“How to avoid repeated testing has always been the direction of the country’s reform in recent years. In the future, with the implementation of the “Administrative Measures”, repeated testing is expected to be gradually reduced in the next few years.” Member of the National Committee of the Chinese People’s Political Consultative Conference, Chinese Academy of Medical Sciences Cancer Hospital Endoscopy Section director Wang Guiqi told the Health Times reporter. On February 18, four departments including the National Health Commission and the National Medical Insurance Bureau jointly issued the “Administrative Measures on Printing and Distributing the Mutual Recognition of Inspection Results of Medical Institutions”, which will be officially implemented on March 1.
The doctor looks at the CT scan. Photo by Bao Jie
For treatment in another hospital, CT and MRI have to be redone
“My mother was treated in a local tertiary hospital for intracranial hemorrhage and underwent a series of examinations such as brain CT and MRI. Due to the complicated condition, the local hospital doctor suggested that we go to the provincial capital tertiary hospital for further diagnosis and treatment. Treatment. Taking the local hospital inspection report, I was informed by the provincial capital’s top three hospitals that they could not accept and recognize the inspection results made by the city’s third-level hospital, and needed to re-examine and test.” Mr. Zhou from Weifang City, Shandong Province told Health Times. Mr. Zhou’s experience is not an isolated case. The inspection results between medical institutions are not mutually recognized, and patients need to repeat the inspection from time to time. According to the “Analysis of Current Situation and Countermeasures of Repeated Medical Examinations by Imaging” published by China Public Health in 2018, the incidence of repeated medical examinations by imaging was 41.82%.
Why are medical test results so difficult for each other?
Director Wang Guiqi said, “The equipment performance, quality of results and inspection level of some primary hospitals cannot be compared with those of tertiary hospitals for the time being. Moreover, the inspection equipment, medical equipment, and testing level of each hospital are not the same. Secondly, The timeliness of many tests in the laboratory is very short. For example, some malignant tumors spread rapidly, such as small cell lung cancer, and distant metastasis, especially brain metastasis, may occur in a short period of time. If you simply rely on the original data and examinations The report is unreliable.” Director Wang Guiqi added, “In addition, the mutual recognition process also has a problem of legal responsibility identification. Mutual recognition of test results means that clinicians must take non-our hospital’s inspection reports to make corresponding decisions for patients. Diagnosis, after a little inadvertently making a wrong judgment, the law needs to clearly define the division of responsibilities.”
Multiple provinces and cities have carried out mutual recognition of inspection results in advance. The “Measures” clearly pointed out that medical institutions should meet the needs of diagnosis and treatment in accordance with “guaranteeing quality and safety as the bottom line, taking quality control as the premise, and reducing the burden on patients as the guide. The principle of mutual recognition of inspection and test results shall be carried out based on the principle of taking the judgment of the receiving physician as the standard”. And it is clarified that these measures are applicable to all types of medical institutions at all levels. This marks that the long-awaited mutual recognition of inspection and inspection results by the common people for many years is finally coming to fruition. In fact, the mutual recognition of inspection results has been brewing for many years in my country.
A reporter from Health Times found that the National Health Commission and other institutions had issued documents in 2006, 2012, December 2020, July 2021, and November 2021, emphasizing the need to strengthen the mutual recognition of test results in hospitals . “The country has been making every effort to promote the rational use of limited testing resources in hospitals, avoiding waste of medical resources, saving patients and national medical insurance costs, avoiding repeated inspections, and improving the efficiency of diagnosis and treatment.” Wuhan University People’s Hospital Laboratory Clinical Pathogen Professional Group Chang Wangming said in an interview with a Health Times reporter. Health Times reporters found that at present, Beijing-Tianjin-Hebei-Lu, Jiangsu, Yunnan, Henan, Shanxi, Shaanxi, Sichuan-Chongqing and other places have taken the lead in carrying out the mutual recognition of inspection results in the province.
Clarify the scope of mutual recognition test results, excluding diagnostic conclusions
So, which inspections support mutual recognition? The inspection results mentioned in the “Measures” refer to the images or data information obtained by inspecting the human body by means of ultrasound, X-ray, MRI, electrophysiology, nuclear medicine, etc.; The material from the human body is tested in biology, microbiology, immunology, chemistry, blood immunology, hematology, biophysics, cytology, etc., and the obtained data information. It is particularly emphasized that the inspection results do not include the diagnostic conclusions issued by doctors. “Mutual recognition of medical test results is a good thing for the people, but it does not apply to all medical tests.”
Director Wang Guiqi emphasized, “For example, endoscopic operations are very technical, and there may be some differences in the level of different doctors. Moreover, each doctor’s examination methods, diagnostic criteria and language for diagnosing diseases The differences are very large, so the diagnostic conclusions issued will also be different, so this “Measures” does not involve diagnostic conclusions.”
Director Wang Guiqi believes that “the homogeneous development of laboratories and imaging departments is the basis for promoting mutual recognition of inspections. If inspection results are to truly benefit the people, it is necessary to strengthen the quality control of laboratories in primary medical institutions and improve the accuracy of inspection results. If the initial inspection can be implemented in the grassroots or community hospitals, and we do some other inspections on the basis of mutual recognition inspection, it will be a good promotion for both patients and medical institutions.”
(Health Times)