"hù lián wǎng +hù lǐ fú wù" shì diǎn gōng zuò fāng àn
2 Basic Information"Internet + Nursing Service" Pilot Work Program was developed by the General Office of the National Health and Health Commission (NHHC) on January 22, 2019, "The General Office of the National Health and Health Commission on Carrying Out Notice on the Pilot Work of "Internet + Nursing Service" (NHHOC Medical Letter [2019] No. 80) was released.
3 Release noticeNotice of the General Office of the National Health and Health Commission on the pilot work of "Internet + Nursing Service"
(State Health Office Medical Letter [2019] No. 80)
Provinces, autonomous regions, municipalities directly under the Central Government and the Xinjiang Production and Construction Corps of the Health and Health Commission (Health Planning and Sanitation Commission):< /p>
In order to implement the "Opinions of the General Office of the State Council on Promoting the Development of "Internet + Healthcare"" (Guo Ban Fa [2018] No. 26), and to implement the "Guiding Opinions on Promoting the Reform and Development of Nursing Services" of the 11 departments of the Commission and other departments, and to standardize the " Internet + nursing services", to protect medical quality and safety, and help implement the strategy of Healthy China, after research, the Commission determined that Beijing, Tianjin, Shanghai, Jiangsu, Zhejiang, Guangdong Province as "Internet + nursing services" pilot provinces. Other provinces combined with the actual situation in the region to select pilot cities or regions to carry out pilot work. The pilot work program is issued to you, please combine the actual development of the implementation of the program.
Pilot provinces should submit the implementation plan before February 25, 2019. The relevant provinces should effectively strengthen the leadership, combined with the actual organization and implementation, in December 2019 before the end of the pilot work summary (including the implementation plan, the list of pilot medical institutions, the development and introduction of policy documents, etc.) submitted to the Medical Affairs Bureau of the Commission.
Contact: Nursing and Rehabilitation Division, Medical Affairs Bureau? Yang Filtration, Meng Li
Tel: 010-68791850, 68792208
Fax: 010-6879259
Email: HLKFC@nhfpc.gov.cn
The National Health and Wellness Commission General Office
January 22, 2019
4 Full text of the work programPilot work program of "Internet+Nursing Service"
"Internet+Nursing Service" mainly refers to the use of medical institutions to utilize nurses registered in the institutions The "Internet + Nursing Service" mainly refers to the nursing service provided by medical institutions to discharged patients or special groups of people suffering from diseases with limited mobility by relying on information technology such as the Internet and the mode of "online application and offline service". In order to standardize and guide the healthy development of "Internet+Nursing Service" and further guarantee the quality and safety of medical care, according to the Regulations on the Administration of Medical Institutions, the Regulations on Nurses and other laws and regulations, and the Opinions of the General Office of the State Council on Promoting the Development of "Internet+Medicine and Healthcare Internet Diagnosis and Treatment Management Measures (for trial implementation)" and "Internet Hospital Management Measures (for trial implementation)" and other documents, the development of this pilot program.
4.1 I. General requirements(a) Guiding ideology. With *** the new era of socialism with Chinese characteristics as a guide, the full implementation of the 19th CPC National Congress and the National Health and Health Assembly, in accordance with the overall requirements of the implementation of the health of China strategy, "people's health" as the center, focusing on the main contradictions in the field of nursing and key issues, highlighting the shortcomings of filling boards, strengthening the weaknesses of the innovative care model, expanding services, improve service efficiency, standardize service delivery, and improve service delivery, and improve service delivery.
(ii) Work objectives. After about a year of piloting, in the context of the "Internet + health care", to explore the "Internet + nursing services" management system, service model, service norms and operational mechanisms suitable for China's national conditions. Give full play to the driving demonstration role of pilot areas, form replicable and beneficial experience, take the lead and gradually promote it, and standardize and guide the healthy development of "Internet+Nursing Service". The supply of nursing services will be further expanded, and the people's sense of access will be significantly enhanced.
4.2 Second, the basic principles(a) carried out in accordance with the law, standardized services. "Internet + nursing services" to the relevant laws and regulations based on the requirements, adhere to the "online and offline, the same quality management" principle, to ensure that the relevant services standardized to protect the quality of medical safety and the legitimate rights and interests of patients and nurses.
