Ultrasound down the countryside Zhejiang Breakthrough Sample

Economic Observation Network reporter Zhang Ying "In the past, emergency patients needed to be sent to county hospitals to get diagnosis. Now emergency patients such as abdominal pain and trauma can be diagnosed in the village for basic screening." On September 4th, Shanghai, Shanghai Peng Chengzhong, director of the ultrasound department of the Tenth People's Hospital, said at the second China Ultrasound Medical Development Conference held in Huzhou, Zhejiang.

He introduced the pilot project of the Ultrasonic Low of Taihun County, Wenzhou, which he led. The project formed a long -range ultrasonic consultation mechanism for doctors in the top three hospitals with the primary doctors.

Peng Chengzhong believes that ultrasound is the most likely to sink to the grass -roots inspection tools in medical imaging equipment. The price is relatively low, the equipment volume is small and easy to move, and there are fewer requirements for the use venue, especially the palm ultrasound can be carried with you.

In recent years, the palm of the grass -roots inspection has become a new direction for the ultrasound industry. At present, more than a dozen Chinese companies including Xiangsheng Medical (688358.SH), Sono Star, and Stocks have deployed in this field. In foreign countries, the products of GE Medical, Butterfly and other companies have also been approved by the US FDA.

However, some people in the industry believe that although the popularity of ultrasonic equipment is less difficult, the ultrasonic doctors and unprepared grass -roots application scenarios are all key factors to restrict ultrasound sinking. ", To promote high -quality medical resources, we need to continue to explore.

Pilot into the village

"The ultrasound equipment on the palm allows the villagers of the mountains to do the ultrasound at home. At the same time, the patients in the county and the experts of the Three Hospital" face -to -face '. "Wang Yang, a general doctor of Xixi Town, Xishun Town, Taishun County, participated in the national health Health Commission Capability Construction and Continuing Education Center "County Medical and Health Service Property Improvement Project" ultrasound direction pilot project.

Taishun County is the pilot county of the project. Taishun is located at the junction of the two provinces of Fujian, Zhejiang. It is nearly 400 kilometers from the provincial capital Hangzhou. The terrain is mainly mountainous areas. The traffic is inconvenient. It is the last county in the province. Peng Chengzhong believes that it is reasonable to conduct ultrasound strong grass -roots pilots in a county with a relatively lack of medical resources in Taishun.

Since its official pilot in March 2021, the project has been implemented in 13 rural health centers in Taishun County, providing more than 1,000 patients with palm ultrasound inspection services.

For example, Wang Yang said that in July this year, when she was under the village with an ultrasound on her palm, she met a male villager with a belly bulge. At first glance, she thought it was obesity, but the villager had a yellow skin. With tenderness, Wang Yang immediately contacted Peng Chengzhong, who was far away from Shanghai for online B -ultrasound examination. He finally diagnosed the "intrahepatic hybrid echo group block and suspected liver cancer." At the suggestion of Wang Yang, the patient went to the higher -level hospital for review, and was diagnosed with liver cancer a few days later.

Peng Chengzhong introduced that in the past, there were no ultrasound equipment at the village -level health center. The pilot projects expanded the scope of the popularity of ultrasound equipment, allowing grass -roots doctors to improve screening and diagnosis services for patients through ultrasonic scanning. In addition to emergency patients such as abdominal pain and trauma, the project also provides aspiration for patients with chronic diseases at home for a long time and dynamically observed their disease changes.

Difficulty in talent

Peng Chengzhong recalled that the most difficult problem at the beginning of the pilot was not the equipment, but the talent. "The general doctors at the grassroots level basically only use simple equipment such as auspiciousness, blood pressure gauge, and thermometer. Ultrasonic examination requires technical accumulation. If it is not used, it will be misdiagnosed and missed."

