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The Planning Commission clarifies the specific direction for improving medical services, and the informatization construction has a long way to go.

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 On January 4, 2018, the "Notice on Printing and Distributing the Action Plan for Further Improvement of Medical Services (2018-2020)" (hereinafter referred to as the "Notice") was officially released on the official website of the National Health and Family Planning Commission. System construction and innovative medical services put forward clear requirements.

Beginning in 2018, medical institutions must establish an appointment diagnosis and treatment system, a telemedicine system, a clinical path management system, a system for mutual recognition of inspection results, and a system for medical social workers and volunteers.

(1) Appointment diagnosis and treatment system. Tertiary hospitals have further increased the proportion of appointments for diagnosis and treatment services, and vigorously promoted appointments for diagnosis and treatment and centralized appointments for examination and inspection, and the appointment time was accurate to one hour. The tertiary hospitals give priority to reserve the source of appointment diagnosis and treatment numbers to the primary medical and health institutions in the medical association. Priority treatment, examination, and hospitalization are implemented for reserved patients and reserved referral patients to guide the first consultation and two-way referral at the grassroots level. Hospitals with conditions have gradually improved inpatient beds, day surgery appointment services, and explored the provision of extended services such as reserved parking.
 
(2) Telemedicine system. All medical consortia across the country have achieved full coverage of telemedicine. The Medical Consortium takes the lead in establishing a telemedicine center in the hospital to provide services such as remote consultation, remote imaging, remote ultrasound, remote ECG, remote pathology, remote rounds, remote monitoring, and remote training to medical institutions within the medical consortium. Grassroots medical and health institutions gradually expand the scope of telemedicine services, so that more suitable patients can obtain diagnosis and treatment services from higher-level hospitals at their doorsteps. Primary-level medical and health institutions can explore to provide appropriate services such as telemedicine, remote health monitoring, and remote health education for contracted patients.
 
(3) Clinical path management system. Medical institutions realize the informatization of clinical path management, gradually incorporate pharmaceutical services, inspection and inspection services, etc. into clinical path management, increase the proportion of inpatient clinical path management, realize the integration of clinical path "medicine, nursing, and patient", and enhance the standard of clinical diagnosis and treatment behavior And transparency. Conditional medical unions can explore the establishment of integrated clinical pathways, and medical institutions at all levels can divide labor and collaborate to provide patients with smooth referral and continuous diagnosis and treatment services.
 
(4) The system of mutual recognition of inspection results. Realize full coverage of professional medical quality control in medical inspection, medical imaging, pathology, etc. everywhere. Medical institutions that pass the provincial, municipal and other relevant professional medical quality control qualifications shall implement mutual recognition of inspection and inspection results in the corresponding administrative areas. The medical association realizes the sharing of medical imaging, medical examination, pathological examination and other data and information, and implements mutual recognition of examination and test results.
 
(5) Medical social worker and volunteer system. Medical institutions set up medical social workers positions, responsible for assisting in the communication between doctors and patients, and providing patient support services such as diagnosis and treatment, life, legal affairs, and assistance. A tertiary hospital with conditions can set up a medical social work department, be equipped with full-time medical social workers, open a patient service call center, and coordinate and solve the relevant needs of patients. Medical institutions vigorously promote volunteer services and encourage medical staff, medical students, and caring members of the community to provide volunteer services to patients after training.
 
The 2018-2020 Action Plan for Improving Medical Services focuses on innovative medical services in the following 10 areas
 
(1) Taking the patient as the center and promoting the multidisciplinary diagnosis and treatment model. For tumors, difficult and complex diseases, and multi-system and multi-organ diseases, medical institutions can open multi-disciplinary outpatient clinics to provide patients with "one-stop" diagnosis and treatment services. For inpatients, we can explore evidence-based medicine as the basis for formulating single-disease multi-disciplinary diagnosis and treatment standards, and establish a single-dise multi-disciplinary case discussion and joint ward round system to provide inpatients with multidisciplinary diagnosis and treatment services. Encourage qualified medical institutions to include professional and technical personnel in anesthesia, medical laboratory, medical imaging, pathology, pharmacy, etc. into the multidisciplinary diagnosis and treatment team, promote the coordinated and coordinated development of various professions, and improve the comprehensive diagnosis and treatment of diseases and the comfort of patient medical services. TCM medical institutions should continue to explore the establishment of TCM comprehensive treatment and multi-specialty combined diagnosis and treatment models that conform to the characteristics of TCM techniques, which are conducive to giving play to the characteristics of TCM and improving the clinical efficacy of TCM, and are convenient for the masses to see a doctor.
 
(2) Innovate emergency and first-aid services, focusing on critical and critical illnesses. In prefecture-level cities and counties, eligible medical institutions have established chest pain centers, stroke centers, trauma centers, critically ill maternal care centers, critically ill children and newborn care centers. The medical institution realizes the overall coordination of relevant majors of each center, provides patients with green channels for medical treatment and integrated comprehensive treatment services, and improves the quality and efficiency of medical treatment for major acute diseases. Pre-hospital medical emergency institutions and centers form a network to realize the sharing of patient information in the pre-hospital and build a fast, efficient, and full-coverage emergency and critical medical treatment system. Where conditions permit, we can explore the establishment of land and air three-dimensional rescue modes.
 
