(Health Times, Zhao Mengmeng, Jin Jiali) "How to avoid repeated testing has always been the direction of the country's reform in recent years, and repeated testing is expected to gradually decrease in the next few years with the landing of the "Management Measures" in the future. Wang Guiqi, a member of the CppcC National Committee of the Chinese People's Political Consultative Conference and director of the Endoscopy Department of the Cancer Hospital of the Chinese Academy of Medical Sciences, told the Health Times reporter.
On February 18, the National Health Commission, the National Medical Insurance Bureau and other four departments jointly issued the "Measures for the Administration of Mutual Recognition of Inspection and Inspection Results of Medical Institutions", which will be formally implemented on March 1.
The doctor looks at CT pictures. Photographed by Bao Jie
Change the hospital treatment, CT, MRI have to be done again
"My mother was treated in a local tertiary hospital for intracranial hemorrhage, and a series of brain CT, MRI and other examinations were done in the hospital, and due to the complexity of the condition, the local hospital doctor suggested that we go to the provincial capital third-class hospital for further diagnosis and treatment." With the local hospital examination report, they were told by the provincial capital third-class hospital that they could not accept and recognize the test results made by the municipal third-level hospital and needed to re-examine and test. Mr. Zhou from Weifang City, Shandong Province, told Health Times.
Mr. Zhou's experience is not unique, the test results between medical institutions do not recognize each other, and patients need to repeat examinations from time to time. According to the "Analysis of the Status Quo and Countermeasures of Imaging Repeated Medical Examinations" released by Chinese Public Health in 2018, the incidence of imaging repeated medical examinations was 41.82%.
What is so hard about the results of medical examinations?
Director Wang Guiqi said, "The equipment performance, result quality and inspection level of some grass-roots hospitals cannot be compared with tertiary hospitals for the time being. Moreover, the level of examination equipment, medical equipment, and laboratory tests in each hospital is different. Second, many of the tests in the lab are very time-sensitive. If some malignant tumors spread relatively quickly, like small cell lung cancer, there may be distant metastasis in a short period of time, especially brain metastasis. It would be unreliable to rely solely on the original information and inspection reports. ”
Director Wang Guiqi added, "In addition, there is also a problem of legal responsibility identification in the process of mutual recognition, and mutual recognition of test results means that clinicians must take the examination report of the non-hospital to make corresponding diagnoses for patients. ”
Many provinces and cities have taken the lead in carrying out mutual recognition of inspection results
The "Measures" clearly point out that medical institutions should carry out mutual recognition of inspection and inspection results in accordance with the principle of "taking quality and safety as the bottom line, quality control as the premise, reducing the burden on patients as the orientation, meeting the needs of diagnosis and treatment as the foundation, and taking the judgment of the receiving physician as the standard". It is also clear that these Measures apply to all types of medical institutions at all levels. This marks that the mutual recognition of the inspection and inspection results that the people have been looking forward to for many years is finally coming to the ground.
In fact, the work of mutual recognition of inspection results has been brewing on the mainland for many years. The Health Times reporter inquired that the National Health Commission and other institutions have issued documents as early as 2006, 2012, December 2020, July 2021 and November 2021 to emphasize the need to strengthen mutual recognition of test results in hospitals.
"The repeated issuance of documents shows that the state has been making every effort to promote the rational use of limited testing resources by hospitals, avoid waste of medical resources, save patients and national medical insurance costs, avoid repeated examinations, and improve the efficiency of diagnosis and treatment." Wang Ming, head of the clinical pathogen professional group of the Department of Clinical Laboratory of Wuhan University People's Hospital, once said in an interview with the Health Times reporter.
The Health Times reporter combed and found that at present, Beijing-Tianjin-Hebei, Jiangsu, Yunnan, Henan, Shanxi, Shaanxi, Sichuan-Chongqing and other places have taken the lead in carrying out mutual recognition of inspection results in the province.
Clarify the range of mutual recognition test results, excluding diagnostic conclusions
So, which inspections support mutual recognition? The examination results mentioned in the "Measures" refer to the images or data information obtained by examining the human body by means of ultrasound, X-ray, nuclear magnetic resonance imaging, electrophysiology, nuclear medicine and other means; the so-called test results refer to the data and information obtained by biological, microbiology, immunology, chemistry, blood immunology, hematology, biophysics, cytology and other tests on materials from the human body. In particular, it is emphasized that the results of the examination do not include the diagnosis conclusion issued by the doctor.
"Promoting mutual recognition of medical examination results is a good thing for the people, but it does not apply to all medical examinations." Director Wang Guiqi stressed, "As an example of endoscopy, endoscopic operation is also very technical, and there may be some differences in the level of different doctors. Moreover, the methods of examination, diagnostic criteria and language for diagnosing diseases are very different for each doctor, so the diagnostic conclusions issued will also be different, so the "Management Measures" do not involve diagnostic conclusions. ”
Director Wang Guiqi believes that "the homogeneous development of laboratories and imaging departments is the basis for promoting mutual recognition of inspection and inspection. If the inspection results are to truly benefit the people, it is also necessary to strengthen the quality control of the laboratories of grass-roots medical institutions and improve the accuracy of the test results. If the initial examination can be achieved in the primary level or community hospital, and we do some other examinations on the basis of mutual recognition examination, it is a good promotion effect for both patients and medical institutions. ”