(2) People-oriented, to meet the needs. Give full consideration to the health characteristics of different groups of people and the urgent need for nursing services, "people's health" as the center, the integrated development of institutional nursing, community nursing and home care services, increase the supply of nursing services, and constantly meet the people's diversified, multi-level health needs.
(C) encourage innovation, tolerance and prudence. Innovative care service model, explore the cultivation of new forms of care services. Encourage the active participation of social forces, follow the laws of the market, stimulate market vitality. The implementation of an inclusive and prudent regulatory approach to ensure quality and safety.
(D) according to local conditions, step by step. Encourage local active exploration, combined with local practice and care work characteristics of the law, scientific and steady, step by step to carry out the pilot work. Summarize in a timely manner, constantly adjust, and effectively safeguard the rights and interests of the public health.
4.3 Third, the pilot content(a) clear "Internet + nursing services" to provide the main body. Pilot area health administrative departments can determine the actual obtaining of "medical institutions practice license" and has a home bed, rounds and other service mode entity medical institutions (hereinafter referred to as "pilot medical institutions"), relying on the Internet information technology platform, sent the agency registered nurses to provide "Internet + nursing services", the "Internet + nursing services", the "Internet + nursing services", the "Internet + nursing services", the "Internet + nursing services", the "Internet + nursing services". Internet+Nursing Service", extending nursing services from the organization to the community and family. The registered nurses dispatched should have at least five years of clinical nursing experience and the technical title of nurse or above, and be able to query in the national nurse electronic registration system. Pilot medical institutions in a position to do so are encouraged to strengthen the management of nurses through facial recognition and other human characteristic recognition technologies, and to equip them with nursing recorders. For the violation of relevant laws and regulations, adverse practice behavior record of nurses should be established exit mechanism.
(2) clear "Internet + nursing service" service object. Focusing on the elderly or disabled elderly, rehabilitation patients and terminal patients and other people with limited mobility, to provide chronic disease management, rehabilitation care, specialized care, health education, hospice care and other aspects of nursing services. Pilot area health administrative departments can combine the actual and population health characteristics, in accordance with the focus on the population, to ensure quality and safety, prevention and control of practice risk principle, to determine the "Internet + nursing services" pilot work of the specific service recipients.
(C) clear "Internet + nursing services" program. Pilot areas should be combined with the actual, in the investigation and study of the public service needs, fully assess the environmental factors and practice risk based on the organization of the development of the region's "Internet + nursing services" project. In principle, the service program to demand, low medical risk, easy to operate and implement the technology is appropriate, you can use the "positive list" and "negative list" combination of ways to be clear, and effectively protect the quality and safety of medical care.
(D) standardize the "Internet + nursing services" behavior. Pilot medical institutions in the provision of "Internet + nursing services" before the applicant for the first diagnosis, the disease condition, health needs and other circumstances to assess. If the applicant is assessed to be able to provide "Internet+Nursing Service", nurses with appropriate qualifications and technical skills can be dispatched to provide relevant services. Nurses shall strictly abide by relevant laws and regulations, professional ethics and technical operation standards in the course of practice, standardize service behaviors, and effectively safeguard medical quality and safety. The data generated during the service process should be fully traceable, searchable and traceable to meet the needs of the industry's regulatory needs.
(E) Improve the "Internet + nursing service" management system and service norms. Pilot area health administrative departments and pilot medical institutions should be in accordance with the relevant national management regulations and technical specifications, combined with the actual establishment of the perfect "Internet + nursing services" related management system and service norms, such as nursing management system, medical quality and safety management system, medical risk prevention system, medical documents writing management regulations, Privacy protection and information security management system, medical waste disposal process, home care service process, dispute complaint handling procedures, adverse events prevention and disposal process, related service specifications and technical guidelines.
(F) Strengthen the management of the Internet information technology platform. Pilot medical institutions can independently develop Internet information technology platform or with qualified third-party information technology platform to establish cooperation mechanisms. The Internet information technology platform should have the equipment and facilities, information technology, technical personnel, information security system to carry out the "Internet + nursing service" requirements. The basic functions at least include service object authentication, medical record data collection and storage, service personnel positioning and tracking, personal privacy and information security protection, service behavior throughout the trace traceability, workload statistical analysis. The company is not allowed to buy, sell, or disclose personal information.
