Internet hospitals provide convenience for the masses to seek medical treatment (Health Focus)
Not long ago, the State Council issued the "14th Five-Year Plan for the Development of Digital Economy", proposing to accelerate the development of Internet hospitals and promote Internet medical services such as health consultation, online consultation, and remote consultation.
In recent years, my country's Internet hospitals have developed rapidly, and the number has increased from more than 100 in 2018 to more than 1,600 at present, initially forming an online and offline integrated medical service model.
What convenience does the Internet hospital bring to the masses?
How can Internet hospitals achieve high-quality development?
The journalist made an interview about this.
Mobile phone for follow-up
Internet hospitals allow patients to enjoy medical services without leaving home by integrating follow-up, follow-up, and consultation services
"Hello, Dr. Chen! I want to prescribe medicine for the elderly." Mr. Li, who lives in Chaoyang District, Beijing, prescribed medicine to his father through the "Handheld Xuanwu Hospital" mobile app of the Xuanwu Hospital Internet Hospital of Capital Medical University.
His father is over 80 years old and suffers from cerebrovascular disease, and he needs to be regularly prescribed drugs to prevent cerebral infarction.
Chen Fei, the chief physician of the Department of Neurology of Xuanwu Hospital, prescribed the medicine on the "Handheld Xuanwu Hospital" APP (doctor's side).
Chen Fei said that Mr. Li is his old patient and has prescribed medicines more than ten times online.
"I used to go to the hospital to get medicines, and I had to take a morning off every time. It was hard work and delayed work." Mr. Li said that after Xuanwu Hospital opened an Internet hospital, you can directly use your mobile phone to register and prescribe medicines, and the medicines will be delivered the next day. It's very convenient to get home.
Chen Fei's specialty is cerebral vascular stent implantation, and it is often difficult to get access to his offline outpatient clinic.
Since the Internet hospital is not limited by the number source, patients can be linked to his number.
"Most of the patients I see require regular follow-up visits and prescriptions. Patients can contact me at any time on the Internet hospital to facilitate postoperative management and follow-up." Chen Fei said.
Chen Qiulin, deputy director of the Health Industry Development Research Center of the Chinese Academy of Social Sciences, believes that by integrating follow-up, follow-up, and consultation services, Internet hospitals allow patients to enjoy medical services without leaving their homes, which can improve the accessibility of medical services and reduce the cost of medical treatment for patients.
During lunch time, an inquiry message popped up in the "Three Gorges Hospital" mobile app of Xu Wei, the chief physician of the Endocrinology Department of the Three Gorges Hospital Affiliated to Chongqing University.
Xu Wei skillfully adjusted the patient's medication: "According to your blood routine, you need to add another pill."
Xu Wei introduced that patients with chronic diseases such as diabetes and hyperthyroidism need long-term treatment, and the dosage of medication should be adjusted on a weekly and monthly basis.
Now, patients no longer need to regularly come to the hospital to register and queue up, and they can consult online.
At present, Xu Wei receives more than 700 online consultations every month.
"During the online consultation process, if the patient's condition is found to be abnormal, I can help them make an appointment for examination and hospitalization in time, which improves patient satisfaction."
According to Zeng Xia, director of the Internet Hospital Office of the Three Gorges Hospital, in May 2021, the mobile APP of the Three Gorges Hospital Internet hospital platform "Three Gorges Hospital" was officially launched. The main users are patients with chronic diseases and those who need regular follow-up visits.
The staff of the follow-up center of the Internet hospital will regularly arrange discharge, outpatient service and physical examination according to the follow-up route and online outpatient period set by the doctor.
The patient will have a video follow-up visit or a graphic follow-up visit with the doctor online, the doctor will issue a prescription according to the patient's condition, and the hospital will mail the medicine to the patient's home.
In order to help patients who are bedridden all the year round to provide regular care, the Internet Hospital of Three Gorges Hospital has also opened an online appointment for nurses to visit nursing services.
Home care includes replacement of gastric tube, joint loosening training, catheter maintenance, dressing change for pressure injury, blood oxygen saturation detection, and trace blood sugar detection.
