Study On The Current Situation And Countermeasures Of Telemedicine Service In Guizhou Province

Objective:To investigate the current situation of telemedicine service in medical institutions at four levels(the provincial,municipal,county and rural levels)in Guizhou Province.And know about the configuration and development of telemedicine in medical institutions at four different levels,and the use of telemedicine equipment in rural medical institutions.Discussing the significance,problems and influencing factors of telemedicine service,and put forward relevant suggestions.In order to provide basis for the policy formulation in Guizhou Province.Methods:Using a combination of quantitative research and qualitative research.A census was conducted on 12 provincial hospitals,44 municipal hospitals,and 237 county hospitals in 9 cities and prefectures in Guizhou Province.And randomly select 207 rural medical institutions for sampling survey.Obtain relevant data such as the deployment of full-time telemedicine personnel,service project,and the use of telemedicine equipment in rural medical institutions.Interviews with 9 relevant persons in charge of the telemedicine platform in medical institutions,to analyze the relevant factors affecting the development of telemedicine.Results:(1)In 2018,100%,81.82%,67.51% and 58.45% of medical institutions at the provincial,municipal,county and rural levels have been equipped with full-time telemedicine personnel.Among them,more than 60% of medical institutions at four levels have been equipped with full-time management personnel.Only 50% of rural medical institutions have been equipped with full-time technical maintenance personnel.(2)From 2016 to 2018,12 provincial hospitals have carried out remote consultations.56.82% of municipal hospitals have carried out remote consultations,showing a downward trend.44.73%,49.28% of county and rural medical institutions have carried out remote consultations,showing an increasing trend.Remote diagnosis is mainly carried out in 69.19% of county hospitals and 55.07% of rural medical institutions.(3)In 2018,the total number of remote consultation invitations in medical institutions at four levels exceeded 22,000.The county hospitals accounted for the highest proportion,accounting for about 60%.The total number of remote diagnosis in medical institutions at county and rural levels is over 141,000.The main projects are remote image diagnosis and remote ECG diagnosis,accounting for about 60% and20%.(4)About the remote consultation,the response rate of provincial and municipal hospitals remained between 80% and 90%.In 2018,the response rates of county and rural medical institutions were 81.84% and 62.18%,showing a downward trend.About the remote diagnosis,the response rates of remote image diagnosis and remote ECG diagnosis in county hospitals were 47.07% and 53.18%,showing an increasing trend.The response rate of remote B-ultrasound diagnosis in rural medical institutions increased from 11.24% to 99.19%,but the response rate of other items dropped between 64.81%-69.32%.(5)About 80% of rural medical institutions using DR,static ECG,and color Doppler ultrasound.Automatic biochemical analyzers and blood cell testers have the largest number of inspections,which is over 180,000,and the average number of daily inspections is about 30 persons per day.The total number of inspections by Holter and general medical instruments is the least,only about 200 persons per year and the average number of inspections is 0 per day.(6)Through the interview,it is found that the main factors affecting the development of telemedicine are the medical institutions,doctors and patients are lack of willingness to use telemedicine;the telemedicine platforms are lack of professionals and full-time personnel and fail to achieve interconnection of information;the number of patients in medical institutions is small,which leads to high costs.Conclusions:Since becoming a telemedicine policy pilot,the development of telemedicine in Guizhou Province has rapidly and effectively improved.It could improve the medical and health service capabilities of county and rural medical institutions.Alleviating the problem that primary medical institutions are idle,but large hospitals are overcrowded.But we should promote the propaganda and construction of telemedicine,strengthen patients’ trust and enthusiasm of using telemedicine,to keep patients stay at the primary medical institutions.It could bring direct or indirect economic benefits to medical institutions.At the same time,we should pay attention to capital investment and benefit distribution to hospitals and doctors,and mobilize the enthusiasm for participation.For the current problems of telemedicine in Guizhou Province,it is not forced to be resolved in a short time.We should fully consider the number of the patient and the distance between the institution and the superior medical institution,to determine whether it is necessary to configure telemedicine equipment or to carry out telemedicine service.In order to find a suitable path for the telemedicine based on local conditions in Guizhou Province.