General Secretary Xi Jinping creatively put forward the concept of new quality productivity and made major arrangements, pointing out that "it is necessary to firmly grasp the primary task of high-quality development and develop new quality productivity according to local conditions". In recent years, the mainland has accelerated the application of artificial intelligence and other information technologies in the field of health care to improve the level of medical and health services and meet the diversified needs of the people, while also actively cultivating and developing new quality productivity. From today, the Health News will open a column of "Focus on New Quality Productivity and Artificial Intelligence" to report on the application of artificial intelligence and other technologies in the field of health to iteratively upgrade services, and the vivid practice of the development of health care to become "new".
Artificial intelligence (AI) is a strategic technology that will lead the future, influencing not only the future of healthcare, but also the future of healthcare. The 2024 Government Work Report proposes: accelerate the development of new quality productivity; Deepen the R&D and application of big data and artificial intelligence, and carry out the "artificial intelligence +" action.
At present, the application of artificial intelligence in the medical and health industry is accelerating, driven by the continuous release of health needs and technological innovation. Recently, a reporter from Health News interviewed in Shanghai, Zhejiang Province, Anhui Province and other places found that as an important engine of new quality productivity, artificial intelligence has brought new opportunities and challenges to the development of medical and health undertakings, and is also profoundly changing the mode of disease diagnosis and treatment, the way of medical treatment and the form of health management.
Deep integration
The vigorous development of artificial intelligence technology is rapidly advancing healthcare into the intelligent era. The combination of ever-changing technology and the mainland's massive medical data resources, huge social needs, and open market environment has formed a unique advantage in the development of the mainland's medical artificial intelligence industry. At present, artificial intelligence and medical care have entered the stage of deep integration, and their applications are emerging in an endless stream, allowing people to enjoy high-quality health services while cultivating and developing new quality productivity.
"The application of CT for the auxiliary diagnosis of thoracic pulmonary nodules has widely covered more than 80% of cases, shortening the original diagnosis time of 7 minutes to 2 minutes; The application of coronary CT angiography to assist in diagnosis shortens the diagnosis time from 25 minutes to 3 minutes; The jointly developed domestic proton therapy system has been clinically verified to show that the local control rate of tumors is 100%, the safety is good, and the treatment cost is significantly reduced...... "Ning Guang, academician of the Chinese Academy of Engineering, president of Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, and director of Shanghai Digital Medicine Innovation Center, said that through the application of artificial intelligence-assisted diagnosis, Ruijin Hospital not only improves the quality and efficiency of medical services, but also enhances patients' sense of access to medical treatment.
Ning Guang said frankly that when the Shanghai Digital Medicine Innovation Center settled in Ruijin Hospital, they could not fully appreciate the importance of digital medicine to clinical practice, but today, digital medicine has blossomed everywhere in Shanghai's hospitals, improving patient experience, doctor experience and hospital control. Application scenarios such as convenient medical services, medical image-assisted diagnosis and treatment, intelligent pathology-assisted diagnosis, full life cycle health management, medical resource sinking services, medical language model empowerment, and intelligent manufacturing achievement transformation have been fully promoted in Ruijin Hospital.
In Shanghai, the digital transformation of healthcare has achieved full coverage. Among them, in recent years, Shanghai has continued to carry out the construction and application of digital scenarios of "convenient medical services", focusing on the reengineering of service processes and management processes, and creating many service application scenarios to improve the convenience of patients' medical treatment, such as accurate appointments, intelligent pre-consultations, and medical payment "one thing".
Recently, Master Ban from Hegang Village, Xiaotian Town, Shucheng County, Lu'an City, Anhui Province, came to the village clinic for treatment. After receiving the consultation, Shi Huaxiu, the village doctor, combined with the patient's physical signs, was preliminarily diagnosed with respiratory tract infection, but the "intelligent medical assistant" system on the side suggested that "tonsillitis may be possible". Shi Huaxiu further conducted a physical examination on Master Ban and was finally diagnosed with "purulent tonsillitis". Shi Huaxiu revised the diagnosis and was treated with levofloxacin sodium chloride injection as usual. At this time, the "intelligent medical assistant" artificial intelligence reviewer reminded the patient that he had a history of quinolone allergy in the past and that there were contraindications to medication. Shi Huaxiu modified the medication regimen according to the prompts and gave symptomatic treatment.
According to the relevant person in charge of the Anhui Provincial Health Commission, up to now, the province's "intelligent medical assistant" system has covered 1,702 township health centers (community health service centers) and 17,000 village clinics in 104 counties, using 32,000 doctors, providing 680 million auxiliary diagnoses, and assisting grassroots doctors to complete 310 million electronic medical records, with an electronic medical record standardization rate of 98.69%. "Intelligent Medical Assistant" standardizes the behavior of primary diagnosis and treatment, improves the ability of primary diagnosis and treatment, provides a comprehensive guarantee for the quality of primary medical care, and improves the efficiency of primary public health.
