Recently, the "Detailed Regulations on Internet Diagnosis and Treatment Supervision (Trial)" (hereinafter referred to as the "Detailed Rules") formulated by the National Health Commission and the State Administration of Traditional Chinese Medicine was officially implemented, aiming to standardize Internet diagnosis and treatment activities, strengthen the construction of an Internet diagnosis and treatment supervision system, and prevent and resolve the disease. Internet diagnosis and treatment security risks, and ensure the safety and quality of medical services.This is based on the "two measures and one standard" in 2018, such as "Internet Diagnosis and Treatment Management Measures (Trial)", "Internet Hospital Management Measures (Trial)" and "Telemedicine Service Management Regulations (Trial)". Faced with the outstanding problems, heavy policies have been introduced again, providing clearer policy guidelines and more detailed regulatory requirements for the future development of Internet diagnosis and treatment.
Since the General Office of the State Council issued the "Opinions on Promoting the Development of "Internet + Medical Health" in April 2018, Internet medical care has a certain market size and a growing momentum, and has gradually become an important innovation in my country's medical system.Data shows that up to now, more than 1,700 Internet hospitals have been approved nationwide, 30 provinces have established provincial-level Internet medical service supervision platforms, and at least 160 Internet-related medical policies have been issued at the national and provincial levels. Under the integrated medical service model and quality supervision system, to ensure the quality accessibility and security of Internet medical services.General hospitals have become the main body of Internet hospital construction, accounting for nearly 70%. In addition, specialized hospitals and traditional Chinese medicine hospitals are also accelerating their deployment.More than 50% of the national second-level and above public hospitals have carried out appointment diagnosis and treatment, and more than 4,800 hospitals can make accurate appointment diagnosis and treatment in different time periods.Telemedicine covers all prefecture-level cities and more than 90% of counties (cities, districts) in the country, which has led to the increase of high-quality resources for primary medical care and the improvement of service capabilities.Especially since the outbreak of COVID-19, various regions have accelerated the development of Internet hospitals relying on physical hospitals. Internet diagnosis and treatment services have played an active role in ensuring patients' medical service needs, alleviating the pressure on hospitals' offline medical services, reducing personnel gathering, and reducing cross-infection.Online medical care has initially formed a user base, and the demand for health services generated by the epidemic is being released. By the end of last year, the number of online medical users in my country reached 298 million, an increase of 83.08 million over 2020, and online medical users accounted for 28.9% of the total number of netizens.The National Medical Insurance Administration has also issued guidance on the price of "Internet +" medical services and medical insurance payment policies for many times, improving and optimizing the medical insurance payment policy and medical insurance handling and management services of Internet medical care, and further meeting the people's needs for convenient medical services.
The "Detailed Rules" further improves the Internet medical supervision system based on "two methods and one standard", which means that the Internet medical industry bid farewell to the "barbaric growth" period, returns to the essential positioning of "serious medical care", and enters the era of strong supervision.According to the value orientation of the medical industry, the "Detailed Rules" organically combine the serious supervision of health authorities with the self-regulation of medical institutions and medical personnel, and clarify the supervision of medicine, medical treatment, personnel, technology, quality and safety of Internet diagnosis and treatment. The requirements and division of responsibilities provide a basic system specification with strong operability for government departments, medical institutions and medical personnel, patients and the general public to participate in the governance of Internet medical services.
The first is to highlight the value concept of "people's health as the center".The "Detailed Rules" incorporates Internet diagnosis and treatment into the overall medical service supervision system, pays special attention to achieving an orderly balance between medical quality and patient safety, jurisprudence and medical theory, emphasizes that the medical service process must be subject to quality and safety, and ensures the integration of online and offline. To ensure homogeneous management, homogeneous quality and homogeneous safety.The second is to emphasize the whole-process compliance supervision.The "Detailed Rules" refine the regulatory rules for medical institutions, medical personnel, business activities, quality and safety, etc. that carry out Internet diagnosis and treatment activities, require complete recording of the process and results, and trace the flow of key information such as qualifications, medical records, prescriptions, and drugs, to ensure that The entire process of Internet diagnosis and treatment is monitored and protected in accordance with the law.The third is to emphasize the supervision of technical information.The "Detailed Rules" are based on the patient's medical data and electronic medical records to support the digital, precise and intelligent development of Internet diagnosis and treatment, and require that the diagnosis and treatment, quality control, supervision, complaints, data sharing and other behaviors that occur on the Internet must rely on physical medical institutions. , and regulate the rational application of new technologies such as artificial intelligence and big data in specific business work, further clarify the boundaries of Internet medical care, and optimize the allocation of medical resources.The fourth is to emphasize quality and safety supervision.The "Detailed Rules" are based on ensuring the quality and safety of medical care, and require all provinces to establish provincial-level supervision platforms, follow laws and regulations such as network security, data security, and privacy protection, and set clear requirements for medical care, patients, and information, supported by informatization. , innovate supervision methods, connect with provincial supervision platforms, and carry out online and offline integrated supervision.
At present, Internet medical care has steadily entered the fast lane of standardized development.From the perspective of the national medical insurance reform, as an extension of the offline service model, especially outpatient co-ordination is about to be fully rolled out, Internet medical care can become an integral part of outpatient co-ordination, which is the value of its development and is conducive to providing universal access to the whole population. Beneficial, all-round, full-cycle services to meet people's diverse and multi-level medical and health service needs.As an important part of the multi-level medical security system, commercial health insurance, in the development of Internet medical care, reduces the possible hospitalization rate by improving the accessibility of Internet medical care and improving the coordination ability of medical services. To control medical costs, promote the design and dynamic pricing of follow-up insurance products by integrating and sharing data platforms, and provide customers with a more convenient and high-quality service experience by optimizing the Internet medical treatment and insurance claims process, so as to achieve closed-loop management between customers, insurance and hospitals. Become a tool for medical insurance reform and Internet medical development.(Author: Institute of Hospital Management, Tsinghua University)
