共享风吹到了医护界,你怎么看待“网约护士”的呢?

共享风吹到了医护界,你怎么看待“网约护士”的呢?
2020年09月25日 21:51 CGTNBizTalk

With a population of about 250 million aged over 60, China is challenged by a huge shortage of nurses, whose registered number barely reaches four million. /AFP

随着我国老龄化社会进程加快,延续护理成了刚性需求。时下,“网约护士”在全国多地试水。通过微信下单,患者即可享受经验丰富的护士提供的上门服务。

2019年2月,国家卫健委出台新政,对“互联网+护理服务”的提供主体、服务对象、服务项目、服务管理、风险防控等提出了原则性要求,并确定北京、天津、上海、江苏、浙江、广东六省市作为试点。此次国家层面政策的出台,被网友称为“网约护士”的官方版。

As China's aging population increases faster, the demand for professional nursing and care services has also grown quickly. Currently, many Chinese cities are building pilot programs for online nursing services appointment. The elderly can book experienced nurses via online apps and mini webpages, and have professional services at home. 

In many Chinese cities, local governments have set up various digital access – WeChat programs, registered apps, hospital-affiliated websites – for residents to book online. 

In February 2019, China's National Health Commission (NHC) launched a pilot program – the Internet Plus Nursing Services – in six provincial-level regions including Beijing, Tianjin, Shanghai, Jiangsu, Zhejiang, and Guangdong, in an attempt to make use of nurses' spare time to provide door-to-door nursing services. Under the program, discharged patients and disabled people can apply for registered nurses to serve them at home via an online system. 

With a population of about 250 million aged over 60, China is challenged by a huge shortage of nurses, whose registered number barely reaches four million. /AFP

湖南省人民医院肝胆外科“80后”护士吴秀娟就是这样一名“网约护士”。拥有15年工作经历的她,是一名资深护师。前年她通过网约平台接了第一单,如今已经提供上门服务上千次,“很多患者都是老熟人了,他们的信息我了如指掌,服务起来也得心应手”。

湖南省人民医院老年医学部主任石小毛介绍,“网约护士”一般服务的对象为老年人、留守儿童、慢性病患者,接单的护士一般都利用工作以外的休息时间。以PICC维护为例,“网约护士”每次出诊收取患者150元,包含上门费、护理费、交通费、护士保险费。

Being such a nurse, Wu Xiujuan from Hunan Renmin Hospital has serviced her patients many times. "Many people are familiar with me, and I know their health info as well. So this long-term booking mechanism can make nursing work more effective," she said. 

Shi Xiaomao, director at the gerontology department of Hunan Renmin Hospital, said services are usually provided to senior citizens, kids, chronic patients or disabled people. Nurses make use of their off-work time to carry out such services. Usually, fees charged by them include traffic, nursing, insurance and service. 

新型延续护理满足刚性需求

自2017年起,湖南省人民医院依托“熙心养护”等微信服务平台,将“网约护士”项目从医院延伸到社区、家庭,构建连续性护理服务模式。目前“网约护士”项目共有护士近200人,“活跃护士”110人左右。

湖南省人民医院为有效开展“网约护士”项目,还专门搭建了“网约护士”App。护士们下载App后,即可浏览下单情况、病人信息、病人医疗记录、费用支付和患者反馈等。为了实现照护专业精准,“网约护士”App具有日常监督、护士上门观察病情、与主管医生实时对接等功能,养、护、医一体化的医养结合服务体系由此建立。

“通过一键下单,即可为有需求的患者提供像‘滴滴打车’软件一样的智能匹配和快速便捷服务。”湖南省人民医院副院长秦月兰介绍,“网约护士”项目,应用了信息化、大数据和“云医院”整合的护理新模式,体现了健康生态圈的服务理念,加强了护理人员、主诊医生、居家老人和家庭成员之间的实时联系。截至2020年7月,“网约护士”这一服务覆盖了湖南省大部分地区以及部分周边省份。

In Hunan Province, patients in need can browse the messaging app WeChat's official account "Xixin Health" to check nurses' info and select the one they want, then make an order on WeChat. Nurse will come to patients to proceed with professional services afterwards. 

Nurses using the apps can check and record patients' orders, health info, clinic records and payments. To conduct more professional tailor-made services, the apps are used by a third party to supervise nurses' work, contact their superintendents, and provide advice. A system integrating nurses, doctors, patients, and hospitals is thus established. 

"You just need to click the button, like hailing a taxi online, the instant services will be offered," said Qin Xiulan, vice president at Hunan Renmin Hospital. "This is a smart application based on big data and AI. By July this year, it has covered most of the areas within Hunan."

"The evaluation is very strict. Nurses need to know well about the patients beforehand, take photos of the onsite situations and upload them to the hospital platform once they got to their homes. This is for our information consistency and following treatments," she said. 

It is key to guaranteeing the quality of services, and make sure the nursing service is traceable and controllable, in order to continue this service. Door-to-door nursing is special considering it requires onsite services, so timely monitoring and instructions are necessary. 

“网约护士”有什么弊端吗?

新生事物需要妥善引导

北京协和医学院教授张宏冰说,“网约护士”是共享医疗的重要内容,方便了群众。但要注意的是,不能让护士疲劳工作,将上门服务变成疲劳的“兼职”,应继续尝试建立专门的上门医学团队,为患者提供护理服务。充分考虑不同护理服务的风险层级,制定“网约护士”上门服务项目目录清单,确保上门服务过程留痕、可追溯,将上门服务内容纳入医疗监测平台,利用互联网技术确保护士在上门服务时得到相应的远程医疗指导,确保医疗护理服务的安全性。

“网约护士”上门服务的价格目前是根据市场需求定价,采取备案制。秦月兰等业内人士建议,相关部门应梳理制定明确的收费项目,并纳入医保报销范畴。同时,应由政府提供专项资金,建立机制,激励更多具备资质的护理人员,特别是基层医疗机构的护理人员加入这项工作中来,让社区的群众就近享受便捷的医疗服务。

As Qin suggested, charging standards should be regulated and included into health insurance. In the future, more support from China's public sector is needed to encourage more qualified nurses to register. 

According to the NHC, the average life expectancy of Chinese people reached 77 years in 2018, but, healthy life expectancy was 68.7, indicating a huge number of seniors are living with illness for about eight years on average before they die. With a population of about 250 million aged over 60, China has a huge shortage of nurses, where there are barely four million registered.

(中文部分选自新华网

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