Notice of the General Office of the National Health and Wellness Committee on the Pilot Work of "Nursing Service in internet plus"
Guo Wei Ban Yi Han [2019] No.80
Health and Health Committees of all provinces, autonomous regions, municipalities directly under the Central Government and Xinjiang Production and Construction Corps (Health and Family Planning Commission):
In order to implement the Opinions of the General Office of the State Council on Promoting the Development of "Internet+Medical Health" (Guo Ban Fa [2018] No.26), implement the Guiding Opinions on Promoting the Reform and Development of Nursing Service Industry by 11 departments including our Committee, standardize "internet plus Nursing Service", ensure medical quality and safety, and help implement the strategy of healthy China, through research, our Committee has determined Beijing, Tianjin, Shanghai and Jiangsu. Other provinces select pilot cities or regions to carry out pilot work according to the actual situation in the region. The pilot work plan is hereby printed and distributed to you, please formulate the implementation plan according to the actual situation.
The pilot provinces shall submit the implementation plan before February 25, 2019. All relevant provinces should earnestly strengthen their leadership, seriously organize the implementation in light of the actual situation, and submit the summary of the pilot work (including the implementation plan, the list of pilot medical institutions, and the policy documents formulated and promulgated) to the Medical Administration and Hospital Authority of our Committee before the end of December 2019.
Contacts: Yang Wei, Li Meng, Nursing and Rehabilitation Department of Medical Administration Hospital Authority.
Tel: 010-68791850, 68792208.
Fax: 010-68792959
Email: HLKFC@nhfpc.gov.cn
General Office of National Health and Wellness Commission
January 22, 2019
(Information disclosure form: voluntary disclosure)
"internet plus Nursing Service" Pilot Work Plan
"Nursing service in internet plus" mainly refers to the nursing service provided by medical institutions for discharged patients or special people who suffer from diseases and have difficulty in moving, relying on information technology such as the Internet and taking "online application and offline service" as the main mode. In order to standardize and guide the healthy development of "Nursing Service in internet plus" and further ensure the quality and safety of medical care, this pilot scheme is formulated according to the Regulations on the Administration of Medical Institutions, the Regulations on Nurses and other documents, the Opinions of the General Office of the State Council on Promoting the Development of "Internet+Medical Health", the Administrative Measures for Internet Diagnosis and Treatment (Trial) and the Administrative Measures for Internet Hospitals (Trial).
I. General requirements
(1) Guiding ideology. Guided by Socialism with Chinese characteristics Thought of the Supreme Leader in the New Era, fully implement the spirit of the 19th National Congress of the Communist Party of China and the National Health and Wellness Conference, follow the overall requirements of implementing the Healthy China Strategy, focus on "people’s health", closely follow the main contradictions and key issues in the nursing field, highlight shortcomings and strengths, innovate nursing models, expand service supply, improve service efficiency, standardize service behavior, ensure quality and safety, and accurately meet the diverse and multi-level health needs of the people.
(2) Work objectives. After a year’s trial, under the background of "Internet+medical health", we explored the management system, service model, service standard and operation mechanism of "internet plus Nursing Service" which is suitable for China’s national conditions. Give full play to the demonstration role of the pilot areas, form reproducible and beneficial experiences, gradually promote them from point to area, and standardize and guide the healthy development of "Nursing Service in internet plus". The supply of nursing services has been further expanded, and the people’s sense of acquisition has been significantly enhanced.
Second, the basic principles
(a) to carry out and standardize services according to law. "Nursing service in internet plus" should be based on the requirements of relevant laws and regulations, adhere to the principle of "online and offline, homogeneous management", ensure the standardized development of relevant services, and guarantee the medical quality and safety and the legitimate rights and interests of both nurses and patients.
(B) people-oriented, to meet the needs. Fully consider the health characteristics of different groups of people and the urgent demand for nursing services, take "people’s health" as the center, coordinate the development of institutional nursing, community nursing and home nursing services, increase the supply of nursing services, and continuously meet the diverse and multi-level health needs of the people.
(3) Encourage innovation and be tolerant and prudent. Innovating nursing service mode and exploring and cultivating new nursing service formats. Encourage social forces to actively participate, follow market rules, and stimulate market vitality. Implement an inclusive and prudent supervision method to effectively ensure quality and safety.
