Medical Seasonal (Running) information (zssure): Mobile medicine is not a problem

background

Recently watching Dr.2 's book, "Mobile Medical that little thing", so this blog post is brazen called "mobile health is not a problem." New year, new accumulation and progress, continue to focus on the latest developments in the medical industry. This is the main introduction of the "Free practice" and "e-case" news. Running ...

Free Practice

In "Mobile medicine", Dr.2 begins by asking a question "What kind of doctor will come out and practise freely?" Will the newly graduated children come out and practise freely? "The idea is that doctors who come out of the system are usually doctors who are the backbone of the clinical business, or those who are famous and who are dissatisfied with the status quo," he said. The number of people in this group is not particularly large, but the impact on the industry is not small. Because healthcare is a knowledge-intensive industry, sometimes an elite can lead a team, a department, or even a hospital "1".

Of course, the above view is understandable, completely correct, Zssure want to say is what kind of doctor just call "backbone"? Does the current medical industry have a thinking pattern of fame (whether it is the doctor's own fame or hospital fame)? Since the medical reform is to be practised freely, and to change the core resources of doctors in medicine, what is the best way for young doctors to come out? The reason why young doctors come out is relatively low, and the Chinese doctor's training system has a close relationship.

At present, the medical students in our country are divided into 5 years undergraduate, 7 years of master-in-law, 8-year master Boljan reading, the most important feature of this system is to pay attention to postgraduate education, clinical doctor training purposes are not clear, resulting in medical students need to stay in hospital for many years before the doctor will be qualified to see a doctor. And the resident system is precisely the birth of "fame/popularity level" phenomenon occurred in the essence of the reason, the current domestic resident system is basically strict and wide out, just the first step in the promotion, the real training is quite limited, which is what doctors often say "iron rice bowl". Any medical institutions can cultivate resident doctors, medical graduates assigned to what hospital, in what hospital to receive training, training mode is often the Master apprentice style, after the end of the training, regardless of level heights almost absolutely stay in the hospital work, so that the current patients only recognize the hospital brand, the hospital is a good hospital doctors regardless of the old/ Regardless of seniority level is high "2".

So the physician level cannot be judged by fame/seniority, and I remember the family doctor's idea of a "acquaintance pattern" that I mentioned in a previous blog post, the starting point of which is to build trust through transcendental cognition, and the majority of people who are friends or family, or who they recommend, will trust their level, So try to change the awkward situation with the seniority level of fame. Finally, I would like to say that once the medical mountain began to collapse, the traditional system began to disintegrate, the free-practice environment of young doctors and senior experts may stand on the same starting line, fair competition, each rely on their own technology and services to attract patients, so not only the backbone of doctors will choose to practise freely.

Electronic Cases

Today's health headlines forward the "Doctor vs Patient Case attribution controversy", "3". Although the headline is attractive, the content is somewhat hollow, just a list of some of the respondents ' opinions. In fact, before discussing this problem, we should make clear the following points:

1) What is the medical history? What is included in the content?

2013 the definition of medical records is clearly stated in the new medical records provisions, as shown in

Compared to the previous version, the regulations also put forward the differences between medical records and medical records. In the third chapter of the provisions of the "custody of medical records" issue, in principle, patients have the ownership of medical records, the hospital according to the specific circumstances of the right to custody, which is to facilitate the patient to review, such as "4."

We can see that the medical record is very complex, contains a lot of content, and the daily we are often considered to be your medical records and video materials, especially nowadays mobile medical and wearable hot situation, most of the "patient" as the center, the establishment of patient personal health records, Most of the information on their phones is not part of a medical history, so the personal health record at this time is not a real one.

So that's the problem? What is the main body of ownership discussed in this paper? Do you mean all of the hospitalization records in the prescribed? Do you mean all the options listed in the rules? At present, the test report class data (such as radiological imaging, chemical inspection, doctor's order, etc.) can be quickly disclosed, transferred to the patient's hands, and not very difficult. (There will also be a problem, that is, the issue of mutual recognition of medical records, "The Practice Physician Act" stipulates that doctors must conduct appropriate tests in order to make the correct diagnosis, so even if the patient with the previous test report, known as the so-called personal records to visit, may not be effective, for chronic diseases may have a role.) Based on this level, the rules for mutual recognition of medical records can also be a problem. And for the related Operation Records, treatment plan discussion record, meeting record may be open difficult, here involved in multi-stakeholder issues, especially after the medical disputes, so the hospital in public this part of the disease has been inert,

2) What does ownership refer to? Is it storage? Or is it publicly accessible?

What does a patient have his own medical history referring to? Is it that the so-called patient has the ownership of a medical record that requires the hospital to print a bunch of data to you at the time of discharge? Presumably we do not want this program, so patients with electronic medical records need a unified management center for storage, the previous reason that the patient is not the owner of the medical records because the hospital is an island of information, we can not access and browse their records anytime and anywhere, and each hospital's medical records are not mutually recognized, Therefore, if the same medical record Management Center is established, patients can visit at any time, and their doctor can always access, so the so-called medical records ownership may not be so important. When it comes to the management of medical records, there is a management body, is the state? Hospital? Or a third-party agency? China has not done a very good record management system, the only possible is the identity card and household registration, if replaced by hospital management, then the current situation is not very different; if you switch to a third-party organization, you may encounter many problems because of the lack of experience, but it is also a new model that remains to be tried.

3) who are the medical principals in the future? Doctor? Patients?

The blog "5" describes the American medical model experienced a lot of "pit", only to replace the current patient-centered medical system, so the future of domestic medical care should be patient as the main body, with the implementation of free practice, doctors become independent subjects, doctors need to provide patients with quality services to obtain recognition, As a result, doctors in the future will only have access to medical records, and ownership naturally belongs to patients.

Mobile Healthcare

China's overall medical system is the 5, 60 Soviet Union helped to build up the system, the core of the system is to visit the foundation, the responsibility is "to save lives", only have serious illness to go to the hospital, other time to find the local health clinic (I remember when the village has barefoot doctors, package cure all kinds of diseases, cure all sorts of incurable disease) , with the stability of the situation after the founding of the state, responsibility slowly shifted to "saving lives", continued to this day. With the aging of China now, the existing "Saving lives" system has lagged behind, everyone is sick to the three-armor hospital, leading to more and more weak basic health care "6".

The current involvement of the internet and mobile internet, driven by patient demand, is disruptive to a variety of vertical segments, and may reverse the reform of the healthcare system. At present, the large hospital location is unclear, the three-nail hospital and other large-scale general hospital long-term commitment to the role of primary medical care, leading to waste of grass-roots resources, personnel and drugs, and thus the impact of patients on primary medical information, so formed a vicious circle. Therefore, with the advancement of new medical reform, allowing social capital to enter, it is expected to reverse the status of basic health care, at the same time large public general hospital should be timely transformation, return to first aid and treatment of major diseases.

References

"1" http://read.douban.com/ebook/8028730/?icn=from-reader-page

"2" http://news.163.com/special/00012Q9L/yishengpeiyang091116.html

"3" http://www.cn-healthcare.com/article/20150119/content-469075.html

"4" http://www.cn-healthcare.com/article/20140606/content-457932.html

"5" http://www.vcbeat.net/8873.html

"6" http://www.cn-healthcare.com/article/20150113/content-468535.html

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Date: 2015-01-20

Medical Seasonal (Running) information (zssure): Mobile medicine is not a problem