The expansion of electronic health card and the breakthrough of the three medical associations

Wen: Zhao Weiwei has chickens first, or eggs first? "This is a philosophical question of exploring the origin of life, but it also appears on the exploration of electronic health cards.
, the electronic health card is "chicken" and the application behind it is "egg".
As early as the beginning of the second decade of the twenty-first century, the National Health and Safety Commission (formerly the Ministry of Health) and other institutions on the idea of health cards, health insurance cards, social security cards and many other cards electronic, universal, to solve the problem of people every time they go to see a doctor with a lot of cards, the settlement of the problem of hurried card search.
, but at that time, the term Internet medical is still in the concept, medical information reform has just begun.
whether it is urging hospitals to issue cards to patients, or connecting cards with applications under the hospital's information system, it was almost impossible to get started at the time.
this idea continued into 2016.
with the hospital's information upgrading and information system connectivity issues gradually received attention, card electronic and application docking two issues gradually appeared their own solutions, but new problems followed.
" is the popular card first or the hospital application first? The problem troubled us for a long time at that time.
, " recalls Zhong Weijun, director of the information center of the Hunan Provincial Health and Wellness Commission.
year, the electronic health card in Hunan region entered the planning stage, but just started, the problem followed.
" as the provincial health and health committee, we asked all hospitals to reform, the original diagnosis and treatment card to replace the electronic health card.
this time the dean will ask: the hospital can do a good job, but the people have not done cards, how to use? But if we first go to the people to issue cards, after the card, the people found that this card hospital can not be used, this situation is even worse.
" the difficulties of the year is really difficult to solve, indeed inhibited the development of electronic health card and its entrance electronic health code, but with the promotion of medical information and the strong support for Internet medical, hospital information exchange continued to accelerate, the gap between different applications of different systems was gradually opened up, the application side of the problem was solved one by one.
coupled with this year's sudden outbreak, the epidemic prevention work suddenly put the electronic health card through WeChat, hospitals and other entrances to the local residents, card issue work with less effort.
problem of "chicken" and "egg" is solved.
But this is only the beginning, in the use of electronic health code for epidemic prevention process, we gradually found that such a simple two-dimensional code, not only to track patients, to solve the patient's personal health and personal epidemic prevention information connectivity, but also to solve the common health and access to medical interconnection.
health care, medicine, medical care seems to be a small code string up, the three medical linkage problem has once again opened a small gap ... Foundation: Under a single city, the linkage between medical and medical insurance in 2019, Guangxi City Health and Health Bureau issued the "implementation of the three medical linkage of new initiatives, problems and recommendations" pointed out that the three medical linkage is difficult to implement one of the problems is that the "joint" word is not thoroughly implemented.
specifically, regulators cannot monitor and manage the institutions involved in patient care without a database containing complete patient information.
the outbreak, in order to meet the needs of residents travel tracking in the anti-epidemic work, some cities of electronic health card information and public security identity system naturally connected.
the event's landmark significance for the leap forward in electronic health, when personal health information is exchanged with epidemic prevention information, a large data center based on electronic health cards begins to take shape.
"Why can I regulate an electronic health card?" Because it contains the patient's medical identity.
" Yihui Technology Wu Wei told Arterial Network, "As long as the patient is connected to the electronic health card of the hospital, the doctor through the patient's electronic health card identity, can easily query the history of prescriptions, diagnosis, medical history and a series of medical records of the patient."
", the electronic health card builds the foundation of information connectivity.
, however, the electronicization of health cards alone will not completely solve the problem of "association", and health care and payment intervention are equally critical.
, the proposition of "multi-code fusion" came into being.
Taking Fujian Province as an example, in 2018 the National Health and Health Commission, together with the Fujian Provincial Health Care Commission and the Fujian Provincial Health Insurance Bureau, took the lead in piloting the national pilot, combining electronic health codes, medical insurance electronic vouchers, and financial payment codes, also known as "three-code fusion".
