Telemedicine is not as simple as developing an app

Medical Network August 16th "Run thousands of miles, queue for a few nights, wait a few hours, visit a few minutes, spend tens of thousands of dollars." This medical circle popular ridicule, to some extent reflects China's medical care Medical status of large differences in quality, poor referral coordination, and low-risk treatment.

At the "2018 China Health and Wellness Innovation Development Summit and the 5th International Telemedicine and Health Service Conference" held recently, Lu Qingjun, director of the Telemedicine Center of the China-Japan Hospital, said that at present, telemedicine, Internet diagnosis and treatment, etc. Perhaps it can be one of the ways to alleviate the problem of “seeking a doctor for medical treatment” in China.

However, after 20 years of history, China's telemedicine still faces a series of difficulties. At the meeting, experts pointed out that this includes information resources platforms that are not open and not included in medical insurance.

Heavy equipment light application, lack of top-level design

Lu Qingjun introduced that there are currently two modes of telemedicine in China. One is the telemedicine model between medical institutions, and the other is the Internet clinic mode for medical institutions. In addition, there is a type of paramedical model that belongs to the category of health promotion rather than medical.

The Internet diagnosis and treatment model is currently limited to the return of some common diseases, that is, the patient must go to the hospital to see a doctor at the initial diagnosis. After the doctor understands the patient's condition and masters the patient's medical record data, he can conduct a follow-up or follow-up through the Internet platform. "It is very dangerous for the patient to be diagnosed through the Internet video. Because the patient describes the condition is not professional, it is difficult for the doctor to know the patient's vital signs. At present, the country is not allowed to use the Internet platform for the initial diagnosis." The PLA General Hospital Telemedicine Director Zhang Meikui said.

“It is reliable for the grassroots doctors to transfer the patient's medical records to remote experts.” Zhang Meikui explained that this is the current mainstream telemedicine model. Patients go to the primary hospital for treatment. The grassroots doctors can judge that the patient's condition is complicated and the local medical conditions are difficult to diagnose and treat. Applying for telemedicine to a remote consultation center and transmitting the patient's medical records to a telemedicine platform, the telemedicine experts will help the grassroots hospital doctors to develop a more scientific plan.

In response to recent fire health consultations, online registration, enquiry and inspection results, and resident health records, Lu Qingjun said that these are all medical assistance services, and patients can log on to major medical platforms for consultation. However, the medical auxiliary business is a market behavior and medical knowledge sharing behavior, and is not in the scope of telemedicine.

However, "telemedicine still has a series of problems such as heavy equipment, light application, lack of top-level design of telemedicine, poor connection between business processes and clinical work." Lu Qingjun concluded that telemedicine emphasizes the quality of video transmission and ignores medical records. Quality; emphasizes technical expressions, ignores clinical application characteristics; emphasizes industry capital investment, neglects actual performance output; emphasizes hype business concepts, ignoring the status of clinical resources.

The exaggerated propaganda, the naive technology platform and the unrealistic process are the development of Internet + medical. "Many platforms claim that patients can link experts with one click. In fact, they do not face the problem of insufficient medical resources in our country and the need to grade the disease. It is definitely not in line with the actual hospital." Lu Qingjun bluntly.

“The most important thing is how to make telemedicine comply with the medical law. The medical industry needs practicing qualification and medical quality management, instead of developing an APP to do medical treatment.” Lu Qingjun said that the State Council’s Document No. 26 also clearly stated that Internet hospitals need Relying on physical medical institutions.

It is difficult to price low reimbursement, and who will pay for treatment costs

At present, telemedicine charges are not uniform across the country, ranging from 50 to 2,000 yuan. However, according to Lu Qingjun, the average cost of a 30-minute video consultation is between 3,000 and 5,000 yuan. Because the medical insurance department is difficult to calculate the cost of telemedicine and other reasons, the failure to reimbursement is also a stumbling block on the development of telemedicine.

Lu Qingjun said that due to the different pricing principles across the country, commercial pricing and government pricing coexist, and the current pricing of telemedicine is “very unreasonable”.

In Guizhou, an outpatient clinic is 300 yuan, and 5 patients can be seen in half an hour. However, a remote consultation in Guizhou Province is 100 yuan. Only one patient can be seen in half an hour because the remote doctor should answer the question during the remote consultation. Many problems of the grassroots doctors.

Telemedicine pricing is low and localities are not uniform. From the perspective of labor costs and technical costs, it is as high as 3,000-5,000 yuan. Telemedicine equipment is millions of people. Regardless of the disease , a remote consultation requires at least six or seven people, including telemedicine experts, primary hospital physicians and technical support management, and a team that maintains remote cloud platforms.

At present, many hospitals have set up telemedicine platforms, each of which bears the high cost of telemedicine. However, because the pricing problem has not been resolved, telemedicine can not be reimbursed by medical insurance, and the cost of hospitals cannot be shared. Many telemedicines in hospitals are trying to "make it look like this."

Lu Qingjun pointed out that there are some hospitals in order to reduce operating costs, and even the private network has been canceled, and telemedicine is in name only in some hospitals. (Intern reporter Tang Fang)