In order to allow grass -roots doctors to master the ultrasound technology, Peng Chengzhong sent experts at the Zhejiang Provincial People's Hospital at the time to conduct a week -long theoretical training to doctors, and asked him to follow the county hospital's ultrasound doctor for two weeks of practice training. The training content is based on more basic emergency ultrasound. For example, when encountering abdominal pain, grass -roots doctors need to master the skills of evaluating the diseases such as gallstones, kidney stones, pancreatitis, and ectopic pregnancy rupture.

In order to ensure the diagnostic effect, the ultrasound department of Zhejiang Provincial People's Hospital and 13 rural health hospitals in Taishun County have established a assistance mechanism. When the grass -roots doctors in Taishun County have ultrasound examination needs, the ultrasound doctor of Zhejiang Provincial People's Hospital conducts remote guidance. The information system transmits real -time transmission of ultrasound images and grass -roots doctors.

However, to push the pilot experience of Taishun County to the whole country, Peng Chengzhong believes that the doctor's training mechanism, the charging mechanism, and the related medical responsibility identification mechanism have a long way to go.

For example, on the charging mechanism, the ultrasound examination of the middle -village doctor and the consultation of superior experts are free, which is equivalent to volunteer services. Peng Chengzhong believes that if you can incorporate grass -roots ultrasound inspections in medical insurance or conduct certain financial subsidies in the future, it will be more conducive to project promotion.

In addition, the current remote ultrasound mode also needs to solve the legal effect of ultrasound reports.

Peng Chengzhong said that during the remote consultation, doctors of higher -level hospitals need to be responsible for the ultrasonic examination report issued, but the examination is operated by local grassroots doctors. The potential risk of diagnosis diagnosis is currently lacking clear specifications of how disputes define the responsibilities of both parties.

How to move towards homogenization of ultrasound

The lack of ultrasonic talents also confirm with the results of the ultrasound test.

Medical examination results are important means to avoid repeated examinations and reduce the burden on patients. Zhejiang is one of the provinces that take the lead in conducting medical examination results nationwide. One year ago, the Zhejiang Provincial Health and Health Commission, the Medical Insurance Bureau and the Finance Department jointly issued the "Implementation Opinions on Comprehensively Promoting Medical Image Inspection Data and Medical Inspection Results of Medical Institutions", and requiring urban medical consortia and county medical doctors All medical institutions in the community recognize 180 medical imaging materials and 93 medical test results. Hu Xiaojun, deputy director of the Huzhou City Health and Health Commission, introduced that after a year of practice, the medical federation and medical community in Huzhou have basically realized the mutual recognition of the project required by the documents.

However, as the most popular medical imaging inspection items for ultrasound, the most popular at the grassroots level have not been included in the mutual recognition directory of Zhejiang Province.

In this regard, Hu Xiaojun believes that there is a prerequisite for the realization of the inspection results. The inspection level of various medical institutions must be homogeneous so that each other can trust each other's inspection results. Ultrasound has already achieved full coverage at the community health service centers and township health centers in the Huzhou City, but it is easy to popularize equipment and difficulty in technology.

Lu Wenming, director of the Ultrasound Medical Division of the First People's Hospital of Huzhou City, further explained that there are very few full -time ultrasound doctors in communities and township hospitals. The technical professionalism is not high, and it is difficult to achieve mutual recognition of inspection results under the circumstances of technical level.

"Improvement of ultrasound technology is part of our entire strong grassroots system construction. Next, how to make ultrasound examinations achieve grass -roots examination and diagnosis of higher -level hospitals, and also need to explore." Hu Xiaojun said that at present, Huzhou City has been completed in infrastructure construction such as informatization transmission. It just needs to solve the technical problems of personnel.

In addition, with the pilot of the portable palm ultrasound in various places, Huzhou is also thinking about how to make the applied ultrasound in the future wider and more grounded. For example, Hu Xiaojun said that the current pregnancy management of pregnant women needs to go to the hospital for examination. If technology can make pregnant women's homes monitoring in the future, family doctors are responsible for follow -up, and at the same time, the enterprise is responsible for the leasing operation of the equipment. Serve.

- END -