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艾社康知识中心双周报-8月上篇|ACCESS Health Research Unit Newsletter,August

本期主题

 政策聚焦

明星企业跨界进军医疗产业

 科研与社论:英格兰的心理健康改革

 

Policy Highlights
政策聚焦

Picture Cerdit: 上观新闻

【7.22】《上海市社区老年人日间照护机构管理办法》正式出台

近日,上海市民政局通过发布《上海市社区老年人日间照护机构管理办法》。《办法》规定,新建居住区应当配套建设日间照护设施;已建居住区的日间照护设施建设未达到规划要求或建设标准的,应当通过购置、置换、租赁等方式进行建设。日间照护设施应当按照本市相关设施建设标准,结合实际服务需求,设置以下功能区域:(一)生活服务区域;(二)保健服务区域;(三)公共活动区域;(四)服务保障区域。 日间照护机构应当配备与其开展服务相适应的养老护理员、专业技术人员。养老护理员、专业技术人员总数不少于3人,其与机构服务对象数配比不少于1:8。《办法》同时规定,日间照护机构可以为社区老年人提供下列服务:(一)提供生活照料、生活护理、膳食供应、精神慰藉等日间托养服务;(二)通过与医疗服务机构签约合作等方式,提供健康管理、预防保健、医疗护理等医养结合服务;(三)根据老年人需求,提供交通接送、生活辅助,以及早托、晚托等个性化服务;(四)依托日间照护机构的专业能力,上门开展居家照护服务和社区支持服务。

The Civil Affairs Bureau of the Shanghai Municipality has recently passed and published the “Regulation on Shanghai Community Daycare Institutions for the Senior”. The Regulation stipulates that plans to construct daycare facilities should be included in the blueprint of building up new residence compounds. As for the existing compounds with substandard daycare facilities, local authorities must phase out such facilities and construct new ones through purchasing, exchanging, rental, or other necessary means. Pursuant to relevant construction standard and service demands of the elderly, daycare facilities must establish the following four areas, namely daily service area, healthcare service area, public activity area, and service maintenance area. A daycare facility should be equipped with professional technical and nursing staff. One such facility should have at least three such staff members, and the staff customer ratio should be no less than one to eight. The Regulation also states that daycare facilities should offer the following services: 1. Nursing services, food supply, and mental care; 2. Medical and nursing services such as health management, disease prevention and rehabilitation exercise; 3. Personalized services such as free transportation, daily assistance, daycare, and/or night care based on the needs of the elderly; 4. Home care and community care services.

Picture Credit: 中国网

【8.1】8月1日起,广州正式试点实施长期护理保险制度!

近日,广州市政府印发《广州市人力资源和社会保障局 广州市财政局 广州市民政局 广州市卫生和计划生育委员会关于印发〈广州市长期护理保险试行办法〉的通知》。《通知》公布广州市自2017年8月1日起正式试点实施长期护理保险制度。试点将持续两年,在此期间广州将探索为长期失能人员提供服务保障并建立社会保险制度的可能性。此次试点参保人员为本市职工医保参保人员,今后将会扩大至城乡居民社会医保参保人员及其他人员。参保范围内已在广州市长护定点机构入住的长期失能人员可申请长护评估,符合条件者可享受长期护理保险基本生活照料待遇。试点阶段广州市将根据参保人员年龄将其分为85岁及以上、80至84岁和80岁以下三档,85岁及以上失能人员可优先提出长护评估申请。广州长护保险制度提供基本生活照料与医疗护理两类服务,同时设有居家及机构护理两种待遇类别。目前,广州已确定29家长护定点机构。