As early as 6 years ago, the National Health Commission began to organize special research on the application and development of medical artificial intelligence, and put forward 12 main application directions of medical artificial intelligence in 5 categories, such as clinical assisted diagnosis and treatment, public health intelligent services, etc. Subsequently, the pilot implementation of the application of medical artificial intelligence technology in primary health services was launched, and a number of replicable medical artificial intelligence primary auxiliary diagnosis and treatment application systems were formed.
Looking at the whole country, artificial intelligence plays a prominent role in improving the resource utilization efficiency of the medical and health industry, improving the level of medical and health services, reducing medical costs, and promoting the implementation of hierarchical diagnosis and treatment policies, and has performed well in many medical and health application scenarios. Among them, the application of artificial intelligence in assisted medical imaging diagnosis, digital pathology diagnosis, physiological signal diagnosis, clinical decision support, health management and other aspects has been accelerated. Medical robots have been popularized and applied in the medical system, and medical robots such as surgical robots, diagnostic robots, rehabilitation robots, service robots, and disinfection robots have begun to be applied; The application of artificial intelligence in auxiliary drug research and development, hospital intelligent management, medical equipment management, medical education and training is also being actively explored.
Accelerate the transition
The application of medical artificial intelligence in mainland China started late, but the starting point is not low, and the development speed is very fast, and important breakthroughs have been made in key core technologies in some fields, and speech recognition, image recognition and other subdivision technologies are world-leading.
Behind the iterative upgrade is strong support at the national level. In recent years, the state attaches great importance to promoting the development of artificial intelligence applications, and has successively issued the "Development Plan for a New Generation of Artificial Intelligence", "Guiding Opinions on Promoting and Regulating the Development of Health and Medical Big Data Applications", "Opinions on Promoting the Development of "Internet + Medical Health" and other documents, vigorously encouraging the application and development of artificial intelligence, big data, Internet, 5G, blockchain, Internet of Things and other new generation information technologies in the health industry, and effectively promoting the application of medical artificial intelligence in the mainland to take root and thrive.
At present, the total amount of medical and health resources in the mainland is relatively insufficient and unevenly distributed, the aging of the population continues to deepen, and the incidence of chronic diseases such as hypertension and diabetes is increasing year by year...... With policy support, the rapid development of medical artificial intelligence has provided the possibility to solve these problems, changing the traditional mode of disease prevention, detection, and treatment, and accelerating the capacity leap of the entire health industry.
In view of the difficult and blocking problems of poor process, weak interaction and low efficiency in medical and health services, Zhejiang Province has built a digital health person "Andiao" with provincial sharing and digital and real integration relying on large models and big data, and built a new medical and health service system with full coverage inside and outside the hospital and online and offline integration. Liu Xiaozhou, director of the Planning, Development and Information Technology Department of the Zhejiang Provincial Health Commission, introduced that the digital health person "Andiaoer" can provide a number of intelligent services such as intelligent guidance and medication guidance, and also connects the online and offline services of the hospital before, during and after the diagnosis, and pushes real-time message reminders and hospital navigation such as number picking, calling, inspection and testing, and drug picking. Since its launch, it has covered 92 provincial and municipal hospitals in the province, with a monthly service volume of more than 300,000 person-times and a user satisfaction rate of 98%, and will cover all provincial, municipal and county-level hospitals by the end of this year. In addition, the large medical artificial intelligence model developed by the province based on provincial medical data has been connected with the embedded docking of "Andiao'er", becoming the basic intelligent base of digital family doctors.
Zhongshan Hospital affiliated to Fudan University is building a medical device R&D and innovation platform under the framework of the Shanghai International Medical Science and Technology Innovation Center, upgrading the R&D experience of high-end imaging equipment and degradable stents, integrating intelligent elements, and promoting the formation of a new generation of pharmaceutical and medical device R&D platform. Gu Jianying, Secretary of the Party Committee of the hospital, introduced that the hospital has built an intelligent medical equipment innovation platform with the collaboration of industry, university, research, medical and government, and formed a new generation of closed-loop intelligent device R&D and verification environment by building a medical-engineering cross-joint laboratory to integrate the clinical verification environment, artificial intelligence R&D platform, and medical device R&D environment, and create a closed-loop R&D of the whole process from clinical front-line needs to medical device design, analysis and verification, prototype R&D, prototype testing, application testing, productization, and clinical verification. Realize the R&D and application of medical devices featuring intelligent and comprehensive empowerment.
