In the era of "strong supervision", where is the road for Internet diagnosis and treatment?

  "Who is to be held accountable if there is a problem with a doctor's practice on an online platform?" In the past, individual platforms claimed that the doctor's behavior had nothing to do with the platform, and there were many cases of "playing the ball".

The "Detailed Regulations on Internet Diagnosis and Treatment Supervision (Trial)" that came into effect recently clearly stipulates that Internet medical institutions need to assume certain responsibilities, emphasizing the relying role of Internet hospitals on physical medical institutions.

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  For practitioners in the field of Internet diagnosis and treatment, recently, with the official entry into force of the "Detailed Regulations on Internet Diagnosis and Treatment Supervision (Trial)" (hereinafter referred to as the "Detailed Rules"), an era of "strong supervision" has arrived.

  On the evening of June 10, at the online salon of Yinchuan Internet + Medical and Health Association, a number of experts exchanged views on the "Detailed Rules".

Experts generally believe that this is good news for practitioners who really want to do a good job in Internet diagnosis and treatment.

  Lu Qingjun, director of the National Center for Telemedicine and Internet Medicine and director of the Development Office of the China-Japan Friendship Hospital, said that this set a clear bottom line for Internet diagnosis and treatment activities, clarified how relevant departments should manage and what the scale of management should be, and also refined the Internet How should the diagnosis and treatment platform be managed, and what should practitioners do?

Delineate the "bottom line" and "demining" the industry

  Under the epidemic, the demand for Internet medical care has continued to rise. While bringing convenience to people, some problems have also become prominent, especially problems such as medicine first, AI prescribing, and disguised rebates. These problems seem to be buried in the industry. One after another "dark thunder" in it.

  According to Chen Qiulin, deputy director of the Health Industry Development Research Center of the Chinese Academy of Social Sciences, the "Detailed Rules" are aimed at solving some of these outstanding problems.

"It's also 'demining' the development of the industry," he said.

  It can be seen that the "Detailed Rules" clearly stipulates the supervision of medical institutions, personnel supervision, business supervision, quality and safety supervision, and supervision responsibilities for Internet diagnosis and treatment.

  Specifically, the "Rules" clearly stipulate that it is strictly forbidden to use artificial intelligence to automatically generate prescriptions; it is strictly forbidden to provide medicines to patients before prescriptions are issued;

  Lu Qingjun said that from the perspective of the above four "prohibitions", the assessment mechanism for practitioners pays special attention to medical quality and medical safety issues.

  Chen Qiulin also pointed out that for a long time, it has been a big problem to clarify the rights and responsibilities among medical institutions, Internet medical platforms, doctors, and patients.

In this regard, the "Rules" particularly emphasize the need to formulate corresponding rules and agreements to deal with these issues.

  "Who is to be held responsible for the problems doctors practice on the online platform?" This is also one of the most concerned questions for patients.

Wang Hang, founder and CEO of Good Doctor Online and president of Yinchuan Internet + Health Association, said that in the past, some platforms claimed that doctors' behavior had nothing to do with the platform, and it was not uncommon to "kick the ball".

  In the current environment, platforms can no longer stay out of the picture.

The "Detailed Rules" clarifies that Internet medical institutions need to assume certain responsibilities.

  Lu Qingjun also observed this.

He pointed out that the personnel management of Internet hospitals in the "Detailed Rules" follows the management logic of traditional medical institutions, implements a real-name system for practitioners, and discloses and reports information as required.

  Wang Hang said that the "Detailed Rules" emphasizes the management responsibility of Internet medical institutions to medical personnel. Institutions need to verify the authenticity of medical personnel's identities, ensure that they are qualified for diagnosis and treatment, and ensure that doctors themselves receive medical treatment, and also ensure the training of doctors. , examination, etc.

Every step can be traced back to who is responsible

  With the introduction of the "Detailed Rules", Lu Qingjun has an obvious feeling that there is a basis for business quality control and supervision.

In Chen Qiulin's view, both for practitioners and regulators, the operability is stronger.

  The definition of follow-up consultation is a problem that has long plagued practitioners in the field of Internet diagnosis and treatment.

"Details" gives some corresponding operating norms.

Patients should provide medical records with a definite diagnosis, such as outpatient medical records, inpatient medical records, discharge summary, diagnosis certificates, etc., and the receiving physician will keep relevant information and determine whether they meet the conditions for follow-up visits.