The Guangzhou Municipal Government has recently released the “Implementation Measures of Long-term Care Insurance in Guangzhou”. The Implementation Measures stipulate that the city of Guangzhou would start the trial of implementing long-term care insurance starting from August 1st, 2017. During the trial period, Guangzhou will explore the possibility of designating care services to citizens with long-term disabilities and establishing social insurance system for this group. This pilot program will first cover those enrolled in the Urban Employee Basic Medical Insurance and will later expand to cover those enrolled in the Urban and Rural Resident Basic Medical Insurance. The ones with long-term disabilities admitted into designated long-term care facilities are eligible to enter the assessment pool of long-term care insurance, and those who pass the appraisal mustard will be entitled to daily care services covered by long-term care insurance. Guangzhou government will divide eligible insurers into three categories, namely those above the age of eighty five, those between eighty and eighty four, and those under the age of eighty. People above the age of eighty five have the priority to apply for the insurance. Guangzhou’s long term care insurance will provide both home care and institutional care services,. There are twenty-nine government designated long term care facilities in the city at the moment.

Picture Credit: 搜狐财经

【8.10】养老机构内设诊所审批取消 实行备案制

近期,国家卫生计生委出台了《关于深化“放管服”改革激发医疗领域投资活力的通知》(下文简称通知)。在今年8月10日的新闻发布会上,国家卫计委医政医管局副局长焦雅辉强调了全国社会办医机构在推动我国医疗体系发展壮大的过程中已成为一方不可或缺的力量。根据统计,截至4月底全国社会办医机构有44.4万家,占医疗机构总数45%;社会办医院有1.69万家,占医院总数57.2%。为了鼓励并规范化社会办医的市场,通知具体提出了三点要求。首先,通知指出要取消养老机构内设诊所的审批,实行备案制。此外,社会资本可独立开设康复、护理、安宁护疗中心。第三,养老机构内设置诊所,不对社会开放以保证对老人的护理质量。其他重点的改革举措包括:各级卫生计生部门要加快推进医疗机构、医师和护士电子化注册管理改革进程;进一步简化医疗机构审批程序;进一步提升医疗领域对外开放水平等八项举措。包括上述养老机构报备的备案制措施,本次通知一共提出十项举措,是卫计委近期放管服工作的重中之重。下一步,卫计委还将深化细化改革举措,制订出台具体的、具有可操性的文件,明确时间表和路线图,抓好十项改革举措的落地工作。

China’s National Health and Family Planning Commission issued a Notice on furthering the reform on reducing bureaucracy, increasing management capacity, and improving service quality. At the press conference on August 10th, Yahui Jiao, the Deputy Director of the Medial Affairs Department, emphasized the importance of the influx of social capital into the medical system. Based on recent statistics, as of April, 2017, private investment has led to the establishment of over 444,000 medical institutions, accounting for 45% of the total medical institutions nationwide. Among them, 16,900 are hospitals, accounting for 57.2% of the hospitals in China. To encourage and regulate social capital investing in the medical industry, the Notice stipulates three requirements. Firstly, the Notice stipulates the cessation of the approval procedure for establishing medical facilities within nursing institutions. Instead, a filling system will be implemented to encourage combining medical care with nursing services. Secondly, individuals or for profit enterprises will be allowed to invest in the establishment of rehabilitation, nursing centers or hospices. Thirdly, medical facilities within nursing institutions will not be open to the public to ensure the quality of care for the aged. Other measures of reform include digitizing the registration and management system for medical professionals, simplifying the approval procedure of establishing medical institutions, and further opening up the medical industry to social capital.

In the News

新闻速递

The March into Healthcare
明星企业跨界进军医疗产业

Founder and CEO of Amazon: Jeff Bezos
Picture Credit: CNBC
【7.23】亚马逊成立“1492”实验室,或秘密探索EHR和远程医疗技术

据外媒报道,科技巨头亚马逊已秘密建立名为“1492”的医疗实验室,意在探索电子健康记录(EHR)及远程医疗技术。据CNBC报道,亚马逊曾在招聘网站上发布招募a1.492团队成员的招聘广告,要求应聘人员具有医疗IT和医疗行业分析经验,并且掌握电子健康记录(EHR)相关知识。据悉,目前已知的团队成员包括两名机器学习专家、一名用户体验设计师以及两名项目管理人员。公元1492年,哥伦布跨越大西洋到达美洲,开启了探索新大陆的帷幕。亚马逊的1492实验室似乎也在传递着公司渴望征服新大陆的愿景和决心。目前,所有关于a1.492的招聘信息已全部被移除,亚马逊发言人称公司拒绝对谣言发表评论。

