To ensure the quality of online diagnosis and treatment, the Internet diagnosis and treatment supervision rules are here

  The "Internet Diagnosis and Treatment Supervision Rules (Trial)" jointly formulated by the General Office of the National Health Commission and the Office of the State Administration of Traditional Chinese Medicine was announced recently.

What regulatory provisions have been made in the detailed rules for social concerns such as prescription review, privacy protection, and diagnosis and treatment quality control in Internet diagnosis and treatment?

  Must meet the conditions for follow-up

  In 2018, the General Office of the State Council issued the "Opinions on Promoting the Development of "Internet + Medical Health", and Internet diagnosis and treatment has experienced large-scale growth.

By the end of 2021, there will be more than 1,700 Internet hospitals nationwide.

  "Space" treatment is not suitable for all patients.

The follow-up of common diseases and chronic diseases has been the positioning of Internet diagnosis and treatment for a long time.

However, the lack of specific standards in the industry for what constitutes a follow-up visit has led to some regulatory vacuums.

  The detailed rules announced this time require that patients should provide medical records with a clear diagnosis, such as outpatient medical records, inpatient medical records, discharge summaries, and diagnosis certificates, etc., and the receiving physicians should retain relevant information and judge whether they meet the conditions for follow-up visits.

  "The standard is more operable." Chen Qiulin, deputy director of the Health Industry Development Research Center of the Chinese Academy of Social Sciences, believes that there are clear regulations on which diagnostic materials should be provided by patients and who should judge whether they meet the conditions for follow-up visits.

  The detailed rules also require that when a patient's condition changes, the doctor judges this visit as the first visit, or there are other circumstances that are not suitable for Internet diagnosis and treatment, the receiving doctor should immediately terminate the Internet diagnosis and treatment activities, and guide the patient to a physical medical institution for treatment.

  It is strictly forbidden to "medicine first"

  Buying medicines first, then formulating medicines, and even automatically generating prescriptions by artificial intelligence software - such operations on some Internet medical platforms have been exposed many times.

  The rules announced this time stipulate that prescriptions should be issued by the receiving physicians themselves, and the use of artificial intelligence to automatically generate prescriptions is strictly prohibited.

Prescription drugs shall be sold, dispensed and used on the basis of a physician's prescription.

It is strictly prohibited to provide a drug to a patient before a prescription has been issued.

  The detailed rules also stipulate that doctors need to carry out real-name authentication before receiving medical consultations to ensure that they provide medical services.

  "Quality and safety are the eternal themes of the medical industry." Shu Ting, director of the Medical Informatization Research Department of the Hospital Management Institute of the National Health Commission, said that any behavior that challenges the bottom line of medical quality under the guise of the Internet is a blasphemy to the safety of patients' lives. .

  On the one hand, it is to strengthen the supervision of prescriptions, and on the other hand, it is to explore more convenient online follow-up and renewal prescriptions.

In Zhejiang Ningbo No. 1 Hospital, the Internet hospital platform has opened the entrance for chronic disease refills.

After the patient applies, the team of full-time doctors will renew the prescription according to the actual situation, and the patient can usually receive the medicine at home on the same day.

  Online and offline integration

  Is the quality supervision of online diagnosis and treatment consistent with that of offline diagnosis and treatment?

The detailed rules announced this time give a positive answer, requiring that Internet diagnosis and treatment be incorporated into the overall medical service supervision system based on physical medical institutions.

  According to the detailed rules, the process and results of Internet diagnosis and treatment must be completely recorded, and the circulation of key information such as medical records and prescriptions should be traceable, so as to ensure that the entire process of Internet diagnosis and treatment is within the scope of monitoring and protection by regulations.

  "Internet diagnosis and treatment behavior has the same effect as offline diagnosis and treatment behavior." Zhao Wei, deputy director of the National Center for Cardiovascular Diseases and vice president of Fuwai Hospital of the Chinese Academy of Medical Sciences, explained that the diagnosis and treatment, quality control, supervision, complaints and data occurred on the Internet. Behaviors such as sharing must rely on physical medical institutions to ensure the integration of online and offline.

  Lu Qingjun, director of the National Center for Telemedicine and Internet Medicine and director of the China-Japan Friendship Hospital Development Office, believes that Internet hospitals should clearly position themselves as operators of medical institutions, which is an important role for companies that set up independent Internet hospitals. convert.

  Clarify the relationship of rights and responsibilities

  While Internet diagnosis and treatment have brought a lot of convenience, the issue of privacy information leakage has also attracted much attention.

  The detailed rules clearly require that medical institutions should establish systems such as network security, data security, personal information protection, and privacy protection, and sign agreements with relevant partners to clarify the rights and responsibilities of all parties.

  Regarding the protection of patient privacy, some places have issued relevant policies.

The Measures for the Management of Bad Practice Behavior Points of Internet Hospitals issued by Ningxia stipulates that if Internet hospitals "have not properly kept patient information, illegally trade or leak patient information", or "have not taken effective measures immediately when patient information and medical data are leaked", etc. , will be scored 12 points at one time.

This means that the Internet hospital will start the verification process in advance and give a 1 to 6 month suspension of verification.

  It is understood that Ningbo No. 1 Hospital has added "three insurances" to the weak links of privacy protection such as patients' past medical records and health files, in combination with the actual situation in the hospital, to comprehensively protect the privacy of doctors and patients.

  Shu Ting said that the detailed rules have more detailed elaboration on issues such as medical record retention, platform data, privacy protection, and information security, which are of high concern. These requirements point out the direction for the specific implementation of the next step of supervision.

  Implementation plans can be formulated in combination with local conditions

  Wang Hang, founder and CEO of Good Doctor Online, believes that this document was released during the rapid development of the industry, and practitioners should follow the idea of ​​"serious medical care" to further promote the healthy development of Internet diagnosis and treatment services.

  "The business volume of Internet hospitals is currently uneven. Some are very busy, while others are similar to 'zombie' hospitals with single functions." Yu Xinle, deputy director of the Zhejiang Provincial Health Commission, said that while standardizing management, relevant training should be strengthened. Guide suppliers to better match social needs.

It is necessary to establish a professional supervision team, including medical management experts and experts in informatization and big data.

  Shu Ting said that considering the uneven development speed of various regions, while the detailed rules delineate the bottom line and red line, localities can also further formulate implementation plans based on their own actual conditions to promote the healthy development of Internet diagnosis and treatment.