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Objective:To analyze the actual and expected incentives and key issues of telemedicine providers in China and to provide important references for optimizing telemedicine incentive policies.Methods:The sample data came from a questionnaire survey of 1 084 providers in 7 provinces of Fujian, Hainan, Henan, Hunan, Guizhou, Sichuan and Qinghai in October and November 2019 and a semi-structured interview data at 6 hospitals in Henan province in January 2020. Descriptive analysis was used to sort such data into text data for classified summation.Results:The greatest gaps were found between actual incentives and expected ones in expense subsidies, title promotion and excellence awards, with such gaps as high as 18.65, 28.26, 29.28 percentages among providers of junior, deputy senior and senior academic titles respectively. Hospitals fall short in providing adequate incentives for telemedicine providers, not to mention lack of differentiation and diversification in personnel incentives, and poor implementation of incentive policies.Conclusions:It is suggested to strengthen incentive demand analysis, break the homogenization bottleneck of incentive policies, and consolidate internal publicity and implementation of incentive policies.
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Objective:To analyze the usage intention and key issues of medical staff to use telemedicine, for improving telemedicine service system in China.Methods:From October to November 2019, medical workers of both the inviting party and invited party who experienced telemedicine in seven provinces of Fujian, Hainan, Henan, Hunan, Guizhou, Sichuan and Qinghai were selected for an online questionnaire survey. Areas covered included their usage intention, satisfaction and cognitive appraisal of telemedicine. Descriptive statistical analysis and non-parametric test were used to discuss the intention of further use, satisfaction and challenges of medical workers in various provinces and regions.Results:1 084 valid questionnaires were recovered. The data found the overall satisfaction was 98.62%, and the proportion of their intention of further use was 98.25%, and those from the eastern and western provinces presented higher intention of usage. The top challenges as reflected by these medical workers were named as follows: timeliness of consultation progress and information feedback; long latency time; low Internet speed, poor and interrupted Internet signal; inadequate system equipments and inconvenient operation; difficulties in remote physical checkup and overall understanding of patient conditions; as well as substandard, incomplete and poor medical records.Conclusions:These medical workers are satisfied with the telemedicine services and willing to continue to use telemedicine.For those existing problems, it is suggested to strengthen the infrastructure and optimize the process of telemedicine services, so as to encourage them in greater use of telemedicine.
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OBJECTIVES@#To analyze the regional epidemic features of coronavirus disease 2019 (COVID-19) in Henan Province, China.@*METHODS@#According to the data of COVID-19 patients and the resident population at the end of 2018 in Henan Province, statistical description and analysis of epidemiological characteristics of COVID-19 in Henan Province were conducted, including the time distribution, population distribution, and regional distribution.@*RESULTS@#The cumulative incidence of COVID-19 in Henan Province was 1.32/100 000, the cure rate was 98.03%, and the fatality rate was 1.73% by March 9, 2020. The incidence curve showed that the epidemic peak reached from January 24 to January 28. The high-incidence area was Xinyang, with a standardized cumulative incidence rate of 4.36/100 000. There were 580 female COVID-19 patients (45.60%), 688 males (54.09%) in Henan Province. The incidence of males was 1.41/100 000, while the incidence of females was 1.23/100 000. The age with the highest incidence of COVID-19 in Henan Province was 20-69 years old (88.68%). The incidence rate was highest in men aged 30-39 (2.51/ 100 000), while the lowest rate in women aged 0-9 (0.16/100 000). There were 1 225 local patients (96.31%), and the rural patients (45.73%) were slightly higher than the urban patients (44.02%) in Henan Province. A total of 63.60% patients had traveled or lived in Hubei or contacted with people who came from Hubei to Henan. The proportion of patients whose family members suffered from COVID-19 was 32.70%. Global spatial autocorrelation analysis suggested that there was a statistically significant positive correlation in the spatial distribution of COVID-19 patients in Henan Province (Moran's =0.248, =2.955, <0.01).@*CONCLUSIONS@#There are differences in the morbidity and mortality of COVID-19 patients in different areas of Henan Province, with epidemic peak reaching from January 24 to January 28. Henan is dominated by local patients, male patients, and patients with contact history in Hubei. The space appears to be moderately clustered.
