"At present, the average daily number of prescriptions in our hospital is about 2,000, including about 300 extension prescriptions and 200 emergency prescriptions. About 1/7 of the prescriptions have entered the pharmacy through the prescription sharing platform, and the prescription drug collection rate has reached more than 90%. "Huang Yunqi, director of Wuzhou Red Cross Hospital, told Arterial Network.
At 1:50 p.m. on November 15th, the reporter came to the outpatient building of the Red Cross Hospital in Wuzhou City, 10 minutes before the working hours of the medical staff in the afternoon.
In the outpatient hall, there was no noise and noise, and the patients consciously sat in the hospital's waiting chairs and waited quietly.
At 2 p.m., the nurse showed up at the triage table on time. With their ID cards, the patients spontaneously lined up in a neat line and began to register their real names for medical treatment.
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Founded in 1911, Wuzhou Red Cross Hospital has gone through a hundred years of glory. It is one of the earliest Red Cross hospitals in China.
The annual diagnosis and treatment volume of the hospital is about 700,000 people (the population of Wuzhou is 3.475 million, according to the data of Wuzhou Bureau of Statistics in 2016). Covering southeastern Guangxi and western Guangdong.
Not only that, Wuzhou Red Cross Hospital is also the first pilot unit of prescription information sharing platform in the country.
Wuzhou Model - Prescription Sharing Platform
On May 23, 2017, Guangxi Wuzhou Red Cross Hospital launched the country's first prescription information sharing platform, and implemented the "Wuzhou Model" to implement a branch of medicine. It has achieved remarkable results in the few months of operation and has been recognized by all sectors of society. On November 15, Guangxi Wuzhou Municipal Health and Family Planning Commission and Baiyang Intelligent Technology Easy Review Terminal launched the construction of the city's prescription information sharing system. More than 20 second-level and above hospitals and more than 100 pharmacies in the city will jointly access prescriptions Information sharing platform.
Qingdao Easy-Rediagnosis Network Technology Co., Ltd. is a holding subsidiary of Baheal Intelligent Technology focusing on medical information technology. Management tools, comprehensively improve the doctor-patient relationship and post-diagnosis disease management level, and at the same time comply with the policy direction of medical reform, provide a professional prescription information sharing platform for hospitals.
The prescription sharing platform is very different from the " Internet hospital". It is an information platform jointly built by the hospital, government health and family planning commission, drug administration, social security and other departments, as well as social pharmacies, with patients as the core. The platform can realize the interconnection and real-time sharing of prescription information of medical institutions, medical insurance settlement information and drug retail sales information.
In addition, the platform can be directly connected to the hospital HIS system. During the face-to-face consultation between the doctor and the patient, the doctor prescribes the prescription according to the patient's condition, and the patient chooses to pick up the medicine in or out of the hospital. Moreover, if the pharmacy does not have a real-time inventory that meets the entire prescription, the system cannot issue a shared prescription, which ensures that the patient can definitely get the medicine when they go to the pharmacy.
Every shared prescription issued by a doctor needs to be reviewed by the hospital's rational drug use system and pharmacy department before entering the platform. For example, according to the national prescription management method, a prescription cannot exceed five varieties of drugs. Once a doctor prescribes six varieties of drugs, the system will pop up a prompt that the doctor is not allowed to prescribe any more drugs.
After the approval, the platform will immediately push the prescription information to the patients in the form of text messages, so that the patients can choose to purchase medicines offline at any platform pharmacy completely independently. It also recommends cooperative pharmacies for patients, as well as map navigation to the pharmacy, so that patients can choose the nearest pharmacy by themselves. The inventory management of the pharmacy will determine the name of the pharmacy in the SMS.
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In addition, the patient's medical insurance card can also be used in the extension prescription. The picture below shows a patient getting medicine by swiping the medical insurance card.
