Access To Medical Insurance Internet Medical Acceleration First Diagnosis Still Needs Breakthrough

Editor's note

Since last year, the net sale of prescription drugs has been released, and the "Internet + medical insurance" has accelerated to the ground this year, and the policy barriers restricting the development of Internet health care are being gradually eliminated. In 2020, under the dual support of the new medical insurance policy and the epidemic situation, internet medical treatment really entered the outbreak period. In the face of frequent good new deal, how do enterprises view it? With the admission of public Internet hospitals, what impact will it bring to the industry? What else will the Internet healthcare industry expect to break through in the future?

We hope that today's group of reports can bring some inspiration.

? ? ? Recently, the national development and Reform Commission and the central network office jointly issued the "implementation plan for the development of new economic development" on the promotion of "intelligent operation on cloud computing". The plan has covered many areas. Among them, the internet medical service has proposed: "take the national digital economic innovation development Experimental Zone as the carrier, and explore the internet medical insurance system and the appointment triage system in the field of health and health. "

This is the first time in the policy level of the state that internet medical care can be first diagnosed and included in health insurance. In this regard, there is a view that the internet medical "no first visit" this restriction is expected to usher in a breakthrough. On April 20th, Liao Xinbo, deputy director of the Guangdong Provincial Department of health and inspector general, said in an interview with the twenty-first Century economic report reporter that he has been calling for the internet medical first visit system. It is worth noting that the main body of this document is the national development and Reform Commission and the central network letter office. The wording is "exploration and propulsion", and the Wei Jian Committee of the ministries and commissions and the state health insurance agency are not involved. From the point of view of "exploration and advancement", there will be no concrete policies at present.

"The above two departments issued more articles from the industry point of view, and in the medical and health system so far has never put forward the liberalization of the internet medical first diagnosis," the National Health Insurance Bureau has never followed this up. Previously, part of the internet medical insurance has been liberalized. Under the special circumstances of the epidemic, some diseases are opened conditionally. A long-term Internet health care industry insider pointed out to the twenty-first Century economic news reporter.

At the policy level, the State mentioned for the first time that internet medical care can be first diagnosed and included in health insurance. Vision China -

Internet Medical + health insurance landing accelerated

? ? ? The above plan pointed out that the national digital economic innovation and development trial area as the carrier, in the field of health and health to explore the promotion of internet medical insurance first appointment system and appointment triage system, to carry out the Internet health care medical insurance settlement, payment standards, drug sales, grading treatment, remote consultation, multi-point practice, family doctors, online ecosphere reception reform pilot, practical exploration and application. Extension.

It is understood that in October 2019, the implementation plan of the national digital economic innovation and development pilot zone, Zhejiang, Hebei (Xiong an new area), Fujian, Guangdong, Chongqing and Sichuan six places were identified as the national digital economic innovation and development test area.

The industry insiders told the economic news reporters in twenty-first Century that the focus of the document issued by the NDRC and the central network office is the two aspects of internet medical "first visit" and "medical insurance".

At present, the access management of Internet diagnosis and treatment is responsible for the formulation and specific management by the National Health Committee's functional departments. The payment of medical insurance is carried out by the national health insurance agency. The two departments need to collaborate to get through the two departments.

? ? At the beginning of March, the national health insurance agency and the National Health Protection Commission issued the "guiding opinions on carrying out" Internet + "medical insurance services during the period of promoting the prevention and control of new crown pneumonia. After signing a supplementary agreement with the regional health insurance agency, the "Internet +" re visit service provided by the insured for common diseases and chronic diseases can be included in the payment scope of the medical insurance fund.

In March 6th, the Chongqing Municipal Health Insurance Bureau issued the notice on Issuing the pilot scheme for the use of the Internet to achieve the convenient settlement of hypertension and diabetes out-patient clinic (Yu medical insurance hair [2020] 11).

