互联网诊疗的感知风险与基于技术融合的防控--基于“打防并举”到“管理服务”变迁历程的研究

Perceived Risk of Online Diagnosis and Treatment,and Prevention and Control Based on Technology Integration

互联网医疗从互联网辅助医疗向互联网诊疗延伸,会带来风险放大效应。从既往碎片化研究转向系统性探讨互联网诊疗的感知风险,有助于推动互联网诊疗从积极发展转向规范发展。本文通过半结构化访谈、爬虫软件搜集资料,应用扎根理论进行分析。研究发现:(1)互联网诊疗的感知风险为“双驱”模型:以功能风险、安全风险、经济风险、时间风险为构念的医疗型感知风险和以隐私风险、网络风险为构念的互联网型感知风险是互联网诊疗感知风险生成的内驱因素,政策技术支持乏力与配套就医流程断裂是感知风险的情境外驱因素。(2)互联网诊疗是互联网与医疗的技术融合,感知风险发生的深层次原因是互联网与医疗的技术融合成熟度低所导致。(3)感知风险的防控需要互联网诊疗实现技术融合单元的匹配耦合、技术融合模式的互利互补、技术融合环境的正向促进。“双驱”模型将研究视野从互联网诊疗感知风险碎片式探讨延伸到涵盖内驱因素和外驱因素的整体分析;并从技术融合角度提出了互联网诊疗风险防控对策,为探索“互联网+专业技术服务”感知风险防控提出了技术融合的新治理模式。

The extension of Internet medicine from Internet assisted medicine to Internet diagnosis and treatment will bring about risk amplification effect.The shift from previous fragmented research to systematic discussion on the perceived risk of Internet diagnosis and treatment will help to promote the positive development of Internet diagnosis and treatment to standardized development.This paper collects data through semi-structured interviews and crawler software,and applies grounded theory for analysis.(1)The perceived risk of Internet diagnosis and treatment is a"dual-drive"model:Medical-type perceived risk with functional risk,security risk,economic risk and time risk as the concept,and Internet risk with privacy risk and network risk as the concept.The type of perceived risk is the internal driving factor for the generation of the perceived risk of Internet diagnosis and treatment,and the lack of policy and technical support and the fracture of supporting medical treatment process are the situational external driving factors for perceived risk.(2)Internet diagnosis and treatment is the technology integration of the Internet and medical care.The deep-seated reason for the perceived risk is the low maturity of the technology integration of the Internet and medical care.(3)The prevention and control of perceived risk requires Internet diagnosis and treatment to realize the matching and coupling of technology integration units,the mutual benefit and complementarity of technology integration modes,and the positive promotion of technology integration environment.The"dual-drive"model extends the research horizon from the fragmented discussion on the perceived risk of Internet diagnosis and treatment to the overall analysis covering internal and external driving factors;From the perspective of technology integration,it puts forward the prevention and control countermeasures for Internet diagnosis and treatment risks,and puts forward a new governance model of technology integration for exploring the prevention and control of perceived risks of"Internet+professional technical services".