Analysis of pathological diagnosis center mode based on big data + AI technology

Author: Jiang Yangjun Zhong Nanshan once wrote for Chinese Journal of pathology that "the level of clinical pathology is an important mark to measure the quality of national medical treatment" However, it is such an indispensable "bridge discipline" In recent years, it has become the "bottleneck" of medical development in China The shortage of pathological talents and the lack of diagnostic ability are increasingly prominent Pathology is a very important subject in the whole western medicine system In foreign countries, pathology is usually called "the foundation of medicine" and pathologist is called "doctor's doctor" Pathological diagnosis is directly used for the diagnosis of clinical diseases through the morphological observation of biopsy tissue, autopsy and exfoliated cells It is the monitoring and supplement of clinical diagnosis and plays an important role in medical practice As far as patients are concerned, the results of pathological diagnosis are related to the selection of their follow-up treatment plan （1） Pathologist gap is widespread It's not easy to cultivate a qualified pathologist After graduation, the residents generally need standardized training to obtain the qualification of pathologists After 10 years of clinical pathological diagnosis practice in the pathology department of large hospitals, they can complete the pathological diagnosis of common diseases on their own "The clinical medicine sub specialty is more and more detailed, and the treatment plan is more and more accurate First of all, the pathological diagnosis of disease classification and classification must be accurate, but the total number of pathologists in China is too small to meet the clinical needs.", Bian Xiuwu, academician of the Chinese Academy of Sciences and chairman of the pathology branch of the Chinese Medical Doctor Association, said that at present, there are less than 20000 licensed pathologists in China According to the allocation requirements of the national health and health commission that every 100 beds should be equipped with 1-2 pathologists, the gap of pathologists is more than 90000 （2） "Heavy assets" of hardware facilities, affecting the level of diagnosis With the development of clinical treatment towards personalized precise medical treatment, pathological diagnosis is also facing the transformation from single morphological diagnosis to integrated morphological diagnosis, molecular typing, immunohistochemistry and diagnosis mode In this way, the pathology department needs to invest a large amount of money to buy large-scale equipment in the early stage of construction However, for some basic hospitals, due to cost-effectiveness considerations, they are often unable to replace and add the latest equipment in time, thus affecting the quality of diagnosis, and becoming a bottleneck problem in the development of new technology Pathological diagnosis center has become one of the hot spots in medical reform Since 2009, the state has launched various policies to promote the development of pathology industry Table 1 inventory of relevant national policies in China In the United States, there are three common types of independent pathology institutions: pathology laboratories in various universities, independent pathology laboratories and medical centers, and independent pathology departments and pathology diagnosis centers in hospitals At present, in China, there are independent pathological institutions that do third-party pathological diagnosis, and some companies that do third-party inspection regard pathological diagnosis as one of their businesses In 2012, Ningbo clinical pathology diagnosis center (Ningbo pathology center of Shanghai Tumor Hospital), the first regional pathology diagnosis center in China, was established On January 12, 2018, Shanghai Hengdao medical pathological diagnosis center, the first independent third-party pathological diagnosis center in China, officially opened in Shanghai On the whole, the pathological diagnosis center has provided a strong support for the supply side structural reform of the medical industry, mainly in the following six aspects: (1) Activate resources and promote the sharing and reuse of equipment and human resources in the region; (2) Promote the cooperation between large public hospitals and grass-roots hospitals, and implement the hierarchical diagnosis and treatment policy; (3) Improve the diagnosis ability and service of basic hospitals in the region; (4) Promote the data sharing of medical institutions in the region, and make the data produce the secondary development value; (5) It is convenient for patients, improves diagnosis efficiency, lightens patients' burden and improves medical experience; (6) Give full play to the advantages of intensification and specialization, reduce costs and improve the quality of diagnosis 1 Build a highly informationized pathological information management system The center will be connected with all hospitals and community health service centers Doctors can consult pathological reports through the system terminal, print reports independently, realize paperless whole process, electronic application form, barcode specimen, unified logistics distribution, automatic sample scanning, electronic signature of reports Fig 1 mechanism of pathological information management system 2 Pathological AI improves the efficiency of pathological diagnosis The development of pathological AI will effectively share the workload of pathologists, make up for the shortage of pathologists in the industry, and directly promote the development of upstream pathological industry market At present, the combination of pathology and big data algorithm is an important direction to solve the shortage of pathologists The development of pathological AI assisted diagnosis will effectively reduce the workload of pathologists 3 Overall planning and sharing of pathological resources Pathological diagnosis center has important advantages in resource integration, centralized development and so on In the practice of scale economy effect, it refers to a large number of single species The scale economic effect is determined by the cost structure The larger the proportion of fixed cost in a medical technology department, the higher the scale economic effect Among the medical technology departments, the pathology department, the laboratory department and the radiology department are all the departments with large fixed costs For the medical services that need to purchase large-scale equipment, if a certain scale of specialized service organization is set up, it is more economical to provide services than scattered in various general hospitals, so as to realize the sharing of equipment, etc.