"Intelligent medical assistant" has become a good helper for Anhui health authorities to monitor the quality of primary medical care. The relevant person in charge of the Anhui Provincial Health Commission said that the "intelligent medical assistant", as a background monitoring software, does not interfere with or affect the diagnosis and treatment process of grassroots doctors, and grassroots doctors can not actively click to use, but all diagnosis and treatment processes are under system monitoring. The diagnosis and treatment rationality analysis data and medical record normative analysis data extracted by the "intelligent medical assistant" can monitor and evaluate the quality of primary medical care, and can play an important role in the quality control and performance evaluation of primary medical care.
Be prudent and inclusive
Artificial intelligence is not simple, and it is even more difficult to superimpose it with medicine. The accelerated iteration and leapfrog development of medical artificial intelligence will inevitably have an impact on the existing policies, regulations, and standard systems, which will put forward higher requirements for government supervision. Last year, the World Health Organization publicly called for caution in the use of AI-generated large language model tools. At the same time, despite the continuous advancement of artificial intelligence technology, doctors' professional judgment and humanistic care are still irreplaceable core elements.
A number of interviewed experts said that artificial intelligence has entered a critical stage of explosive development, and it is necessary to embrace new things and seize new opportunities, but also to put brakes on the road before hitting the road, jointly promote the global governance of artificial intelligence, and adhere to the prudent and inclusive regulatory thinking. In 2020, the National Health Commission issued the "Opinions on Strengthening the Construction of the National Health Information Standardization System", which clearly stated that it is necessary to study and formulate research guidelines for the application of medical artificial intelligence, accelerate the research and formulation of relevant application standards and safety standards for artificial intelligence technology, build artificial intelligence technology application and safety evaluation standards, improve the quality of artificial intelligence technology application, and strengthen the safety management of artificial intelligence technology application.
All localities are also actively improving relevant policies. For example, Fujian Province conducts inductive analysis of data and technology application security, medical ethics, supervision and other aspects according to the dimensions of field, level, and time, and writes research reports on laws and regulations related to the application of medical artificial intelligence, so as to guide the scientific development of research projects; Shenzhen, Guangdong Province, has formulated the implementation principles and strategies for the evaluation of the effect of medical artificial intelligence products, constructed the evaluation strategy and observation path of the effect of intelligent clinical auxiliary diagnostic products, developed and completed the social governance evaluation index system of intelligent clinical auxiliary projects, and is carrying out index data collection......
However, there is still a long way to go in the development of medical artificial intelligence. There is a lack of unified and authoritative standards and specifications for the evaluation of AI datasets and model effects, and there are phenomena of duplicate construction and difficulty in reusing data and applications, which makes it difficult to scientifically evaluate the actual effects of similar applications or products, and some AI application effects are exaggerated. In addition, as a new generation of information technology, the current relevant regulatory system and laws of artificial intelligence are not perfect, the regulatory review mechanism is not perfect, and it is difficult to define the responsibility for medical disputes arising from the application of artificial intelligence technology. Data security risks are also prominent, and most of the business demanders cooperate with commercial companies, and they do not have independent R&D capabilities, so there is a risk of data leakage. It is worth noting that most of the software and tools used in artificial intelligence technology come from abroad, and most of the algorithm models are modified and improved based on foreign public models, and the proportion of independent technology ownership is low.
Ningguang said frankly that there are many scientific and technical problems that need to be solved to transform the large number of clinical activities carried out by the hospital into valuable clinical data, and it is also very important to establish relevant ethical norms, formulate corresponding policies and increase financial investment. He suggested that the formulation of specific policies and guidelines for medical and health data sharing should be promoted as soon as possible, and on the basis of clarifying the security requirements for the transmission, storage and use of medical and health data, the compliance data sharing between medical institutions and scientific research institutions should be encouraged, and guidance on the value assessment of medical and health data should be issued to pilot the market-oriented flow of medical and health data. At the same time, according to the characteristics of medical artificial intelligence research and application, improve the ethical review mechanism and requirements of artificial intelligence medical devices, strengthen the ethical education of medical artificial intelligence researchers, and enhance ethical awareness and responsibility; Sort out the pricing situation of artificial intelligence medical device applications, and gradually form a market-oriented reasonable charging mechanism.
"The digital transformation of medical and health care is fundamentally to serve 'people', and always takes improving the people's sense of experience as the starting point and foothold of digital transformation work, and takes this as the evaluation standard for digital transformation work." Luo Meng, deputy director of the Shanghai Municipal Health Commission, said that in the scene collection, medical institutions at all levels in Shanghai highlighted the core of "people", accurately and scientifically discovered and implemented the scene, and selected scenes that can be felt, known and accessible to the majority of patients. After the scenario is completed, guide medical institutions to establish a mass evaluation mechanism, so that the people can find problems, and truly meet people's needs to promote the quality and upgrading of medical digital transformation.
Text: Chief Reporter of Health News Yao Changfang Editor: Yang Zhenyu Proofreader: Li Shiyao Review: Qin Mingrui Xu Bingnan
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