Internet diagnosis and treatment:

Convenience, but also troubles

  Economic Daily·China Economic Net reporter She Ying

  Recently, Peking Union Medical College Hospital's Internet diagnosis and treatment was officially launched. The online departments include cardiology and endocrinology, which will be gradually expanded to all clinical departments in the hospital after stable operation. The picture shows Zhang Huabing, an endocrinologist at Peking Union Medical College Hospital, visiting the telemedicine center. Photo by Xinhua News Agency reporter Zhang Yuwei

  Since the beginning of this year, due to the impact of the new crown pneumonia epidemic, Internet diagnosis and treatment has gone from a niche perspective to popular demand—patients who are inconvenient to go to the hospital directly inquire about medicines on traditional Internet diagnosis and treatment platforms such as Doctor Chunyu and Good Doctor Online. BAT strongly recommends My own Baidu asks doctors, and chronic disease management platforms such as Alibaba Health, Penguin Almond, and Medical Federation are increasingly being accepted by doctors and patients. For a time, people’s mobile phones have many doctor lists, and they can open a remote consultation without registration at any time. Different from "Internet + hospital", which mainly improves the convenience of seeking medical treatment, Internet diagnosis and treatment focuses on activating the stock, allowing doctors to use their leisure time to carry out practice, and allowing more patients to share high-quality medical resources.

  However, in recent visits to some doctors, patients, and medical platforms, the reporter found that the popular Internet diagnosis and treatment is indeed convenient. Although it has developed rapidly, there are still "growth worries", and further clarification and support of policies are urgently needed.

 Patient: It's really convenient to see a doctor, but it's a bit expensive

  Ms. Xiong from Shanggao County, Yichun City, Jiangxi Province has suffered from hypertension for many years. In recent months, she feels dizzy badly. "The doctor in the county doesn't look good, so let me go to the First Affiliated Hospital of Nanchang University." Ms. Xiong spent more than 70 yuan on the fare to Nanchang and another 25 yuan for registration, but the doctor could only prescribe medicine for one month. And the outpatient service cannot take medical insurance. Ms. Xiong was worried that she would have to be so frustrated next time she sees a doctor. The doctor told her that she could contact her online and consult her condition at any time. If the medicine is finished, she can buy it online. Ms. Xiong returned home with confidence.

  "The internet doctor is very good. I didn’t control my blood pressure for a day or two after taking the medicine, so I posted a picture to the doctor on the Internet, and the doctor instructed me to continue taking the medicine, not to stop for now, and to strengthen exercise. I can adjust the medicine when it is stable. "Ms. Xiong said, "Because the use of WeChat graphics and text for consultation is free, I have since asked the doctor four or five times." Ms. Xiong’s only dissatisfaction is the price. “The use of telephone to communicate with doctors requires a fee of 50 yuan for 10 minutes. In addition, the cost of medicine cannot be reimbursed by medical insurance, which feels a bit expensive.” Compared to Ms. Xiong, Mr. Li of Langfang, Hebei now relies more on the Internet diagnosis and treatment platform and has a higher acceptance. Because of the recurrence of lung adenocarcinoma after surgery, Mr. Li has developed drug resistance, and currently he can only rely on chemotherapy for treatment. But it is very inconvenient to go to Beijing during the epidemic, and the hospital number is not easy to hang up.

  In February of this year, Mr. Li’s attending doctor recommended him to use the Medical Federation to conduct a local examination in Langfang, and upload the results to the doctor. If adverse reactions occur during chemotherapy, he can communicate in time. The most important thing is that he can register for free. "During chemotherapy, I feel nauseous and uncomfortable, and various blood indicators have changed greatly. I can find the doctor team to answer questions at any time, and I feel more at ease." Mr. Li said that there is a nutritionist in the doctor team to guide him on how to eat nutrition, and he feels he is recovering. Not bad, "I didn't have the energy to speak before." Mr. Li told reporters that he did not go to a hospital in Beijing recently. If necessary, he will ask for a consultation online: “It’s OK to spend some money.” He doesn’t care about the reimbursement ratio. “We don’t have a cancer hospital here. I’ll go Cancer hospitals can’t be reimbursed for medical treatment. Internet diagnosis and treatment is really convenient.”

  Doctor: Conveniently manage patients and build personal brand

  Chen Enqiang is an infection doctor at West China Hospital in Sichuan, specializing in liver disease diagnosis and treatment. Chen Enqiang said that Huaxi Hospital has its own Huayitong online, but it can only provide simple services such as registration and checking laboratory results. At present, he uses the best doctors and medical associations the most. Especially the Medical Federation has become his main tool for out-of-hospital management of patients.

  “Most of the people who see me for treatment are patients with liver disease, and they generally need long-term medication.” Chen Enqiang told reporters that in the past, these patients had to come to West China Hospital to scramble for numbers to review, issue laboratory tests, and prescribe medications. After returning home, patients took medication and recovered. The doctor has no way of knowing. "Especially for patients in some districts and counties, it is not easy to come to the hospital once. Each time they come, they may catch up with a new doctor, and they need to be familiarized with their condition again."

