China's medical changes

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1985 is often referred to as the first year of China's medical reform. After 33 years, China's medical reform has gone through "only giving policies but not giving money", "opening the floodgates and releasing heavy investment", and "it is difficult to balance supply and demand for interests". Today, artificial intelligence is empowered, industries are interconnected, and medical reform has opened the digital age.
History cannot give us the answer to every question, but it can help us to see the times we live in. Health care reform is a long way off.
Tough move forward
In 1985, the State Council approved and transmitted the "Report on Policy Issues Concerning the Reform of Health Work" drafted by the Ministry of Health, delegationing power and profits, expanding the autonomy of hospitals, liberalizing and invigorating hospitals, and improving the efficiency and effectiveness of hospitals ".
In 2003, SARS was rampant, and the national public health system was unable to identify the source of the disease for a long time. The sudden virus destroyed the already weak medical system. People began to pay attention to the country's investment in medical and health care, which opened the prelude to the reform of the medical system for 15 years.
"It is difficult to see a doctor, but it is expensive to see a doctor" are the two Swords of Damocles that have hung over the heads of the Chinese people for many years. In order to solve these two major problems, all sectors of society have also made suggestions and suggestions to promote the development of medical reform. After the SARS incident in 2003, the central and local investment in medical finance was like opening the floodgates to release water, once as high as more than 60000 billion.
The medical reform that has invested heavily has indeed achieved some results. It has achieved universal medical insurance, full coverage of primary medical and health institutions, and established a basic drug system, which has changed the "medicine to support doctors" and "department contracting" that appeared due to funding constraints in the past. "The medical chaos.
But money alone can't solve all problems. The top medical journal "The Lancet" published a research data this year. During the 10 years from 2005 to 2015, 4.7 million medical students graduated in China, but the total number of doctors increased by only 750000, and the brain drain was serious.
The Chinese doctor population is also aging, with the proportion of young doctors aged 25-34 falling from 31.3 per cent to 22.6 per cent and the proportion of doctors over 60 increasing from 2.5 per cent to 11.6 per cent. Tension between doctors and patients, low salary levels of doctors, nurses and other hospital employees, high work pressure and other reasons have led to a cliff-like decline in medical personnel in recent years.
The survival pressure and social pressure faced by medical practitioners are increasing day by day. In addition to brain drain, hospitals also face problems in economic revenue, resource competition, and improvement of medical standards. Especially after the country increased medical investment, the head effect became more and more obvious in this industry, and "super hospitals" represented by West China Hospital and the First Affiliated Hospital of Zhengzhou University were born ".
Public hospitals bind the most core medical resources with multiple systems such as career establishment, scientific research projects, academic status and administrative resources, and can also motivate medical staff with abundant cash flow priorities, upgrade medical facilities, and attract more patients to see a doctor, generating income again.
However, over-concentrated resources have made it more difficult and expensive for ordinary people to see a doctor. On the other hand, the discipline development of private hospitals is blocked, there are no excellent practitioners, no patients to see a doctor, and they have been marginalized for a long time. 20% of super hospitals have concentrated 80% of their resources, and the stronger the stronger.
In order to alleviate this phenomenon, the state has successively introduced reform methods such as "multi-point practice", "graded diagnosis and treatment" and "precision medical treatment", hoping to break the bottleneck of the development of private hospitals by opening up the mobility of doctors' human resources, but the effect is also "treating the symptoms but not the root cause". Promoting the progress of medical research requires not only high-quality talents, but also the sharing of resources and data and the exchange of scientific and technological achievements. The technical ability and data collaboration ability of medical individuals and enterprises have become a new problem restricting medical reform.
medical science and technology
The rapid development of artificial intelligence has brought about many technological innovations such as computer vision, natural language processing, speech recognition and machine processing. These technologies can also be applied to many scenes in the medical industry, covering the processing of medical record information, image information, pathological information, inspection information and large health information, so as to assist doctors' comprehensive judgment and help hospital medical quality management.
The improvement of the underlying technologies such as big data, artificial intelligence, AI imaging and mobile payment has gradually pushed medical reform to the deep water area.
Compared with traditional industries, Internet enterprises update and iterate faster and have more innovative consciousness. Internet giants with certain financial strength are also more willing to invest in research on cutting-edge technologies, eager to seize the tide and not be eliminated by the times.
The medical industry is related to the people's livelihood of the country. In terms of extremes, if you can "buy life with money", then this will be an unlimited demand. It also means that the industry is sustainable and the investment in the medical industry will not turn into a bubble.
BAT, which accounts for the first half of the mobile Internet bonus, will naturally not let go. However, in comparison, the layout of the three is still very different.
Affected by the "Wei Zexi incident", Baidu only withdrew its medical division in March last year and made little move. In addition to the core business of medical e-commerce, Ali Health has also set up an artificial intelligence laboratory and withdrawn from the medical imaging AI product Doctor You. In addition, under the Ali system, there are Alipay Smart Hospital and Aliyun ET Medical Brain.
Tencent also began to make efforts after its strategic investment of US $70 million in September 2014 in clove garden. It has successively invested in micro-medicine (formerly registered network), Zhuo Jian technology, medical association, good doctor, penguin doctor, carbon cloud intelligence, etc. Most unicorns in the medical industry have been taken in by it.
