It is undeniable that Internet medical care has not been fully and widely used so far. Most medical personnel are far from fully grasping the relevant concepts, and may not have carefully studied relevant national policies. This article combines the author's many years of Internet medical practice, especially the experience accumulated after online consultation and video clinics, to try to interpret some problems in the field of Internet medical.

I. Relevant policies and concepts

National policy on Internet medical policy

There are two documents that need to be mentioned. One is the 2016 Key Tasks for Deepening the Reform of the Medical and Health System in 2016 issued by the General Office of the State Council. The document states:

“Selecting qualified regions and areas to promote the health care big data application pilot. Integrate health management and medical information resources, promote appointments, online payment, online follow-up, and online inspection of inspection results, and actively develop telemedicine and diseases. Business applications such as management and pharmacy services. Strengthen the development of clinical medical big data applications."

Previously, the “National Health and Family Planning Commission's Opinions on Promoting Telemedicine Services in Medical Institutions” (hereinafter referred to as “Opinions”) in 2014 has been very clear about the relevant concepts and policy provisions for telemedicine. The Opinions states:

"Telemedicine service is a medical institution (hereinafter referred to as the inviting party) that invites other medical institutions (hereinafter referred to as the invitee) to use the communication, computer and network technology (hereinafter referred to as information technology) to provide technical support for the medical institutions to treat patients. Medical activities. Medical institutions use information technology to provide medical services directly to patients outside medical institutions, which are telemedicine services. Telemedicine services include: remote pathology diagnosis, telemedicine imaging (including imaging, ultrasound, nuclear medicine, Electrocardiogram, electromyogram, electroencephalogram, etc.) diagnosis, remote monitoring, teleconsultation, remote clinic, remote case discussion and other items prescribed by the administrative department of health and family planning above the provincial level."

At the same time, it is also specifically stated that “non-medical institutions may not carry out telemedicine services”. Regarding the issue of international telemedicine, the "Opinions" are so stated: "If telemedicine services are carried out between medical institutions and overseas medical institutions, refer to this opinion."

By 2015, for some commercialization purposes, "online consultation", the spokesperson of the National Health and Family Planning Commission, told the media that "the medical diagnosis and treatment on the Internet is not allowed, and only health consultation can be done. ", but there are no follow-up documents, so it has not effectively stopped online disease diagnosis and treatment counseling, including Internet medical treatment activities conducted by non-medical institutions. Obviously, there is a very vague area between “health consultation” and “disease treatment”, which is difficult to distinguish or define.

The so-called "Internet hospitals" that have received much attention recently are actually based on the need for wired medical institutions. The medical institution and its medical process, like a huge and bulky tank, can be used to insert wings on the tank, making the tank more flexible and moving forward faster, but the tank is the tank after all, and the wings are not enough to support Its flight.

Several nouns that are easy to confuse

Internet medical, telemedicine and mobile medical , these three terms frequently or frequently appear in various media and various conference reports, and often appear in people's verbs, the meaning of expression seems the same, at least not much difference. However, the author believes that the meaning of the different names is quite different. The author has thought about this, and it is expressed as follows for readers' reference: "The interconnection does not necessarily move, the mobile must be interconnected; the remote must be interconnected, the interconnection may not be remote; the near distance can be moved, and the movement may not be remote." Example explanation:

1. The interconnection does not necessarily move, and the mobile must be interconnected. Mobile medical care must be realized through the Internet, and Internet medical care does not necessarily need to be moved. The Internet transmits text, images, audio and video data between different places via wired or wireless communication systems. This is the current practice of online health or disease text consultation, online or offline interpretation of video data, remote video consultation and remote video clinics. The conditions that must be met. Obviously, the focus of the Internet is on the word "link", which does not necessarily need to be moved. Mobile medical care emphasizes the dynamics and mobility of the medical treatment process, with emphasis on “mobile”, such as text and audio and video processing equipment such as computers, tablets and mobile phones, and various wearable devices participating in the medical treatment process. And constitute the basic elements of "mobile". With the help of these mobile devices, medical staff can perform medical treatments at any place and at any time, so it is "mobile medical", but its most basic carrier is still the Internet.

2. The remote must be interconnected and the interconnection may not be remote. The telemedicine process is to express the physical distance between doctors and patients (B2C) or doctors and doctors (B2B), perhaps between different medical institutions in the same city, perhaps in different cities (provinces) Between institutions; even between international medical institutions; or the simplest and roughest understanding of telemedicine as a “non-medical institution”. As long as it is not a medical treatment within the “medical institution”, the absolute physical distance is not very important. Maybe it is several kilometers apart, perhaps as long as thousands of kilometers. As long as there is Internet connection, the physical distance is no longer an obstacle to medical treatment. However, the information management or medical informatization of medical institutions led by HIS is essentially connected by the Internet. It can be connected by wire or wirelessly, and also by Internet technology. Obviously, it is not necessarily "remote."

3. It can be moved from near to far, and the movement may not be remote. With the foregoing, this issue is not difficult to understand. What needs special explanation is that many large medical institutions carry out mobile medical treatment in the hospital extensively. For example, using a tablet to carry out mobile rounds of ward rounds, the traditional medical records are similar. For example, the mobile app allows the ward doctor to view the treated patients anytime and anywhere. The patient's condition changes, medication status, and postoperative recovery; when the doctor is in the clinic, he or she can know the condition of the inpatient and issue a doctor's order to the lower-level doctor or nurse; and when the doctor is on a business trip, he can also know the patient's condition at any time. Reminders, suggestions or medical advice. Such mobile medical behavior can be either close-range or remote.

In short, at this stage, the above three nouns are basically universal, and no institution has mandated that a certain name must be used. The texts interpreted in this article are limited to their own understanding.

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