Recently, Hou Jianming, a member of the National Committee of the Chinese People's Political Consultative Conference, submitted a proposal to fill the gap in mobile medical supervision.
The proposal pointed out that mobile medical breakthroughs in the time and geographical restrictions of traditional medical methods, improving patients' medical experience and promoting the development of health services have become a major trend in medical treatment in the future. However, in its explosive development, the gaps in the access system, the commercialization of industrial operations, the lack of laws and regulations, and the disclosure of personal information have gradually emerged.
The proposal suggests that the first is to clarify the positioning of mobile medical care and establish a mobile medical standard system in China. By approving the standardization of the certification process, improving the administrative licensing standards, and ensuring access control, to ensure the quality of mobile medical services, to avoid the commercialization of behavior, and to return to the public welfare nature. The second is to formulate and improve laws and regulations to provide complete legal support for mobile medical supervision. Establish the National Health and Family Planning Commission as the main body of mobile medical supervision, and clearly include regulatory objects such as doctors, mobile medical equipment , and mobile medical applications. The third is to improve the supervision and punishment mechanism and mobilize the enthusiasm of doctors to respond online. On the one hand, the positive incentive mechanism is established according to the professional level of the doctor and the online time. On the other hand, the doctors who violate the mobile medical laws and regulations implement the penalties policy equivalent to the offline. The fourth is to establish a social supervision channel, while exposing, supervising and warning the risk and quality defects in mobile medical applications, strengthen the basic medical knowledge education of patients, and ensure the effectiveness, reliability and safety of mobile diagnosis and treatment.
Extension: The mobile medical industry does not need legal regulation
In 2017, China Mobile's White Paper (2017) was released. According to the white paper, the National Health and Family Planning Commission shows that in 2015, China's total medical and health expenditure was about 4.1 trillion yuan. From 2010 to 2015, national health expenditures rose year by year. Although the total medical expenses are increasing, due to China's large population base and vast territory, medical needs are still not well met.
The white paper believes that the emergence of mobile Internet provides a high-quality technical soil for the optimization of the medical industry chain. Under the background of national medical reform, mobile medical care has developed rapidly. According to the statistics of Analysys, the market scale of the mobile medical industry has increased year by year, reaching 10.56 billion yuan in 2016, an increase of 116.4% compared with 2015.
Mobile healthcare brings new risks
At present, there are many mobile medical apps popular in the market, and the positioning functions are different.
According to Dr. Deng Yong from the Law Department of Beijing University of Traditional Chinese Medicine, mobile medical apps can be divided into three categories: medical treatment mode, which provides medical treatment for patients; health advice model, health advice or reference standards for the general public; medical professional model It is specially designed for medical professional users, including products in the fields of ophthalmology and dentistry.
Mobile health has also brought some new risks compared to going to the hospital.
"The main risks include: misdiagnosis risk, because it is online, it is equivalent to guessing things, increasing the risk of medical misdiagnosis and delay of diagnosis; the diagnosis and treatment model provided online causes various questions; the personal information security risk may be due to equipment invasion, system Risk and abuse lead to information leakage," Deng Yong said.
Wang Yue, director of the Center for Medical Ethics and Legal Studies at Peking University, believes that mobile medical care is now developing rapidly and is an off-site medical service, which is the biggest legal risk. According to the relevant regulations of the Practitioners Physician Law, "Physicians implement medical treatment, prevention, and health care measures, and sign relevant medical certification documents, which must be examined and investigated in person." The "personal diagnosis and investigation" mentioned here, although there is still some controversy, some people think that "personal" as long as it is, and some people think that "personal" must be on-site, face-to-face consultation, investigation, but I personally prefer In the latter understanding. This is also the biggest legal bottleneck and legal obstacle to Internet medical treatment.
"Medical behavior is special, it can also be called non-trial and error. The risk of medical behavior is high, safety should be placed first, and efficiency should be second." Wang Yue said that the biggest advantage of Internet medical treatment lies in The convenience of crossing time and space. If you limit it to consultation on some diseases, not for actual treatment or for prescribing medication, there is definitely no problem. For chronic disease management, Internet medical treatment is also suitable. The United States also imposes strict restrictions on Internet medical treatment, such as limited to chronically ill patients. After a long illness, the patients themselves have a certain understanding of the drugs they take. In addition, even if the online medical treatment prescribed, it is limited to the patient himself to go to the hospital to see the disease within a certain period of time. All in all, it is to open up the Internet to medical care in areas where the risk of disease is relatively small.
“We can try further in this regard. For example, community doctors, family doctors, and online counseling services between them and their patients, there is a lot of room for development. For most elderly people, it is chronic disease management. This occupies a major part of the basic medical behavior, and there is no problem in the law." Wang Yue said.
Is it conducive to resolve the dispute between doctors and patients
For a long time, in the medical field, doctor-patient disputes have attracted much attention.
Can the development of mobile medical care have a positive impact on resolving disputes between doctors and patients?
Deng Yong believes that mobile medical provides a platform for communication between doctors and patients, which can connect doctors and patients directly, so that doctors and patients can interact with the platform. Through such a mechanism, doctors and patients can establish long-term contact. Make doctors and patients directly cross the hospital wall and establish trust and network connections.
"Mobile medical provides a platform for the connection between doctors and patients, which helps solve the problem of difficult medical treatment and expensive medical treatment. It can help doctors build their own brands, establish their patient groups, restore the intellectual value of doctors, and make doctors sunshine. Legally earning money. At present, our medical status is that the distribution of medical resources is very uneven. Mobile medical care may improve the current situation of this kind of medical treatment. In addition, doctors can continue education through mobile medical treatment, allowing doctors to diagnose and treat patients more standardized. , thereby reducing the social and economic burden." Deng Yong said.
Wang Yue believes that mobile medicine has the nature of “double-edged sword†for resolving disputes between doctors and patients. “The good side is that it can improve the efficiency of communication between doctors and patients. It may be difficult for us to find a doctor before. We can't find anyone upstairs and downstairs. Now, through the App, you can quickly contact the doctor. The downside is that Therefore, such communication lacks temperature and does not substantially narrow the distance between doctors and patients."
"On this aspect, you can also make some restrictions. For example, when it comes to mobile medical services, you can ask for video communication. Relatively speaking, video communication is much better." Wang Yue said.
Should be conservative and cautious
To ensure that mobile medical care is on a sound development path, Deng Yong believes that it is necessary to ensure that quality medical services are quality-oriented, patient-centered, and user information is protected.
Regarding how to regulate mobile medical care, Deng Yong suggested that the State Food and Drug Administration should make clear provisions through legislation to have discretion over the supervision of low-risk mobile medical apps. If a mobile medical app is identified as low risk, then The supervisory authority has the right to choose whether to conduct pre-market review and approval according to the actual situation; for higher-risk mobile medical applications, clear and specific supervision and guidance programs should be formulated to maintain the order of the mobile medical App market.
"Mobile medical care can't replace the traditional medical model, it should be an assistant to help doctors to see a doctor. Medical behavior is different from shopping online. It reflects the attitude towards life. In the face of life, we should still greet with a conservative and cautious principle. New things should not be too radical. People usually say that they spend money to buy lessons, but the medical industry is different from other industries. It is impossible to be wrong. It is like no one wants to take a newly developed aircraft that no one has ever sat. "Wang Yue said. (Fujian People's Government website)
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