（三）以医联体为载体，提供连续医疗服务。医联体内实现电子健康档案和电子病历信息共享，医疗机构间以单病种一体化临床路径为基础，明确分工协作任务，以病人为中心，为患者提供健康教育、疾病预防、诊断、治疗、康复、护理等连续医疗服务，完整记录健康信息。加强医疗质量控制体系建设，重点加强医联体连续医疗服务各环节的医疗质量控制，推动基层医疗质量有效提升，保障医疗安全。医联体内以信息化为手段，形成患者有序流动、医疗资源按需调配、医疗服务一体化的分级诊疗格局。
 
（四）以日间服务为切入点，推进实现急慢分治。符合条件的三级医院稳步开展日间手术，完善工作制度和工作流程，逐步扩大日间手术病种范围，逐年增加日间手术占择期手术的比例，缩短患者等待住院和等待手术时间，提高医疗服务效率。鼓励有条件的医院设置日间病房、日间治疗中心等，为患者提供日间化疗、新生儿日间蓝光照射治疗等日间服务，提高床单元使用效率，惠及更多患者。医联体内基层医疗卫生机构为日间手术和日间治疗的患者提供随访等后续服务。
 
（五）以“互联网+”为手段，建设智慧医院。医疗机构围绕患者医疗服务需求，利用互联网信息技术扩展医疗服务空间和内容，提供与其诊疗科目相一致的、适宜的医疗服务。利用互联网技术不断优化医疗服务流程，为患者提供预约诊疗、移动支付、床旁结算、就诊提醒、结果查询、信息推送等便捷服务；应用可穿戴设备为签约服务患者和重点随访患者提供远程监测和远程指导，实现线上线下医疗服务有效衔接。医疗机构加强以门诊和住院电子病历为核心的综合信息系统建设，利用大数据信息技术为医疗质量控制、规范诊疗行为、评估合理用药、优化服务流程、调配医疗资源等提供支撑；应用智能导医分诊、智能医学影像识别、患者生命体征集中监测等新手段，提高诊疗效率；应用互联网、物联网等新技术，实现配药发药、内部物流、患者安全管理等信息化、智能化。
 
（六）以“一卡通”为目标，实现就诊信息互联互通。基于区域全民健康信息平台，加强居民健康卡、医保卡等应用，实现地级市区域内医疗机构就诊“一卡通”，患者使用统一的就诊卡可以在任一医疗机构就诊。鼓励有条件的省级行政区域实现患者就诊“一卡通”。鼓励有条件的地方将就诊卡整合就诊、结算、支付、查询、挂号等功能。
 
（七）以社会新需求为导向，延伸提供优质护理服务。进一步扩大优质护理服务覆盖面，逐步实现二级以上医院优质护理服务全覆盖，基层医疗卫生机构逐步开展优质护理服务。在医联体内实现优质护理服务下沉，通过培训、指导、帮带、远程等方式，将老年护理、康复护理、安宁疗护等延伸至基层医疗卫生机构。有条件的医疗机构可以为合作的养老机构内设医疗机构提供护理服务指导，提高医养结合护理服务水平。有条件的基层医疗卫生机构，可以探索为患者提供上门护理、居家护理指导等服务。
 
（八）以签约服务为依托，拓展药学服务新领域。二级以上医院实现药学服务全覆盖，临床药师利用信息化手段，为门诊和住院患者提供个性化的合理用药指导。加强医联体内各级医疗机构用药衔接，对向基层医疗卫生机构延伸的处方进行审核，实现药学服务下沉。临床药师通过现场指导或者远程方式，指导基层医疗卫生机构医务人员提高合理用药水平，重点为签约服务的慢性病患者提供用药指导，满足患者新需求。鼓励中医医院为患者提供中药个体化用药加工等个性化服务，充分运用信息化手段开展中药饮片配送等服务，缩短患者取药等环节等候时间。
 
（九）以人文服务为媒介，构建和谐医患关系。弘扬卫生计生崇高职业精神，医疗机构建立医务人员和窗口服务人员的服务用语和服务行为规范。加强患者隐私保护，在关键区域和关键部门完善私密性保护设施。有条件的医疗机构可以探索开展心血管疾病、肿瘤疾病、糖尿病等慢性病相关临床科室与精神科、心理科的协作，为患者同时提供诊疗服务和心理指导。
 
（十）以后勤服务为突破，全面提升患者满意度。医疗机构不断改善设施环境，标识清晰，布局合理。加强后勤服务管理，重点提升膳食质量和卫生间洁净状况。有条件的医疗机构可以在公共区域为候诊患者提供网络、阅读、餐饮等舒缓情绪服务，为有需要的住院患者提供健康指导和治疗饮食。
 
《通知》还指出，2018—2020年，将进一步巩固改善医疗服务的有效举措，将其固化为医院工作制度，不断落实深化。进一步应用新理念、新技术，创新医疗服务模式，不断满足人民群众医疗服务新需求。利用3年时间，努力使诊疗更加安全、就诊更加便利、沟通更加有效、体验更加舒适，逐步形成区域协同、信息共享、服务一体、多学科联合的新时代医疗服务格局，推动医疗服务高质量发展，基层医疗服务质量明显提升，社会满意度不断提高，人民群众看病就医获得感进一步增强。