In the north bank of Luoshui, in Dangjia Village, Dongming Town, 5 kilometers away from Lushi County in western Henan, the village clinic has a "new partner".
"One-click call, the rural doctor will be around", "No errands, no registration, you can find a big expert in Beijing to see a doctor" "Don't talk about it, let's take a look"......
On the morning of June 29, as soon as the reporter entered the village, he heard several villagers discussing. Following the guidance, the reporter came to the Dangjia Village Clinic.
In a small consultation room, there are several villagers waiting in line. At this time, Liu Haihong, a rural doctor, is connecting with experts in Beijing through a portable medical device to communicate with the patient's condition. The reporter was curious, could this be the "new partner"?
A magical "treasure chest"
"Professor Ma, in the past two days, the patient has experienced symptoms of chest tightness and fatigue after slight activity, and the medical records have been uploaded, please give guidance on the next treatment plan."
"This patient intervened relatively early, and the stent was placed two years ago, and the current blood pressure and blood lipids are also well controlled. All things considered, I recommend that the cardiac enzymes be checked again to see if there is any new myocardial bleeding, and if necessary, a contrast examination. Just because a stent is placed in one blood vessel does not mean that there will be no problems with other blood vessels......"
After listening to Ma Shuhai, an expert from Beijing Aerospace General Hospital, Liu Haihong felt much more at ease.
Liu Haihong said that it turned out that rural doctors did not dare to accept patients with serious heart disease like this, but they did not expect that this "treasure chest" like a general practitioner assistant package would solve this big problem. With it, it is equivalent to sending "the testing equipment of the second-class hospital" and the "doctor of the third-class hospital" to the doorstep of the people.
Weighing about 15 kilograms and the size of a student's school bag, there is a "general practitioner workstation" that can provide remote consultation, as well as more than 10 pieces (sets) of instruments and equipment for testing and testing.
In Lushi County, there are 80 rural doctors and 20 general practitioners from township health centers, just like Liu Haihong, who have general practitioner assistance kits. Since the end of March this year, they have carried the general practitioner's assistant bag to the village to visit the village, provide door-to-door service, carry out blood pressure, blood lipids, body temperature, blood glucose, blood oxygen, uric acid, electrocardiogram, B ultrasound and other examinations, and provide initial diagnosis and health guidance to patients.
Zhou, a Hubei patient working in Lushi County, suddenly fainted, and the electrocardiogram results showed "sinus bradycardia, acute inferior myocardial infarction, atrial premature contractions, and T-wave changes"; Yin, a patient from Zhao Village, Hengjian Township, Lushi County, was diagnosed with "myocardial ischemia" by electrocardiogram examination...... This was discovered by the rural doctor in time through the general practitioner's assistant kit when they came to the door. Subsequently, with the help of the information platform and the green channel, the patient turned from critical to safe.
Implement "one-click call"
"We are now located in the county health 180 project command center located in Lushi County People's Hospital, the big screen displays the health 180 operation supervision data, and on the left side of the screen is the number of rural doctors online on the day......" On the morning of June 29, Lushi County, Henan Province held the launching ceremony of the "walking hospital" health 180 project, and the narrator explained the operation of the project.
The "Walking Hospital" Health 180 Project, initiated by the Revitalization and Development Working Committee of the China Council for the Promotion of International Investment and the Central and Western Revitalization and Development Office of the China Primary Health Care Foundation, mainly allocates general practitioner assistance packages for grassroots doctors, and relies on "Internet + remote diagnosis and treatment" to open up the "last mile" of national health. The project settled in Lushi County, and sent 100 medical assistance kits, 100 health patrol vehicles, 100 sets of work clothes and heart failure diagnosis and treatment equipment and other medical supplies with a total value of 20.1 million yuan. In addition, the China Primary Health Care Foundation also provides 100 "top three" hospital experts every day for the people in Lushi County from Monday to Friday.
So far, 100 grassroots doctors in Lushi County who carry general practitioner assistance bags can deliver high-quality medical resources to the masses immediately and nearby through the dispatch of the county health 180 project command center when the masses are in need.
Subsequently, the staff of the command center demonstrated the operation of WeChat "one-click call" for reporters: first, open the WeChat public account of "Walking Hospital Health 180" on the mobile phone, and then carry out "one-click call".
When receiving a "one-click call" from the masses, the Health 180 Operation Supervision Data Platform will receive the order...... When the order is completed, the primary doctor will generate a health examination report for the patient through the "general practitioner workstation", which can be printed out on the spot and handed to the patient. If there is a critically ill patient who needs emergency medical assistance, the grassroots doctor will also inform the patient as soon as possible and call the 120 emergency number.