Subject(s)
Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Young Adult , Betacoronavirus , China , Epidemiology , Coronavirus Infections , Epidemiology , Incidence , Pandemics , Pneumonia, Viral , Epidemiology , Spatial AnalysisABSTRACT
Driven by demand and policy guidance, the construction of Internet hospitals is on a fast track mode in China. To address such a situation, the state requires that before Internet hospitals are admitted, the provincial health authorities should establish an Internet medical service supervision platform to interconnect with the Internet hospital information platform for real-time supervision. This study discussed and introduced the Internet medical service supervision platform in Henan province, covering its system architecture, functions, regulatory indicators and operation mode. The platform is officially in operation and has completed docking with 7 medical institutions. It can implement entire process supervision with a total of 186 indicators in five categories in Henan, providing a reference for the construction of Internet medical service supervision platforms in other provinces.
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The actor network theory, with reference to systems science, sociology and management science, offers a new perspective for research of the technology-society binary view. This theory as introduced by the authors, analyzed the constituent bodies and their relationship of the operation of the precise medical service system, and studied the translation process of the actor network. The analysis showed that the main factors affecting the operation of the precision medical service system were hospitals, patients, governments, scientific research institutions, technology-based enterprises, and universities, which were suppliers, demanders, managers, funders, and technical supporters of precision medical services. Among them, 82.72%(335/405) of clinicians believed that hospitals were the core actor that affected the operation of precision medical service system. 71.60%(290/405) of the clinicians thought that the training of medical workers was the current focus of the hospital, i. e., the mandatory access point for this actor network. Through training, the accurate medical service ability of medical workers and hospitals can be improved.
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Objective:To investigate the influencing factors of the implementation of precision medical services based on clinician cognition, and provide a scientific reference for the implementation and advancement of precision medical services.Methods:Using electronic questionnaires, clinicians from 48 hospitals in 12 provinces(autonomous regions and municipalities directly under the Central Government) were surveyed from July to September 2019, with 341 valid questionnaires collected. Descriptive statistics and factor analysis were performed on the survey data.Results:Three dimensions that affect precision medical services were identified from the recovered questionnaires, namely external support factors, hospital drive capabilities, patient information provision and protection. The contribution rate of variance after orthogonal rotation was 35.157%, 22.234% and 16.343% respectively.Conclusions:The external supporting factors should be developed, the hospital driving ability should be strengthened, and the patient information reception and privacy information security should be ensured to provide an important basis and guarantee for the implementation of precision medical service.
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Precision medicine can achieve precise prevention and treatment of diseases and improve medical standards. The precision medical service system is a carrier and medium for providing precision medical services, which can promote the implementation of precision medical plans and satisfactorily meet the medical service needs of patients. On the basis of literature research and practice, the authors studied the actual situation and development trend of precision medical development in China and built a general framework of precision medical service system. This framework is based on the precision medical service supply system and demand system, centering on the service product system. Ensured by the supporting system, they proposed the implementation path of precision medical service system construction.
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Objective@#To investigate the influencing factors of the implementation of precision medical services based on clinician cognition, and provide a scientific reference for the implementation and advancement of precision medical services.@*Methods@#Using electronic questionnaires, clinicians from 48 hospitals in 12 provinces(autonomous regions and municipalities directly under the Central Government) were surveyed from July to September 2019, with 341 valid questionnaires collected. Descriptive statistics and factor analysis were performed on the survey data.@*Results@#Three dimensions that affect precision medical services were identified from the recovered questionnaires, namely external support factors, hospital drive capabilities, patient information provision and protection. The contribution rate of variance after orthogonal rotation was 35.157%, 22.234% and 16.343% respectively.@*Conclusions@#The external supporting factors should be developed, the hospital driving ability should be strengthened, and the patient information reception and privacy information security should be ensured to provide an important basis and guarantee for the implementation of precision medical service.
