基于“智联网”架构的分级诊疗模式探究

Research on Hierarchical Diagnosis and Treatment Mode Based on"Intelligent Network"Framework

目的通过对接各级医疗机构资源,实现医疗质量监管、智能分诊及双向转诊,并对漏诊误诊进行干预。方法运用人工智能、互联网、大数据等新兴信息技术构建“智联网”分级诊疗体系,提供人工智能辅助诊断、医疗质量分级监控、疾病诊疗风险评估、安全用药预警监测、疾病诊疗分级干预、智能分诊转诊等功能。结果实现了全流程的疾病诊疗辅助与风险防控。构建的区域“智联网”分级诊疗体系在2020年12月—2021年8月运行期间,共产生1200多条诊疗指导,指导采纳率和回复率达到90%以上;识别疑似风险病历46万份,实际转诊平均75人次/月,提醒处方数约25万份/月。结论“智联网”分级诊疗体系可有效促进基层诊疗能力提升,实现医疗资源的精准对接,助力推进国家“分级诊疗、合理诊治”政策落地。

Objective By linking the resources of medical institutions at all levels,the intelligent triage and two-way referral of patients was achieved;Interventions in the cases of missed diagnosis and misdiagnosis were executed.A full-process disease diagnosis,treatment,risk prevention and control capability was established.Methods Intelligent networking hierarchical diagnosis and treatment system combines artificial intelligence,internet,big data and other emerging information technologies,aiming at providing artificial intelligence-assisted diagnosis,medical quality grading monitoring,and disease diagnosis and treatment risk assessment,safe medication warning monitoring,disease diagnosis and treatment grading intervention,intelligent triage referral and other service.Results The whole process of disease diagnosis,treatment assistance,risk prevention,and control ability were established.Since its operation in December 2020,the hierarchical diagnosis and treatment system of Anhui Zhilian network has produced more than 1200 diagnosis and treatment guidance.The guidance adoption rate and response rate have reached more than 90%;460000 suspected risk medical records were identified,the average number of actual referrals was 75 person times/month,and the number of reminder prescriptions was about 250000.Conclusion The network effectively promote the improvement of grass-roots diagnosis and treatment capacity in Anhui province,accurately connect medical resources,and help to push on the policy"graded diagnosis and treatment,reasonable diagnosis and treatment".