Regional medical care has changed the informatization construction model of the establishment of information systems in the past, which will have a major impact on the domestic medical informationization pattern.

In the morning, Zhang Yang, who was a diabetic, was enjoying her morning running. Her inductive smartphone was monitoring her heart rate and calorie consumption data in real time and transmitting it to her health care manager's computer. Later, her mobile phone feedback showed that she had booked her regular return visit time with the doctor in the afternoon. At 3:12 pm, Dr. Li Bing’s smartphone also suggested that at 3:30, he had an appointment with the patient Zhang Yang. Dr. Li Bing entered the hospital's remote video consultation system and showed Zhang Yang and his clinical research assistants a model of the changes in blood glucose concentration. From this model, Zhang Yang's current health is quite good - her overall health score has increased significantly from the previous 67.8% to 84.2%, and the blood glucose concentration unit is currently 124mg/dl, both of which are better than the standard value. 84% and 126 mg/dl. Zhang Yang later drove to a large self-service pharmacy in the city center, accessed the personal health account with an electronic health care card. After a few light operations, she completed a scheduled test for glycosylated hemoglobin A1c and purchased Dr. Li Bing. Hypoglycemic agents. At this point, her routine diagnosis and treatment ended successfully.

This scene is the future medical vision presented by Microsoft Medical Solutions. It seems to be a bit of a surrealistic Hollywood sci-fi blockbuster. However, Zhang Hongjiang, president of Microsoft's Asian Engineering Institute, told reporters that with the establishment of regional medical complexes and the use of innovative information technology, patients enjoying such fast and convenient medical and health services are just around the corner. Moreover, such health care services will not be the privilege of a few people, but everyone can enjoy them equally. This is the long-term goal of the regional medical center that is now the focus.

Regional medical focus

Zhao Hui, general manager of the Tianjian Technology Regional Medical Division, has recently traveled around the country and is busy tracking regional medical projects. “The investment of 850 billion is a huge temptation, but in the end it is only a small part of the informationization, and regional medical care should be the biggest one and the competition is the most intense. Moreover, the informationization of the medical industry is mainly by technology and application. Demand is driving differently. Nowadays, regional medical informatization is obviously a market driven by policy. It will rise up and heat up quickly, which brings huge opportunities for medical IT service providers.” Zhao Hui said.

In fact, Tianjian Technology set up a regional medical division as early as two years ago, optimistic about the development prospects of regional medical care. Earlier, Tianjian has been planning to establish a small-scale medical sharing system by cooperating with local health authorities. Zhao Hui believes that the exploration and practice in the regional medical field before other companies will undoubtedly lay the foundation for Tianjian to occupy this market in the future.

So, is regional medical care really important for IT companies that want to get involved in medical informationization? A professional believes that due to the investment in medical reform, in the future, domestic medical informatization-related equipment procurement and various application system construction will be carried out around the main line of regional medical care. The central government’s investment and local government investment will be Through the regional health projects through the local health authorities, the right to speak in the regional medical information market is equivalent to occupying a place in the entire medical information market.

It is understood that the mainstream medical IT service providers in China have already acted in regional medical care, such as Neusoft, Tianjian, Hangzhou Venture, Xi'an Tianwang, Jinshida Weining and so on. And because of years of focus on the information technology of the medical industry, these companies are somewhat close to the advantages of water towers.

However, compared to local companies in these professions, some international companies that are otherwise free may cut in more quickly.

Not long ago, Microsoft announced an informational cooperation with the affiliated hospital of Qingdao University Medical College, and launched a high-profile Amalga medical solution, which is in stark contrast to the low-key posture of Microsoft's quietly research and development of medical-related solutions. Zhang Hongjiang, dean of Microsoft's Asian Engineering Institute, also said that not only began to implement hospital information projects, but also established successful cases to promote themselves. Microsoft also participated in regional medical discussion and planning through health authorities, trying to win the right to speak in the establishment of standards.

