"Big positive! The promulgation of this regulatory rule will undoubtedly play a role in promoting the development of Internet consultation platforms. On the evening of June 10, Li Tiantian, the founder of Lilac Garden, said when connecting with hundreds of industry reporters that this detailed rule will introduce the industry into the era of strong supervision.
The Health Bureau learned that the National Health Commission and the State Administration of Traditional Chinese Medicine recently jointly issued the "Detailed Rules for the Supervision of Internet Diagnosis and Treatment (Trial)", which proposes: The use of artificial intelligence and other automatic prescriptions is strictly prohibited; It is strictly forbidden to provide medicines to patients before the prescription is issued; It is strictly forbidden to unify parties for commercial purposes; It is strictly forbidden to refer patients for the purpose of seeking benefits, purchase of pharmaceutical consumables at designated locations, etc.
This means that in the future, the requirements for Internet medical treatment will be the same as the requirements for doctors in general hospitals.
This "Detailed Rules" is actually a supporting document for the "Measures for the Administration of Internet Diagnosis and Treatment (Trial)" issued by the National Health commission in 2018. Nearly 5 years later, the state's supervision of Internet medical care has only come late, but I did not expect that the Internet medical industry has experienced a roller coaster and is now at the bottom.
The new requirements set forth in the Detailed Rules will also accelerate the downward trend of the industry.
Online regulatory requirements are comparable to offline hospitals
Lu Qingjun, director of the National Telemedicine and Internet Medicine Center, believes that the detailed rules this time require that offline physical hospitals be synchronized with Internet medical treatment, and platform-based Internet medical companies will be transformed from corporate legal persons into medical institution legal persons, bearing all legal responsibilities.
There are two main forms of Internet medical institutions in China, one is that traditional hospitals open network-side services, simple such as opening WeChat Mini Program registration, complex will have full-time doctors online video diagnosis and treatment; The other is the medical service organized by Internet companies, some employ practicing doctors to sit in the hall, and more are hung by doctors on the platform to practice at multiple points, "part-time" to receive consultation.
Hiring "part-time" doctors is a way for the platform to operate online diagnosis and treatment at low cost, and after the improvement of the technical level, the platform-based online diagnosis and treatment institutions of Internet genes have opened up more new forms with network style: "AI review", "first drug rear", "network first diagnosis".
Previously, some media reported that putting a picture of a puppy on the Internet can still prescribe drugs. The prescribed prescription review and online consultation have become decorations.
Chen Qiulin, deputy director of the Health Development Research Center of the Chinese Academy of Social Sciences, said: "It is obviously illegal for patients to buy drugs on the Internet platform without providing medical record information, and the platform only prescribes based on the patient's self-statement. ”
The state has always encouraged the follow-up business engaged in by Internet platforms, and the "Detailed Rules" also make clear provisions: patients should provide relevant materials such as outpatient or inpatient medical records, discharge summaries, and diagnostic certificates when returning to the clinic, and the receiving doctor should judge whether the corresponding materials are met.
"Online drug sales" is the main source of income for Internet medical treatment, and relatively speaking, "consultation" fees are very low or even free. This is the main reason why the Internet platform is light on medical treatment and sells drugs heavily.
According to data from the intranet, china's online drug sales exceeded 150 billion yuan in 2020, and the e-commerce platform became the fourth largest pharmaceutical sales terminal after hospitals, physical pharmacies and primary medical institutions.
AI reviewers will greatly speed up the prescription process and reduce the cost of online services for doctors, which is a business that is vigorously developed by various Internet medical platforms. However, the new Rules include such acts in the scope of non-compliance.
Fu Hongqiao, an associate researcher at the School of Public Health of Peking University, believes that a series of regulatory measures such as "first drug before the drug" and "AI trial party" are strictly prohibited, which are consistent with the provisions of "Internet platforms cannot participate in the first diagnosis". The patient's condition must be diagnosed by the doctor, not the computer, and even if the examination material is available, the doctor must draw conclusions, which is an insurmountable red line for medical services.
In the final analysis, whether a person is sick or not cannot be decided by the computer alone.
Internet medical care off the platform
The state documents have tightened regulations, and for most Internet medical companies, the new rules can be done.
On the whole, "Internet medical treatment" is developing in the direction of disengaging from the platform.
Lu Qingjun pointed out that the "Detailed Rules" itself is designed around the idea of developing Internet medical care in public hospitals. Fu Hongqiao said that at present, the Internet hospitals of public hospitals are generally more standardized, and the focus of the supervision of the Detailed Rules is platform-based Internet companies with poor compliance.
Judging from the requirements of the "Detailed Rules", in the future, the regulatory direction of government departments for Internet diagnosis and treatment is: online and offline integration, to achieve online and hospital system docking, so that Internet diagnosis and treatment can return to the essential positioning of "serious medical treatment".
A number of experts told the Health Bureau that the promulgation of the Detailed Rules is to redefine Internet diagnosis and treatment.
Since 2020, the number of Internet hospitals in China has grown rapidly. According to the latest data, as of June 2021, the number of Internet hospitals nationwide has reached 1600. According to the Statistical Report on the Development of China's Internet Network, as of December 2021, the scale of online medical users in China has reached 298 million.
In fact, this number is relatively large, if it is fully in accordance with the hospital's specifications to operate, online prescriptions, AI prescription users can not be regarded as "online diagnosis and treatment users".
True online procedures should be the same or close to hospitals. The "Detailed Rules" require that the medical record information of internet hospitals should be consistent with the format of physical hospitals, and information sharing should be realized, and the online and online integrated quality control of the entity medical institutions on which it is relied should be carried out. Medical records are managed in accordance with the provisions of the hospital outpatient clinic, and the preservation time shall not be less than 15 years, and the treatment records shall not be less than 3 years.
Wang Hang, founder of Good Doctor Online, said that according to the requirements of the "Detailed Rules", the diagnosis and treatment services provided by Internet diagnosis and treatment and physical institutions should be "homogeneous" to the greatest extent.
Internet hospitals need to have offline entities, which the National Health Commission has long stipulated. A number of Internet medical platforms have chosen to open several offline hospitals in Yinchuan and other places to meet regulatory requirements, in fact, there are millions of online consultations, and the process specifications are not consistent with offline hospitals.
Wang Hang believes that the homogenization of the standard poses a great challenge to practitioners, because the characteristics of online and offline diagnosis and treatment are different.
But in the future, this "difference" will not be allowed to exist, obviously, the state is to add the requirements for offline hospitals to online diagnosis and treatment, if it is unacceptable, it can only withdraw from the market.
At the same time, the Detailed Rules require the establishment of an assessment mechanism for doctors, and the assessment is carried out according to the content of lawful practice, medical quality, medical safety, medical ethics, and satisfaction, and the establishment of access and withdrawal mechanisms; Electronic medical records require online and offline connections. These strategies are based on the offline hospital supervision system.
Internet medical care is an extension of traditional physical hospital services and is the biggest signal revealed by the Detailed Rules.
Lu Qingjun said that medical service services are public welfare, and only the provision of technical support and resources for medical services can be commercialized.
The Health Bureau learned that the National Health Commission will implement the link between the provincial-level supervision platform and the Internet diagnosis and treatment institutions, and formulate implementation measures based on the actual situation in the region to promote the implementation of supervision.
Written by | millet
Edited | Jiang Yun Jia Ting
Illustrations | Visual China
Operational | Twenty-thirteen
Cartography | twenty-thirteen
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