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For the safety of patients, Wuzhou Red Cross Hospital will supervise the specifications, varieties and manufacturers of drugs in the prescription sharing platform pharmacy, which are consistent with the drugs in the hospital pharmacy. In addition, the pharmacist of the pharmacy will attach the method of taking the medicine when handing the medicine to the patient, so that the patient can experience the safety and peace of mind to the greatest extent.
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According to President Huang Yunqi, the current average daily number of prescriptions in Wuzhou Red Cross Hospital is about 2,000, including about 300 extension prescriptions and 200 emergency prescriptions. About 1/7 of the prescriptions have entered the pharmacy through the prescription sharing platform . The drug taking rate also reached more than 90%.
In addition, considering the real-time nature of emergency, hospitals generally do not issue extended prescriptions for emergency patients. In the future, President Huang hopes that 70% of the prescriptions can be extended to pharmacies, and only 30% of the prescriptions will be processed in the hospital.
In fact, pharmaceutical companies are more willing to sell their own medicines in pharmacies than in hospitals. The evaluation standards for tertiary hospitals strictly stipulate that the types of medicines and western medicines not exceed 1,200 types, and the types of traditional Chinese medicines shall not exceed 300 types.
And the hospital's drugs are one product and two specifications, and a drug can only have two specifications. Strict control has prevented many pharmaceutical companies' drugs from entering the hospital. However, when a pharmaceutical company goes to a pharmacy, although it needs to pass GSP certification, there are far more varieties than hospitals, ranging from 3,000 to 5,000. There is also greater choice for patients.
For patients, the main reason for reluctance to pick up medicines at the hospital pharmacy is the queue. The tertiary hospitals are overcrowded, and taking medicines often requires long queues of patients, which consumes a lot of precious time. Not only do retail pharmacies do not have to queue, but their prices are not higher than that of hospitals, and the service is better. Coupled with some preferential promotions, patients' willingness to choose out-of-hospital drug purchases has been greatly enhanced.
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Up to now, more than 20,000 shared prescriptions have been issued through the prescription information sharing platform, accounting for 11% of hospital outpatient prescriptions. Open more than 700 kinds of prescription drugs, the varieties and specifications are consistent with the hospital drugs, and the drug prices are consistent with the hospital.
As the platform builder, Yifuyin not only launched a prescription information sharing platform in Wuzhou, Guangxi, but also launched pilot projects in 6 cities in Guangdong, Harbin, Qingdao in Shandong and other places, covering a total of more than 40 hospitals in 7 cities.
Doctors are more motivated to prescribe extension than traditional prescription
Regarding the power of doctors, President Huang Yunqi said that with the deepening of medical reform, the hospital has gradually canceled the drug addition, and the proportion of drugs has gradually decreased. Since drugs cannot become a part of revenue, doctors also hope to reduce the proportion of drugs. Therefore, doctors are willing to let patients go to the pharmacy outside to get the medicine.
In addition, in the process of further communication between doctors and patients on drug purchase channels, it can promote the establishment of the doctor-patient relationship, so compared with traditional prescriptions, doctors are more motivated to issue extended prescriptions.
Separation of medicine, the general trend
Hospitals have long relied on the sale of their medicines for revenue. Under the medicine-supporting system, outpatients can only buy medicines at the hospital with prescriptions issued by doctors. 2017 is the first year for the separation of medicine and medicine. Several government documents require "explore the interconnection and real-time sharing of prescription information of medical institutions, medical insurance settlement information and drug retail consumption information."
In order to implement the "Implementation Opinions on Further Reforming and Improving the Policies for the Production, Circulation and Use of Drugs", more than 20 provinces and cities across the country have recently issued relevant policies to improve the quality and efficacy of drugs, and regulate the distribution and use of drugs. These local policies mention that medical institutions should Prescriptions are issued according to the generic names of drugs, and prescriptions are provided to patients on their own initiative. Patients can choose to purchase drugs in medical institutions or retail pharmacies.
From the encouragement of patients in 2014 to explore the new model of "patients purchase medicines from medical institutions or retail pharmacies with prescriptions", to the promotion of hospitals in 2015 by "prohibiting hospitals to limit the outflow of prescriptions", to the latest "medical reform" in 2017 It can be seen that the separation of medicine has become an irreversible trend in hospitals.
