＂Consultation＂ Internet Hospital： Offline examination results can be mutually recognized, why doesn’t it work online？

　　Zhao Chunqing painted

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　　The problem of "data island" is also one of the "blocking points" in the development of Internet hospitals. The data is not interoperable, which will easily lead to repeated and additional examinations, waste medical resources, increase the cost of patients’ medical treatment, and is not conducive to doctors’ comprehensive judgment and consideration of the condition. Professionals pointed out that Internet hospitals should strengthen the top-level design, locate the platform development, break the "data island", and at the same time, improve the supervision system to ensure the privacy and safety of patients.

　　Guo Yue, from Shenyang, Liaoning Province, suffers from hypothyroidism. After the outbreak of COVID-19, she has been making follow-up visits to Internet hospitals. "Online visits are efficient and convenient, and medicines are delivered directly from hospital pharmacies, which is safe and reliable".

　　However, Guo Yue bluntly said that there are also problems that cannot be avoided in seeing a doctor in an Internet hospital. "I checked three items of A-class work in a second-class hospital near my home, and then went to another Internet hospital for follow-up. The previous report data was not recognized and needed to be re-examined." Guo Yue also found in the process of long-term hospital running that dozens of top three hospitals in Liaoning mutually recognized the inspection results, but it was not feasible to put them on Internet hospitals.

　　The Workers Daily reporter learned from interviews in Liaoning, Beijing, Shenzhen and other places that many Internet hospitals are in a state of "data islands", and basic data such as patient’s vital signs information, disease information, image inspection reports, Internet diagnosis and treatment records, and drug use cannot be shared among hospitals, and all Internet hospitals are almost "fragmented". In addition, as the other side of information interconnection, the information security of Internet hospital users has also been concerned.

　　Breaking the "data island" to facilitate patients’ online treatment

　　"Realizing the sharing of patients’ previous medical information is conducive to doctors’ comprehensive judgment and consideration of the condition, and can also effectively use various medical resources to avoid duplication and extra examinations and waste the time of doctors and patients." Zhang Ningbo, director of the medical department of Shenzhen Hospital in Peking University, said in an interview with Workers Daily.

　　Li Yaqin, an attending physician in the infectious diseases clinic of Peking University Shenzhen Hospital, said that compared with face-to-face consultation, online consultation can’t directly observe the patient’s condition, and the advice given by doctors will be relatively conservative. "If we further improve the Internet hospital system and let different medical institutions share patients’ examination reports, we can effectively avoid the inaccurate dictation of patients and make patients’ online treatment more efficient and convenient."

　　It is understood that at present, Internet hospitals built by public hospitals in Beijing have not yet achieved comprehensive interconnection with each other.

　　Chen Qiulin, deputy director of the Health Industry Development Research Center of China Academy of Social Sciences, pointed out that in order to break the "data island" and improve the efficiency of information communication, public hospitals need to strengthen the top-level design, position the platform development, and adopt the way that the government builds an Internet medical information platform or uses a third-party platform to realize the interconnection of medical and health information.

　　Xu Xuedong, director of the Medical Department of Peking University Third Hospital and director of the Internet Hospital Office, believes that under the premise of ensuring safety, realizing the sharing of patients’ medical information requires medical institutions to ensure the integrity, accuracy and timeliness of data such as case information and inspection, as well as the technical standardization of information interfaces, improve the data access and authorization mechanism between Internet hospitals and sharing platforms, and ensure the security of data transmission and the security of patients’ privacy.

　　Both interconnection and information security should be ensured.

　　The other side of the interconnection of Internet hospital medical data is the safety of patients’ personal information. In the process of online medical treatment, personal information such as patient’s vital signs, diseases, medical records and so on need to be transmitted online, and there are hidden dangers in information security.

　　Since the outbreak, Chen Fangling, a citizen of Shenzhen, has been consulting in Internet hospitals almost every month. Talking about information leakage, she said that in the era of big data, this is inevitable. "But if you go to a reliable online medical institution, I think information security can still be guaranteed."

　　Zhang Ningbo pointed out that just as some mobile applications can collect data through the background, understand users’ preferences and then push targeted advertisements, Internet hospitals also have data security risks.

　　"However, the hospital has a clear network security management system to protect the privacy of patients. Doctors also need to set password management in their daily operations. " Zhang Ningbo said, "If you inquire about the patient’s previous medical treatment due to the need of diagnosis and treatment, the operating system will strictly correspond to the job number of each doctor."

　　Xie Zhiyi, director of the medical management department of Tsinghua Chang Gung Memorial Hospital, said that the establishment of an Internet hospital requires strict safety qualification examination, and the hospital will also require online diagnosis and treatment in accordance with the privacy protection standards for offline diagnosis and treatment.

　　In Xu Xuedong’s view, improving the supervision system, optimizing the technical means of supervision, and establishing an emergency plan for data leakage need to be included in the key work areas of the normalized safety management system of Internet hospitals.

　　According to the Administrative Measures for Internet Hospitals (Trial), the Internet hospital information system implements the third-level information security level protection in accordance with relevant national laws, regulations and provisions. The Supervision Rules for Internet Diagnosis and Treatment (Trial) promulgated in February 2022 also proposed that medical institutions should establish systems such as network security, data security, personal information protection and privacy protection, and sign agreements with relevant partners to clarify the rights and responsibilities of all parties.

　　Let the role of Internet hospitals play a further role.

　　It is understood that some places have made attempts to interconnect Internet hospital information, and some have also issued more detailed regulations on patient information protection in Internet hospitals.

　　In 2017, the Beijing Municipal Health and Wellness Commission issued a notice requiring all 30 pilot hospitals to share and access electronic medical record information. Xie Zhiyi told the Workers’ Daily reporter that as one of the pilot hospitals, Tsinghua Chang Gung Memorial Hospital has realized the sharing of electronic medical record information. As long as the patient is authorized to agree, doctors can access and check the relevant medical information of patients in non-local medical institutions.

　　Zhou Wen, chief physician of internal medicine of a 3A hospital in Shenyang, said in an interview that at present, some regions have explored the establishment of regional medical groups, and hospitals within the groups can share patient information.

　　In terms of patient information protection, last year, Ningxia issued the Measures for the Management of Bad Practice Points in Internet Hospitals in Ningxia (for Trial Implementation), which includes problems such as improper care of patient information, illegal trading, disclosure of patient information, and disclosure of patient information and medical data in Internet hospitals. If effective measures are not taken immediately, the hospitals involved will be dealt with accordingly.

　　The emergence of Internet hospitals conforms to the development trend of mobile Internet, which brings practical convenience for people to seek medical treatment. However, the reporter found in interviews in many places that many Internet hospitals are in a state of "building but not using" and "thunder and little rain". If Internet hospitals want to change from "flower shelf" to "real style", they need to clear the "blocking points" such as the lack of popularization of medical insurance payment, low enthusiasm of doctors and inability to interconnect data.

　　Zhang Ningbo believes that if Internet hospitals are used well, they will play a more important role than seeking medical advice in the future. For example, they can give full play to their integrated online and offline diagnosis and treatment functions and do a good job in post-hospital management. "If the charging items are properly liberalized, Internet hospitals can also equip corresponding health managers according to the health conditions and needs of the people, and even formulate appropriate exercise and diet programs for them to help improve the overall health level of society."