(four) according to local conditions, step by step. Encourage all localities to actively explore, combine local conditions and the characteristics of nursing work, and carry out pilot work scientifically, steadily and step by step. Timely summary, continuous adjustment, and earnestly safeguard the health rights and interests of the people.
Third, the pilot content
(A) a clear "internet plus nursing service" to provide the main body. The health administrative department in the pilot area may, in combination with the actual situation, determine the entity medical institutions that have obtained the Practice License for Medical Institutions and have provided services such as family beds and rounds (hereinafter referred to as "pilot medical institutions"), and rely on the Internet information technology platform to send registered nurses of the institutions to provide "internet plus Nursing Service" to extend the nursing service from the institutions to the communities and families. Registered nurses should have at least five years of clinical nursing experience and technical titles above that of nurses, and can query in the national electronic registration system for nurses. Encourage qualified pilot medical institutions to strengthen the management of nurses through face recognition and other human feature recognition technologies, and equip them with nursing recorders. A withdrawal mechanism should be established for nurses who violate relevant laws and regulations and have bad practice records.
(two) clear "internet plus nursing service" service object. Focus on providing chronic disease management, rehabilitation nursing, special care, health education, hospice care and other nursing services for the elderly or disabled elderly, convalescent patients and terminal patients with mobility difficulties. The health administrative departments in the pilot areas can determine the specific service targets of the pilot work of "internet plus Nursing Service" according to the actual situation and the health characteristics of the population and the principles of highlighting key groups, ensuring quality and safety, and preventing and controlling practice risks.
(three) clear "internet plus nursing service" project. The pilot area should be combined with the actual situation, on the basis of investigating and studying the service needs of the masses and fully evaluating the environmental factors and practice risks, organize and formulate the "internet plus Nursing Service" project in this area. In principle, the service items should be technologies with large demand, low medical risk and easy operation and implementation, and the combination of "positive list" and "negative list" can be used to make it clear, so as to effectively guarantee the quality and safety of medical care.
(four) standardize the "internet plus nursing service" behavior. Before providing "internet plus Nursing Service", the pilot medical institutions made the first visit to the applicants, and evaluated their diseases and health needs. If it is considered that "internet plus Nursing Service" can be provided, nurses with corresponding qualifications and technical ability can be sent to provide relevant services. Nurses should strictly abide by relevant laws and regulations, professional ethics and technical operation standards, standardize service behavior, and effectively ensure medical quality and safety. The data generated in the service process should be traced all the way, which can be queried and traced to meet the regulatory needs of the industry.
(5) Improve the management system and service standard of "internet plus Nursing Service". The health administrative departments in the pilot areas and the pilot medical institutions should establish and improve the relevant management systems and service specifications of "internet plus Nursing Service" in accordance with the relevant national management regulations and technical specifications, such as nursing management system, medical quality and safety management system, medical risk prevention system, medical document writing management regulations, personal privacy protection and information safety management system, medical waste disposal process, home care service process, dispute complaint handling procedure, adverse event prevention and disposal process, relevant service specifications and technical guidelines.
(six) to strengthen the management of Internet information technology platform. Pilot medical institutions can independently develop Internet information technology platforms or establish cooperation mechanisms with qualified third-party information technology platforms. Internet information technology platform should have the equipment and facilities, information technology, technical personnel, information security system, etc. required to carry out "internet plus Nursing Service". The basic functions at least include the identity authentication of clients, the collection and storage of medical records, the positioning and tracking of service personnel, the protection of personal privacy and information security, the traceability of service behavior throughout the process, and the statistical analysis of workload. Do not buy or sell or disclose personal information.
(seven) clear "internet plus nursing service" related responsibilities. Pilot medical institutions and third-party Internet information technology platforms shall sign cooperation agreements, in which their respective responsibilities and rights in medical services, information security, privacy protection, nurse-patient safety and dispute settlement shall be clearly defined. When implementing "internet plus Nursing Service", a pilot medical institution shall sign an agreement with the client, and inform the patient of the service content, process, responsibilities and rights of both parties and possible risks in the agreement, and sign an informed consent form.