(VII) clear "Internet + nursing services" related responsibilities. Pilot medical institutions and third-party Internet information technology platforms should sign a cooperation agreement, in the cooperation agreement, should be clear in their respective responsibilities and rights in medical services, information security, privacy protection, patient safety, dispute resolution. Pilot medical institutions to implement the "Internet + nursing services", should sign an agreement with the service users, and in the agreement to inform the patient of the service content, process, the responsibility and rights of both parties, as well as possible risks, etc., signed an informed consent.
(H) actively prevent and control and respond to the "Internet + nursing services" risk. Pilot regions and pilot medical institutions should summarize the experience and practices of some localities in exploring and carrying out "Internet+Nursing Service", and draw on the risk prevention and safety management measures of the Internet+ other industries. Service recipients can be required to upload identity information, medical records, family contracting agreements and other information for verification; the qualifications of nurses providing "Internet+Nursing Service", the scope of services and project content requirements; Internet information technology platforms can purchase/***enjoy the public security system's personal identity information or verify the information through face recognition and other human body feature identification technologies for comparison. feature recognition technology for comparison and verification; pilot medical institutions or Internet information technology platforms should, in accordance with the agreement, provide nurses with cell phone APP positioning tracking system, configure nursing work recorder, make service behavior traceable, equipped with one-key alarm device, purchase liability insurance, medical accident insurance and personal accident insurance, etc., to effectively guarantee the safety of nurses' practice and personal safety, and to effectively guard against and cope with the Risks. It is necessary to establish a mechanism for preventing medical disputes and risks, and formulate an emergency disposal plan. At the same time, open up the complaint and comment channels, accept social supervision, and safeguard the rights and interests of the public health.
(IX) to establish the "Internet + nursing services" price and payment mechanism. Pilot areas should be combined with the actual supply needs, play the market bargaining mechanism, with reference to the local medical service prices and charges, taking into account the cost of transportation, information technology costs, the technical value of the nurse's labor and labor compensation and other factors, to explore the establishment of prices and related payment guarantee mechanism.
4.4 IV. Pilot areas and pilot time(a) Pilot areas. I identified Beijing, Tianjin, Shanghai, Jiangsu, Zhejiang, Guangdong Province as the "Internet + nursing services" pilot provinces. Other provinces combined with the actual situation to select pilot cities or regions to carry out pilot work.
(ii) Pilot time. 2019 February-December.
4.5 V. Requirements(a) Raise awareness and strengthen leadership. Pilot areas and pilot medical institutions should fully understand the importance of standardizing the "Internet + nursing services" to accurately docking the people's diversified, multi-level health needs as a starting point to safeguard the public's health rights and interests and protect medical safety as a starting point to strengthen the organization and leadership, coordination and promotion. The administrative departments of health care in the pilot areas should actively coordinate with the relevant local departments to formulate and improve relevant policies and promote the pilot work. Pilot medical institutions should be clearly responsible for departments and personnel, improve the relevant management system, service norms and emergency response plan, to ensure that the pilot work is carried out in an effective and orderly manner.
(b) Pilot first, summarize the experience. Pilot areas of health care administration in conjunction with the relevant departments to combine the actual, develop a pilot work program and organize the implementation. The main focus of the "Internet + nursing service" management system, service model, service standards, risk prevention and control, as well as price and payment policies and other aspects of active exploration, pilot first, summarize and promote the beneficial experience. Timely grasp of the work progress of the pilot medical institutions, to ensure that the pilot tasks are completed on time and in good quality. The difficulties and problems that arose in the course of the pilot program were identified and actively studied and resolved.
(C) Strengthening supervision and risk prevention. Pilot area health administrative departments should work with the relevant departments to strengthen the "Internet + nursing services" supervision and guidance. The health administrative department should publish a list of pilot medical institutions to carry out "Internet + nursing services", publish supervision telephone or other supervision methods, timely acceptance and disposal of reports. Give full play to the role of social organizations to strengthen the "Internet + nursing services" industry supervision and self-regulation. Pilot medical institutions should establish and improve the relevant management system, and strengthen the practice safety education and business knowledge and skills training for nurses. In accordance with the principle of localized management, local health administrative departments will take the initiative to pay close attention to the development of the new industry of "Internet + nursing service" within their jurisdiction, take effective measures to actively prevent and respond to possible risks, and guide the "Internet + nursing service" to be carried out in a standardized manner. The company's website has been updated with the latest information on the development of the Internet.