At this year's Tencent Global Partner Conference, Ma Huateng published an open letter "Helping the Real Industry Grow More World Champions", and pointed out in the letter: Tencent will next make connectors to enter the "digital world" for all walks of life. "Provide the richest" digital interface ", be a good ecological co-player, provide new infrastructure such as cloud computing, big data and artificial intelligence, and stimulate every participant to carry out digital innovation, together with partners from all walks of life, we will build a" digital ecological community ".
The cooperation concept of assistance, co-construction and win-win also applies to China's medical reform. Human life is at stake, and improving the accuracy of medical consultation is the well-being of the whole people. On the demand side, if the disease can be detected early with the help of scientific and technological means, early treatment can not only greatly reduce the medical burden of patients, but also increase the chances of survival of patients.
For supply-side hospitals and medical staff, the accuracy of disease judgment is improved with the help of AI medical imaging and other high-tech means, which not only effectively relieves the tense doctor-patient relationship, but also reduces the work pressure of medical staff.
There are some problems such as contradiction between supply and demand of medical resources, uneven informatization of medical industry, scattered data, uneven quality of medical information and low accuracy. Under the premise that there is no way to change the contradiction between supply and demand and control demand, we can only use scientific and technological means and Internet capabilities to alleviate the contradiction between supply and demand and improve hospital efficiency.
In August this year, Tencent released the AI medical imaging product Tencent Seeking Shadow, which uses artificial intelligence medical imaging technology to assist doctors in early esophageal cancer screening, and officially entered medical artificial intelligence with Seeking Shadow. In addition to the previous Baidu medical brain, Ali ET medical brain, BAT three giants once again met in the core field of medical care.
At the end of 18 years, some media counted the market value ranking of Internet companies. Tencent led with $383.3 billion, followed by Ali with a market capitalization of $339.5 billion and Baidu in third with a market capitalization of $54.9 billion. They are the benchmark of domestic Internet companies and the vane of the industry. Giants have set foot in medical care, industry prospects can be seen.
In the past three decades, health care reform has relied on the promotion of the national government to achieve universal health insurance, and the proportion of personal expenditure on total national health expenses has been reduced to less than 30% in 2015. In the next 30 years, in the environment where the main battlefield of the mobile Internet is transferred to the industrial Internet, the Internet and all walks of life will be deeply integrated, and the reform of the medical industry will also shift to digitalization and intelligence.
Online registration inquiry, examination report, electronic prescription, medical payment, online drug purchase, diagnosis and treatment card and other ways to improve medical efficiency need to be deepened, medical insurance, new rural cooperative medical system, commercial insurance and other medical security methods need to be excavated, and the construction of Internet medical ecology has become the theme.
Paying attention to the life cycle of patient health management, from early knowledge and insight to a series of complex operations after admission to the hospital, including guidance, medical treatment, registration, hospitalization, follow-up after leaving the hospital, chronic disease management and a complete set of connected upgrade system is the vision of future smart hospitals and the ultimate goal of medical reform.
New Future of Medical Industry
The realization of the wisdom of the hospital needs the support of the data center, the assistance of artificial intelligence technology, the renewal of the concept of the people...... a long way to go.
The overall digital transformation of the medical service industry requires many basic capabilities, including technology and business, such as a doctor qualification certification system that supports doctors' multi-point practice, an electronic prescription certification platform that supports prescription circulation, and a credible medical knowledge map. Information security, privacy protection mechanisms, etc., these basic capabilities or components are very important in supporting the digital transformation of the entire industry, and they all require long-term research and development investment.
However, at present, it seems that it is difficult to change the current situation that data in the medical industry is connected but not connected by shares or existing technical service cooperation. If head enterprises want to go deep into and control an industry, they should become the data center of the whole industry. Ali is the data center of the e-commerce industry, Tencent is the data center of the social industry, but in the medical industry, similar "data center of gravity" is very lacking.
In April this year, the "Opinions on Promoting the Development of" Internet Medical Health "" (Guo Ban Fa [2018] No. 26) was released, echoing the policy demands that the industry has been calling for for a long time.
The policy setting of the Healthy China 2030 has directly promoted the continuous expansion of the trillion-level market, and several opinions on promoting the development of the health business have also pointed out the direction for the big health industry, scientific life, health management, healthy consumption and a series of sub-circuits. Entrepreneurs continue to emerge.
"Internet medical health" became a hot time. The temple has high hopes for the reform of the medical industry and continues to release favorable policies, but in the world, private hospitals represented by the "Putian Department" have become a sharp weapon to harvest the people.
In 2016, the death of a young college student named Wei Zexi pushed Baidu's "bidding ranking" to the forefront.
Two years later, the world's first gene-edited baby immunized against AIDS was born in China, and the participating Shenzhen Hemei Women's Pediatric Hospital was also exploded to belong to the Lin family, one of the four major families of the "Putian Department.
The word "profit" is the first, and it is inevitable that someone will follow suit. Medical reform does not rely on heavy money to achieve results. The road of medical reform has been going on for more than 30 years. With the verticality and refinement of the industry, the upgrading of the medical system is on the line.
The future Internet is to use artificial intelligence to process big data in the cloud, tap the online informatization, digitization and Internet capabilities in the hospital process, set the reimbursement ratio for graded diagnosis and treatment according to medical technology, limit the rampant operation of large hospitals, ensure that doctors practice more and get more for more work, patients choose doctors on the basis of medical insurance based on their own payment ability, and promote economies of scale in the production of medical supplies based on drug effectiveness......
China's medical reform, a long way to go