移动医疗机器人在社区医院得到应用

2015-06-04 佚名 携手健康网

最近,移动医疗机器人在上海社区医院得到应用,社区医院看病可以依靠它了。 在浦东南汇的社区卫生服务中心,与社区医生一同出诊的,竟还有机器人。借助远程传输技术,电脑屏幕会接通上级医院医生一同讨论病情。这是浦东医院从美国最新引进的移动医疗机器人,据此,优质医疗资源打破了地域限制。  基于分级诊疗这个关键词,作为我国最基层医疗体系的社区,已出现、并还会出现许多翻天覆地的变化。近日在沪举行的“20

最近,移动医疗机器人在上海社区医院得到应用,社区医院看病可以依靠它了。


 
在浦东南汇的社区卫生服务中心,与社区医生一同出诊的,竟还有机器人。借助远程传输技术,电脑屏幕会接通上级医院医生一同讨论病情。这是浦东医院从美国最新引进的移动医疗机器人,据此,优质医疗资源打破了地域限制。
  
基于分级诊疗这个关键词,作为我国最基层医疗体系的社区,已出现、并还会出现许多翻天覆地的变化。近日在沪举行的“2015分级诊疗模式创新研讨会”上传出信息:眼下,新型分级诊疗制度呼之欲出,它可能带来我国就医理念与方式的一次大改变,也将对一二三级医院的定位做出重新布局。
  
“没有家庭医生制度,不可能有新型分级诊疗”
  
说了多年的分级诊疗,今年列入了我国城市公立医院综合改革的重点任务。国家卫计委医政医管局医疗资源处处长焦雅辉称,国家正在研究“顶层设计”,将专门出台关于推进分级诊疗工作的指导意见,“预计今年下半年会掀开新局面”。
  
分级诊疗希望引导人们有序就医,对医疗资源合理分配、医保控费、疾病预防与早期发现等都有着深远意义。不过,要将无序就医变为有序就医,难度不小。
  
在上海,社区成为政策关注的“风口”。上海市卫计委党委书记黄红说,上海将家庭医生制度作为构建分级诊疗体系的重要突破口,通过政策引导以及提高优质服务,吸引签约居民在社区首诊。
  
这涉及多层次地引导有序就医。2012年起,上海试点医疗联合体,大医院门诊资源优先向家庭医生开放。在此期间,上海完成了多项基础性工作,比如,上海居民健康电子档案建档率达到96%,在全国率先实现公立医院互联互通,共享数据中心已有110亿条诊疗数据,这为分级诊疗提供了有利的支撑。
  
“分级诊疗要改变的是老百姓的就医选择,但百姓的这个能力是很弱的。提高百姓的这种选择能力,靠什么?靠具有全科医学知识的家庭医生。”复旦大学社会发展与公共政策学院院长梁鸿教授说,“没有家庭医生制度,不可能有新型分级诊疗。”
  
病人回到“家门口”,社区能否接得住
  
可以想象,多年后,人人都有自己的家庭医生,社区医疗将获得前所未有的发展。新问题随之而来:当病人真的都回到“家门口”,社区能否接得住?
  
“基层现在最大的问题,一是能力不足,二是积极性不足。”焦雅辉说,各地已通过全科医生培训、医联体、区域诊断中心、远程会诊等,对提升基层医疗作了有益探索。在能力提升的同时,社区医生的积极性问题日益突出。在专家看来,通过各种综合方式来提升基层医务人员的积极性是方向。在此期间,就涉及绩效工资、支付方式等改革。“吸引优秀医生到社区,收入是重要的调节杠杆,但也不能忘记监管。”中欧商学院卫生管理与政策中心研究员曹健去基层调研时发现,“不少家庭医生流于形式,有时候,所谓的病例覆盖竟是随意编出来的。这里就缺乏一个第三方的监管机制。”
  
新型分级诊疗,还需引导大医院“断离舍”
  
毫无疑问,在分级诊疗的趋势下,二三级医院将面临重新定位。有专家当着瑞金医院院长瞿介明、中山医院副院长秦净、曙光医院副院长周嘉等三甲“大佬”的面直言,推进新型分级诊疗,还需要大医院“断离舍”—舍得放病人。
  
“你推动医联体,提升社区医疗水平,吸引居民去社区看病,你的病人少了怎么办?”许多人这样问浦东医院院长余波。对此,余波答得坦率:“第一,病人涌到我这里,我们的医疗风险上去了。第二,虽然我们业务量上去了,但忙于应对常见慢性病,医疗水平难有大突破。”
  
余波是敢于“放病人”的院长。组建医联体、区域诊断中心,甚至在浦东医院开设“全科门诊”,请社区医生来坐诊……种种举措都是为了提升老百姓对全科医学的认识。
  
并非所有二三级医院的院长都如此释怀。“大医院人满为患,但这些医院是‘痛并快乐着’。”焦雅辉说,“现在的财政补偿基本还是按照业务量来补偿。并且,我们的支付方式还是单一的总额预算,那么医院收的疑难病例越多,可能赔的钱也越多,据此他们更愿意收一些简单的病人。由此看来,现有的引导机制实际上起着负向引导的作用。”
  
推进分级诊疗,就需要对财政补偿、支付与价格体系做进一步设计与调整。上海市卫计委党委副书记邬惊雷说,“三甲医院更多应该做疑难危重病例,支付设计就要给予这方面的鼓励与引导。对一些简单的病例,当然需要不断的经验累积,但如果这家医院大量地做简单的病种或手术,就提示需要支付方式做些调整。”
  