With the help of "multi-code fusion" QR code to achieve the whole process of "one-yard consultation" services, covering the establishment, appointment, diagnosis, examination, examination, drug, report form and other aspects of the consultation, in improving the medical experience, but also strengthen the government's supervision and services.
more than a year of pilot practice, effective and challenging.
National Health Commission and related departments realize that the electronic health code, medical insurance electronic vouchers, financial payment code "three codes in one" statement is not accurate enough, "collaboration" is the essence of multi-code mutual recognition and coexistence.
Departments do not need to redestrate the entrance to the unified service, load a new unified entrance on the original entrance, through which residents scan the code, the system will automatically identify the contents of the service, and then jump to the health card, health insurance vouchers or payment entrance.
In layman's terms, it's like when we shop in a supermarket, if we swipe with WeChat, the system will jump to the WeChat interface, and if you use Alipay to sweep code, the system will jump to the Alipay interface.
, this step solves the most important multi-sectoral coordination problem, Fujian is the establishment of the "eight health code" as the core of the "multi-code coordination" system.
at the 15th China Health Information Technology/Health Care Big Data Application Exchange Conference held in Haikou in September this year, the multi-code fusion official name and the product display of the whole industry have been adjusted to "multi-code collaboration".
then, when the system of patients, medical care, health care has been basically information connectivity, who will lead patients into the system? Who is responsible for out-of-health payments? Outside hospitals, Internet companies also play an important role.
an artery network survey on appointments, the activity of the entrances to appointments in the Internet medical age was counted.
The survey sampled appointments in four cities: Beijing, Chongqing, Fujian and Guangdong, and the data showed that weChat's public number port showed a general trend in all kinds of entrances, second only to Alipay Life.
specifically, 44 of the 47 hospitals that opened appointment registrations were registered online through WeChat Public Number, and 22 hospitals opened multiple appointment registration ports.
view, WeChat is becoming the smart hospital era, the main entrance for patients to access medical services, but also during the outbreak, electronic health card, medical insurance e-voucher card issued one of the main entrance.
, WeChat also played a key role in financial payments.
because of its broad coverage advantages among people of all ages, many older people in their 60s are now able to pay via WeChat.
has abandoned the complex payment process and the delivery of bills, Tencent's involvement has made the process easier.
, the basic functions of electronic health cards and electronic health codes have been laid.
is not difficult to find, whether it is "card", or "code", its form is not important, the key is the existence of a medium, patients and medical care, health care linked.
, cards, codes may not exist, face, fingerprints are likely to replace cards, codes as the new media.
the key lies in the basic level of medical informationization in Our country.
: At the municipal level, the extension of medical services based on electronic health cards "if only based on multi-code collaboration to create a basic health information integration platform, there is little technical difficulty."
But to load enough valuable applications on it, first of all, the hospital itself has a certain information ability, can carry the cutting-edge intelligent applications;
," Wu told Arterial Network.
Taking Fujian Province mentioned above as an example, Yilian will make full use of the information construction foundation in medical, medical and pharmaceutical, integrate resources, open application, and closely link medical services with "three medical links" through multi-code coordination.
difficulty of the former is that many hospitals do not realize the importance of information ability, or do not have enough funds for information transformation.
hospitals are either unable to load many applications or have applications, but old data standards are not keeping pace with national standards.
difficulty of the latter lies in coordination, to play a good channel, we have to find information customers along the line, one by one open the interface.
" therefore, a region based on electronic health card medical services can do more people, depending on the level of hospital information in the region, but also depends on the level of local medical information enterprises.
at the Digital China Construction Summit held in Fujian in 2020, "brushing your face and taking medicine" in Fujian Province is an important process for the exhibition hall of the National Health Insurance Administration.
Specifically, users only need to receive health cards through the hospital public number, Fujian Provincial Health And Safety Commission public number and other channels, follow-up without the need to show documents, can be in the designated hospital outpatient settlement after the "swipe the face to get medicine."
the technology's core and electronic health card consistent, only the certification of the credentials from "card", "code" changed to face, more people.
this is an extension of the health card role.
