The essence of medical care is not by inspection, not by selling drugs, but by service.
The AI digital medical industry must start from the medical itself. Technology is only an auxiliary tool and means. Only when it truly supports medical services will it produce great value.
——Jin Xin, founder and CEO of Aiyisheng Health
This article is the original of the polypeptide chain Peptide society.
Author Yang Huilin
Open the circle of friends and see that Jin Xin has two labels for himself: AI+ medical , outdoor sports. He has repeatedly surfed the Tengger Desert in cross-country and ran alongside the wind at -25 °C.
The label "Medical AI" is because he is the founder of Yisheng Health. This company specializing in intelligent medical slow disease management aims to build China's chronic disease medical ecological intelligence medical engine.
In fact, after graduating from Shanghai Jiaotong University with a master's degree in computer network, Jin Xin has worked in Ericsson, Hewlett-Packard, and Redback Networks in the United States. He has 20 years of experience in market operations of Internet, telecommunications, and IT multinationals, and is well versed in the use of big data.
This laid the foundation for Jin Xin to establish the health of Yiyisheng.
Since the establishment of Aiyisheng, we have continuously explored the value of data in the dynamics, explored business models, and supported a set of systems with a set of development logic. Since 2014, the system has covered 100 medical institutions and 1 million patients.
Jin Xin said: "Although the company was established five years ago, the previous technical reserve took 10 years and has a considerable technical threshold. Unlike general medical imaging or voice-based robots, this is a true clinical level of artificial intelligence products. â€
National Guide + AI + Chronic Disease Management
“More than 90% of chronic disease medical expenses are reimbursed by medical insurance, which accounts for 70% of the total medical expenditure.â€
Combine the national guidelines related to chronic diseases with artificial intelligence to form the core product of Aiyisheng - the national guideline GDS (Guideline-based Decision Support), a guideline-based clinical decision support system and a A series of clinical tools that automatically generate results.
National guidelines are expert consensus and clinical standards in the medical community. Regarding the prevention and treatment of chronic diseases in the group, the state's authoritative academic institutions, organizing state-level experts, after 3 to 5 years of evidence-based medical research, formed research results, formed consensus through expert discussion, and applied to the prevention and treatment of chronic diseases in large populations.
GDS first is a medical product, not an IT product.
"GDS is like a Rolls-Royce aero engine, which can promote Boeing and promote Airbus. It is the medical engine of chronic disease management, promotes the construction and operation of various chronic disease management systems, and solves the grassroots standard service. Capacity and efficiency, as well as clinical and general clinical synergy issues," Jin Xin said.
At present, GDS has adopted 18 relevant national guidelines for cardiovascular and cerebrovascular diseases, including hypertension, diabetes, dyslipidemia, coronary heart disease, cerebrovascular disease, gout, and cysteine. "We have 15 software copyrights that will allow the guide to reach its maximum extent."
GDS is mainly divided into three major blocks: doctor assistant . Including outpatient assistants, follow-up assistants, chronic disease rounds and discharge assistants, assist the doctor's clinical work, including the management of chronic disease clinics, follow-up and contracted groups of patients.
“Our application system will be embedded in the HIS interface, and the background will interface with the patient's electronic health record and electronic medical record to provide doctors with tools for disease analysis, risk assessment, treatment goals, guide treatment recommendations, follow-up planning and follow-up execution.â€
Nurses around . On the one hand, it is possible to make individualized consultations at any time for the patient's chronic illness.
On the other hand, you can do chronic disease monitoring. Provide one-stop guidance for continuous monitoring of blood pressure and blood sugar. The patient completes the blood pressure and transmits it to the cloud in one click. After the cloud GDS analyzes it, the analysis results are transmitted back to the mobile phone. Through automatic interpretation, the two most critical information is presented: what is the clinical significance of the uploaded data, what needs to be paid attention to, and the enthusiasm for increasing the patient's blood pressure.
AI chronic disease big data . GDS can understand the whole process of medical behavior between doctors and patients, continuous collection of real-time data and corresponding efficacy correlation, clinical level of AI mining, prevention and treatment of chronic diseases in the whole population, key population and high-risk groups , the performance management of doctors and patients, as well as the innovative management of medical institutions, have a new meaning.
For example, during the follow-up of chronic disease, comparing the different medical effects produced by different times of one-year follow-up, AI chronic disease big data can be known, from the perspective of clinical and health economics, the optimal number of follow-ups should be.
Jin Xin explained: “Previous doctors' study guides usually involve training and then combined with their clinical work. Now the GDS system integrates chronic disease related guidelines, simulates doctors' clinical thinking, and automatically converts guides into clinical work tools. GDS is like a robot doctor assistant, stationed in every HIS terminal, in every doctor's workstation, and at the same time like the nurses around the patient, stationed in each patient's mobile phone, let the guide become doctors clinical and patients Part of home self-management."
Doctors are the most important customers of Yiyisheng. Jin Xin said: "Use the system to help doctors manage patients, and intervene in the whole process of medical behavior, so that doctors and patients can experience improvement. With data, it is paved the way."