Primary patients benefit
The combination of remote consultation and follow-up consultation can detect and deal with new diseases in time, so that the life and health of patients can be more guaranteed
"When I buy medicine, I can also video link with experts from the top three hospitals to consult about the condition. I really didn't expect it!" Lao Yan, a resident of Gaosuntang Street Community, Wanzhou District, Chongqing City, has a long-standing problem of leg pain, and he has never found the cause.
He came to the Gaosuntang branch of Zhongxing Pharmacy, sat in front of the computer, and had a video follow-up consultation with the general practitioner of the Three Gorges Hospital.
"Since the installation of the Internet hospital terminal, many elderly people in the community will come to the pharmacy to find an 'online doctor' for consultation." Liu Xuemei, a staff member of ZTE Pharmacy, told reporters that seeing a doctor in the pharmacy is not only free, but also very convenient. It's more convenient than going to a community hospital.
The reporter saw that the pharmacy has opened up a special area, which is not only convenient for customers to see a doctor, but also protects privacy.
The remote reception point is equipped with computers, cameras, headsets, and consultation tables and chairs. The walls have patterns such as the logo of the remote reception point of the Three Gorges Hospital, which are simple, elegant, and eye-catching.
It is understood that the Three Gorges Hospital has selected two larger chain pharmacies in Wanzhou District, ZTE and Hongda, as the remote consultation points. The first batch of 59 pharmacies have launched online customer follow-up services.
At present, there are more than 300 online follow-up visits on the pharmacy side.
How to further leverage the advantages of Internet hospitals to benefit more grassroots patients?
The Three Gorges Hospital cooperated with the village doctor to set up an Internet hospital terminal in the village clinic.
In the clinic of Guanba Village, Longju Town, Wanzhou District, the village doctor Li Xiaojian is instructing the villagers to use the terminal computer of the Three Gorges Hospital networked hospital.
"Sometimes when we encounter a condition that we are not sure about, we will also contact the doctor of the Three Gorges Hospital to ask questions, which greatly facilitates the villagers to seek medical treatment." Li Xiaojian said.
Zhang Xianxiang, president of the Three Gorges Hospital Affiliated to Chongqing University, introduced that the Three Gorges Hospital will continue to expand the coverage of Internet hospitals so that more patients can see a doctor at home.
At the same time, increase the linkage with pharmacies and village doctors, and deploy Internet hospital terminals in surrounding districts and counties to benefit more people.
The Internet hospital effectively solves the difficult and critically ill and complex disease patients in remote areas.
Lao Wang, who lives in Jinzhai County, Anhui Province, suffers from rheumatoid disease. His condition worsened not long ago. After being treated in a local hospital, his condition was not under control.
In less than two days, Lao Wang was already unconscious and did not cooperate with the physical examination.
Through the Internet telemedicine platform, local doctors sought help from Chen Xiaoping, deputy director of the Department of Endocrinology at the China-Japan Friendship Hospital in Beijing.
Chen Xiaoping organized experts from the rheumatology and immunization department, endocrinology department, and respiratory department of the China-Japan Friendship Hospital to jointly conduct remote consultation and follow-up consultation, and diagnosed Lao Wang as a brain injury caused by severe hyponatremia, accompanied by mild lung infection.
After systematic and standardized treatment, Lao Wang recovered quickly and was able to work in the fields.
Cui Yong, vice president of the China-Japan Friendship Hospital, introduced that one of the characteristics of the Internet hospital of the hospital is the combination of telemedicine and Internet diagnosis and treatment, which combines the improvement of grass-roots diagnosis and treatment capacity with the convenience and benefit of the people.
The target of telemedicine is the critically ill and complex disease patients in grass-roots institutions, and the Internet diagnosis and treatment is for the patients who are re-examined for confirmed cases.
For some returning patients, their condition may deteriorate during the follow-up period. If they cannot be rushed to a large hospital for treatment within a short period of time, the treatment may be delayed.
Through the combination of remote consultation and follow-up consultation, with the assistance of local doctors, new conditions can be discovered and dealt with in time, so that patients' life and health are more guaranteed.
At present, the China-Japan Friendship Hospital Internet hospital system has connected nearly 6,000 medical institutions across the country, including more than 580 medical and nursing institutions, and implemented more than 13,000 remote consultations.