(D) Increase publicity, correct guidance. Pilot area health administrative departments and pilot medical institutions to strengthen publicity and training, positive guidance of public opinion. The use of the Internet, newspapers, television, radio and other new media and traditional media, widely publicized in accordance with the law to carry out "Internet + nursing service", further safeguard the public health rights and interests and protect the importance of medical safety, reasonable guidance of social expectations. It has strengthened publicity and education, guided the correct concept of medical care, and prevented medical safety risks. At the same time, strengthen the training and education of medical institutions and the majority of nurses, to improve the "Internet + nursing services" new business and service model awareness, strengthen the awareness of practice safety, and constantly standardize the service behavior, to provide high-quality nursing services for the masses.
5 Policy InterpretationPolicy Interpretation on the Pilot Work of "Internet + Nursing Service"
5.1 I. BackgroundAccording to the National Bureau of Statistics, as of the end of 2017, China's population aged 60 years old and above was 240 million, accounting for 17.3% of the total population. There are 150 million elderly people with chronic diseases in China, accounting for 65% of the total number of elderly people, and about 40 million disabled and semi-disabled elderly people. The increase in the number of disabled, elderly and empty-nested elderly has led to a surge in demand for in-home care services from many elderly people who are surviving with illnesses. In recent years, the CPC Central Committee and the State Council have issued documents such as the "Healthy China 2030" Planning Outline, Several Opinions on Promoting the Development of the Health Service Industry, and Several Opinions on Accelerating the Development of the Elderly Care Service Industry, making it clear that it is necessary to actively develop the care service industry and accelerate the promotion of healthy aging.In April 2018, the The General Office of the State Council issued the Opinions on Promoting the Development of "Internet+Medical Health", making it clear that it is necessary to improve the service system of "Internet+Medical Health" to satisfy the growing demand for medical and healthcare services from the public, and at the same time, strengthen the supervision of the industry and safety guarantee. In June 2018, the Commission issued the Guiding Opinions on Promoting the Reform and Development of the Nursing Service Industry jointly with 11 departments, including the Development and Reform Commission, Ministry of Education, Ministry of Civil Affairs, and Ministry of Finance, to increase the supply of nursing services and promote the rapid development of the nursing service industry, and in July 2018, it issued the Measures for the Administration of Internet Diagnostic and Treatment (for Trial Implementation) and other documents, to further standardize the behavior of Internet diagnostic and treatment and to ensure the quality and safety of medical care. quality and medical safety.
With the deep integration of Internet information technology and health care work, the recent emergence of some areas of ? In fact, the essence of the Internet + nursing services, that is, relying on the Internet and other information technology, through the "online application, offline service" way, by the nurse door to provide nursing services for the masses.
In order to further implement the "General Office of the State Council on the promotion of" Internet + health "development of the views", in accordance with the "encourage innovation, tolerance and prudence" principle, to encourage the development of new forms of business, accurate docking of the masses of diversified health needs. At the same time, it will guide the development of "Internet+Health". At the same time, we will guide the standardized development of "Internet+Nursing Service", continuously improve relevant policies and measures, effectively safeguard people's health rights and interests and life safety, and ensure medical quality and safety. The Commission will carry out the pilot work of "Internet + nursing services", and on the basis of summarizing the pilot experience, accelerate the improvement of relevant policies, and gradually meet the diversified and multi-level health needs of the masses.
5.2 The process of formulationConducted a thematic study on "Internet+Nursing Service", and went to some provinces to carry out thematic research, sort out local practices and summarize local experiences. The seminars were held several times to listen to the opinions and suggestions of local health administrative departments, research institutes, industry associations, hospital management, nursing management, and Internet medical enterprises. Relevant issues were fully discussed and demonstrated, and opinions were sought on the pilot work program and revised and improved. On this basis, the study formulated the "Internet + Nursing Services Pilot Work Program".
5.3 Third, the main idea and content(a) The main idea. To "people's health" as the center, "problems and needs" as the guide, adhere to the encouragement of innovation and standardization and guidance, innovative nursing service model, increase the supply of nursing services, accurate docking of the masses of diversified health needs. At the same time, to guide the standardized development, to protect the quality and safety of medical care.