With the continuous penetration of digital technology in various industries, digital information technologies such as the Internet, big data and artificial intelligence have brought profound changes to medical services, security, and drug production and circulation. The sudden outbreak of the epidemic has made online diagnosis and treatment, big data, artificial intelligence, 5G technology, and other technologies the technical responsibility to fight against the epidemic. Especially, the intelligent management of big data has become an effective means for medical institutions to promote their work. In the eyes of industry managers, now is a favorable opportunity to accelerate the application of new technologies in the medical field. However, medical institutions have gained and also have doubts in practicing digital healthcare.
Chronic disease management is an important application scenario of Internet information technology
What changes will digital information technology bring to the healthcare industry?
In the face of the impact of informatization, we should make several changes. Firstly, patient-centered intelligent services; secondly, intelligent healthcare centered on improving medical quality and efficiency; and thirdly, intelligent management of online and refined medical management. "Wang Xinsheng, Secretary and Minister of the Medical Department of the Party Committee of Qingdao University, introduced at the" Digital Technology, Changing Healthcare "2020 Health Policy Roundtable Conference hosted by Shanghai Chuangqi Health Development Research Institute that Qingdao has made relevant explorations in the medical treatment mode, such as improving appointment diagnosis and treatment, intelligent voice input system, cloud film, paperless medical records, building a complete information-based graded diagnosis and treatment platform, clinical medical decision support system, IoT intelligent blood management solution system, computer-assisted surgical screen, and surgical intelligence. Display system Advanced 3D image post-processing system, clinical rational drug use support system, medical knowledge base, clinical research big data, etc.
In the opinion of Wan Jun, vice president of the People's Hospital of Wuhan University, the Internet and information technology have extremely important application scenarios in the field of chronic disease management. For example, Wuhan University People's Hospital has proposed the concept of a medical assistance service system, which uses wearable devices, artificial intelligence, and rapid diagnosis to intervene in a timely manner and achieve effective and timely allocation of treatment resources. At the same time, the connotation of "chronic disease management+active health" is also proposed, which means using wearable devices and artificial intelligence as auxiliary means, combined with chronic disease detection and management, to change the passive medical treatment mode, achieve prevention before illness, accurate treatment of chronic diseases, early treatment of serious diseases, and rapid treatment of urgent diseases.
Xiamen also has its own experience in chronic disease management. The Deputy Director of Xiamen Municipal Health Commission introduced that medical resources in Xiamen are relatively scarce, with more tertiary hospitals and primary medical institutions than secondary hospitals. In response to these characteristics, the local government has adopted a combination of hierarchical diagnosis and treatment, information technology construction, and organic application methods. The Xiamen Citizen Health Information System has been in operation since 2007, reforming the tertiary hospitals and community health service centers in six districts of Xiamen, and implementing the "chronic disease first, three teacher joint management" approach around hierarchical diagnosis and treatment. This means that patients are at the center, and specialized physicians in large hospitals and general practitioners and health managers at the grassroots level provide personalized management through contracted services. Su Miaoling said that "three teacher joint management" identifies contracted patients through informatization, uses data platforms to standardize management in daily testing and public health follow-up, and improves management efficiency. At the same time, expand the common diseases in the community. Su Miaoling introduced that currently 95% of the permanent residents in Xiamen have comprehensive and lifelong electronic records, and residents can access their personal health records through various means, with a high cumulative utilization rate.
Cai Jiangnan, an expert in health economics and health policies and executive director of Shanghai Chuangqi Health Research Institute, stated that in China, areas with good application of information technology in the medical and health field include Xiamen, Shenzhen, etc. Xiamen has applied information technology to places where residents urgently need it, making hierarchical diagnosis and treatment truly accessible.
Whether 'big data' or 'big data' directly affects the process of digital healthcare
The occurrence of the COVID-19 has shown us that the medical model has changed, and diagnosis and treatment can be achieved without doctors and patients meeting. Relying on the Internet platform, with the help of information technology, it can realize the scene of multiple experts in different regions around a patient. "This is all based on the sharing of medical and health information and mutual recognition and sharing of detection results." Gao Jiechun, director of the Hospital Management Research Institute of Fudan University, stressed that health information sharing is the basis of Internet medicine and smart medicine, which is also the bottleneck of the further development of Internet medicine and artificial intelligence medicine in China.