The example of "brushing the face to get medicine" is only one part of Fujian's civilian service, in fact, Yilian public and other information-based enterprises are trying to simplify 11 offline links to four, only to retain the consultation, examination, drug withdrawal, report sheet printing 4 must be patients to the hospital to conduct the link.
to continue to deepen, medicine, report form printing can be in the future, by courier direct mail home.
, under the mature electronic health card system, the change of medical treatment can be divided into three main points: First, the change of the way of medical treatment.
of physical cards for patient visits are gradually migrating to e-cards under government standards, and gradually realizing "a mobile phone to seek medical treatment".
is a change in the medical process.
the original patient's offline consultation to the online transfer, to achieve the integration of offline and offline consultation.
, appointment, settlement, inspection report and other links, the original patients need to queue online, now based on the mobile phone side of the electronic health card, can achieve real-time operation online.
is a change in payment methods.
The original hospital needs to open artificial window or payment terminal to help patients settle, now with mobile payment settlement, the number of payment terminals will gradually decrease, mobile payment will bring patients a lot of time savings.
present, the application and construction level of electronic health card in China's region is still in a low position, in the stage of touching the stone across the river, only Fujian, Zhejiang several cities go far ahead.
next, existing smart medical applications may be connected to more electronic health cards, just as more innovative applications will be developed by the electronic health card information base.
depth: nationalization, differences in health-care policies and cross-regional mutual recognition the two phases mentioned above are confined to one region, but in practice, the cross-regional movement of population is very large.
as things stand, every time we go to a city, we need to open a local health code, to a local hospital, we need to open a hospital health code.
is the issue of electronic vouchers for health insurance, which vary from hospital to hospital due to different health insurance policies.
example, Fuzhou children go to Xiamen Children's Hospital at their own expense, but in Fuzhou can participate in health insurance reimbursement.
this case, e-health insurance vouchers cannot interact with information as easily as electronic health cards, and must be constrained by rules to accommodate regional policies.
the situation, the National Health Care Commission plans to establish a unified standard of health cards, to break the 2020 "million-yard Pentium" problem.
basis, provinces and cities need to be customized according to the actual situation.
But compared with the vertical unification of a single city electronic health code, horizontal unification between provinces and cities in the same province is obviously much more difficult, but the patient's identity is mutually recognized among the systems this matter, will become the focus of medical information reform in the next few years.
two examples to explain the role and potential problems of electronic health card application, china's current stage of electronic health card propulsion speed is how? A set of figures released during the 2020 CHITEC period by Wang Depository, Deputy Director of the Statistical Information Center of the National Health and Health Commission and Vice Chairman of the Health Card Application Management Committee, may clarify the status quo.
As of September 2020, the total number of cards issued in China's provinces has reached 569 million, with 100% coverage in 13 provinces, including Hunan, Gansu, Zhejiang, Shandong, Jilin and Inner Mongolia, and more than 50% in Hebei, Xinjiang, Sichuan and Jiangsu provinces;
From the scope of application of medical institutions, the total number of e-health cards accepted by third-level hospitals nationwide is 1179, with an acceptance rate of 48%;
From the application point of view, booking registration, report form query 2 business applications to achieve the city accounted for more than 50%, online payment, clinic settlement, inspection appointment, intelligent consultation, queuing to collect medicine, queuing call 6 business applications to achieve the city accounted for more than 30%.
regional policy differences mentioned above, the promotion of electronic health cards varies from region to region.
specifically, this paper will be in Hunan Province, Shandong Province, two cities of the electronic health card promotion situation.
the development of electronic health cards in Hunan Province is known as "wide coverage".
Since 2018, the popularization of electronic health card application work began, in just two years, the province's 198 secondary public hospitals completed the application of electronic health card transformation, can be used in the whole process of diagnosis and treatment of electronic health card;