Huang Hongli responded to patient consultation on the Internet hospital platform.
He Qiang
Wang Lina
Internet hospital started in China in 2015. At that time, it was mainly to solve the problem of "difficulty in seeing a doctor" in remote areas. Patients can hang the expert number of high-level doctors in China through Internet hospitals, and the doctors will then put forward corresponding medical opinions based on the patient's complaint and related examination reports. Nowadays, many famous doctors from tertiary hospitals in Guangzhou will release expert accounts on the Internet hospital platform for consultation and consultation between patients across the country. So, on the Internet hospital platform, how do patients see a doctor? How do doctors receive treatment? How to deliver medicines? What else is worth improving at the moment? The reporter investigated this. Text/Guangzhou Daily All-Media Reporter Wu Wei Photo/Provided by the interviewee Registration is unlimited, medical insurance settlement can be made, and medicine is delivered to home. It is more convenient to use Internet hospitals for chronic disease re-examination. The reporter's investigation found that for patients with chronic disease, the advantages of Internet hospitals are very obvious. About 2 months ago, Xiaoya (pseudonym), a 16-year-old girl with Crohn's disease, came to Guangzhou First People's Hospital for treatment. Huang Hongli, deputy chief physician of the Department of Gastroenterology who treated Xiaoya, told reporters that Xiaoya weighed only 70 kilograms at that time and was in a serious condition. She was hospitalized in the hospital for more than half a month. When she was discharged, the doctor placed a nasal intestinal tube for her and specifically asked her to drip the enteral nutrient solution through the nasal intestinal tube and asked her to go back to the hospital for regular follow-up visits. "According to the medical insurance policy, she can only take the dosage for 7 days after she was discharged from the hospital, but after she went back, the current round of epidemic in Guangzhou began." Huang Hongli told reporters, "The little girl was very anxious at the time, so I asked her to hang my account on the Internet hospital and ask her about the specific situation. I will teach her on the platform how to adjust the drip speed, how to adjust the concentration of the intestinal nutrient solution, and how to care for the nasal and intestinal tube. Every time her medicine is almost used up, I will adjust the prescription according to the condition. After she paid online, she asked the pharmacy to send it directly." Huang Hongli told reporters that the hospital attaches great importance to the construction of Internet hospitals. The hospital's official account has an outpatient registration system. Patients can register for outpatient registration or Internet hospital registration when they enter the page. When they choose to register for an Internet hospital, the pages of the relevant departments, the doctors who visit and their related introductions will appear; and when the patient fills in his personal information and clicks to submit, the hospital will notify the doctor himself by text message and remind the doctor to go in and check it in time. "We usually have to check within 24 hours, and the maximum length cannot exceed 48 hours. After entering the system, we will see the patient's information and case information. After understanding the patient's condition, we will conduct some additional consultations based on the patient's demands." Huang Hongli also said that for patients who are newly diagnosed, she cannot prescribe medicine in Internet hospitals, so she can only give some medical advice first. "If a patient says abdominal pain and acid reflux, we may recommend him to do gastroscopy . But if he is a patient who is following up and some patients who are clear about replacing the chronic disease, the doctor will prescribe a prescription in an Internet hospital based on his previous medication information." "After prescriptions, we submit them to the pharmacy and let the pharmacist review the prescription. After the review is passed, the hospital system will remind the patient to pay the drug fee online, and the pharmacy will then deliver the medicine to the patient." Huang Hongli said, "This method has solved many problems for patients with chronic diseases, especially patients in other places and in risk areas. At present, Class I special patients can automatically settle medical insurance in the Internet hospital of our hospital, which is very convenient for patients, especially if it is not convenient to come for treatment during the epidemic, they can register for consultation in the Internet hospital." Huang Hongli said that in the past three years, the number of consultations she has in the Internet hospital has doubled almost every year. "I used my free time, basically half an hour to an hour a day. Not only patients from other places, but some local patients are also used to this. For doctors, this is a good platform for communication with patients. For patients, there is currently no limit on registration for Internet hospitals, and the registration fee is cheaper than offline clinics." Online consultation first and then follow up offline treatment. It is easier for patients with surgical diseases to choose famous doctors and hospitals. During the interview, the reporter also found that surgeons also use Internet hospitals to carry out diagnosis and treatment activities.He Qiang, director of the Department of Surgery and chief physician of the Department of Hepatobiliary Surgery of the East Hospital of the First Affiliated Hospital of Sun Yat-sen University, told reporters: "On our Internet hospital platform, the reception process is for patients to upload medical records, imaging materials, and medical needs through the platform, and the platform managers will notify me through text messages as soon as I see the information. As long as I have time, I will reply to the patient as soon as possible, unless sometimes standing on the operating table. But once the surgery is done, we will reply as soon as possible." He Qiang said. He Qiang is mainly engaged in hepatobiliary and pancreatic surgery. Most of the patients consulted him are patients with liver, gallbladder and pancreatic surgery. Unlike the internal medicine department who mainly treats chronic diseases, most of He Qiang come into contact with patients who are first-time patients, and there are few elderly patients. "In Internet hospitals, there are patients from this city, province, and other provinces. More and more patients seek medical treatment through online methods. Compared with three years ago, I personally feel that there is an increase of at least 20% to 30%. Internet hospitals have indeed provided convenient ways for some patients with relatively long distances and poor medical resources in their areas, so that they can access better hospitals and better doctors online." He Qiang said: "During this round of Guangzhou epidemic, I