In the past few days, after the three-game losing streak of the Korean player Li Shishi against the "Alpha Dog", the news of one of the gods regaining a city has caused social concern. More people are imagining the future of artificial intelligence. Is there an "Alpha Dog" in the medical field? Will the status of irreplaceable medical scarce resources be shaken? According to Fang Laiying, director of the Beijing Municipal Health and Family Planning Commission, in the medical field, the Internet is still a tool. What will happen after the “medical + Internet†exceeds the powerful human brain data processing? It is worth looking forward to.
On March 13th, the “Internet Medical Care in Your Mind†theme salon sponsored by the Health Newspaper and the Mobile Health Research Institute was held in Beijing. Government officials, CPPCC members, experts and scholars, representatives of medical personnel, representatives of the mobile medical industry and other parties gathered to talk about their views and suggestions on Internet medical treatment.
Graded diagnosis and treatment focus on "minutes"
"Internet-assisted grading diagnosis and treatment, first of all to find out who is to divide, what is divided, what is the tool, according to what standard." Beijing Hospital Authority Medical Care Department Director Gu Shui believes that grading diagnosis and treatment must be by professional institutions Professionals are divided according to professional standards. The basis must be the condition, which can be based on regional medical information technology and mobile Internet technology. Second, we must also clearly define what the policy is. The behavior of the sub-division includes the behavior of the patient and the behavior of the doctor, as well as the behavior of the medical institutions at all levels. There must be a policy-driven action so that the actors can be motivated to divide. In addition, we must also face the problem of how to share the risk. "From the current point of view, the responsibility and risks of the Internet triage are not well clarified, so we are trying to diagnose the treatment. The so-called light consultation is only consultation and advice, and can not be regarded as medical behavior."
In addition, the application of Internet tools, the two sides of the connection need to be clarified. According to the current regulations, whether it is the regulations of medical institutions or the Law on Practitioners, the two ends of the connection must be institutions and institutions, or doctors practicing in institutions.
Gu Shui said that in the process of providing services on the Internet, the quality and safety of medical care itself may need more attention. Because this is a bottom line and a red line as a doctor and a hospital. In addition, we must also consider fair and orderly, which is also one of the requirements for graded diagnosis and comprehensive appointment.
Gu Shui believes that whether it is a grading clinic or a doctor team, it is not only a formal and structural reform, but also will bring more changes in the future. "Of course, around the in-house grading, performance evaluation, job setting, responsibilities, etc. must be adjusted. This is also the request of the Beijing Municipal Hospital Authority for medical institutions. The evaluation of experts and the evaluation of the team can no longer be simple. Looking at the workload, there is also the difficulty of diagnosis and treatment, quality and safety, and talent output. This requires constant exploration, summarization and pilot."
Medical needs need to be differentiated
“The payment method of medical insurance is a killer.†According to Gu Xuefei, deputy director of the Medical Insurance Research Office of the National Health and Family Planning Research Center, the basic medical and health institutions and general hospitals are paid according to the project, and the disorderly treatment will definitely result in The phenomenon of siphoning makes the strong strong. As far as the classification and treatment of chronic diseases is concerned, without a good medical insurance payment, it is impossible for the general hospital to actively strengthen the management of chronic diseases and reduce complications.
Gu Xuefei believes that medical insurance must be persuaded to pay for health management, and to promote the division of labor between general hospitals, primary health care institutions, and public health agencies through the payment system of medical insurance. "'Internet +' must be done, because only the proof mode has cost effect, and in the long run it is money-saving, it is possible to convince the payer to pay for it. From this perspective, the separate use of the medical insurance fund and the public health fund will result in inefficiency. ."
“As people's needs become more and more differentiated, medical care is also differentiated.†Yang Jinsheng, member of the National Committee of the Chinese People's Political Consultative Conference and the State Administration of Traditional Chinese Medicine, advised the director of the Taiwan-Hong Kong-Macao Chinese Medicine Exchange and Cooperation Center to clarify the basic medical security system and the medical security system. Concept, the expert number is reserved, and the general number is fully released. "The realization of grading diagnosis and treatment requires the linkage of three doctors and exerts the leverage of medical insurance. I resolutely oppose the inclusion of registration fees into medical insurance, and medical insurance must give guidance to different levels of reimbursement."
Gu Xuefei said that the core of grading diagnosis and treatment is not a grading, but a division of labor. Different levels of medical institutions should be a division of labor and cooperation, and institutions at the same level should encourage competition. Only differentiated positioning is conducive to long-term balanced development.
Managing the New Deal is forced out
After the introduction of the Beijing series of new policies, the most concerned is the “cutting off medical staff and commercial websites to register and gain illegitimate interestsâ€. On the online and offline open discussion salon held on the same day, Professor Yin Jia, director of the Allergy Department of Peking Union Medical College Hospital, asked this document through the Internet platform: "Beijing recently issued a new registration policy, forcing me to stop all free of charge through the Internet platform. Appointment, which is inconvenient for many patients. I think that a free appointment through a commercial website that does not occupy the general outpatient source should be allowed."
Fang Laiying, director of the Beijing Municipal Health and Family Planning Commission, responded that the boundary of this policy document is very clear, that is, “paid plus, participation and sharingâ€. The time and space within the work must comply with the hospital's regulations, and the time and space outside the work is the doctor's own grasp. The current policy interpretations have different voices or excessive interpretations, and may come more from the internal requirements of individual hospitals for medical personnel.
In response to the non-emergency comprehensive appointment, Fang Laiying said that the concept of appointment registration was started in Beijing around 2010. Initially, it cooperated with the “114†telephone reservation platform, and then gradually expanded to the network platform, WeChat, App and so on. After years of hard work, Beijing has achieved realistic and technical support for non-emergency comprehensive appointments. "The concept of a comprehensive appointment must first be clarified. Non-emergency full appointments, not to go to the hospital in the morning can not hang the number, but said that no matter when, you must complete the registration through the network system. Instant registration also to go to the network system."
Some people question whether a comprehensive appointment can be implemented. Fang Laiying said that the results of the half-year practice of Beijing Children's Hospital, which has more than 10,000 outpatient visits per day, showed that the hospital's medical environment has improved. At present, the patient has not received any complaints that the patient cannot see the disease because of a comprehensive appointment.
Fang Laiying introduced that the design of the expert team work system hides the concept of future referrals in the future. It is brewing to maximize the benefits of expert resources, rather than let patients blindly seek medical treatment. The resource allocation method considered in Beijing is consistent with the in-hospital level treatment and the grading diagnosis and treatment system centered on the regional medical center.
Fang Laiying said that overall, the new internal management of Beijing hospitals was forced out by the market, and it was also the product of the combination of Internet technology and traditional medical services. “The traditional medical service model will undergo revolutionary changes due to the development of Internet technology, and Internet technology will have revolutionary changes in the exploration of integration with medical technology.â€
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