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Image Source @视觉中国

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文|八点健闻,作者|季敏华

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Last weekend, the first Sino-US Hospital Cooperation Summit (CUHC) was held in Beijing. Dr. Song Donglei, who listened to the day, summed up in his circle of friends:

The US side of the speech is a professional manager of the hospital. The Chinese dean is a professional doctor. Most of them are still seeing a doctor. The US is focused on patient experience and services. The Chinese side emphasizes the discipline construction and business development.

At the summit, almost all representatives of the best hospitals in the United States were represented, including: John Hopkins Medical Group International President Charles Wiener, Cleveland Clinic Abu Dhabi (Abu Dhabi) Chief Medical Officer, Jorge A. Guzman, Inc., Inc. Harold Lilly et al., Vice President, International Department, (UCSF) Medical Center, University of California, San Francisco. In a day-and-a-half forum, the American deans shared their latest insights into current medical management.

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"Patient-centered" revolutionized the US healthcare system

However, the difference between China and the United States is not always the case.

For a long time in history, American doctors have considered disease more than patients. "This was very common in the 20th century. We didn't pay enough attention to patients at that stage. Now we are back to the attention of patients." Charles Wiener said frankly.

He said that if you want to redefine the quality of medical institutions, the most critical one is "patient-centered medical and patient experience."

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Wiener emphasizes that reputation is critical to a hospital. A 2016 study conducted by Deloitte in the United States found that 50% of respondents believe that hospital brand and reputation affect their choice of medical treatment, and positive patient experience can significantly enhance hospital reputation and patient loyalty.

In the new era of the rise of the Internet, such influences will be magnified: social media has a very important reputation. 70% of patients with positive experiences will tell others through social media; and among negative users, 76% will tell others, and 43% will no longer choose this hospital.

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Similar to China's prominent contradictions between doctors and patients, there are many medical lawsuits in the United States. Years of research have found that in the United States, the primary cause of a complaint is that the patient experiences problems rather than the skills of the doctor.

Increasing the patient experience will certainly increase the cost of the hospital, but these inputs will ultimately bring the benefits of the hospital. According to a survey in the United States, hospitals that performed well in hospital satisfaction surveys had higher profitability than hospitals with low evaluations. Wiener also said that in Maryland, where the Johns Hopkins Medical Group is headquartered, the state government has proposed to link medical expenses reimbursement to patient experience, safety, and outcomes. If the patient experience score is high, the reimbursement rate is high.

Cediars-Sinal, the eighth of the nation's best hospitals, created the patient experience office in 2016. This is the largest non-profit hospital in the western part of the United States, with over 4,500 health-care workers in the Los Angeles hospital and more than one million people a year.

Alan Dubovsky, Chief patient experience Officer for Health Systems at the Cedar Sinai Medical Center, shared some specific practical experiences-

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"The questions we asked were all about today, yesterday, and most the day before yesterday, and they were very detailed, and they were designed for each doctor," Dubovsky said. With the Internet and AI, West Dasena used the AI ​​voice system, which was followed by automated voice calls after the patient was discharged from the hospital. The results showed that the patient's response rate was as high as 75-80%. The system has been in use for 18 months in the hospital, showing a 16% increase in patient follow-up rates.

Improving the patient experience requires a lot of financial and human resources. Dubovsky said that because the doctor is very busy and there are many patients to be treated every day, they have made some short videos to tell the doctor how to improve the patient experience. The results show that doctors who learn by video can increase the patient experience by 15-20%.

Neveen El-Farra, associate dean of the University of California, Los Angeles (UCLA) Medical Center, shared the CICARE model of the center's emphasis on patient experience. The medical center ranks seventh in the nation's best hospitals and has more than 5,000 health care workers.

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CICARE has four behavioral modes, namely patient communication, ward round, multidisciplinary participation and college training. “At the beginning of the rounds, it is very important to consider the problem from the perspective of the patient, expand empathy, and communicate with the patient to create a treatment plan. This is very important,” Farra said. “Every time you meet with the patient, don’t let He feels that you are very busy."

Eventually, the patient's commitment to the experience will be remembered after she leaves the hospital. El-Farra says she receives letters from patients every year to express their value for a good patient experience. For example, "the last few months have been my toughest months, but the patience and empathy you have shown me really impressed me." "my usual presence with such good paramedics as you has increased my determination to overcome my illness by a factor of 1 million."

However, why do Chinese hospitals agree with the patient experience in concept, but it is difficult to emulate in the current practice?

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△ excerpt from Heitham Hassoun speech PPT

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Three major trends in the global health care system

Professor William A. Haseltine from Harvard University proposed at the China-US Medical Cooperation Summit that it is now necessary to focus on the transformation and transformation of the health care system from a global perspective.

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For example, Haseltine says that about 5% of patients in the United States account for 50% of medical expenses. They are often elderly patients. The United States is trying to transfer these 5% of patients to home care based on analysis of various factors in the hospital. In order to reduce overall medical costs, while improving patient satisfaction.

Harold Lilly, vice president of the (UCSF) Medical Center at the University of California, San Francisco, presented the hospital's innovations in digital medicine at the summit. UCSF Medical Center ranked sixth among the best hospitals in the United States, specializing in organ transplants. In particular, the number of kidney transplants in the world number one, but also the largest brain tumor treatment centers in the United States.

According to Lilly, digital healthcare is primarily concerned with patient experience, seeking solutions between doctors and patients, and increasing coverage through telemedicine and secondary care services. Second, digital healthcare is focused on improving precision care and addressing healthcare costs. Excessive problems improve the efficiency of doctors.

The second biggest trend in the world is the global expansion of medical institutions. Jorge A. Guzman, chief medical officer of the Cleveland Clinic Abu Dhabi, shared the development of the international branch of Cleveland at the summit.

Cleveland has a century-old history, and the hospital has made great progress after World War I. in 1920, it admitted the first international patient, acquired the hospital in the rest of the world from the 1990s, and formed a global system. For example, the acquisition of a Canadian hospital in 2007, followed by the opening of the Abu Dhabi branch and so on.

These top medical institutions in the United States are also enthusiastic about entering Chinese markets and seeking Chinese partners. However, at present, most of them still stay in the medical management consulting business. There are few cases of joint ventures, and there are only a few in-depth strategic cooperation. For example, Taihecheng Medical Group cooperates with MD Anderson Cancer Hospital, Green Leaf Medical Group and Cleveland Clinic. Cooperation and so on.

Hassoun said the Cedar Sinai International Medical Center hopes to promote health care and create social impact through internationalization, while he believes globalization is also valuable in strengthening and protecting the Cedar Sinai brand.

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Qu Wei, founder of Ultimate Healthcare, the host of the summit, said the agency's business model is to integrate the world's top medical institutions and localize their resource experience models in clinical, scientific and educational fields. To empower Chinese medical institutions and doctors to internationalize.

The third major trend in globalization is the trend of medical talents moving around the world, followed by global clinical trials in the field of drug development. For example, doctors in Africa flock to South America and China, doctors in Southeast Asia move to China, and Russia. Clinical trials for the development of new drugs have evolved from a single region in the past, and have evolved simultaneously across multiple regions of the world.

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Professor Haseltine agrees, "now that we are putting research into the transformation of the health system at the bottom of the spectrum, that is not the case. It determines the future of our industry and should be given more attention. "

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