Starting from March 1, my country will realize mutual recognition of inspection results between different medical institutions. After the 16-year-old reform breaks the ice, the burden of patients' medical treatment is expected to be reduced.
A few days ago, the "Administrative Measures for the Mutual Recognition of Inspection and Test Results of Medical Institutions" (hereinafter referred to as the "Administrative Measures") jointly issued by the National Health and Health Commission, the National Medical Insurance Administration, the National Administration of Traditional Chinese Medicine, and the Health Bureau of the Logistics Support Department of the Central Military Commission If the existing inspection and test results meet the conditions for mutual recognition and meet the needs of diagnosis and treatment, the medical institution and its medical staff shall not repeat the inspection and inspection.
Liao Zangyi, an associate professor at the School of Politics and Public Administration of China University of Political Science and Law, told Yicai that the "Administrative Measures" will help control excessive inspections and abuse of medical resources in medical institutions, reduce the burden of patients' medical treatment, and improve the medical treatment experience.
This reform requires special attention to two aspects, one is how to ensure the quality and safety of inspection results, which is the bottom line and the red line, and the other is how to motivate medical institutions and medical personnel to implement the mutual recognition policy, which is the difficulty and the key point.
Mutual recognition has certain mature conditions
"Reducing the burden of medical treatment for the people and ensuring the quality and safety of medical care" are the two main purposes of the "Administrative Measures". For a long time, medical institutions have used inspections to support doctors, and due to the inability of mutual recognition and sharing of inspection results between medical institutions, excessive and duplication have resulted. Inspection and testing are an important reason for the high medical expenses and the heavy burden of seeing a doctor.
The promulgation of the "Administrative Measures" has enabled medical institutions to realize mutual recognition and sharing of inspection results, with clear connotation definitions, unified mutual recognition rules and quality control standards, and also clarified the reasonable behaviors of medical institutions and medical personnel. Supervision and management responsibilities of the department.
The inspection results mentioned in the "Administrative Measures" refer to the images or data information obtained from the inspection of the human body by means of ultrasound, X-ray, MRI, electrophysiology, nuclear medicine, etc.; Human body materials are tested in biology, microbiology, immunology, chemistry, blood immunology, hematology, biophysics, cytology, etc., and the obtained data information.
The inspection results do not include the diagnostic conclusion issued by the physician.
Xu Yucai, a medical reform expert and deputy director of the Shanyang County Health Bureau of Shaanxi Province, reminded that the mutual recognition here is "image or data information", excluding the diagnosis conclusion issued by the doctor.
In practice, many clinicians have limited technical skills and do not read medical imaging data. They only rely on other doctors to make inspection reports to diagnose diseases, which must be paid attention to.
The "Administrative Measures" proposes to meet the national-level quality evaluation indicators and participate in the inspection and inspection projects that have passed the national-level quality evaluation. The scope of mutual recognition is the whole country.
Meet the local quality evaluation indicators, and participate in the inspection and inspection projects that pass the quality evaluation of the local quality control organization, and the mutual recognition scope is the area corresponding to the quality control organization.
The sign of mutual recognition of inspection results of medical institutions is unified as HR.
If the inspection and inspection items participate in the quality evaluation carried out by quality control organizations at all levels and are qualified, the medical institution shall mark its corresponding mutual recognition scope + mutual recognition logo.
Such as: "National HR", "Beijing-Tianjin-Hebei HR", "Beijing Xicheng HR" and so on.
Liao Zangyi believes that the current mutual recognition work has certain mature conditions. The construction of the electronic medical record system in the hospital can realize the digital storage and transmission of inspection and inspection data; the construction of the regional health information platform promoted by the health department can realize the sharing of inspection and inspection data within the domain. .
The unified medical insurance information platform promoted by the medical insurance department and the reform of DRG and DIP payment methods have turned inspection and testing from income into cost, and hospitals are motivated to reduce excessive inspections and achieve mutual recognition and sharing of inspection and inspection results.
In addition, in the construction of medical alliances and medical communities in recent years, especially among close medical communities, unified medical imaging centers, medical inspection centers, and pathological diagnosis centers have been established. Achieve mutual recognition and sharing of inspection results.
Guarantee medical quality and safety
As early as February 2006, the General Office of the Ministry of Health issued the "Notice on Issues Concerning the Mutual Recognition of Medical Examinations and Medical Imaging Examinations among Medical Institutions", stating that the mutual recognition of examinations among medical institutions includes not only the mutual recognition of test results but also the mutual recognition of examination data. .
In the following ten years or so, the central and local governments have also issued documents to promote this matter many times, but the mutual recognition of inspections has remained at the level of "calling".
Xu Yucai believes that there are three major reasons why it is so difficult to promote mutual recognition of inspection results. One is economic interests, the other is legal responsibility, and the third is technical issues.
In judicial practice, there have also been many cases where hospitals were awarded compensation due to mutual recognition of test results.
After a doctor-patient dispute arises, all examination results will exist as evidence, and the results from this hospital have reliable legal effect.
If the examination results from other hospitals are used, once a doctor-patient dispute arises, the conflict will become more complicated.
In order to avoid unnecessary trouble, doctors are more willing to trust the examination results from this hospital.
Xu Yucai believes that mutual recognition must fully and accurately grasp the five principles, that is, Article 4 of the "Administrative Measures" states that medical institutions should follow the principle of "taking quality and safety as the bottom line, quality control as the premise, reducing the burden on patients as the guide, and taking the To meet the needs of diagnosis and treatment as the fundamental, take the judgment of the receiving physician as the standard" principle, carry out the mutual recognition of inspection and test results.
Quality and safety is the bottom line of mutual recognition.
Regarding the selection of mutual recognition projects, the "Administrative Measures" proposes that the inspection and inspection projects to be carried out for mutual recognition should have good stability and have unified technical standards to facilitate quality evaluation.
Liao Zangyi said that the measures can urge medical institutions to strengthen the quality management of inspection items; optimize the allocation of regional medical resources, improve the utilization efficiency of medical and health resources; and promote the homogeneous management of medical services such as medical imaging, medical examination, and pathological diagnosis.
The "Administrative Measures" stipulates that whether the inspection results can be mutually recognized must be "based on the judgment of the receiving physician. Xu Yucai believes that this principle is the most fundamental. Mutual recognition cannot be mutually recognized. On the contrary, if misdiagnosis, missed diagnosis, delay in diagnosis and treatment are caused by mutual recognition, the receiving physician should naturally bear the corresponding responsibility. Therefore, as a receiving physician, you must be familiar with the business, communicate effectively, and make it clear to patients or their families that they cannot The reasons for mutual recognition make patients convinced and consciously cooperate.