At the same time, Informatica, which specializes in enterprise data platforms and data integration services, recently sponsored the Regional Health Information Integration Summit in Shanghai. Wu Haoyi, managing director of Informatica Greater China, admitted that the company is optimistic about the large market of regional medical care in China and is optimistic about the opportunities for data integration. It is understood that although Informatica has been prestigious in the digital medical market in North America, it has just started in China's medical information market, and it is clear that it is the latest medical reform policy.

IBM also "cooperated" with the announcement of the medical reform implementation rules and quickly launched four major medical solutions, the first of which was the IDS integrated delivery system for regional medical treatment, and soon signed a regional medical information service platform with Chongqing Nan'an District. Cooperation agreement.

This is just the tip of the iceberg. Intel and Cisco and other international companies that have been investing heavily in digital medical care have quickly developed new strategies for China's medical information market and participated in high-profile participation.

Obviously, the investment of 850 billion yuan is no different for the IT companies under the influence of the economic crisis. At the same time, however, these companies are also thinking about some common problems. Where should regional medical care start? What problems can IT companies solve? What role does informatization play in it? Or, what role should an IT company play in regional health care? In fact, this is the key to winning the medical information market in the future.

Regional medical treatment with informationization as the "jing"

In February 2009, Shanghai announced that it will build a regional medical and health complex in accordance with a model consisting of three tertiary hospitals, a number of tertiary hospitals, secondary hospitals and community health service centers.

This model originated from the Waigaoqiao Functional Area Medical Consortium piloted in Pudong New Area two years ago. At that time, the Seventh Hospital of Shanghai absorbed four community health service centers in Gaoqiao, Gaodong, Gaoxing and Lingqiao Towns nearby to form a medical complex across urban and rural areas, through two-way referral, advanced medical facilities sharing, mutual confirmation. Diversify cooperation in the form of inspection projects and business guidance of experts.

It is understood that this model has a good effect. Anyone who is treated in these four township hospitals in remote suburbs can get almost the same level of treatment as the Seven Hospitals, and thus it is possible to further expand the scope. .

This successful practice in Shanghai has undoubtedly increased confidence in regional health care reform in other regions. In the entire medical reform, the regional medical consortium is a key point, because if this problem is solved, other problems such as urban and rural areas, public health, etc. will be solved or become much simpler. Therefore, regional medical care has become a breakthrough in medical reform.

However, where should regional medical care break through? Experts unanimously set their sights on informationization. The establishment of regional medical care is inseparable from informatization, and the sharing of medical resources must be achieved through a complete information system. Therefore, informationization is actually the meridian or aorta of regional medical care. By serialization, exchange, and sharing, the system can be active and resources can flow.

Zhang Hongjiang, dean of the Microsoft Asian Academy of Engineering, believes that if informationization in the past is dispensable to hospitals, informatization is a necessity in the context of regional medical care or the future development of the medical industry. “In the past, you might think that medical information systems are luxury goods, so now it is no longer a luxury, but a basic construction. Just like when you cover a hospital, you will use the bed as part of the infrastructure. Today the entire information system should also be used as a infrastructure. Part of it, not how to build the information system later."

It is true that the establishment of an interconnection and interoperability system that can share various information and medical resources is the goal of regional medical informatization construction. However, the implementation process of this goal is obviously difficult. Since 2006, IT companies and some local health authorities have been working together to pilot small-scale regional health care, hoping to use information technology to build a shared system that can better utilize existing medical resources. However, after a few years, there are few success stories, and planning is still planning.

Wu Haoyi, Managing Director of Informatica Greater China, has nearly 15 years of experience in the field of medical informatization. He believes that the biggest problem in regional medical care is to resolve conflicts of interest, and medical insurance is a key breakthrough.

Experts believe that medical insurance is the key

"I have been running regional medical care for so many years. There is a lot of difficulty in promoting information sharing between hospitals. It seems that in the future, information will be concentrated in the medical insurance center, through which it will be transferred and shared. And now there are some HIS companies in Contact the insurance company to do this.” A Deputy General Manager of HIS revealed such a message.

