Trends in the development of medical testing 2017
With the progress of science and technology and the improvement of the level of people's health care undertakings, the health care system is also bound to be followed by continuous change and gradual improvement. Its development trend will be polarized: on the one hand, in order to reduce costs, improve efficiency and effectiveness, the promotion of new technologies, new equipment, but also in order to strengthen medical care, teaching and medical scientific research, and training of talents, will be further developed to the concentration of the moderate scale; on the other hand, with the aging of the population, in order to facilitate the masses, reduce the burden, strengthen the health care guidance and the prevention and treatment of multiple diseases, chronic diseases, a number of geriatric and Chronic disease patients need to be diverted to community health care. The prerequisite for the diversion of patients is a corresponding improvement in the level of medical care in the community, so that the basic needs of medical care can be met, and patients can be attracted by attentive service, a comfortable environment, easy access to medical care and reasonable prices. With the reform of the health care system and medical insurance system, the clinical laboratory discipline is also bound to change accordingly. The following is my knowledge of the development trend of medical testing for you to bring, welcome to read.
? First, the laboratory automation system and laboratory information system for further improvement, the vast majority of routine operations will be replaced by machines
? From receiving specimens to data analysis will be transitioned to the assembly line and realize the whole laboratory automation. Specialized tests will be transferred to central or reference laboratories. The traditional mode and structure of the clinical laboratory needs to be adjusted or reorganized, in addition to special microbiological testing of aseptic, isolation or biosafety laboratories, routine clinical testing will be entered into the assembly line operations to improve efficiency and reduce costs; closed operations will be replaced by open operations, and move towards internal unity and external cooperation. Laboratory standardized management, test results into the information network, the implementation of medical information resources **** enjoy, in order to reduce the patient's medical expenses. Decentralization, inefficiency, wastefulness will be centralized, high efficiency, saving mode replaced, rough operation will be transformed into intensive operation.
? Second, the implementation of round-the-clock services, with the minimum limited amount of medical resources invested to obtain the maximum health care benefits, in order to reduce the economic burden on patients and the country
? High-grade medical equipment for the whole community to **** enjoy, has been a global development trend. Due to the large number of small test instrument development, simple and rapid immediate test (point of care testing, POCT) will go to the community health care and into the family, the convenience of the patient's bedside, clinic, micro-laboratory testing or patient self-monitoring will be emphasized and popularized.
? Only resources ****share, technology ****share, information ****share and benefit ****share inter-hospital collaboration model is conducive to the convenience of patients, reduce the waste of medical resources, improve the overall level of medical care in the whole society, and reduce the gap between the advanced and the backward development of the imbalance. Experience has proved that only by first solving the reasonable distribution of benefits, and the need to make appropriate inclination and support to the community and township hospitals and clinics is it possible to solve the other several problems? *** enjoy? , give full play to the efficiency of high-grade equipment and carry out comprehensive inter-hospital collaboration, and guide the rational triage of patients. Otherwise, any medical consortium or collaborative group is unlikely to be consolidated in the long term. This is an economic principle that cannot be ignored under the conditions of a commodity economy, and it is also a health policy issue that should not be ignored by the government in order to ensure that everyone has access to basic healthcare services.
? Third, the development of computer networks will be more convenient to the clinic, the convenience of patients, more conducive to the use and exchange of information; the development of biochips, the decryption of gene maps and proteomics research, will certainly further change the face of clinical testing
? A large number of advanced, sophisticated, cutting-edge analytical instruments will be gradually equipped with modern medical laboratories, the classic serological and microbiological methods, will be more sensitive, accurate, simple, fast method and instrumental analysis replaced. Enzyme chemical analysis, enzyme immunochemical technology, fluorescence polarization technology, chemiluminescence technology, time-resolved immunofluorescence technology and electrochemical technology will be further developed and popularized. Cell morphology and cytopathology tests will be further combined with histochemistry, immunochemistry and other physical chemistry methods to reach the level of ultrastructural and molecular tests. The development of medical bioengineering and molecular biology technology, the improvement of nucleic acid molecular hybridization, PCR, DNA sequencing technology and the analysis and development of gene mapping and proteomics, DNA microarray and protein fingerprinting and other new technologies will make the etiology and pathogenesis of many diseases further elucidated at the molecular level. Patients only need to provide a small number of specimens to obtain more test information, it can reveal the disease . . etiology, pathogenesis, pathology, pathophysiology, and even a complete picture of the disease including genetics. The development of certain bedside tests and monitoring, non-invasive sensors will reduce much of the medical suffering of patients.
