In some places, dozens of tertiary hospitals mutually recognize inspection results, but in Internet hospitals, the data reported by other hospitals are not recognized.
["Inquiry" Internet Hospital ④] Offline examination results can be mutually recognized, why can't it work online?
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The "data island" problem is also one of the "blocking points" in the development of Internet hospitals.
Data is not interoperable, which is easy to bring duplication and additional examinations, waste medical resources, increase the cost of patients seeing a doctor, and is not conducive to doctors' comprehensive judgment and consideration of the disease.
Professionals pointed out that Internet hospitals should strengthen top-level design, locate platform-based development, and break "data silos". At the same time, they should also improve the supervision system to ensure patient privacy.
Guo Yue from Shenyang, Liaoning, suffers from hypothyroidism. After the outbreak of the new coronary pneumonia, she has been going through the Internet hospital for follow-up visits. "Online medical treatment is efficient and convenient, and the medicines are delivered directly from the hospital pharmacy to the home, which is safe and reliable."
However, Guo Yue bluntly said that there are also problems that cannot be avoided when seeing a doctor in an Internet hospital, "I checked the three items of thyroid function in a second-class hospital near my home, and then went to another Internet hospital for a follow-up consultation. The previous report data is not recognized, it is necessary to Re-examine." Guo Yue also discovered during his long-term trip to the hospital that dozens of tertiary hospitals in Liaoning recognized each other's inspection results, but it was not feasible to put them on Internet hospitals.
"Worker's Daily" reporters have interviewed in Liaoning, Beijing, Shenzhen and other places and learned that many Internet hospitals are in a "data island" state. Patients' vital signs information, disease information, imaging test reports, Internet diagnosis and treatment records, drug use and other basic data It cannot be shared among hospitals, and each Internet hospital is almost "separate."
In addition, as another aspect of information interconnection, the information security of Internet hospital users has also received attention.
Breaking "data silos" to facilitate online medical treatment for patients
"Realizing the information sharing of patients' past medical visits is conducive to doctors' comprehensive judgment and consideration of the condition, and can also effectively utilize various medical resources to avoid repeated and additional examinations, wasting the time of doctors and patients." Zhang Ningbo, director of the Medical Department of Peking University Shenzhen Hospital, said in In an interview with the "Workers Daily" reporter, he said.
Li Yaqin, an attending physician in the Department of Infectious Diseases of Peking University Shenzhen Hospital, said that compared with face-to-face consultation, online consultation cannot directly observe the patient's condition, and the doctor's advice will be relatively conservative.
"If the Internet hospital system is further improved to allow different medical institutions to share the patient's examination report, it can effectively avoid inaccurate patients' oral descriptions, and make online medical treatment more efficient and convenient for patients."
It is understood that at present, the Internet hospitals built by Beijing public hospitals have not yet achieved comprehensive interconnection with each other.
Chen Qiulin, deputy director of the Health Industry Development Research Center of the Chinese Academy of Social Sciences, pointed out that in order to build Internet hospitals in public hospitals, to break the "data island" and improve the efficiency of information communication, it is necessary to strengthen the top-level design, position the platform for development, and adopt the government to build an Internet medical information platform or use The third-party platform realizes the interconnection of medical and health information.
Xu Xuedong, director of the Medical Department of Peking University Third Hospital and director of the Internet Hospital Office, believes that sharing patient diagnosis and treatment data on the premise of ensuring safety requires medical institutions to ensure the integrity, accuracy and timeliness of case data and inspection data. The data access and authorization mechanisms of Internet hospitals and sharing platforms are improved to ensure the security of data transmission and the security of patient privacy.
It is necessary to ensure both interconnection and information security
Another aspect of the interconnection of medical data in Internet hospitals is the security of patients' personal information.
In the process of online medical treatment, personal information such as patients' vital signs, diseases, and medical records need to be transmitted online, and there is a hidden danger of information security leakage.
Since the outbreak of the epidemic, Shenzhen resident Chen Fangling has visited the Internet hospital almost every month.
Talking about information leakage, she said that in the era of big data, this is unavoidable.
"But if you go to a reliable online medical institution, I think information security can still be guaranteed."
Zhang Ningbo pointed out that, just as some mobile applications can collect data through the background, understand user preferences and then push targeted advertisements, Internet hospitals also have data security risks.
"However, the hospital has a clear network security management system to protect the privacy of patients. Doctors also need to set up password management for daily operations." Zhang Ningbo said, "If the patient's past visits are inquired due to the need for diagnosis and treatment, the operating system will strictly correspond to each doctor. 's job number."
Xie Zhiyi, director of the medical management department of Beijing Tsinghua Chang Gung Hospital, said that the establishment of an Internet hospital requires strict security qualification review, and the hospital will also require online diagnosis and treatment in accordance with the privacy protection standards for offline diagnosis and treatment.
In Xu Xuedong's view, improving the supervision system, optimizing the technical means of supervision, and establishing an emergency plan for data leakage need to be included in the key work scope of the normalized safety management system of Internet hospitals.
According to the "Administrative Measures for Internet Hospitals (Trial)", the Internet hospital information system implements the third-level information security level protection in accordance with relevant national laws, regulations and regulations.
The "Detailed Rules for the Supervision of Internet Diagnosis and Treatment (Trial)" promulgated and implemented in February 2022 also proposed 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 of all parties. responsibility relationship.
Let the role of Internet hospitals further play
It is understood that some localities have made attempts to interconnect information in Internet hospitals, and some have issued more detailed regulations for the protection of patient information in Internet hospitals.
In 2017, the Beijing Municipal Health Commission issued a notice requiring all 30 pilot hospitals to share and access electronic medical record information.
Xie Zhiyi told the "Worker's Daily" reporter that as one of the pilot hospitals, Beijing Tsinghua Chang Gung Memorial Hospital has realized the sharing of electronic medical record information. As long as the patient authorizes and agrees, the doctor can access the relevant medical information of the patient in a non-local medical institution.
Zhou Wen, chief physician of the internal medicine department of a tertiary hospital in Shenyang, said in an interview that at present, some regions have explored the establishment of regional medical groups, and hospitals within the group can share patient information.
In terms of patient information protection, last year, Ningxia issued the "Administrative Measures for Bad Practice Behavior Points in Ningxia Internet Hospitals (Trial)", which includes Internet hospitals failing to properly keep patient information, illegal trading, leaking patient information, and discovering patient information and medical treatment. If data leakage and other issues are not taken immediately and effective countermeasures are not taken, the hospital involved will be dealt with accordingly.
The emergence of Internet hospitals conforms to the development trend of mobile Internet and brings practical convenience to the masses for medical treatment.
However, the reporter found in various investigations and interviews that many Internet hospitals are in a state of "build but not use" and "big thunder and little rain". If Internet hospitals want to change from "pretty" to "real", they need to clear the medical insurance payment one by one. The "blocking points" such as popularization, low enthusiasm of doctors, and inability to interconnect data.
Zhang Ningbo believes that if the Internet hospital is used well, the future role it can play will be more than just seeking medical treatment.
"If the charging items are properly liberalized, the Internet hospital can also be equipped with corresponding health managers according to the health conditions and needs of the people, and even formulate appropriate exercise and diet plans for them to help improve the overall health of the society."
Dou Feitao Liu Xu Liu Youting