In fact, the difficult advancement of electronic medical records is a typical example. Many HIS companies should still remember the electronic medical record fever of five or six years ago. Standards, technology, medical systems, security, privacy... When the fog was set aside, IT companies discovered that the deeper roots were still behind.

Experts also admit that because hospitals and community health services in a city belong to different institutions, it is very difficult to share information between organizations.

Wu Yuyi made such a conclusion with his experience: "Don't think about the problem of active sharing among hospitals. It is impossible. The best thing is to do a medical record summary. It is useless or not, because it is useless because That is the survival of the hospital. No hospital will give comprehensive information on medical records, and at most it can only give a summary of medical records. The medical record summary is by far the most perfect. After the medical records are given, the standards must be unified. This is even harder. But this is not impossible. If the expenses incurred by the hospital are finally paid by the medical insurance center, if the information is not paid, the exchange can naturally be realized."

In Wu Yiyi's view, the future medical insurance center will become a hub for information exchange. “The medical insurance center is both a unit for collecting money and a unit for paying hospitals. It will be the most respected unit of all hospitals, and its information system will be the most important information system.”

IBM also put forward a similar view that IDS integrated delivery system will become the key to regional medical informationization. IBM proposed the concept of collaborative medical care, which believes that collaborative medical care extends the coverage of central or specialist hospitals, enhances the accessibility of quality resources, and reduces the cost of medical services as a whole. And certain governance rules can gradually pull the service level of the coordinated members. In this way, the same patient experience can effectively divert the source of the disease. But the IDS model also faces challenges, namely quality assurance and financial distribution models. Since there is no merger of property rights of medical entities in the process of coordination, how to establish a long-lasting effective management model for management, treatment and charging is the key to the sustainable development of IDS.

So, what kind of action does health care currently have in participating in the construction of regional medical complexes? Not long ago, the China Insurance Regulatory Commission said that it will introduce commercial insurance to participate in the medical reform policy in the near future, and will support insurance institutions to participate in the restructuring and restructuring of existing medical institutions. Professionals believe that this will touch the existing mechanism, form an effective constraint on medical service providers, and effectively control the unreasonable expenditure of medical expenses. More importantly, multi-participation will help to achieve regional medical information sharing.

Standard issues need to be resolved

The key to regional health care is information integration, and when it comes to information integration and sharing, it is impossible to talk about information standards. This is also the biggest problem that currently exists. In the past ten years of informatization construction, hospitals often establish their own independent information systems, using different hardware and software products, many application systems are custom developed, which invisibly sets obstacles for information exchange.

Zhang Hongjiang, president of Microsoft Asia Engineering Institute, said: "Not only between hospitals, but in many departments of the same hospital, the system application is also very different, which makes the compatibility and circulation of the entire hospital data inconvenient. Different regions of China, different There are many differences in the types of hospitals and medical institutions in terms of business processes and the work habits of medical staff. The information systems software and hardware platforms used by different departments in the same hospital are also different. To help China's large medical institutions realize information systems. Intelligent, we must first understand what they need, what they want to do, and what are the challenges."

how to solve this problem? Zhang Hongjiang believes that there must be a very scalable platform that is compatible with a wide variety of data structures. "Microsoft is also doing something in China to see if we can establish domestic medical system standards. At present we do not have a very uniform standard."

Yinjiang Science and Technology has also encountered similar problems. Although it is not a problem of resolving information islands, the process reengineering under informatization still needs standardized support. Zhang Jiangzhong, executive general manager of Yinjiang Electronics, said: "In terms of hospitals, the core competitiveness of hospitals is actually the medical level of doctors and the application of some new technologies. In addition, it is management and medical safety. Medical treatment may be related to informationization. The degree of relevance is not very high, but the quality of medical services, especially medical safety, is highly correlated with informatization. In fact, this can be fixed through processes such as infusion and injection. To be streamlined, standardization is required. Management. It is understood that Yinjiang Technology also participates in the formulation of relevant standards through cooperation with Intel.

Standards have always been a must, and almost all of the strengths of the manufacturers are striving to participate in the establishment of relevant standards, but they will also take the lead.