  "On this point, medical institutions still have to take the initiative." Wang Hang pointed out that although it is up to the doctor to judge whether the patient meets the conditions for follow-up consultation, the medical institution should clarify the relevant red line-define the termination conditions for diagnosis and treatment.

The "Detailed Rules" point out that when a patient's condition changes, the doctor determines that the visit is the first visit, or there are other circumstances that are not suitable for Internet diagnosis and treatment, the receiving physician should immediately terminate the Internet diagnosis and treatment activities and guide the patient to a physical medical institution for treatment.

  Chen Qiulin said that another obvious feature of the "Detailed Rules" is that it continues the principle of traceability throughout the whole process and the pursuit of responsibilities.

The medical field is a highly regulated system, and every step needs to be traced back to who is responsible.

For example, it is proposed that the preservation period of patients' electronic medical records shall not be less than 15 years, and the recording period of graphic dialogues, audio materials and other processes in diagnosis and treatment shall not be less than 3 years.

  It is worth noting that the "Details" also take into account the data security of Internet diagnosis and treatment.

The "Detailed Rules" mentioned that medical institutions open data interfaces to regulatory authorities.

Lu Qingjun pointed out that the "Detailed Rules" also pointed out that relevant parties should refer to the Data Security Law and the Personal Information Protection Law, and adopt the "least available principle" to collect relevant data such as electronic medical records, electronic prescriptions, and medication conditions.

"Get rid of worries and burdens, let go and make great strides for development"

  Under the strong supervision, what is the living space of Internet hospitals?

  "Medical quality and patient safety come first." Lu Qingjun said that the development of Internet diagnosis and treatment needs to conform to the general trend of "medical reform".

Medical care is one of the most important areas for people's livelihood security, and more emphasis is placed on public welfare to prevent monopoly and huge profits.

It is precisely because of the particularity of the industry that the relevant departments will not relax the access and process supervision of the industry, but will only become stricter and more standardized.

  Lu Qingjun believes that strict supervision does not mean that the living space in the field of Internet diagnosis and treatment has been squeezed out.

On the contrary, the promulgation of the "Detailed Rules" allows public hospitals to have laws and regulations to abide by when opening Internet hospitals, and have clear boundaries.

  At present, under the influence of multiple factors, the Internet hospitals opened by some public hospitals have not used external doctors on a large scale.

  "Get rid of the worries and burdens, and let go of the big step for development." Lu Qingjun believes that the Internet hospitals opened by public hospitals can boldly start doctors from other hospitals to carry out diagnosis and treatment activities, especially doctors from members of the medical alliance. For example, using the medical alliance The county hospitals and community hospitals in the body will further strengthen the treatment of chronic diseases of the common people.

This has given medical institutions a "reassurance" to a certain extent.

  At the same time, the "Detailed Rules" also pointed out the direction for enterprises to invest in independent Internet hospitals.

Lu Qingjun believes that enterprises need to change their identity to a certain extent, from corporate legal person to medical institution legal person, and need to pay more attention to public welfare.

  In the opinion of Li Tiantian, founder and chairman of Lilac Garden and vice president of Yinchuan Internet + Health Association, the core of the "Detailed Rules" is to manage the chaos in the industry and prevent it from developing savagely.

This is a benefit for platforms that provide online medical consultation services in compliance with regulations.

  Li Tiantian used four key words to describe the characteristics of the "Detailed Rules": "clear", "perfect", "compliant" and "balanced", that is, the main responsibility and quantitative standards of Internet diagnosis and treatment are clearer; the content of the "Detailed Rules" is more complete, not only covering Not only the diagnosis and treatment activities themselves, but also information security protection, etc.; and making the industry more compliant; and striving to achieve a balance between effective supervision of the industry and the promotion of Internet medical development.

Regarding the trend of the industry, Li Tiantian said, "Be patient in the short term and have confidence in the long term."

  "Those (bad) behaviors will be 'stuck' by strict supervision." Wang Hang is very confident in the development prospects of the industry after the implementation of the "Detailed Rules".

Wang Hang believes that this allows practitioners to follow the "serious medical treatment" and the idea of ​​doing things seriously, "bite the hard bones in the industry" and do valuable things.

He said that truly solving the key problems plaguing the industry is the foundation of a company's life.

  China Youth Daily, China Youth Daily reporter Zhao Limei Source: China Youth Daily