Amazon has secretly established a lab named 1492, dedicated to exploring healthcare opportunities such as telemedicine and digital medical records. According to CNBC, prior to their reporting, Amazon had published multiple recruitment advertisements on jobs sites for this lab under the keyword “a1.492″. These advertisements enlist candidates with relevant experience either in telemedicine or the medical consulting field. Some of the positions also require applicants to have abundant knowledge in electronic health records. It is said that the stealth team has already recruited two machine learning experts, a user experience designer, and two program managers. The name“1492” appears to be in reference to the year of Christopher Columbus’ arrival in America. Since CNBC’s reporting, Amazon has removed all the recruitment information from the jobs sites and did not respond to requests for comment.

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Founder and CEO of Wanda Group: Wang Jianlin
Picture Credit: NetEase News
【8.2】万达“去地产化”进军医疗大健康领域

8月2日晚间重磅消息,房地产巨头万达集团在现有四大产业集团(万达商业、万达文化、万达网络、万达金融)之外新设万达大健康集团,此举标志万达“去地产化”、“轻装上阵”策略的又一实质性动作。据悉,截至目前,万达在医疗领域的投资已达到1440亿元。早在今年1月,万达集团董事长王健林在2017冬季达沃斯年会上就曾公开表示万达正在考虑发展连锁医院。同年4月,万达集团与成都市人民政府签订合作备忘录,双方协议耗资700亿元,打造一座世界级的医疗健康产业中心。7月,万达在昆明斥资500亿元,打造以医疗健康为核心的医疗与大健康产业园。

Wanda Group, China’s top real estate tycoon, has grown another branch called Wanda Healthcare Group in addition to its four existing branches in commerce, entertainment, internet, and finance. The establishment of Wanda Healthcare Group aligns with Wanda’s overall mission to transition away from a pure real estate mogul. Wanda Group’s investment on the healthcare industry has topped 144 billion RMB. In January, 2017, Jianlin Wang, the founder of Wanda Group, announced at the 2017 World Economic Forum that Wanda was considering operating chain hospitals across the country. In April, 2017, Wanda signed an agreement with the Chengdu Government in which the two parties agreed to invest in 70 billion RMB jointly to establish a world class healthcare center. In July, Wanda invested 50 billion RMB in Kunming in the construction of a healthcare industry park.

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Picture Credit: Sina Tech

【8.4】腾讯发布腾讯觅影,正式进军AI医学影像领域

8月3日,腾讯公司发布腾讯觅影系统,正式进军AI医学影像领域。觅影系统包含6个人工智能系统,分别为:早期食管癌智能筛查系统、早期肺癌筛查系统、糖尿病性视网膜病变智能筛查系统、智能辅助诊疗系统、宫颈癌筛查智能辅助系统和乳腺癌淋巴清扫病理图像识别系统。这套系统目前已经在深圳南山医院部署一个月,每天为几十位患者筛查。腾讯方面表示,目前暂不会考虑将产品商业化,而将主要重心放在科研和通过基金会进行公益普查上。腾讯也是继百度医疗大脑及阿里”Doctor You”之后又一家进军医疗AI领域的巨头。

On August 3rd, China’s Internet Giant Tencent released “Tencent MiYing”, an artificial intelligence system specifically for medical imaging. MiYing contains six artificial intelligence systems, namely early phase esophageal cancer screening system, early phase lung cancer screening system, diabetic retinopathy screening system, smart diagnosis assisting system, cervical cancer screening system, and breast cancer lymph removal imaging system. The MiYing system has been deployed at Nanshan Hospital in Shenzhen for a month and is now screening dozens of patients everyday. Tencent is said not to have plans to commercialize this system at the moment. The company will instead focus on using this system for research and charitable screening purposes. With the introduction of Tencent MiYing, China’s internet Big Three, namely Alibaba, Baidu, and Tencent, have all entered the healthcare market.