In April 9th, the "Internet +" medical insurance service for outpatients with common diseases and chronic diseases in Chongqing was first implemented in Yuzhong district. The hypertensive and diabetic patients in the Chongqing emergency center as designated treatment institutions were selected to apply for remote referral through the city emergency center Internet hospital, completing the online diagnosis and treatment of drug expenses and medical insurance settlement, and enjoying the door-to-door service of drug delivery.

Chongqing's "Internet +" medical insurance service is also a breakthrough in implementing the spirit of the above-mentioned documents of the national Wei Jian Commission and the national health insurance agency. Li Zhixiang, chairman of Jing Yi group, an Internet healthcare company, told reporters in twenty-first Century that the outpatient service in many local hospitals was not open during the epidemic period. In order to protect the service of new crown infections, many places had issued many licenses, and the situation of Internet hospitals had been launched. In this case, non emergency patients and chronic patients can consult online, so that they can enjoy medical insurance reimbursement.

In addition, according to incomplete statistics of twenty-first Century economic report reporters, Shandong, Sichuan, Shanghai, Beijing, Guangdong, Hubei and other provinces and cities have issued relevant policies.

Internet medical treatment still needs breakthrough

For the document issued by the NDRC and the network letter office, there is a viewpoint analysis that the successive introduction of Internet related medical insurance policies is a major long-term benefit for the whole industry. The entry of medical insurance as an important payment means a profit turning point for the continued loss of the Internet healthcare industry, or therefore it will arrive ahead of schedule and benefit the development of enterprises.

However, from the implementation details of Chongqing and other places, the main reason for the inclusion of medical insurance reimbursement is "common and chronic diseases' Internet +" re visit services. However, "the state authorities have not released the internet medical first visit." Li Zhixiang twenty-first Century economic report reporter analysis.

In September 2018, the National Health Protection Committee and the State Administration of traditional Chinese medicine jointly issued the "Internet diagnosis and treatment management method (Trial Implementation)" clearly stated that no Internet diagnosis and treatment should be carried out for the first diagnosed patients. Since then, the docking of internet medical and health insurance is also advancing. In August 2019, the national health insurance agency issued the guidance on improving the policy of "Internet +" medical service prices and medical insurance payment policy, and defined the "Internet +" medical services that meet the requirements. The policy of supporting medical insurance was complied with the principles of fairness under the online and offline principles, and the agreement management, settlement process and related indicators were improved according to the characteristics of service.

Fu Gang, chairman of Baiyang group, believes that Internet health care must be based on physical medical institutions and will not give Internet Co too many opportunities. And to twenty-first Century economic report reporter analysis pointed out that the internet medical first consultation and the National Health Protection Committee policy conflict, the first consultation must face to face, otherwise it is not consistent with the medical theory.

However, in Liao Xinbo's view, under the modern scientific means, the traditional formula can break through, such as the tongue image of the Chinese medicine can be more accurate than the subjective observation of the individual, the ophthalmoscope can also be clearly transmitted to the mobile phone and the computer interface, and overcomes the error of the doctor's individual knowledge and experience.

Chen Jinxiong, director of the information technology expert committee of the Nanjing General Hospital of the former Fuzhou military region, has long been concerned about medical information. The main risk point of Internet diagnosis and treatment is the identity of doctors. However, at present, technology has been solved and will not become an obstacle to the first diagnosis.

"However, how to collect and diagnose the signs and diagnosis of the Internet effectively is a difficult problem. Without sufficient evidence, the correct diagnosis can not be achieved and effective treatment can not be carried out. Under the face-to-face condition, doctors can see and hear (traditional Chinese Medicine) or touch percussion (Western Medicine), and medical institutions have complete equipment for further inspection. Chen Jinxiong pointed out.

Chen Jinxiong believes that there is not much difference between effective medical treatment and Internet visit. How to ensure quality and safety online is the main concern. On the one hand, how to ensure the management and control of medical quality and safety, including the control of the quality of drugs, on the other hand, on the other hand, the doctors and equipment lacking in emergency under the condition of sudden illness. "If we want to release the Internet, the first medical treatment can be carried out under certain conditions, such as specific diseases, special patients, special systems, special areas and special scenes."

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