Near the Spring Festival of 2020, a pneumonia epidemic caused by 2019-nCoV swept through China, Due to a large-scale population flow during the Spring Festival. Centered in Wuhan, the COVID-19 rapidly spread to the whole country and some overseas countries and regions. By March 2, 2020, a total of 80,175 cases and 2,915 deaths had been confirmed in China. At present, all provinces and cities have announced that launching the first-level response to major public health emergencies, implementing the strictest prevention and control measures. Issued by the State Council on January 27, “the recent infection prevention and control plan of COVID-19”, made it clear to apply the “Big Data + Grid”, pays attention to the early warning, monitoring, screening, testing and other work of epidemic. Epidemic prevention and control large data transfer through the private network of China Mobile Communications Group Co.,Ltd, realize the real-time data transmission report of 72 hospitals in Wuhan, make the information open and transparent.
In Hubei Wuhan, with the growth of confirmed cases, reached 67103 cases. Follow the “Xiaotangshan Hospital” during the period of SARS in 2003, “Huoshenshan Hospital” and “Leishenshan Hospital” has been built in a week. From design, construction and to be put into use. In this particular period, China has created so many myth in the facilities infrastructure. At the same time, dozens of mobile cabin hospitals have been put into use successively, so that before February 20, the number of reserve beds in Wuhan reached 100,000 (14,000 severe patients, 30,000 mild cases and 56,000 concentrated isolation points), which greatly relieved the pressure of front-line by cooperating with the medical workers all over the country.
In views of the high “human to human” risk of the 2019-nCoV. It puts forward very strict requirements of professional pressure resistance for front-line medical workers from consulting, treatment and nursing. Especially in throat swab test and tracheal intubation, the most common way of bacterial infection are the exhalation of air and spatter from severe patients. On the other hand, severe pneumonia patients not only have the respiratory diseases caused by pneumonia, but also have respiratory failure and other organ damage. If multiple system organ failure, it will lead to respiratory failure, heart failure, coagulopathy, renal failure, shock and other conditions. The patient will in a critical condition. Emergency operations must be performed in negative pressure operating rooms, and the small space will increases the risk of infection for medical workers.
So effort to such a major epidemic, how to improve the efficiency of clinical work, increase the cure rate and reduce the risk of secondary infection have become very necessary and realistic problems. Medical digitalization and informatization has been applied in consulting, treating and recovering in this epidemic. It has accumulate valuable clinical experience to dealing with public health emergencies and hospital construction.
Digital in diagnosis
According to the “standard for severe pneumonia”, a guideline of the China association of respiratory diseases. Combined clinical manifestations, respiratory status, oxygenation index, blood pressure, chest X-ray imaging and other data with the score of CURB, PSI and CPIS to estimate the severity of patients. And take special care for severe patients.
For complex cases with multiple system organ failure and clinical manifestations that are not reflected by the respiratory system (such as the digestive system), expert teleconsultation via video conferencing system can make full use of the superior medical resources in different parts of the country to solve the epidemic resistance problem in isolation points or small and medium-sized inland cities. It is also convenient for government departments or hospitals to match or allocate medical resources.
Digital in intensive care
The nursing level of ICU patients is divided into special, first, second and third level.
Nurse need to record patients’ data like each instrument monitoring records, nursing content including giving medicine to patients, nursing, observation and score according to the frequency of hours, every 4 hours statistics patient’s intake (calculate the input and the effluent), a large number of written records and calculation will occupy nurse a third of the time. Doctor need accurate real-time condition to observe the patients.
Through the Heal Force professional ICU/CCU clinical information software, it is convenient to solve the heavy nursing records and clinical quality control problems such as nursing scheduling, automatic input of doctor’s orders, automatic data collection, fluid volume balance and automatic calculation of medical score.
For the synchronous monitoring of patients with dozens of beds in mobile cabin hospital, Use the wired or wireless central monitoring system to collect continuously, track and check the situation of all patients in real time, and take nursing protection to the accident of any patients.
Digital in operation
In the traditional operating room, no matter it is the integration of various equipment or the communication with the outside such as the acquiring of image, pathological test samples and interaction with family members. And when the organs of severe pneumonia patients be open up, the deadly bacteria spread in the air, and the surgeon, anesthesiologist and nurse spend hours in such a small space, there is a very high risk.
- How to achieve device centralized control to reduce users’ control times and the risk of cross-infection
- How to record and summarize the surgical cases to guide the treatment of similar situations
- How to share the experience in the front-line fight against the epidemic
- How can the surgeon conveniently refer to all kinds of relevant images and pathological data to revise the surgical plan
- How to solve the difficult problem of operation and improve the safety through expert teleconsultation in real time
- How to arrange the medical urgent resources properly
- How to manage the control procedures of special surgical instruments with high infection risk
So in order to achieve a large number of medical information inside and outside the operating room communication via audio and video. It is necessary for professional equipment manufacturers, audio and video communication manufacturers and professional hospital IT software team to cooperate to provide a reasonable and convenient solution,
It is important that the implementation of digitalization and informationization of operating rooms or treatment sites under epidemic conditions. What must be taken into account is its convenience. Because many medical facilities are built quickly, the plan needs to be easy to implement
- The installation is simple, can be upgraded in a few days
- The operation is simple, every medical workers can operate the system with training
- After the operation, the perioperative records, tracing and induction are provided automatically, so that high-risk areas need not be retained
Recovery and traceability
After recovery, the patient should stay in isolation due to the incubation period of COVID-19 varies from 14 to 27 days. During the period, the digital medical solution can support the patient to realize teleconsultation, registration and inquiry.
When the epidemic end, Production and work is resumed across the country. With Big Data traceability system provided by “China mobile”, “China unicom” and many information technologies, Chinese government is able to check the population flow. These system not only will it be easier for domestic provinces to adjust control measures, but relevant experience can also be Shared with other countries which suffering from the epidemic and used to specify strategies to fight with the epidemic.
The positive and effective prevention and control measures taken by the Chinese government have been highly praised by the international organization (WHO) and the international community. But there are three obvious lessons.
Public health and disease control systems have been neglected. The development of public health theory and practice is divorced from each other.
Science and technology innovation based on clinical orientation is not targeted, data sharing and transformation application channels are not smooth
The establishment of hierarchical medical system is incomplete. High-quality medical resources are concentrated in a few coastal or large medical institutions. After the outbreak of the epidemic, weak prevention and control awareness and limited resource support in the mainland led to the spread of the epidemic and increased mortality.
Hierarchical medical system is one of the most important impetus for the growth of digital medical industry
One of the most prominent problem in China medical field is the unbalance of resources distribution. High quality medical resources are concentrated in the economic developed area or a few head of medical institutions, and that large-scale hospitals are often overcrowded and overload. But large Numbers of small hospitals, community health service centers have no patients.
As mentioned above, Medical IT technology plays a positive role in obtaining patients’ information, improving the accuracy of medical workers’ diagnosis and treatment, reducing the risk, promoting the hospital management and improving the patients’ hospital experience.
In terms of the current China medical industry, there are two urgent tasks First is to improve the efficiency of resource allocation of the whole medical system through institutional construction. Second is to control the increase of medical insurance payment reasonably. The former is also one of the important ways to promote the implementation of the latter. The above two tasks are respectively corresponding to hierarchical diagnosis and medical insurance control, which are the most powerful growth impetus of the medical IT industry in medium term, as well as the most important starting point for industrial policies such as the grading review of electronic medical records application, medical consortium /DRGs and so on.