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The actor network theory, with reference to systems science, sociology and management science, offers a new perspective for research of the technology-society binary view. This theory as introduced by the authors, analyzed the constituent bodies and their relationship of the operation of the precise medical service system, and studied the translation process of the actor network. The analysis showed that the main factors affecting the operation of the precision medical service system were hospitals, patients, governments, scientific research institutions, technology-based enterprises, and universities, which were suppliers, demanders, managers, funders, and technical supporters of precision medical services. Among them, 82.72%(335/405) of clinicians believed that hospitals were the core actor that affected the operation of precision medical service system. 71.60%(290/405) of the clinicians thought that the training of medical workers was the current focus of the hospital, i. e., the mandatory access point for this actor network. Through training, the accurate medical service ability of medical workers and hospitals can be improved.
ABSTRACT
Precision medicine can achieve precise prevention and treatment of diseases and improve medical standards. The precision medical service system is a carrier and medium for providing precision medical services, which can promote the implementation of precision medical plans and satisfactorily meet the medical service needs of patients. On the basis of literature research and practice, the authors studied the actual situation and development trend of precision medical development in China and built a general framework of precision medical service system. This framework is based on the precision medical service supply system and demand system, centering on the service product system. Ensured by the supporting system, they proposed the implementation path of precision medical service system construction.
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Telemedicine can optimize deployment of medical resources and minimize diagnosis discrepancies.Formulation of a rational project pricing and scientific compensation policy will be conducive to its future development. The concept of human resource consumption in RBRVS was used as reference to improve the activity-based costing ( ABC ) method. The authors sorted out the resource cost repository, identified the activity system, classified the motivation resources into respective activity cost repositories, and calculated the cost of respective cost object distribution.The cost of three telemedicine service items(remote single discipline consultation, remote image consultation and remote pathology consultation were 119.69, 147.03 and 161.61 yuan respectively) was calculated by the improved ABC.It can better indicate project costs than that calculated by the traditional ABC(137.30, 147.17 and 144.08 yuan), and proves more consistent with the existing prices of other province(134.00, 150.00 and 174.00 yuan).
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Based on the literature review of medical behaviors,big data mining and related rules,the paper introduces the basic contents of big data mining and related rule algorithm-Apriori algorithm,takes partial Electronic Medical Records (EMR) system data of the First Affiliated Hospital of Zhengzhou University as the basis,conducts mining analysis on factors such as the gender,age,operation records,critical ill records,visiting distance and hospital days of a patient by adopting Apriori algorithm of related rule,obtains the rules of medical behaviors of patients of different visiting distances,and puts forward relevant policies and suggestions.
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The paper introduces the mutual relationship among the innovation of four dimensions including new medical service concept,new patient interface,new service transmission system and new technology of telemedicine based on the illustration of four-dimensional model of service innovation to the telemedicine service,and makes an analysis by taking the telemedicine service innovation of remote medical center in Henan Province as an example,thus providing reference for the innovative development of telemedicine service.
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Based on analysis of the telemedicine system architecture and collaborative management needs,the author proposed such a collaborative management mode.From such dimensions as judgment of collaboration needs,establishment and assessment of collaboration relationship,governance of collaboration relationship,control of collaboration relationship,and evaluation of the collaboration relationship,the paper probed into the requirements,problems and solutions of telemedicine collaboration.
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China’s existing laws and regulations in telemedicine fall behind practice.As a result, telemedicine is confronted with such vague constraints as permission,legal relations and legal liability, validity of electronic medical records,telemedicine equipment standards,patients’right to know and their right to privacy,as well as disputes settlement.On such basis,the authors propose to improve the laws and regulations in this regard as soon as possible.
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The development of the medical information platform of Henan province is cited as an example,to probe into the organization model of the platform,and the operating and organization model of third-party medical information providers,based on a description of the connotation and development status of the platform,and in consideration of the basic features,technology architecture and key technology requirements of such a platform.
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Described in the paper are the development ideas,technology architecture,functional applications and problems found so far in the regional collaborative medical information platform.The platform is designed to achieve the interconnection and resources sharing among medical institutions,service agencies and regulatory agencies within the region,paving the way for future development of the health and medical system