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It can also be seen from the progressive relationship of policies that the regulator hopes to achieve the purpose of separating medicines by implementing the outflow of prescriptions. The first is to mobilize the enthusiasm of patients, clear the obstacles to the separation of medicines, and allow patients to independently decide where to buy medicines. The second is to improve the patient's drug purchase experience in social pharmacies or other channels through medical insurance docking, prescription information interconnection, etc., forming a substantial "diversion" for hospital pharmacies.
As far as the prescription drug market is concerned, IMS data shows that in 2015, the size of China's prescription drug market was about 990 billion, accounting for about 70% of the total drug size.
As far as specific channels are concerned, since prescription drug sales must rely on the prescriptions and orders issued by doctors, compared with the overall drug market, the proportion of prescription drugs sold in hospitals is higher. In 2015, the three major channels of the prescription drug market (hospitals, retail pharmacies, and third terminals) accounted for 77%, 10%, and 13%, respectively.
According to the industry's estimate of the amount of prescriptions that can flow out of the hospital during the separation of medicines, the general judgment is that the outflow of prescriptions will account for about 1/5 of the total prescription volume in the next five years, and will show rapid growth.
Combined with the growth of the overall drug retail market, it is expected that by 2018, the outflow of prescriptions will bring an increase of more than 250 billion to retail pharmacies; Close to 800 billion.
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A reproducible Wuzhou model
Since the separation of medicines can form such a huge market space, how to replicate an excellent model has become the key to solving the problem. In this regard, Ma Guanglei, executive deputy general manager of Yifuxing, believes that because of the following three characteristics of the Wuzhou model, it has strong reproducibility:
The Wuzhou model has a complete policy basis;
The Wuzhou model is relatively complete in terms of information capability, service capability and supervision system, and is highly professional.
The Wuzhou model will bring drug rationality monitoring to hospitals, convenient and accessible ways for patients to purchase drugs, and a way for pharmacies to legally accept out-of-hospital prescriptions, improve the efficiency of prescription drug marketing, reduce transaction costs, and achieve a win-win situation for all parties. .
In terms of the standardization of pharmacies, in order to connect with the prescriptions of the hospital, each cooperative pharmacy will carry out standardized facade renovation. Ma Guanglei said that the hospital and Yihui Clinic jointly formulated access standards, and the pharmacy applied for admission voluntarily, and the hospital and Yihui Clinic jointly checked. If the verification fails, the pharmacy will not be able to enter the prescription sharing platform. Therefore, in terms of renovation costs, pharmacies will evaluate their own input and output.
"The standard we have set is almost 6 pages, including inventory, store image, clerk standards, etc. The renovation cost of different pharmacies is generally different, and the average renovation cost of a pharmacy is about 50,000 yuan. If it is to be fully achieved, the pharmacy must pay some Work hard." Ma Guanglei said.
Based on prescription sharing, the second phase of the project will be extended to hospital services
If you think that there is only a prescription sharing platform, then you underestimate this project.
According to Arterial.com, the overall project will be completed in two phases. The first phase of the project, which has been launched, mainly builds the medicine separate module of the prescription information sharing platform. By connecting with the hospital HIS system, the authenticity of the prescription source can be ensured. Provide prescription information to patients, connect the platform with the inventory and sales system of pharmacies to ensure convenient and accessible drug purchases, and provide multi-faceted services such as operation supervision and data management.
The second phase of the project under construction will focus on the construction of a medical insurance coordinated retail settlement platform and a drug centralized procurement platform.
These two platforms can realize a variety of ways for patients to collect medicines from online ordering stores and online ordering stores. Hospitals can build smart medical alliance service platforms and health service stations to pilot and extend hospital services, improve doctor brand building and post-diagnosis doctor-patient communication management, promote the sinking of medical resources, and comprehensively improve the medical experience of the masses.