GDS has a remote chronic disease ward round tool to help large hospitals to use the community hospitals under their jurisdiction as virtual wards, specialists and general practitioners of the medical complex, to carry out round-the-clock remote clinical collaboration for key chronically ill patients, and to implement effective Two-way referral. Make full use of the integrated resources of the medical association to serve patients.
In fact, specialists, general practitioners, and nurses, these three types of medical staff continuously communicate and service the patients, so that the treatment plan is continuously adjusted and optimized. That is to say, there is a medical service system to serve patients.
Community of interests brings multi-win
How to reduce unreasonable cost increases, reduce ineffective treatment, save considerable medical insurance funds, and promote the construction of chronic disease medical ecology is a question that Jin Xin has been considering.
It is said that chronic disease management does not make money, or it is too easy to make money. The importance of the model is self-evident. Aiyisheng provides B-side supply side support, like medical engines, supporting medical institutions, and exerting value in chronic disease management , while the profit model is gradually explored in cooperation with medical insurance, commercial insurance and medicine.
· Medical insurance . Jin Xin exemplifies that basically the national medical insurance is slightly different in different regions, but in general, the reimbursement model is almost the same. In the case of comprehensive chronic disease medical insurance reimbursed 5,000 yuan a year, among the 1 million people, underwriting About 10% of chronically ill patients, that is, 100,000 people, this is 500 million. The annual increase in chronic disease costs is around 20% to 30%, 500 million this year, and 600 million next year.
“90% of chronic disease costs are reimbursed by medical insurance. For medical insurance, the value of chronic disease management is reflected in the unreasonable increase in the effective control of medical insurance costs. Who is the biggest economic beneficiary? Medical insurance costs are falling, medical insurance is the biggest Beneficiary."
Through chronic disease management, hospitalization and complications of the slow patient population have declined significantly. “We open up the cost data and the treatment data, which is to link the medical behavior with the effects of health economics.â€
· Business insurance . Aiyisheng monitors chronic disease management, understands, supports and intervenes in medical behavior, analyzes the key points of cost generation, and then carries out risk control in relevant clinical dimensions.
In the past year, after adopting this mode of cooperation in a prefecture-level city in a major province of North China, the increase in chronic disease costs has decreased from 23% to zero, equivalent to a savings of one billion.
“The government will reinvest the cost savings, some of which will be the purchase of clinical big data and medical risk control operations.†Jin Xin said.
·medicine. "Chronic diseases require continuous medication, and 70% of the cost is spent on medicine," Jin Xin pointed out.
The income generated by medicine is that the medicines of the chronic diseases of the whole city, whether in the community or in the tertiary hospitals, are not taken from the pharmacy, but a chronic disease center pharmacy is established and delivered directly to the household.
That is to say, the medication for patients with chronic diseases is not purchased by the hospital, but is purchased by a city. This reduces the cost of circulation and reduces the cost. This saved money can also be reinvested, for residents, Chronic patients provide better chronic disease management services and form a virtuous circle.
In addition, how to mobilize the protagonist of chronic disease management, the enthusiasm of doctors and patients, is the key to whether the community of interests can reach an agreement. Therefore, some of the saved chronic disease costs must be reinvested to stimulate the motivation of doctors and patients with chronic disease management and to implement individualized performance management.
The patient must first sign a contract, and the first diagnosis can be diagnosed in a large hospital. However, after the stable treatment plan is determined, the treatment is in the community, and the family doctor provides continuous service with GDS.
Using GDS to generate chronic disease control targets for patients with underarm disease, including blood pressure, blood sugar and blood lipids, has become a performance management target for contracting between patients and doctors. For patients, by the end of the year in the medical insurance reimbursement, such as 5,000 yuan, 30% is paid by the individual, that is, 1,500 yuan, if the standard is met within the year, you can cash back 50%. That is, in the medical insurance reimbursement, the individual actually pays 750 yuan. The continuous control of chronic diseases is very important. If the second year continues to meet the standard, then the patient's commercial health insurance will be given. Patient compliance and self-management initiative increased significantly. Where does the money come from? Both come from the reduced cost of hospitalization and major complications.
The incentive for doctors is that every time a patient is contracted, the same patient's chronic disease prevention and control goal generated by GDS can be obtained. If the doctor reaches the target at the end of the year, the doctor can get a service fee of 120 yuan. If a doctor signs up to manage 1,000 patients, 120,000 a year, this income is considerable for the grassroots doctors.
"The problem of smooth operation of the medical insurance fund has been solved. The health of the people has been greatly improved. The doctors' services have been recognized by patients and the economic returns. Our resource providers and operators have fully demonstrated their value in the medical environment and have received corresponding Business returns. The community of interests ultimately creates a healthy community!".
Jin Xin said: "Chronic diseases are not finished once. It is important to track services continuously. The 12-month follow-up plan for the whole year is completed to form a chronic disease management plan. This can cause chronic disease between doctors and patients. Management behavior is standardized, personalized, and refined."
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