  "During the epidemic, a patient with liver cirrhosis in a county came to see the doctor, and his condition rebounded after taking a medicine for a long time." Chen Enqiang recalled that he changed the patient to another medicine at that time, and the medicine needed to be changed. Check the verification effect. The patient's travel expenses to and from West China Hospital cost more than 500 yuan each time, so frequent visits are unrealistic.

  After using the Medical Federation, Chen Enqiang will advise the patient to scan his exclusive QR code on the Medical Federation platform. After becoming his patient, he can initiate consultations, upload laboratory tests, and prescribe medication at any time. If you need to register to see a doctor, he can also make an appointment in advance, so that the diagnosis and treatment are more consistent.

  Chen Enqiang's more than 1,000 "fans" of patients basically came from this way, and now there are more than 300 "fans" who often consult him, and the condition of the patient with liver cirrhosis has also been effectively controlled through online consultation.

  As early as 10 years ago, Dr. Xiao Jianpeng of the 900th Hospital of the Joint Service Support Force of the Chinese People's Liberation Army began to contact the Internet for diagnosis and treatment. He first registered on the Haodafu online platform and later contacted the Medical Federation platform. "I mainly focus on diabetes and other metabolic diseases. Patients with this disease need long-term medication and also pay attention to healthy diet. A lot of my work is actually performed outside the hospital." Xiao Jianpeng said that after signing the Internet diagnosis and treatment platform, the platform is equipped with doctors. Assistants and health managers help to collect data, remind patients to pay attention to diet and medicine, and prevent and intervene in time. "Currently, my more than 200 online patients are all old patients I have treated in the outpatient and inpatient departments."

  The reporter noticed that there are more doctors engaged in Internet diagnosis and treatment in the top three hospitals in Beijing, Shanghai, Guangzhou and other places. For example, the Chinese People’s Liberation Army General Hospital, the West China Hospital of Sichuan University, the Second Xiangya Hospital of Central South University, the First Affiliated Hospital of Zhejiang University School of Medicine, and the No. Famous doctors from third-class hospitals such as the third hospital accept online consultation. Doctors in certain third- and fourth-tier cities are also willing to create personal brands through the Internet and interact with patients frequently. In the case of Alibaba Health, some doctors set a price of "300 yuan for graphic consultations and 400 yuan for telephone consultations", and more than 1,700 questions have been answered, showing the urgent needs of patients. There are also many doctors who only charge 5 yuan, 6 yuan, and 10 yuan, and the answers range from hundreds to thousands of questions. There is also a deputy chief physician of Kunming First People’s Hospital who only charges 2 yuan for consultation. More than 800 people have enjoyed his convenient and cheap medical services.

  Contradiction: Encourage development, but it takes time to land

  Although both doctors and their patients agree on Internet diagnosis and treatment, Internet diagnosis and treatment often face embarrassment. The first is the hospital's attitude.

  "The country says it encourages development, but whether it can be done depends on whether the hospital leaders support it." Xiao Jianpeng felt that the director of his department should know that he is engaged in Internet diagnosis and treatment, but he did not comment. "It's good if you don't support, don't oppose, or encourage," Chen Enqiang said. "Some leaders will clearly oppose this, thinking that doctors do this for personal income and delay their work."

  Both doctors said that because the "fans" are chronic patients, the problems are not urgent, and they are common problems. They fix at noon or evening rest time every day, and spend about half an hour to respond to patient consultations, and will not take up operating hours.

  "What doctors really value is the ability to track patients for a long time." Chen Enqiang said, "I have my own database, where patient information, medical records, laboratory results, and diagnosis and treatment results are clear at a glance. The Medical Federation platform regularly pushes patient data analysis reports to doctors. practical".

  “At present, there are 800,000 real-name registered doctors and 50,000 contracted doctors on the Medical Federation platform. They use the platform to manage patients with chronic out-of-hospital chronic diseases and track the structured follow-up and medication data of patients.” The relevant person in charge of the Medical Federation platform It was revealed: "Accumulate clinical treatment data. For some doctors, these scientific research data are more valuable than the sunshine income provided by Internet diagnosis and treatment."

  Money is not a doctor's main consideration, however, patients have to weigh it. Currently, the vast majority of Internet diagnosis and treatment can only be paid at their own expense. Only during the epidemic, Ping An Good Doctor and WeDoctor opened up medical insurance payment in Hubei Province and Wuhan City respectively, and the Medical Federation also opened up medical insurance personal account payment in Chengdu.

  "At present, Yilianyun pharmacy has more than 15,000 chronic disease drugs, including some of the latest innovative drugs on the market. The Internet medical platform has greatly improved the accessibility of these new special drugs, which is also the value of the platform." Liu Zhe, the person in charge of public relations, said. In addition, patients with chronic diseases need long-term medication, and it is hoped that third-party platforms can access medical insurance as soon as possible to reduce the economic burden of patients with medication, so that more patients with chronic diseases can enjoy effective, low-cost and accessible online chronic disease management services, and improve the quality of life .

  Chen Enqiang suggested that at this stage, the doctors who sign on the platform must not be greedy, and that doctors with high professional literacy should be selected, and then they can gain the trust of patients. In addition, it is necessary to ensure that the source of medicines is reliable, the price is reasonable, and the supply is stable. After all, for patients, it is much more important to buy medicines that cure diseases and save lives than the price of medicines.

  She Ying