feel more obvious that more and more patients are on the Internet hospital platform for consultation. Our hospital's Internet hospital has the function of prescriptions and examinations. But in surgery, more patients can mainly know the general diagnosis and treatment direction of their condition through consultation in Internet hospitals, because I can't see the patients, and can only roughly know what the problem is through the patient's description and some uploaded test forms. Indeed, many patients have obtained relatively clear diagnosis through this method, and have also received timely follow-up treatment and hospitalization in the subsequent treatment." He Qiang said: "Some cancer patients were considered to be serious in local hospitals and could not be treated, so they found me through the Internet hospital. After seeing this, I told him that the disease could still be treated surgically. The patient then found us very conveniently, and we then admitted him to the hospital. This indeed brings great convenience to patients from other places. For example, some patients with liver cancer , pancreatic cancer , and cholangiocarcinoma have received more smooth diagnosis and hospitalization treatment through this method." He Qiang said: "Many patients were worried about whether they could go to Guangzhou now when they were online. I told them that if you are from an epidemic-free area, after arriving in Guangzhou, as long as you implement the epidemic prevention and control requirements in Guangzhou and do nucleic acid test in accordance with the hospital regulations, you can be admitted to the hospital smoothly." The demand for online consultation in pediatrics is also high to alleviate the anxiety of children's parents "cloud dispensing" to avoid running back and forth During the epidemic, children's illness often affects parents' nerves the most. "Pediatrics is different from some departments that treat chronic diseases. They prescribe fewer medicines and more consultations. After parents know that there is an Internet hospital, they will come to you through this channel." Wang Lina, chief physician of pediatrics at Guangzhou First People's Hospital, told reporters that the hospital's pediatrics department is in high demand during the epidemic. Wang Lina said: "Our hospital has been in an Internet hospital for two years. The most common consultation problem is children's fever. We actually don't recommend online consultations, but parents attach great importance to the matters of children. When we receive consultation, we mainly calm parents' anxiety, give some attention, and recommend that parents take their children to for medical treatment as soon as possible. There are professional doctors' consultation suggestions, which can also relieve parents' anxiety." Wang Lina mainly treats children's blood diseases, and the Internet hospital also let her contact with more patients. "I remember there was a sick child from another place. His diagnosis results were not very clear. The parents contacted me through the Internet hospital to consult if they could come to our hospital for treatment. After they came, we did bone perforation and various examinations for the child. The child was later hospitalized in our department and recovered well. Now we have been regularly followed up for at least one and a half years." "I think that Internet hospitals under the epidemic have two main functions. One is to relieve the mood of these parents who stay at home for a long time, and the other is to help patients do some practical things.Most of our hospitals have blood diseases, and it is too difficult for them to run back after being discharged from the hospital, but they have to maintain treatment every week, so their medications are basically done through the Internet every week. Children usually have fingers in the local area for testing. The parents send me the test form, and I will tell the parents how to adjust the medicine and prepare the medicine. "Wang Lina said. Now, more and more parents of children have received treatment methods like Internet hospitals. Wang Lina said: "After we received the outpatient clinic, we told our parents that it is not easy to come to the hospital during the epidemic. In the future, we will directly register a number in the Internet hospital and take photos of the test form and medical records for me. I will explain it clearly to them, so there is no need to go there specifically. ” How to optimize in the future? It is recommended to strengthen platform publicity and enrich communication forms to help patients upload high-quality images So, how should patients find Internet hospitals? Currently, Grade 8 hospitals in Guangzhou have opened Internet hospitals, and patients can register Internet hospitals through the hospital's WeChat official account, mini program, etc.; in addition, patients can also view the hospitals that have opened this service through the "Internet Hospital" column on the "Yuejiantong" WeChat mini program, and click directly to the hospital's Internet hospital page to register. Several doctors interviewed have put forward constructive opinions on how Internet hospitals will develop and improve in the future. Huang Hongli said: "The automatic settlement of the hospital's Class I special is very smooth. If the medical insurance payment scope for common and chronic diseases ' Internet + ' medical services can be gradually expanded, it will be more convenient for patients; in addition, we can strengthen the publicity of Internet hospitals to let more patients know, because there are indeed some patients who are not very clear at present. "He Qiang believes that Internet hospitals can improve from the following aspects: First, remind patients or their families to prepare information. The more detailed the information, the more accurate the description, the better the effectiveness of seeking medical consultation; Second, it is recommended that Internet hospitals conduct video consultations, and doctors can make an appointment with the patient for face-to-face online, so that communication will be more convenient and direct; the third suggestion is that if the patient has done some relatively high-quality image examinations locally, it is best to download clear photos and upload them through the Internet hospital platform, so that doctors can see relatively high-quality images. "Now some images are remakes by patients on their own mobile phones, which are not very clear. If there are high-quality images, it is helpful for consultation. "Wang Lina also believes that Internet hospitals should strengthen publicity. "There is a characteristic of pediatrics that the condition changes rapidly. The child may have a stomachache at the beginning, but it will soon become an intestinal obstruction. If parents can use Internet hospitals to communicate with doctors and Internet software can also connect with both doctors and patients more timely and three-dimensionally, it will play a great role in diagnosis and treatment. ”
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