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More on this
延伸阅读:其它跨界医疗行业的国内外知名企业

谷歌的母公司Alphabet旗下有数家子公司正在探索大健康领域内的机会。其中一家名为Verily的公司于今年4月发布了一款健康监控的手表,并希望通过手表采集的数据进行用户健康大数据分析。Calico,Alphabet旗下的另一家公司Calico目前正在探索抗老化、抗老龄相关疾病的相关技术。谷歌内部的DeepMind团队正在利用机器学习技术对眼科扫描的数据进行分析。

Silicon Valley giant Alphabet is embracing the healthcare sector in a big way. Alphabet’s research arm, Verily Life Sciences, unveiled a health-tracking smartwatch this April. Many of the other companies and projects under Alphabet are also making big moves in the healthcare sector, including Calico, an anti-aging effort and DeepMind, a machine learning project inside Google that has already been applied to the analysis of anonymous eye scans.

3

早在2007年,微软便以其HealthVault平台进军医疗健康领域。HealthVault是一款健康数据储存分析平台,它的开放接口使用户能与第三方厂商或保险公司之间进行数据交换,而用户能够自主选择公开哪些数据,因此保证了信息的隐私性。HealthVault的问世彰显了微软在医疗健康领域的野心。今年2月,微软宣布Healthcare NexT计划。该计划借助了微软在云计算及人工智能领域的领先技术,帮助医生进行数据录入整合、检伤分类,减轻门诊压力。

Microsoft began its navigation in the healthcare sector with the introduction of Microsoft HealthVault in 2007. HealthVault is a web-based platform to store and maintain critical health and fitness information. HealthVault also allows information to be exchanged between selected medical devices, such as blood pressure monitors, heart rate watches, etc. Early this year, Microsoft announced its Healthcare NexT initiative, which was intended to use cloud computing and artificial intelligence technologies to help doctors with data entry, patient triage, and outpatient care.

2

阿里健康前身为中信集团旗下中信二十一世纪有限公司。阿里巴巴集团联合云锋基金于2014年1月对中信二十一世纪有限公司进行战略投资,同年10月,中信二十一世纪有限公司正式改名为阿里健康。阿里健康下设四项主要业务,分别为“码上放心”药品追溯平台、医药电商、分级诊疗医疗服务网络及“智能关爱计划”健康管理平台。2017年7月,阿里健康发布“Doctor You”人工智能,包括临床医学科研诊断平台、医疗辅助检测引擎及医师能力培训系统。

Alibaba Health, formerly known as CITIC 21CN Company Limited, is a healthcare company under China’s tech tycoon Alibaba Group. Ali Health boasts four main areas of business, namely a tracking platform for medicines, an online retailer portal for drugs and medical equipment, a tiered diagnosis network, and a health management system. In July, 2017, Ali Health launched “Doctor You”, a platform based on artificial intelligence. This system consists of a clinical diagnosis platform, a disease detection engine, and training system for medical professionals.

4

恒大健康为恒大集团旗下公司之一,是恒大布局大健康领域的重要一环。恒大健康致力发展高端国际医院、社区医养及抗衰老等服务。2015年,恒大健康携手美国布莱根和妇女医院,于博鳌打造博鳌恒大国际医院,目标提供国际一流的肿瘤疾病治疗服务。2016年底,“恒大养生谷”于三亚落地,提供健康教育、医疗服务、颐养康复等22项健康生活服务。

Evergrande Health is a subsidiary under China’s real estate mogul Evergrande Group. The establishment of Evergrande Health marks an important move in Evergrande’s stride into the healthcare industry. Evergrande Health is dedicated to developing top notch international hospitals, community based  medical and nursing services, and anti-aging initiatives. In 2015, Evergrande Health partnered with Brigham and Women’s Hospital and established Bo’Ao Evergrande International Hospital. The goal is to provide world class tumor treatment services. In November, 2016, “Evergrande Health Valley” was established in Sanya. The valley provided twenty two healthcare services including health education, medical services, nursing and rehabilitation services, etc.