Wu Yiyi has made this problem relatively simple: "Which situation will be unified? The key is the medical insurance center. The medical insurance center pays the fee. If it is not standard, the medical insurance center will not pay the money, and it will naturally be unified." Wu Yiyi believes that The medical insurance center is Party A and the hospital is Party B. The hospital will have a special department called the application fee center, which is to apply for medical expenses to the medical insurance center. Under this model, the hospital will take the initiative to unify the information format in accordance with the requirements of the medical insurance center.

Re-recognizing the value of HIS

Assuming that the enthusiasm of exchange sharing is solved, the standard problem is also solved. In the large system of regional medical care, a key system gradually emerges and has to attract people's attention again, that is, HIS (Hospital Information System).

In the past ten years of hospital information construction, HIS has been the first to establish, and also plays an important role in the hospital's informationization process. Under the new informationization pattern of regional medical care, HIS will also play a more important role. “Because regional medical informatization is based on the informationization of various medical institutions, HIS will play an important role as a basic management platform.” HIS professionals think so.

In the eyes of professionals, if the information in the regional medical union is to be exchanged and shared, then each hospital needs to have a unified export of information. As far as the current situation is concerned, the information of other systems must be exchanged with the HIS system. Therefore, HIS is not only a necessary information system for hospitals, but also a platform for information exchange and sharing.

However, some insiders have objected to this and believe that it is also possible to share information through a new export. Because the data from different application systems in the hospital can not be directly given, but through a layer of filtering, also called data cleaning. The data after cleaning will become more complete and fill in the missing data. This is easier to implement for heterogeneous systems in hospitals today.

This is obviously related to the current problems of HIS. According to an industry insider, at present, many hospitals' HIS are not customized on the basis of productization, but are completely based on documents. "There is a big problem, that is, it cannot be upgraded. When the hospital expands and needs information system synchronization, it can only be reinstated. Generally, this is the case in three years."

HIS has exposed many problems, which brings opportunities to some local HIS companies as well as challenges. And whether HIS can reshape its own value, regional medical services provide more possibilities.

Rewriting the medical informationization pattern

It is not difficult to see that regional medical care has changed the informatization construction mode of the establishment of information systems in the past hospitals. The informationization construction of hospitals will follow certain standards. At the same time, the regional medical informationization has changed from the bottom to the top. Planning for the first move, so some insiders believe that this will rewrite the existing medical informationization pattern to some extent.

First, individual small project purchases may be less and less. Since the input of informatization funds is borne by the central government, local governments and hospitals, and regional medical care is a regional overall plan, there may be more and more joint bidding procurement, which gives complete solutions and certain consulting capabilities. The company has brought more opportunities. More and more companies are rolling out total solutions to solve different levels of problems. For example, Microsoft's Amalga medical series solutions include Health Vault, HIS, UIS (Unified Intelligent System), etc. IBM's smart medical solutions include regional medical information networks, clinical research information integration platforms, and medical collaboration platforms. Neusoft has introduced a more comprehensive solution including hardware and software, in addition to public health service system solutions, medical service system solutions, medical security system solutions, and drug supply security system solutions, it also provides high performance. Price than digital medical equipment .

At the same time, counseling also plays an important role in the overall planning of regional health care. In terms of how to implement a regional medical sharing system, IT companies have provided many good suggestions and solutions, and are not limited to technology, but also offer some feasible suggestions for medical reform. Some multinational companies with experience in this area may be the first to enter the ranks of regional medical information consultation.

Second, the advancement of a regulated project team may mean that some IT solution providers in the previous municipal-level medical market no longer have opportunities or fewer opportunities. For example, IBM proposed to set up a project promotion working group composed of the relevant agencies and the Ministry of Health standards experts to achieve standardized information transmission and exchange, standardized data structures and models, unified terminology and data dictionary library and process gradual standardization.

It is not difficult to see that the international giants are not only in the middle of the race, but also have a large amount of research and development investment a few years ago. This has brought a more intense smell of gunpowder to the already fierce regional medical information market.

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