The CPC Central Committee and the State Council attach great importance to the "Internet + Medical Health" work and have successively issued a number of policies, systems and laws and regulations to promote and regulate the development in this field.
has been released in 2018, from the release of the "Internet Diagnosis and Treatment Management Measures (Trial)", "Internet Hospital Management Measures (Trial)" and "Travel Medical Service Management Standards (Trial)" to the issuance of the "Guiding Opinions on Improving the Price and Medical Insurance Payment Policy of "Internet +" Medical Services" in 2019, and then to the issuance of the "Guiding Opinions on Promoting the Development of "Internet +" Medical Insurance Services During the Prevention and Control of the New Coronavirus Pneumonia Epidemic" during the 2020 COVID-19 epidemic, driven by national policies and Internet technology, my country's Internet diagnosis and treatment has entered a stage of rapid development.
However, the field of Internet diagnosis and treatment has always lacked specific regulatory rules. How can effectively supervise the quality and behavior of Internet diagnosis and treatment is still an important factor affecting the development of Internet hospitals.
On July 17, 2018, the National Health Commission and the State Administration of Traditional Chinese Medicine issued "Notice on Issuing 3 Documents, including Internet Diagnosis and Treatment Management Measures (Trial) and other 3 Documents" (Guowei Medical Fa [2018] No. 25), including "Internet Diagnosis and Treatment Management Measures (Trial)", "Internet Hospital Management Measures (Trial)" and "Trial Health Service Management Standards (Trial)", which stipulates that telemedicine services must "implement real-name management of patients."
On October 26, 2021, the National Health Commission announced to the public the "Internet Diagnosis and Treatment Supervision Rules (Draft for Comments)" (hereinafter referred to as the "Draft for Comments"), which made specific provisions on promoting the development of Internet Diagnosis and Treatment Standards. Articles 17 and 18 of the Draft of Opinions stipulate the obligation of patients to visit patients in Internet diagnosis and treatment activities:
"Internet diagnosis and treatment is implemented in real-name system, and patients are obliged to provide medical institutions with real identity certificates and basic information, and are not allowed to fake others for treatment." "When visiting the doctor, patients should provide medical records with clear diagnosis, such as outpatient medical records, hospitalization medical records, discharge summary, diagnosis certificate, etc., and the doctor will determine whether they meet the follow-up conditions and collect paper or electronic certificate information that proves that the patient has been diagnosed."
my country has implemented the real-name system for patients to seek medical treatment in 2007, and has achieved remarkable results in offline diagnosis and treatment work in medical institutions.
First, real-name treatment is convenient for doctors to grasp important information such as the patient's past history, allergy history, etc., avoid "mistakes" during medical treatment, and ensure accurate diagnosis;
Second, real-name treatment is conducive to maintaining the fairness and orderliness of the Internet diagnosis and treatment environment, and can plug the loopholes of account dealers grabbing numbers from the source;
Third, real-name treatment can establish a patient's electronic health record, and subsequently visiting other medical institutions or other places can also realize the resource sharing of personal health information;
Fourth, real-name treatment can provide more effective regulatory means for basic medical insurance and commercial medical insurance.
Internet diagnosis and treatment requires patients to visit medical treatment in real-name, which means that Internet diagnosis and treatment management will be "homogeneous" with the offline diagnosis and treatment services provided by physical medical institutions, and return to the fundamental positioning of medical services.
"Personal Information Protection Law" , which was officially implemented on November 1, 2021, puts forward higher requirements for data compliance processing in the field of Internet diagnosis and treatment. Article 28 of the Law clearly stipulates:
"Medical and health information is sensitive personal information; only if it has a specific purpose and sufficient necessity, and strict protection measures are taken, the personal information processor can process sensitive personal information; once it is leaked or used illegally, it is easy to infringe on the personal dignity of a natural person or endanger the safety of personal and property."
Internet diagnosis and treatment is based on the patient's real identity certificate and medical records clearly diagnosed by physical medical institutions. The medical orders, electronic prescriptions and electronic medical records formed by Internet diagnosis and treatment will also generate new sensitive personal information.The Internet diagnosis and treatment platform collects and processes patients' personal information with two sides. On the one hand, the collection and processing of personal information is to provide better online diagnosis and treatment services; on the other hand, if personal information is collected and processed in violation of regulations, it will not only face corresponding penalties, but will also reduce patients' trust in Internet diagnosis and treatment.
Internet diagnosis and treatment implements the real-name system for patients to visit patients, and the prerequisite is to protect the patient's personal information. is based on the legal framework of the "Personal Information Protection Law" and the "Data Security Law". The "Draft of Opinions" requires medical institutions to "establish systems such as network security, personal information protection, data use management, etc., and sign agreements with relevant partners to clarify the rights and responsibilities of all parties"; once "a network security incident such as patient personal information and medical data leakage occurs, they should report to the relevant competent departments in a timely manner and take effective response measures."
Therefore, when medical institutions build Internet diagnosis and treatment platforms and carry out Internet diagnosis and treatment activities, they should take positive measures to protect patients' personal information, especially sensitive personal information, from infringement.
On the one hand, we adhere to the principle of informed consent and the "two minimums". In order to protect and respect the personal dignity of natural persons, Article 1035 of the Civil Code and Article 41 of the Cybersecurity Law both stipulate that the information collector needs to obtain the consent of the collected information subject to legally collect and use the personal information of the information subject. The Personal Information Protection Law also stipulates that the processing of medical and health information must obtain the "separate consent" of individuals. Therefore, Internet diagnosis and treatment activities should use informed consent as a necessary prerequisite for the collection and use of patients' personal information, and inform the information subject of the purpose, scope of use, disclosure, etc. in advance. In addition, the processing of patient personal information in Internet diagnosis and treatment activities should have a clear and reasonable purpose, and should be directly related to the diagnosis and treatment content, and adopt a method with the least impact on personal rights and interests; when collecting patient personal information, it should be limited to the minimum scope of achieving the processing purpose, and personal information shall not be collected excessively.
On the other hand, the patient's personal information must be safeguarded through management systems and technical means. During the Internet diagnosis and treatment activities of , patients are required to visit the doctors in real names according to the law. The doctors who receive treatment or even consulting doctors have the right to contact and process the patient's personal information. The registration process is an authorization process, but medical institutions and doctors have the obligation to protect patients' privacy. The Internet diagnosis and treatment management system formulated by medical institutions should include protection measures for patients' personal information, and should also include specific requirements for meeting doctors and consulting doctors to protect patients' personal information.
Personal information processing activities are highly technical. When medical institutions need further development and use of patient cases stored in this hospital, they can use encryption algorithms and de-identification technology to separate user identity and user data and protect the privacy of information. stores personal information in a distributed manner, and authorizes access through smart contracts to reduce the risk of data leakage; through blockchain technology and digital signature algorithms, data portability and immutability are realized, so that patients have higher autonomy over their medical and health data; establish a personal information security management system with traceable responsibilities, formulate and organize the implementation of emergency plans for personal information security incidents, improve remedial measures after personal information leakage and regulatory measures for relevant responsible entities, so as to achieve effective protection of personal information in Internet diagnosis and treatment activities.
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Content source: China Social Science Network
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