图片均来自网络

Research and Opinion

科研与社论

Picture Credit: Andrew Testa for The New York Times

英格兰的免费聊天服务:一场野心勃勃的心理健康改革

一场向患有心理疾病的患者提供“免费聊天”治疗服务的全国性精神健康实验项目正在英格兰轰轰烈烈的开展着。到目前为止,该项目已经每年治疗了超过一百万人,有效帮助人们不再为患有心理疾病而感到耻辱,做到畅所欲言。这个项目的最终目的是希望将实验进行全国性的推广,最终建立起一个针对精神健康的初级护理体系。

得益于项目自身的诸多特性,实验取得了实质性的成果。首先,这个项目覆盖全国各地。地域上的广度确保了这个项目可以为更多的人提供治疗。其次,实验针对心理疾病的特点,提供层层递进的治疗方案。该项目中的所有患者都会从他们所属地的项目对应机构接到一个电话,这个电话便是一系列治疗的开端。通过电话,专业医护人员可以将患者的实际情况进行分类,并决定患者是否需要后续的小组或个人疗程。该项目的第三个特点是,实验人员在接到患者的电话后会在第一时间及时回电,这也是整个实验极其关键的部分。如果患者在提出请求后的几天时间内没有接到跟进的电话,他们会对后续治疗产生抵触情绪。最后,这个项目通过两份标准的调查问卷来跟踪病人病情的发展。病人的数据都会被录入数据库中以备后续研究使用。

当然,该实验也有一定的局限性。很多评论家指出,这个项目只有效地使用了行为认知治疗法而没有涉及到其它疗法。其他评论家指出,该项目并没有将心理治疗诊室门前排队的长龙,人们仍然需要排队等待与专业心理治疗师面对面谈话。尽管有这些局限,这项实验依旧有效的缓解了部分患者的心理压力,而且让许多人开始重新正视心理疾病。据悉,后续实验也会利用在线诊疗软件来在全球范围内覆盖更多的患者。

本文编译自纽约时报2017年7月24日文章
原文题为”England’s Mental Health Experiment: No-cost Talk Therapy”

England’s Mental Health Experiment: Free Talk Therapy

England is in the midst of an ambitious national experiment that offers free talk therapy sessions for people suffering from mental illnesses. The program now screens one million people annually and has helped mitigate the stigma of openly discussing mental health issues. The goal of the program is to turn the experiment into a national mental health primary care system for all of Britain.

There are a number of unique characteristics of the program that contribute to its success. Firstly, the initiative offers free talk therapy at clinics throughout the country. This wide geographical coverage ensures the open ended accessibility of this initiative to virtually everyone regardless of where they reside. Secondly, the initiative takes a stepped approach towards mental illnesses. Those who reach out to any of the program affiliated institutions will usually get a phone call, which is often the initiation of a therapy series. Through this call, practitioners will assess the specific condition of a caller and determine whether group or individual sessions will be needed. This stepped approach ensures that everyone will end up getting a tailored treatment plan. Thirdly, the promptness of the initial callback from practitioners proves to be extremely crucial in the entire course of treatment because people tend to grow more reluctant to reach out again if they do not hear back in the first few days. Lastly, the program uses two standard questionnaires to track people’s conditions. Collected information will eventually be entered into a database for further study.

The initiative has certain limitations as well. For example, critics argue that the program only promotes one kind of therapy – cognitive behavior therapy. Others contend that this program does nothing to make the waiting list for psychotherapy shorter. Nevertheless, this initiative is still a bold and effective move towards bringing the conversation on mental illnesses back and eventually creating an effective mental health care system. Similar initiatives may very well take advantage of the prevalence of online therapy software programs and thereby reach a wider audience globally.

The original article appeared on The New York Times on July 24, 2017. It was authored by Benedict Carey. 

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