Explore On Hospital High-Value Consumables Management Based On Internet Of Things Technology To Reach The Clinical Expectation

BackgroundIn recent years,the consumption of medical apparatus and instruments in China has increased year by year.In 2014,the scale of this market is RMB 255.6 billion and it increased to RMB 530 billion in 2018.And in 2018,the market scale of medical consumables is about 168.7 billion yuan,of which the market scale of high-value medical consumables is about 104.6 billion yuan,accounting for 62.0%.It can be seen that high value consumables have become a very important part of the material consumption of medical institutions in China.Our government has issued a series of policies documents to improve the supply guarantee system of medical materials,including consumables,and to strengthen the supervision of various links,including approval,production,logistics and price.Some of them put forward to promote the work of purchasing high value consumables with quantity and zero addition of hospital consumables.In this context,high value consumables in hospitals will change from revenue source to expenditure source.Therefore,it is an inevitable choice for hospitals to introduce a new management mode to improve the management efficiency of high value consumables and reduce the management cost of high value consumables.However,as a special commodity,high-value consumables have the function of curing the disease and saving the people.The focus of its management should not only be on the cost or efficiency,but also on the expected effect of patients using it.This expected effect includes the risk of use,the therapeutic effect and the feelings of patients themselves,which can be called clinical expectation.The management of high-value consumables also needs to be able to help high-value consumables to achieve its clinical expected service.ObjectiveBy comparing the similarities and differences of high value consumables management mode before and after the introduction of Internet of things technology into Z hospital in Shandong Province,this study analyzes the promotion effect of Internet of things technology for high-value consumables management.and optimizes the management process of high value consumables,analyzes the optimization effect,discusses what improvements should be made to the management of high-value consumables based on the clinical expectation,so as to make suggestions for the management of high value consumables in hospitals in China and provide ideas for similar research at home and abroad.MethodsThis thesis mainly takes Z hospital,a large-scale comprehensive third class public hospital in Shandong Province as the research object,literature analysis,on-the-spot investigation,expert interview were used to complete this research.1.Literature analysis:collect the literature related to the supply chain management of high value consumables,the literature related to the therapeutic effect of high value consumables after use,and the relevant laws and regulations of high value consumables.To understand the current situation of high value consumables management;2.Observation method:During the internship in Z hospital,we learned from the consumables supervisors and observed the actual situation of high value consumables management to understand the management mode of medical high value consumables in the hospital.Observe and visit the departments with high consumption of consumables to understand the management process and structure of Medical High-value consumables in Z hospital,observe the data and process of consumables use more intuitively,and analyze the use of high-value consumables in Z hospital more objectively.3.Questionnaire survey:a total of 137 patients who used high value consumables in bone and joint surgery before and after optimization of high value consumables management process guided by clinical expectation in Z hospital were investigated to study the changes of patients' satisfaction after optimization of high value consumables management process guided by clinical expectation.4.Expert interview:Interview with doctors in clinical departments,consumables management personnel and other experts to understand the factors restricting the achievement of clinical expectations.Results1.In the six years from 2014 to 2019,the cost of consumables in Z hospital was 820 million yuan,954 million yuan,1.163 billion yuan,1.365 billion yuan,1.228 billion yuan and 1.453 billion yuan respectively,showing an overall growth trend,and in 2019,the use of high-value consumables accounted for 73.88%of the total consumables.The use of high-value consumables in Z hospital has the characteristics of high amount and large quantity.2.In December 2019,Z hospital used 93.3234 million yuan of high value consumables.Among them,the highest amount of high value consumables is vascular intervention consumables and orthopedic consumables.The amount of high value consumables for blood intervention is 28.358 million yuan,accounting for 30.38%of high value consumables;the amount of high value consumables for orthopedic is 25.624 million yuan,accounting for 27.46%of high value consumables3.The management department of high value consumables in Z hospital has developed a perfect supervision system for all links of high value consumables from access to distribution,use to charging.In order to improve the management of hospital consumables,Z hospital officially launched SPD mode in September 2018 and introduced Internet of things technology to manage high-value consumables After the introduction of Internet of things technology,high value consumables are divided into foreign-surgical consumables and consignment consumables for management.4.After introducing the Internet of things technology to manage high-value medical consumables,Z hospital realized real-time tracking through bar code in the whole process from acceptance to charge after use,automatic management through application,purchase,inventory,etc.,and greatly reduced the operation time.The electronic management and validity reminder are realized for the qualification certificate of the supplier to ensure the safety of the high-value consumables used in the hospital,and the unification of the dictionary library in the hospital is also realized,so as to realize the fine management of the high-value consumables5.In order to further manage the high value consumables based on the clinical expectation,the access,use,follow-up,traceability and other processes of high value consumables in Z hospital were optimized.After optimization,the pass rate of access application was reduced from 67.65 to 53.79%(x2=6.032,P<0.05),and the standard was improved;the satisfaction rate of patients with the treatment effect of high value consumables was increased from 83.33%to 94.91%(x2=5.114,P<0.05);satisfaction rate of medical service attitude increased from 82.05%to 94.91%(x2=5.114,P<0.05);79.49%of patients who used high value consumables before the process optimization were willing to use the consumables again,and 93.22%after the optimization(x2=5.082,P<0.05).After the process optimization,the overall satisfaction of patients has been improved.Conclusion and suggestionsCompared with the traditional management mode of high-value consumables,the introduction of Internet of things technology has brought some changes to the management process,which enables the purchase plan to automatically generated,more standardized management procedures,automatic management of licenses and qualifications,as well as the realization of the whole process of high-value consumables tracking and automatic inventory.But from the perspective of clinical expectation,there are still some problems in the management of many hospitals in China.For example,the insufficient argument for admission leads to the entry of some high-value consumables with high prices or poor effects into the hospital;the functional departments lack of evaluation and monitoring basis for the selection and use of high value consumables by doctors;the lack follow-up leads to the lack of effective guidance for patients after discharge and the failure to achieve full traceability supervision without the introduction of the Internet of things,etc.In general,the introduction of Internet of things technology not only improves the efficiency of high-value consumables management in hospitals,but also forms the technical basis for the clinical-expectation oriented supervision of high-value consumables.Suggestions:1.Multiple consumables should be included in the Department admittance process to discuss and refine the admittance process;2.A health technology assessment team including the doctors in the Department should be set up to carry out the health technology assessment for to make suggestions for the clinical use of high-value consumables;3.The knowledge of high-value consumables should be updated regularly,and the doctors should be trained and assessed to standardize the clinical use management;4.The whole process supervision management of high-value consumables should be carried out,using information technology to carry out the whole process monitoring of high-value consumables;5.Regular follow-up by medical care and high-value consumables engineers after using high-value consumables,timely identify risks,improve the prognosis and health level of patients.