(eight) actively prevent and deal with the risk of "nursing service in internet plus". Pilot areas and pilot medical institutions should sum up the experiences and practices of "internet plus Nursing Service" in some places, and learn from the risk prevention and safety management measures of other industries in internet plus. You can ask the client to upload identity information, medical records, family signing agreements and other materials for verification; Requirements for the qualification, service scope and project content of nurses providing "internet plus Nursing Service"; Internet information technology platform can purchase/share personal identity information of public security system or compare and verify it through human feature recognition technology such as face recognition; Pilot medical institutions or Internet information technology platforms shall, in accordance with the requirements of the agreement, provide mobile APP positioning and tracking systems for nurses, configure nursing work recorders, make the whole service traces traceable, equip with a one-button alarm device, and purchase liability insurance, medical accident insurance and personal accident insurance, so as to effectively protect nurses’ professional safety and personal safety and effectively prevent and deal with risks. It is necessary to establish a medical dispute and risk prevention mechanism and formulate an emergency response plan. At the same time, open channels for complaints and comments, accept social supervision, and safeguard people’s health rights and interests.
(nine) the establishment of "internet plus nursing service" price and payment mechanism. The pilot area should combine the actual supply demand, give play to the market bargaining mechanism, refer to the local medical service price charging standard, and comprehensively consider the factors such as transportation cost, information technology cost, technical value of nurses’ services and labor remuneration, and explore the establishment of price and related payment guarantee mechanism.
Four, the pilot area and pilot time
(1) Pilot areas. Beijing, Tianjin, Shanghai, Jiangsu, Zhejiang and Guangdong have been designated as the pilot provinces of "Nursing Service in internet plus". Other provinces selected pilot cities or regions to carry out pilot work according to the actual situation.
(2) Pilot time. February-December 2019.
V. Relevant requirements
(1) Raise awareness and strengthen leadership. Pilot areas and pilot medical institutions should fully understand the importance of standardizing the development of "nursing service in internet plus", take accurately meeting people’s diverse and multi-level health needs as the starting point, take safeguarding people’s health rights and interests and ensuring medical safety as the foothold, strengthen organization and leadership, and make overall coordination and promotion. The health administrative departments in the pilot areas should actively coordinate the relevant local departments to formulate and improve relevant policies and promote the pilot work. Pilot medical institutions should clarify the responsible departments and personnel, improve the relevant management systems, service standards and emergency response plans, and ensure the effective and orderly development of the pilot work.
(two) the pilot first, sum up experience. The health administrative department in the pilot area shall, in conjunction with the relevant departments, formulate the pilot work plan and organize its implementation. Focus on the management system, service model, service standard, risk prevention and control, price payment policy and other aspects of "internet plus Nursing Service", try first, and summarize and popularize useful experience. Grasp the progress of the pilot medical institutions in time to ensure that the pilot tasks are completed on time and with good quality. Find the difficulties and problems in the pilot process, and actively study and solve them.
(3) Strengthen supervision and guard against risks. The administrative department of health in the pilot areas shall, jointly with relevant departments, strengthen the supervision and guidance of "nursing service in internet plus". The administrative department of health shall announce to the public the list of pilot medical institutions that carry out "internet plus Nursing Service", announce the supervision telephone number or other supervision methods, and accept and dispose of the report in time. Give full play to the role of social organizations and strengthen the industry supervision and self-discipline of "internet plus Nursing Service". Pilot medical institutions should establish and improve relevant management systems, and strengthen professional safety education and professional knowledge and skills training for nurses. In accordance with the principle of territorial management, local health administrative departments actively pay close attention to the development of the new format of "internet plus Nursing Service" within their jurisdiction, take effective measures to actively prevent and deal with possible risks, and guide the standardized development of "internet plus Nursing Service".
(four) to increase publicity and correct guidance. Health administrative departments in pilot areas and pilot medical institutions should strengthen publicity and training, and positively guide public opinion. Using new media and traditional media such as Internet, newspapers, television and radio, we will widely publicize the significance of carrying out "internet plus Nursing Service" according to laws and regulations, further safeguard people’s health rights and interests and ensure medical safety, and reasonably guide social expectations. Strengthen public publicity and education, guide the correct concept of medical treatment, and prevent medical safety risks. At the same time, strengthen the training and education of medical institutions and nurses, improve the understanding of the new format and service mode of "internet plus Nursing Service", strengthen the awareness of professional safety, constantly standardize service behavior, and provide high-quality nursing services for the masses.