Study On Application Management System Of New Clinical Techniques

As for the great contribution of science and technology in medicine and healthcare, the development of new clinical technology (NCT) has been served as an important measure to improve medical service and enhance core competitive strength for medical agencies, and as the main driving force for their development as well. To some extent, NCT has been considered as a key marker for the medical service standard and capability of medical agencies and their staff. Clinical application of NCT has embodied a positive forward momentum from its burgeoning as an exploration by individual doctors to the conscious conduct by medical institutions, and even up to the joint effort by health care practitioners. No matter what different motivations are, NCT, as a common social phenomenon, will inevitably lead to an objective need for standard management. On the one hand, NCT has brought prestige and financial benefits to medical institutions and medical staff; while on the other hand, as for the innovative and exploratory characteristics of NCT, it's necessary to explore a standard application management system of NCT, which will promote healthy development of NCT and safeguard patients'health.1. ObjectivesThis study aimed to explore a series of a more systematic, comprehensive and feasible institutional framework for the management of NCT by combination of theoretical research and administrative practice, including NCT evaluation indicator system and accessible NCT management system, which will improve medical quality, ensure medical safety, and promote progress in clinical medicine.2. Methods and contentsMethodsMany methods using to build NCT management system framework, new technical evaluation indicator system and institutional system of evaluation practices, includes literature review, brainstorming, Delphy method and practice verification.Literature review: to further clarify the concept of NCT and analyze the current situation and problems in national and international NCT management, so as to provide its theoretical basis.Brainstorming: to invite medical experts, management experts and health authorities to hold an open discussion on the status of NCT, including diagnostic evaluation of its management, feasibility studies on its management system framework, discussion on its evaluation system and management in process.Delphy method: to interview with experts face to face, to collect NCT management needs and to revise assessment system, so as to build a suitable regimen system for particular medical institution.Practical verification: to form a "Administrative Measures" on the basis of literature review, institutional research, and Delophy method, and then carry out NCT evaluation in 3 affiliated hospitals annually and improve NCT management institutional system and its evaluation measures according to the information collected during the practice.The main contents of this study include:(A) to make clear the concept of NCT, and make a systematic analysis of its main features from the view over management level;(B) to study on the standard, procedure and methods of the clinical access to NCT and discuss current problems;(C) to investigate the strategies and measures of NCT management (especially the process management);(D) to establish evaluation index system and evaluation organize system of NCT, to verify the system by management practice, and to establish a systematic evaluation organizing methods;(5) to seek multiple points of NCT security and its management, and then to explore appropriate incentive mechanism and regulatory measures;(F) to analyze various risks of NCT application and explore systematically its control and avoidance strategies.3. Main results(A) NCT has five main features:First,relatively advancement. NCT is more advanced than conventional diagnosis and treatment methods, but this innovation is relative in time, places and its application; Second,technological innovation. NCT must be innovative in different levels or methods, including original core technical innovation, and improvement, integration, transplantation and expansion of the scope of mature technics;Third,clinical practicality. NCT must be relatively mature, safe, and can be directly applied to clinics with a good prospect and developing space;Fourth,application accessibility. The financial and technical threshold for NCT shouldn't be too high to be obtained and accepted by patients;Fifth,ethically feasibility. NCT must meet the requirements of laws and regulations, be consistent with social morals and medical ethics.(B) Main contents and methods of NCT access managementAccess management includes 3 aspects, personnel, technology and institutions access. Different administration authorities have different key points in access management, which is different from classified management of macropolicy. From the practice point of view, NCT is classified as introduction of mature technology, integration of innovative techniques and original innovation. Hierarchical management should focus on different aspects of the three kinds of technology.(C) NCT process management is important in guarantee the innovation quality and medical safety.By analyzing input and output factors through NCT implementing process, effective controls aremade in the main input factors, such as people, technology, implementation project, supporting conditions, management systems and patients, which help to improve the quality of output, i.e. satisfactory clinical results, establishment of effective technical methods, improvement of social and economical benefits for medical institutions, and training of academic talents team. Keys to process management implementation include application evaluation, key technologies, program plans, supporting conditions, process quality, patients access, first case check, and stoppage mechanism.(D) Evaluation indicator system was constructed by integrating the nine dimensions quantitative standard and the three grades - five levels qualitative standard; Evaluation system was established by the combination of peers reviews and comprehensive appraisal. This evaluation system was proved to be effective in reflecting the innovative situation of the affiliated hospitals by three years of application practice and its results was used in the (E) Different encouragement methods were used in the phase of NCT implementation and generalization. In the stage of implementation, measures such as building the technological platform, policy priority and financial support were taken to ensure its smooth practice. In the stage of generalization, measures such as innovation incentives, performance appraisal and individual accounting were taken for encouragement. Meanwhile, measures like strict access ratification, process monitoring and tracking supervise were taken to ensure it bound by norms.(F) Since the main risks faced in carrying out NCT came from technical, procedural, ethical, legal and financial aspects, strategy and measures were discussed for risk control.4. Main conclusionsNCT' management includes access management, process management, assessment management, incentive and restraint mechanisms, risk management, etc. This study investigated the characteristics, management strategies and measures, evaluation indicator system and institutional system of NCT, which might be of a great theoretical value and practical guide to the micro-management of hospital NCT. Meanwhile, it might provide a reference for health authorities to enhance standard management of NCT and to promote its healthy development, which will in the end improve overall medical services.