? Fourth, monitoring emerging infectious diseases will be an important task for microbiologists
? Genetic stability and variability are universal laws of biology. Facts have proved that some infectious diseases are eliminated, there will be new infectious diseases; due to genetic mutation, non-pathogenic bacteria may become pathogenic, non-toxic species may become toxic species; due to the abuse of antibiotics, may cause the condition of pathogenic bacteria rampage. As a result of certain uncontrolled human activities, for example, deforestation, uncontrolled clearing of land, construction of large reservoirs, etc., which destroys ecological barriers and forces wild animals to compete with humans for habitat, as well as human hunting of or close contact with wild animals, natural epidemic-origin diseases or certain pathogens with wild animals as their hosts are spreading and transferring to humans, and will ultimately threaten the health and lives of human beings. For example, known tick-borne Borrelia burgdorferi (Borrelia burgdorferi) infected Lyme disease, human immunodeficiency virus (HIV)-infected AIDS, Hantavirus (Hantavirus)-infected epidemic hemorrhagic fever (EHI), Ebola hemorrhagic fever (EHF) infected by Ebola virus, West Nile fever (WNF) infected by West Nile virus, hemorrhagic colitis (HC) infected by O157:H7 serotype hemorrhagic Escherichia coli (HHE), Legionnaires' disease (LD) infected by Legionella pneumophila, and severe acute respiratory syndrome (SARS) associated with human coronavirus (HCV). respiratory syndrome (SARS) associated with human coronavirus, and the threat of human avian influenza. The testing and monitoring of all this will be a key element or important aspect of preventive medicine, disease control and laboratory medicine.
? Material movement is eternal, human understanding is also endless. The progress of basic medicine and the increase in the means of examination and testing will inevitably further promote the development of clinical medicine. However, no matter how the technology develops, how the instrument progresses, the computer ultimately can not completely replace the human creative spirit, electronic instruments can not completely replace the human experience. The basic skills of the examiners under the microscope, clinicians and the basic skills of diagnosis and look, touch, knock, listen, still need to be strengthened and can not be weakened, not to mention discarded. Advances in laboratory medicine, the development of medical imaging, to recognize the disease provides more means; however, the invention of the machine is only to improve the efficiency and effectiveness of medical thinking and medical decision-making based on evidence-based medicine, laboratory standardized management and quality assurance, diagnostic and therapeutic means of reasonable choice, scientific combination and application, to avoid the abuse of medical means and over-consumption of medical resources, etc., is dependent on the use of The knowledge, morality and wisdom of the people who use the instruments and the managers. Quality, efficiency and effectiveness of the continuous improvement of human scientific knowledge, creative spirit, conscious behavior and management. Bridging the gap between testing and clinical needs to rely on the knowledge and experience of both laboratory medicine and clinical medicine, but also need to have a high degree of empathy for the patient, the spirit of extreme responsibility for the work and good professional ethics. Clinicians and examiners are faced with individual differences in patients and changing conditions, only *** with responsibility, close cooperation, adhere to the patient-oriented, all in the interests of patients as a starting point, in order to be more conducive to the diagnosis and treatment of diseases, in order to be more in line with the purposes and principles of medicine. Concerned about and solve these problems, not only is the responsibility of clinical laboratory workers, but also in the health administrators and medical educators in front of an important topic.
?The 21st century will be the era of rapid development of science and technology, especially biological science. As the mystery of life is constantly being revealed, there will be more new technologies used in clinical medicine and laboratory medicine, if the 20th century hospital laboratories for doctors and patients to provide up to tens of thousands of items of the test, then the 21st century is likely to provide more new test items, will effectively help mankind's fight against disease. But just as the development of medicine has positive effects and brings hope for a long and healthy life for mankind, it also has some negative effects problems and brings a series of social problems. In fact, since the end of the 20th century, the development of medicine has brought a heavy economic burden to society. The American Association of Clinical Chemistry (AACC) predicted that under this policy, there are six areas of change that are likely to occur.
? (1) The emergence of intensification of hospital laboratories: the concentration of less intense and infrequent experimental projects in a number of large laboratories, and the possibility of further formation of networks and groups of large laboratories.
? (2) Vigorous staff reductions: the expensive part of healthcare costs in developed countries is staff costs.
? (3) External pressures: there will be greater pressure from both governments and patients that the medical profession can provide more efficient but cheaper services.
? (4) Reduction of unnecessary tests: Screening of current programs to remove unnecessary, duplicative or of little value. For example, the U.S. CPT Code includes a number of clinically useful items in a timely manner, which is often used by Medicare as a basis for payment. In addition, through the FDA's strict review of the new items and new technologies, some of the new items, new technologies, but unreliable, or clinical value is not great, it is not allowed to market flow, or only let the scientific research, can not be charged to patients.
? (5) conduct full laboratory automation: this is the most effective way to reduce labor and improve efficiency. The staff of such laboratories require a comprehensive test technology operations, instrument repair and maintenance capabilities, as well as a new type of technicians with certain management and computer skills.
? (6) to further strengthen the standardization of work: more standard documents will be developed, the technical operation of the norms so that the test department can make more consistent test results.
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