Medical treatment, medical insurance and medicine should be combined to build a whole course management system.

Source: [People’s Daily Health Client]

"Before a new drug and a new technology of treatment enter medical insurance, it often needs a process. In this case, part of it can be commercial insurance to solve the cost problem." On March 13th, Peng Mingqiang, vice president of China-Japan Friendship Hospital and executive vice president of China Rehabilitation Medical Association, said in the People’s Daily Health Client’s "Two-Session Health Policy" that with the continuous deepening of medical reform, medical care, medical insurance and medicine need to be combined to provide quality medical services for more patients.

In the "Government Work Report" of the NPC and CPPCC, it is emphasized that it is necessary to improve the medical and health service capacity, further promote the "Healthy China Action", deepen the reform of the medical and health system, and provide the basic medical and health system to the whole people as a public product, so as to further alleviate the problems of difficulty and expensive medical treatment for the masses. It is very important to construct the whole course management mode through Internet medical treatment and straighten out the relationship among the three service scenarios of "medical treatment, medicine and insurance" for improving patients’ medical experience and solving the problem of medical treatment.

Internet medical care helps the whole course management.

Peng Mingqiang said that Internet medical care is an important part of the medical system reform and an important starting point for implementing graded diagnosis and treatment. In recent years, the state has issued a series of policies and documents to encourage and support the development of Internet medical care and the construction of Internet hospitals in China. It is intended to promote the integration of Internet medical care and medical services, and build a medical model that integrates pre-hospital, in-hospital, post-hospital, online and offline, so that informationization can walk more and ordinary people can run less errands.

"Internet medical care is more for patients with chronic diseases and patients who need rehabilitation management. Informatization can provide patients with convenient, fast and efficient medical services. Patients can make appointments at home, doctors can diagnose online, and patients can take medicine offline. For patients, they can get good medical services at home. Telemedicine is more about communication between medical institutions and medical institutions, which can enable remote areas to obtain high-quality medical services and improve the level of medical services at the grassroots level through remote consultation and guidance. " Peng Mingqiang said.

In Peng Mingqiang’s view, Internet medical care has made the medical system more complete. With the reform of the medical system, some problems existing in Internet medical care will gradually be solved.

Promote the deep integration of medical, pharmaceutical and insurance services.

Peng Mingqiang said that medical treatment is inseparable from medicine, and medicine is a very important aspect in the treatment of diseases. With the development of innovative drugs, many incurable diseases have the hope of radical cure. For hospitals, it is also hoped that drugs will be more and more accurate, the treatment effect for patients will be better and better, and patients can use and afford them, so that drug treatment can better serve patients.

"In the traditional sense, many people may think that the most important function for pharmaceutical companies is to produce and develop drugs, and finally provide drugs to medical institutions, but in fact, the scene of pharmaceutical companies is also undergoing tremendous changes. For a company, it is not enough to focus only on drugs. It is necessary to take patients as the center and bring more care to patients. " Bian Xin, president of Roche Pharmaceuticals China, said that from the perspective of pharmaceutical companies, it is always the core value to constantly develop the best drugs. At the same time, drugs should be used by patients in the end, and pharmaceutical companies should also cooperate with medical institutions, payers and other partners in various fields, so that we can work together to create a linkage scenario of various services such as medical care, drugs and insurance in the future.

Peng Xuan, CEO of Center Huibao, said that the development of Internet medical care, the improvement of medical technology and the emergence of innovative drugs have brought more treatment possibilities to patients, giving patients more choices when facing diseases. At this time, it is very important to have enough ability to pay for medical expenses. As the connecting layer between basic medical insurance and commercial insurance, inclusive commercial health insurance can solve the problems of multi-payment and innovative drug payment more effectively, and it is an important part of the national multi-level medical security system.

He Tao, Chairman and CEO of Center Science and Technology Group, said that at present, Center Science and Technology has three sections: medical technology, drugs and insurance services, which constitute the main scene of patient’s whole course management. In the medical treatment scenario, Center Science and Technology and about 170 3A hospitals jointly build and operate Internet hospitals, and carry out full course management from online to offline, from pre-diagnosis, during-diagnosis to post-diagnosis.

How to manage the whole course effectively? He Tao said that the first thing is to think about where to start management, and the second is how to manage effectively. So first of all, Center Technology reaches users and provides services in three scenarios: medical treatment, medicine and insurance. Then there is how to carry out effective management, including three "initiatives". The first is "active screening". Based on the goal that prevention is greater than treatment advocated by the state at present, we work with medical institutions such as disease control and public hospitals to actively screen patients’ inspection reports and find out the disease stage in which patients are located.

The second is "active management", which labels and structures the test reports of patients at different stages and actively intervenes in people in need; The third is "active inquiry" or active return visit, especially for some patients who have left the hospital, to return to their medication effect, data changes in test reports, follow-up reminders, etc. It is actually complicated and cumbersome to do these three initiatives, because it includes pre-diagnosis, in-diagnosis and after-diagnosis. Now the center of the circle processes the data through some technical means, and then makes the service more efficient with the help of AI and big data.

In the medication scene, Center Science and Technology and excellent enterprises such as Roche jointly promote online and offline pharmacy management to meet patients’ medication needs and follow-up management of treatment effects. He Tao said that in terms of insurance services, the treatment of diseases and the use of drugs are inseparable from payment and affordability. Therefore, Circle Center Huibao, a subsidiary of Circle Center Technology, has joined hands with medical insurance and insurance companies to promote the construction of a multi-level medical security system based on basic medical insurance, supplemented by commercial insurance such as Huimin Insurance and specialist insurance, and jointly help reduce the treatment burden of patients.

Editor: Li Shuang

Editor: Z Ryan

Proofreading: Chen Longfei

This article comes from People’s Daily Health Client and only represents the author’s point of view. The national party media information public platform provides information dissemination and dissemination services.