Zhu Fu, executive director of Shanghai Xuhui District Central Hospital, said frankly that Internet hospitals based on information technology are generally in a state of "hot outside and cold inside", and hospitals lack internal motivation. "Up to now, 24 hospitals in Shanghai have obtained Internet hospital licenses, and about 290 Internet hospitals have been added nationwide since the end of May, but the overall growth is still lower than expected." Zhu Fu analyzed that the main reason is that most provinces and cities do not have a unified health information platform for privacy protection; The information language used in community, district, and municipal hospitals lacks standardization, the quality of health information is not high, and the degree of data interconnection and mutual recognition is not high; The vast health information database has low levels of ownership, openness, and utilization.
'Big data' and 'big data' are not the same concept. 'Big data' refers to a large amount of data, while 'big data' refers to all data being orderly and related. Zhu Fu emphasized that the government has exclusive access to health information, and the lack of corresponding laws and regulations on personal privacy and security is also an important factor in suppressing the enthusiasm of hospitals. Supporting policies and policy dividends should be kept up with as soon as possible.
In Gao Jiechun's view, from the perspective of hospitals, the development of domestic health informationization can be mainly divided into three stages. The first stage focuses on financial settlement and reduces hospital operating costs by improving the efficiency of hospital economic management. This stage marks the basic maturity of health informationization. The second stage is patient-centered and clinical oriented, aiming to improve the medical service capabilities and work efficiency of medical staff, thereby enhancing the quality of medical services. The main feature of this stage is that all information is shared within a single hospital. The third stage is characterized by the sharing and collaboration of medical service information, which integrates medical information resources to improve the overall medical level and efficiency. The main characteristic of this stage is that information sharing occurs between hospitals, within regions, and even at the national level.
Currently, we are in the third stage of health informatization. Although information sharing has been achieved between hospitals and within certain regions, cross provincial and inter provincial health information centers have not yet been established, "said Gao Jiechun. In addition, the medical insurance department's system basically guarantees the sharing of relevant information for medical insurance patients, but there is still a lack of information sharing for non medical insurance patients.
Privacy protection and information sharing are not contradictory, and supporting policies and regulations need to keep up with them
Gao Jiechun stated that privacy protection and information sharing are not contradictory entities. On the contrary, the role of information sharing can be fully leveraged through government led public information open platforms and market-oriented professional institutions, while protecting privacy. He believed that health information sharing could be used in the fields of Internet medicine, mobile medicine, home health detection and artificial intelligence medicine in the future, and explained these concepts one by one.
Internet medicine includes health education, medical information inquiry, electronic health records, disease risk assessment, online disease consultation, electronic prescription, remote consultation, telemedicine, rehabilitation and other forms of health care services with the Internet as the carrier and technical means.
Mobile healthcare refers to the use of mobile communication technologies such as PAD, telephone, and satellite communication to provide medical services and information, and effectively improve healthcare processes and quality.
Family health and medical care is a process that uses mobile communication technologies such as 5G, Bluetooth, WIFI, and medical monitoring devices to collect data on various health and disease indicators of family members, in order to comprehensively detect, analyze, evaluate, provide health consultation and guidance for family members, and evaluate and intervene in health risk factors.
Artificial intelligence healthcare is based on big data and simulates the thinking process and intelligent behavior of doctors through computers, which has the advantages of being more rational, stable, and accurate than traditional medical services.
It is worth noting that the above application scenarios must be based on health information. Gao Jiechun emphasized that this requires the government to formulate relevant laws as soon as possible to clearly stipulate that health information must be shared, so as to ensure that everyone has the right to use medical data normally. The National Health Commission also needs to establish a national health information center and establish a market mechanism guided by the state to complete the cleaning and processing of medical big data.
