How many hurdles must public hospitals have to go through when they "reach the Internet"?

　　At the high-quality development summit forum of Internet hospitals held recently, the relevant person in charge of the National Health Commission introduced that as of June this year, there were more than 1,600 Internet hospitals in my country.

The data shows that 69.5% of the participants come from public hospitals, while private hospitals account for only 6.2%, and other institutions account for 24.3%.

　　Since 2018, with the continuous improvement of "Internet + medical" access and medical insurance payment policies, coupled with the catalysis of the need for epidemic prevention and control, public hospitals have "connected to the Internet."

Internet hospitals relying on public hospitals have a broad stage in promoting the sinking of medical resources, but there are also problems such as low utilization rates.

　　Broaden the radius of medical services

　　Public hospitals have gone through long-term policy guidance and preparations for building Internet hospitals.

In September 2018, the National Health Commission issued the "Internet Hospital Management Measures (Trial)" and other three documents, clarifying for the first time that Internet hospitals must rely on offline physical medical institutions for the state to implement access management.

In August 2019, the National Medical Insurance Administration issued the "Guiding Opinions on Improving the "Internet +" Medical Service Price and Medical Insurance Payment Policy", which for the first time proposed to expand the scope of medical insurance payment from offline medical services to online.

In March 2020, the National Medical Insurance Administration and the National Health Commission jointly issued the "Guiding Opinions on Promoting the Development of "Internet +" Medical Insurance Services During the Period of the Prevention and Control of the New Coronary Pneumonia Epidemic", which included online follow-up services for common and chronic diseases into the payment scope of the medical insurance fund .

　　Qian Buyue, chief scientist of the First Affiliated Hospital of Xi’an Jiaotong University, introduced that with the deepening of the medical reform, drugs and consumables have been purchased in quantities; in order to avoid excessive medical treatment and save medical insurance funds, the DRGs (grouped by disease diagnosis) payment model has been gradually implemented. From "pay by project" to "pay by disease", public hospitals are forced to optimize medical procedures and improve service quality.

　　As a pioneer, Run Run Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine began to explore Internet medical care in 2014, and launched the "Shaw Medical Health Cloud Platform" the following year to build a model of "Internet + regional hospitals + doctors + health industry".

Lin Hui, director of the Internet and Artificial Intelligence Office of the hospital, told reporters that Internet hospitals will promote the formation of a medical and health service system that integrates online and offline, hospitals and hospitals, and superiors and subordinates.

　　"Offline clinics only carry 15,000 visits per day, while online can carry 80,000 visits. Internet hospitals have changed the path of medical treatment, which is conducive to improving the quality and efficiency of hospitals." Qian Buyue said, "Many patients with chronic diseases can be treated every month. It takes a week to be hospitalized for examination, and the whole process consumes at least two outpatient number sources. On the online platform, medical technical examinations are automatically triggered at a fixed time every month, and the patient will follow along with the procedure. The report will be sent to both the doctor and the patient at the same time, and the medicine will be directly Deliver to home."

　　Radiation drives graded diagnosis and treatment

　　In May of this year, the China-Japan Friendship Hospital Internet Hospital was inaugurated and opened to all medical institutions and Internet medical platform companies, covering pre-diagnosis consultation, online follow-up consultations, and two-way referrals.

Patients can apply for a Sino-Japanese Internet Hospital Joint Outpatient Clinic at a local hospital. Experts work with local physicians to receive "primary-level first consultation" patients.

　　"We must make people believe in primary hospitals, rather than crowding into large hospitals." Lu Qingjun, director of the Office of the National Telemedicine and Internet Medical Center and director of the Development Office of China-Japan Friendship Hospital, told reporters that through medical consortium collaboration and remote consultation, lower-level hospitals can be helped. Continuously improving the ability to receive diagnosis is an effective means to promote component-level diagnosis and treatment.

　　"Through the 5G signal transmission system, experts can remotely guide doctors thousands of kilometers away to implement treatment. For patients in remote areas, it is equivalent to the "resident" door of the doctor in the tertiary hospital." Lu Qingjun said.

　　Lin Hui said that Internet hospitals can achieve efficient coordination of resources within the region, and meet the grassroots' desire to "do not ask for everything but use what you want."

"The primary hospitals lack medical resources. Many patients can only be transferred to large hospitals and have to go through the routine procedures again. On the'Shao Medical Health Cloud Platform', the regional hospitals share core inspection equipment. The inspections that the primary hospitals cannot do, you can Help patients make appointments to hospitals with equipment in the province. Similarly, in large hospitals, you need to wait for a few days for general examinations, and patients can choose to go to a community hospital close to home."

　　"After the platform is gradually improved, mild patients in major hospitals will be diverted, and more severe patients can be registered. Primary hospitals save the high cost of self-built Internet hospitals, and they can get support from higher-level hospitals at any time." Lu Qingjun Full of confidence in the future.

　　It still needs a process to break through the blocking point

　　The data shows that the Internet hospitals built by physical hospitals across the country will receive an average of 55 cases per day in 2020, with 31.5 participating departments and 320 doctors.

Even in the event of an epidemic, the online diagnosis and treatment of public hospitals has not yet shown sufficient appeal.

　　Lin Hui analyzed that at present, Internet medical services only allow follow-up visits and charge according to the lowest offline standards.

This also determines that the volume of online diagnosis and treatment is smaller, and more are pre-diagnosis consultations that cannot be charged.

"Doctors in public hospitals are not motivated. If you want to make them daily, you need a long-term and reasonable performance mechanism."

　　Qian Buyue believes that the platform is only a tool for optimizing the medical treatment process, and it must be supported by offline resources.

Doctors respond to the needs of patients on the mobile terminal anytime and anywhere, and manage chronically ill patients in groups. Only 100 patients can be served offline, and 500 can be served on the platform. Naturally, they will be more enthusiastic.

　　Wen Jian, chairman of the Internet Hospital Branch of the Chinese Research Hospital Association, once said that most public hospitals are not fully interconnected.

"An Internet hospital is an island of information. As many hospital experts as patients seek, they need to download as many apps."

　　"The focus of medical services is quality and safety, and it is the same on the Internet." Lu Qingjun pointed out that to ensure medical safety, data security, and patient physical and mental safety, and plug all possible loopholes, public hospitals are bound to have a long exploration.

"Universal face recognition technology has certain risks as a key. At present, we use eID (Citizen Network Electronic Identity Identification), bank cards, medical insurance cards, mobile phone numbers and other identification systems, and there is an urgent need for agreement between hospitals."

　　Lu Qingjun said: "The lack of technical and operational talents is also one of the restrictive factors. Most hospitals do not have technical talents and need to cooperate with Internet companies to build them. The latter do not understand medical care and can only work together and explore."

　　Chen Xi