public) health development, the realization elaboration and implementation of the range complex of the regulatory-normatively, economic, personnel, and organizational activities, measures and arrangements [1].

So, the results of the carried out organizational experiment in the Nizhny Novgorod region have been shown, that the e-services further development should be considered the following: the rendering stages of the medical care, the services types facilitation, their volume planning, the interaction between the services and the (public) health care Institutions, as at the regional, well as at the federal levels. In the formation of the E(P)H organizational-functionally model, the following has been considered by us: the legal-normatively, economic, technological, personnel, methodological and the organizational support and its provision [2].

So, having taken into consideration the innovations complex character and its nature, the total cost and the activities, measures, and arrangements scope, the model realization and its implementation should be constructed, on the basis of the regional programs of the (public) health and the health care development, having contained the «informatization» special section in four stages, when each is practically lasted by 2-3 years (e.g. 12-24 months), and to be included the following sections of the work:

- the pilot Project realization and its further implementation to be created experimental segment tele-medical network service, on the basis of the medico-prophylactic Institution (MPI);

- the first stage organization of the electronic (public) health (EH) system, on the basis of the remote Central Regional Hospital (CRH);

- the second stage organization of the system (on the basis of the inter-regional specialized centers);

- the third stage organization of the system (e.g. the large-scale system implementation and the introduction in the region with all the CRH covering and the clinical hospitals).

So, the regional tele-medical network should have to be included the four levels (e.g. the scheme No. 1):

- the regional tele-medical center (TMC), on the basis of the leading multi-disciplinary clinical hospital with the reserved backup storage of the necessary medical data and the consultation center of the beyond-hospital monitoring;

- the disciplinary TMC, on the basis of the general multi-disciplinary and the specialized regional, municipal hospitals, specialized clinics and dispensaries, and also centers;

- the tele-medical rooms and surgeries, on the basis of the health care facilities (HСА), which are the inter-district and the inter-regional centers (e.g. traumatological, vascular, oncological and other disciplines and profiles);

- the tele-medical rooms and surgeries, on the basis of CRH.

The medical personnel is being trained by the tele-medical technologies, in order to be created the human resource capacity of the tele-medical structure. Such education is complemented by the necessary information, the introductory-informationally and awareness-raising activities, measures and arrangements such, as the theoretical and practical, scientific and practical conferences and exhibitions, the retreats, the regular columns and the constant headings on the tele-medicine in the regional medical journals and the publications.

As it has been shown, the carried out calculations by us, they have been conducted, on the basis of the expert estimates (e.g. the diagnosis making timeliness, and the adequate medical treatment assignment), the projected volume of the tele-medical consultations within the regional network system (e.g. from the regions' district) should be made up about 24 thousand tele-consultations per annual by the 20 disciplines and the profiles, that is accounted 18 thousand TMC working hours.

It had been calculated the hours number of the distance learning, which was amounted 13, 200 hours per annual (e.g. 60 hours per a day), having based on the doctors' number, having worked in the region's public health (12,900 people), the advanced training rise frequency periodicity, the hours proportion of the distance learning, including in the video-conferencing regime, which can be solved at the 10 terminals installations in the Medical Academy of the Nizhny Novgorod Region.

The working time budget of the regional TMC will be in the run up 16,500 hours per annual, with the tele-medical consultations register in the Federal specialized medical Institutions and its facilities (e.g. the distance diagnostics, and also the tele-educational events' direct conducting).

Thus, the total activities volume, per annual, will be amounted to about 5,000 hours for the profile and disciplinary TMC (e.g. on the basis of the regional and municipal clinical HCF). The total activities volume of the regional tele-medical room and its surgery of the first type of the tele-medicine-based CRH or the inter-district and inter-regional centers should be about 2,500 hours per annual, the medical study and its office of the second type (e.g. on the basis of the remote CRH, which are not equipped by the diagnostic AWPs) - 2,200 hours per annual.

The EH wide range use has its high level social-medically efficiency and economic feasibility, and this, moreover, is practically allowed to be solved the challenges by the quality and the population medical care availability improving at the up-to-date level, it is promoted to be strengthened help of the industry branch human capacity, the modern organizational technologies introduction.

ТМ-Center Type                                   Functions                                         Packaging
The regional                            The development coordination                     The central bloc PACS-
tele-medical                              of the regional tele-medical                        system, the hospital
     center                                   system, the interaction with                   information system with the
(on the basis of                                  the Federal centers;                                   specialized sub-
  the regional                                  the tele-consultation,                       systems, the auditorium and
     clinical                                         the remote diagnostics,                     the personal systems of the
     hospital)                                      the video-educational,                              videoconferencing, the
                                                             videoconferencing                         input instrument of the medical
                                                             events' conducting;                         information, the consultative
                                                      the electronic public health                     centers with the equipment
                                             services' development; educational and              for the data processing
 
                  
  The profile                             The interaction with the                              AWPs PACS-systems,
  tele-medical                                    Federal centers;                                   the auditorium and personal
   center                                       the tele-consultations,                            videoconferencing systems,   
(on the basis of                             the remote diagnostics,                   the input instrument of the medical
 the regional and                    the video-educational measures              information, the equipment for the
   municipal                                           conducting,                                           remote diagnostics
    HCF)                                      videoconferencing;
                                                         electronic publiс health                                                                               
                                                     services development
 
The tele-medi-                            The materials preparation and                            AWPs PACS-systems,
cal room of the                               delayed and synchronous                                  the personal systems
1 type (on the                            consultations conducting, the                                 videoconferencing,
   basis of the                                participation in the video-                           the input instrument of the medi-
large CRH and                                 educational activities,                               cal information, the peripheral   
   inter-district                            videoconferencing, diagnostic                             equipment for the remote
      сenters)                                       researches conducting                                             diagnostics
                                                    with the remote transmission
 
The tele-medi-                               The materials preparation for                     The personal computer,
cal room of the                                  the delayed consultations               the simplest instrument input of
2 type (on the                                   the documents' obtaining by                   the medical information
basis of  CRH                                           electronic mail,                               (WEB-camera, flat-bed
of the remote                               diagnostic researches' conducting                scanner, digital camera),
    districts)                                            (EСG) with the remote                    the peripheral equipment for
                                                                       data transfer                            the ECG remote diagnostics

The Scheme No.1. The Structure, Functions and Technological Base of E-Health Network of the Region.

2. Orlov O.E. ,”The Tele-medicine in Public Health Care Organization System”. (The «Practical Tele-medicine» Series. The Issue 3, M.: «The Word» Firm Ltd.», 2002. p. 40.