Unblock difficult points
Accelerate the implementation of medical insurance settlement nationwide, so that patients who go to Internet hospitals to see a doctor can also enjoy medical insurance reimbursement
According to the "Statistical Report on Internet Development in China" released by the China Internet Network Information Center, as of June 2021, the number of online medical netizens in my country has reached 239 million, and the demand for Internet medical treatment continues to grow.
However, the management and operation of Internet hospitals is not optimistic.
The "2021 China Internet Hospital Development Report" jointly released by the National Center for Telemedicine and Internet Medicine and the health community pointed out that while the number of Internet hospitals is growing rapidly, only less than 10% have actually achieved effective operation, and over 90% are under construction and not in use. Or just taste the state of restlessness.
Lu Qingjun, director of the National Center for Telemedicine and Internet Medicine and director of the China-Japan Friendship Hospital Development Office, believes that there are still management and operational blockages for some public hospitals to open Internet hospital services.
For example, the top-level design is not perfect, the business scope is unclear, the supervision of doctor access and online diagnosis and treatment training is insufficient, the lack of standardized Internet medical service process and diagnosis and treatment specifications, the single business type, and the lack of characteristic services.
Some Internet hospitals lack good software and hardware technology, and patients and doctors have poor experience.
Liang Zhigang, director of the Xuanwu Hospital Information Center, said that the current public hospitals' Internet hospital cost compensation mechanism and incentive evaluation mechanism are not perfect, which cannot effectively mobilize the enthusiasm of hospitals and doctors to continue to carry out online diagnosis and treatment services.
Compared with offline outpatient clinics, the pricing of medical services in Internet hospitals is relatively low. For example, Shandong Internet Hospital charges only 6 yuan for a follow-up consultation, while Beijing charges 50 yuan uniformly.
Lu Qingjun analyzed that from the patient's point of view, on the one hand, the patient's understanding of Internet diagnosis and treatment is insufficient, and it takes a process to cultivate the habit of seeking medical treatment.
On the other hand, at present, most Internet hospitals can only achieve medical insurance reimbursement within the province, and patients from other provinces are still unable to enjoy medical insurance reimbursement, which largely limits the choice of Internet consultation for patients.
How to clear the blockage of Internet hospitals?
Lu Qingjun believes that the construction of an Internet hospital must be combined with the hospital's own functional positioning and the actual situation of the region, highlight its characteristics, and avoid homogeneous competition.
It is necessary to strengthen the operation management of Internet hospitals, promote the integration of online and offline, realize the management of the whole cycle of patients' diseases and the whole process of medical treatment, and improve the medical treatment experience of patients.
Lu Qingjun suggested that the online charging system and the performance incentive mechanism for medical staff should be improved.
Internet diagnosis and treatment fees should correspond to offline diagnosis and treatment fees, and different service prices should be set for doctors of different levels to fully reflect the labor value of doctors.
Establish a performance incentive evaluation mechanism for doctors, and give certain performance subsidies to doctors participating in Internet diagnosis and treatment.
Liang Zhigang believes that the nationwide implementation of medical insurance settlement should be accelerated, so that patients who go to Internet hospitals to see a doctor can also enjoy medical insurance reimbursement.
At present, online diagnosis and treatment are mainly aimed at the follow-up of patients with common diseases and chronic diseases, most of whom need to issue electronic prescriptions and medication.
Now the circulation of electronic prescriptions has been realized, and the cross-regional medical insurance settlement of patients has also met the conditions.
If Internet hospitals can achieve medical insurance reimbursement like offline hospitals, more patients will choose online diagnosis and treatment.
Zhang Xianxiang suggested to break down regional barriers and encourage tertiary hospitals to set up remote consultation points in rural areas, which is equivalent to moving large hospitals to villagers' doorsteps, coupled with 5G mobile communication technology and remote imaging, remote ultrasound, remote ECG, etc. The launch of various wearable devices enables the synchronization of primary-level inspections and higher-level diagnoses, and improves the medical service capabilities of township hospitals and village clinics, so that serious and serious diseases can be solved in this province, common diseases and frequently-occurring diseases can be solved in cities and counties, and headaches and brain fever can be solved in rural areas. The goal is to reduce the incidence of poverty and return to poverty due to illness.
Our reporter Shen Shaotie Chang Biluo