在专家看来,在我国推进分级诊疗,改变医疗习惯,涉及医保、财政、价格等多种政策引导与杠杆调节,需横向多部门协调,打通这“最后一公里”。值得注意的是,大多数意见认为,当下的分级诊疗不是回到过去的“定点医疗”,它将是一种新型分级诊疗,这在我国可能是一种模式,也可能是多种模式并存。如今,“互联网+”等新理念引入,也将为这种模式的推进与落地注入更多可能性。

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    2015-06-08 chenhui888

    希望国家大力发展。

    0

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    2015-06-06 xue8602
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    2015-06-06 docwu2019
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    2015-06-06 yahu
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    2015-06-05 1dd7eb8am26(暂无匿称)

    人和机器的结合,移动远程医疗将会把医疗资源有效利用

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=26292, encodeId=3095262922b, content=希望国家大力发展。, beContent=null, objectType=article, channel=null, level=null, likeNumber=167, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=121e1622385, createdName=chenhui888, createdTime=Mon Jun 08 14:01:00 CST 2015, time=2015-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1321864, encodeId=078913218648a, content=<a href='/topic/show?id=890c611854e' target=_blank style='color:#2F92EE;'>#机器人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61185, encryptionId=890c611854e, topicName=机器人)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Sat Jun 06 07:11:00 CST 2015, time=2015-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395619, encodeId=12a4139561968, content=<a href='/topic/show?id=7a89e4036eb' target=_blank style='color:#2F92EE;'>#社区#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74036, encryptionId=7a89e4036eb, topicName=社区)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Sat Jun 06 07:11:00 CST 2015, time=2015-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530431, encodeId=9fec153043156, content=<a href='/topic/show?id=8309e5153aa' target=_blank style='color:#2F92EE;'>#移动医疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75153, encryptionId=8309e5153aa, topicName=移动医疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fbd812108434, createdName=yahu, createdTime=Sat Jun 06 07:11:00 CST 2015, time=2015-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582916, encodeId=9bb4158291646, content=<a href='/topic/show?id=f6e1611840d' target=_blank style='color:#2F92EE;'>#机器#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61184, encryptionId=f6e1611840d, topicName=机器)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13dc16973127, createdName=ms6279672939590805, createdTime=Sat Jun 06 07:11:00 CST 2015, time=2015-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=26030, encodeId=63b5260303d, content=人和机器的结合,移动远程医疗将会把医疗资源有效利用, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e511627114, createdName=1dd7eb8am26(暂无匿称), createdTime=Fri Jun 05 08:05:00 CST 2015, time=2015-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=25985, encodeId=4936259857e, content=高大尚, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200609/ef6a57dbe7f1489dad7446b7c5217858/d5e4fe65996c4446a029b0f5d056abb1.jpg, createdBy=6b011518214, createdName=午夜星河, createdTime=Thu Jun 04 17:29:00 CST 2015, time=2015-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=25975, encodeId=c676259e517, content=这却是一个好的场景,社区医院水平不高正好能够应用, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Thu Jun 04 17:18:00 CST 2015, time=2015-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=25950, encodeId=6fef2595038, content=断电咋办, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f8011617873, createdName=bucm_ting, createdTime=Thu Jun 04 16:28:00 CST 2015, time=2015-06-04, status=1, ipAttribution=)]
    2015-06-04 午夜星河

    高大尚

    0

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    2015-06-04 medcardio

    这却是一个好的场景,社区医院水平不高正好能够应用

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=26292, encodeId=3095262922b, content=希望国家大力发展。, beContent=null, objectType=article, channel=null, level=null, likeNumber=167, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=121e1622385, createdName=chenhui888, createdTime=Mon Jun 08 14:01:00 CST 2015, time=2015-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1321864, encodeId=078913218648a, content=<a href='/topic/show?id=890c611854e' target=_blank style='color:#2F92EE;'>#机器人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61185, encryptionId=890c611854e, topicName=机器人)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Sat Jun 06 07:11:00 CST 2015, time=2015-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395619, encodeId=12a4139561968, content=<a href='/topic/show?id=7a89e4036eb' target=_blank style='color:#2F92EE;'>#社区#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74036, encryptionId=7a89e4036eb, topicName=社区)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Sat Jun 06 07:11:00 CST 2015, time=2015-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530431, encodeId=9fec153043156, content=<a href='/topic/show?id=8309e5153aa' target=_blank style='color:#2F92EE;'>#移动医疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75153, encryptionId=8309e5153aa, topicName=移动医疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fbd812108434, createdName=yahu, createdTime=Sat Jun 06 07:11:00 CST 2015, time=2015-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582916, encodeId=9bb4158291646, content=<a href='/topic/show?id=f6e1611840d' target=_blank style='color:#2F92EE;'>#机器#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61184, encryptionId=f6e1611840d, topicName=机器)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13dc16973127, createdName=ms6279672939590805, createdTime=Sat Jun 06 07:11:00 CST 2015, time=2015-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=26030, encodeId=63b5260303d, content=人和机器的结合,移动远程医疗将会把医疗资源有效利用, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e511627114, createdName=1dd7eb8am26(暂无匿称), createdTime=Fri Jun 05 08:05:00 CST 2015, time=2015-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=25985, encodeId=4936259857e, content=高大尚, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200609/ef6a57dbe7f1489dad7446b7c5217858/d5e4fe65996c4446a029b0f5d056abb1.jpg, createdBy=6b011518214, createdName=午夜星河, createdTime=Thu Jun 04 17:29:00 CST 2015, time=2015-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=25975, encodeId=c676259e517, content=这却是一个好的场景,社区医院水平不高正好能够应用, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Thu Jun 04 17:18:00 CST 2015, time=2015-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=25950, encodeId=6fef2595038, content=断电咋办, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f8011617873, createdName=bucm_ting, createdTime=Thu Jun 04 16:28:00 CST 2015, time=2015-06-04, status=1, ipAttribution=)]
    2015-06-04 bucm_ting

    断电咋办

    0

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