In order to ensure the smooth implementation and smooth operation of the project, Lushi County People's Hospital and Sinopharm China Financial Leasing Co., Ltd. raised 15 million yuan to build a health 180 information platform; Lushi County also took out more than 150 yuan of financial funds to build a command center for the Health 180 Project and a remote consultation, ECG and imaging center; The 180 project command center telephone line was opened.
Based on the situation of each township, the layout of cultural tourism and medical care, the location of village clinics, the distribution of population, the skill level and age of rural doctors, 80 rural doctors, 20 general practitioners from 20 township health centers, 27 ECG and ultrasound experts from two general hospitals of the medical community, and more than 30 outpatient departments were carefully selected from the 300 village clinics in the county, so as to build a "walking hospital" health service network and county in Lushi County, which integrates "center, rural doctors, medical assistants, Internet, experts, and special operation classes". , township and village three-level medical service system.
Since the trial operation of the project in March 2024, as of June 10, a total of 15,194 patients have been served, 40,296 health monitoring services have been implemented, and 3,205 remote ECG consultations have been implemented.
Explore the integration of medical and prevention
"Doctor Xue, I feel chest tightness and palpitation at this time...... Recently, Mr. Yang, a villager from Minwan Village, Duguan Town, Lushi County, called the village doctor Xue Jianchao.
"Okay, I'll be right here." After understanding the situation, Xue Jianchao set off with a general practitioner's assistant bag on his back. When he arrived at Mr. Yang's home, Xue Jianchao found that he was flustered, chest tightness and sweating, so he quickly performed an electrocardiogram examination on him. Based on his experience, he initially diagnosed the patient as myocardial infarction, and the situation was very urgent, so he immediately contacted the Duguan Town Health Center, and at the same time transmitted the ECG examination results to the General Hospital of the Health Community - Lushi County Hospital of Traditional Chinese Medicine through the Health 180 information platform. Under the remote guidance of the main hospital, the Duguan Town Health Center, which received the treatment, quickly launched first aid. After 40 minutes, the patient was transferred to the main hospital and directly entered the green channel, where he immediately underwent coronary intervention. After 20 minutes, blood flow to the occluded vessel was restored, and the patient was relieving.
As a rural doctor, Xue Jianchao not only diagnoses and treats diseases for the villagers, but also is responsible for the health file management of 1,515 people in the village, including 116 patients with hypertension, 38 patients with diabetes, 37 patients with coronary heart disease, 5 pregnant women, and 65 children, as well as 12 major and 39 small public health services such as health education and publicity.
How to combine the project with the construction of a close-knit county-level medical community? How to use the Health 180 information platform to integrate the forces of county, township and village?
After the implementation of the Health 180 project, Lushi County has carried out active exploration, starting from the front end of rural doctors' homes, and "carrying" high-quality medical services such as daily diagnosis and treatment, family doctor contract services, health intervention, and chronic disease management to people's homes. Within the scope of the medical community, the business barriers between medical institutions and basic public health services have been broken down, and three service models of "basic medical care", "basic public health" and "personalized service package for family doctors" have been launched, and a new model of medical and prevention coordination and integration and interconnection at the county, township and village levels has been built. In the diagnosis stage, a model of normalized diagnosis and treatment services is established by the member units of the medical community or the "top three" hospitals in Beijing and other places relying on the Health 180 project.
In addition, the Lushi County Health Commission has held many project operation symposiums and issued the "Lushi County "Walking Hospital" Health 180 Project Service Management (Provisional) Measures", which clearly stipulates the incentive mechanism, raises 792,500 yuan, and according to the effective workload, in accordance with the standard of "ECG detection 2 yuan/case, B ultrasound 3 yuan/case, urinalysis 1 yuan/case, total cholesterol analysis 1 yuan/case, blood sugar test 1 yuan/case", to subsidize rural doctors and stimulate the enthusiasm of grassroots doctors. Ensure efficient project operations.
Duan Huaicheng, Secretary of the Party Group and Director of the Lushi County Health Commission, said that in the next step, the County Health Commission will pay close attention to the operation of the project, strengthen business guidance, actively solve problems in operation, and establish and improve relevant working mechanisms; Strengthen the data analysis of the health 180 information platform, do a good job in health screening, strengthen the connection with public health work, and do a good job in the integrated management of chronic diseases and the integration of medical treatment and prevention; Further improve the training, assessment and incentive mechanisms, improve the service ability of grassroots doctors, improve the enthusiasm of grassroots doctors, promote the effective connection of various work links, and ensure the smooth operation of the project. (Reporter Zhu Xiaojuan)