Dystopia on the Health Superhighway

The emerging Information Superhighway is starting to induce visions of dystopia within the medical profession. In several countries, doctors have opposed plans for the establishment of national health data networks. In the most recent example, the Council of the British Medical Association threatened to boycott the government's national data strategy. This action followed the lead of Australian doctors, many of whom have consistently opposed a national wide-area network for health data. In common is the fear that this data linkage will erode medical independence, increase the power of government health authorities, and eliminate the confidentiality of medical information. Doctors have a duty of care to patients to protect confidentiality, and they say the emerging national networks compromise this responsibility. Here, I argue that the emerging health superhighways should either conform to strict privacy standards or they should be demolished.     

Information management of medical errors in Greece: The MERIS proposal

There is a substantial amount of public concern about patient safety, as, according to estimates from major studies, hundreds of thousands die in hospitals each year all over the developed world as a result of medical errors that could have been prevented. Unprecedented research commissioned by the EU has found that almost one out of every four families has experienced a serious medical error. Greek citizens concerning about serious medical errors in the hospital environment, were at the top of the list. Greek Ombudsman's report on medical errors has raised the debate among health policy makers as to the appropriate response to the problem. Proposals range from the implementation of nationwide mandatory reporting with public release of performance data, to voluntary reporting and quality-assurance efforts that protect the confidentiality of error-related data. Any successful safety program will first require a national effort to make significant investments in information systems, along with providing an environment and education that enables to contribute to an active quality improvement process. In this paper we propose the development and implementation of Medical Error Reporting Information System (MERIS), in order to identify, collect, analyse and report medical errors and patient adverse events, as a tool for enhancing patient safety and health care quality. We also describe the necessary organisational structure and the infrastructure environment of the system and the barriers to its successful implementation.     

从《大医精诚》谈医者气质

《大医精诚》对医者提出了为医的基本要求。一曰仁义,就是要有献身医学的恒心壮志;二曰仁心,即＂诚＂就是要有高尚的医德;三曰仁术,即＂精＂就是要有精湛的医术。＂大医精诚＂乃医者魅力所在。     

基于在线问诊文本信息的医生推荐研究

【目的/意义】为了向在线医疗社区中的用户自动推荐符合其自身实际需求的医生,本文基于在线问诊文本 信息,提出了基于相似用户与相似医生的混合医生推荐算法。【方法/过程】首先从用户咨询问题出发,找到具有相 似咨询问题的用户,将其所选择的医生作为基于相似用户的推荐集合;然后从医生回答从发,通过LDA主题模型训 练,从医生回答文本集中挖掘出隐含的疾病主题,按主题查找具有相似疾病诊治经验的医生作为推荐集合;最后通 过混合相似度计算融合基于相似用户和相似医生的推荐结果,得到最终推荐列表。【结果/结论】通过对在线医疗社 区“39健康网”进行实证研究,结果表明,利用本文提出的方法进行推荐,能够有效降低数据维度,挖掘文本间的潜 在语义关联,有效缩小语义鸿沟,提升推荐质量,具有较好的推荐效果。【创新/局限】本文仅选取了针对科室的小样 本数据进行实验,且部分参数使用经验值,未来可深入探讨该方法在大规模医疗数据集上的应用。     

局域网的信息安全与病毒防治

随着网络时代的来临,计算机网络带来了无穷的资源,但也面临着越来越严重的网络安全威胁,网上信息的安全和保密是一个至关重要的问题。网络的安全措施应是能全方位地针对各种不同的威胁和脆弱性,这样才能确保网络信息的保密性、完整性和可用性,文章重点介绍了局域网信息面临的威胁、安全控制与病毒防治的一些策略。     

医疗活动中的利益冲突与道德判断关系分析

在医疗活动中，利益冲突不仅与经济密切相关，也与理想、安全、偏好、恐惧、竞争等因素有关。医生既是医疗职业者，同时也是社会的一员。医生应当如何处理工作中遇到的利益冲突，应当遵守怎样的道德准则，这些问题可以通过医患关系的不同类型的分析来解决。道德准则不是教条，医生应当根据不同的实际情况做出理性的选择和判断。     

A deep learning-based multi-turn conversation modeling for diagnostic Q&A document recommendation

Online healthcare communities (OHCs) have become producers of medical information. Solving the issue of how to effectively reuse such a large amount of medical data and discover its potential value is of the utmost importance for alleviating the shortage of medical resources. Online consultation has received widespread attention and population since its first appearance in 1999, and as a result, many diagnostic multi-turn questions and answers (Q&A) documents have become available. This type of document is formed by multiple rounds of patient questions and doctors’ diagnostic answers and contains massive medical knowledge and doctors’ diagnostic experience. Few studies concentrate on the modeling and recommendation of this type of document, yet making these documents convenient for reuse reduces the cost of medical consultation for patients and saves time addressing common diseases for doctors. In this paper, we focus on the modeling and understanding of diagnostic multi-turn Q&A records and propose a deep-learning recommendation framework based on patient medical information needs, the contents of Q&A records and doctor background information. With the evaluation based on a real dataset that contains pediatric consultation dialogues fetched from DingXiangYuan, a famous online consultation application in China, we found that the proposed model achieved a good performance on the recommendation of diagnostic multi-turn Q&A records and outperformed baseline models. In addition, we discussed a potential application scenario of the recommendation model, suggesting that the proposed model can promote the reduction of patient costs and doctors’ work pressure in countries or regions with insufficient medical resources.     

“民间120”—一支奋斗在卫生前沿的重要力量!

受劳动关系不明确、执业风险高、收入微薄、养老保险缺失等因素制约,我国很多地区的年轻乡村医生迫于生活压力纷纷外出务工,流失严重,乡医队伍结构日趋老龄化,农村卫生服务网络陷入后继乏人的尴尬局面。目前,一些行政村出现了＂空壳＂卫生室（站）,无法满足当地村民对公共卫生和基本医疗服务的需求。若不及时采取措施稳定乡村医生队伍,优化队伍结构,三级卫生服务网络的＂网底＂将遭遇＂人走网破＂。     

浅析医闹中患者保护的法律对策

在当今社会,作为白衣天使的一部分人以开药牟取私利,视患者死活如儿戏,引发医闹事件,并在全国范围内逐步升级,由小到大,由弱到强,最后发展到带有黑社会组织性质的职业医闹群体行为。本文通过对＂医闹＂这一社会现象进行分析,为构建多元、灵活、高效的医疗纠纷解决机制,提出一些设想。     

中国医院生态与医院经营管理

从医院生态出发，提出支撑其事业大厦的基点只能且必须是高超的医术、高尚的医德和完善的服务；医院经营管理的重点应是如何随着现代医学技术的发展、现代消费者健康理念和道德价值观念的转变，对传统的医术、医德和服务理念加以提升和深化。     

关于加强我国公共卫生应急反应体系建设的思考

随着我国公共卫生事件呈现出多发的趋势,新发突发传染病的预防和控制将会成为制约中国现代化进程、经济社会全面协调可持续发展和国家安全的重要因素。近年来,我国对突发公共卫生事件发生机理的认识、科学高效的应对能力在不断提升。文章通过对发达国家和我国公共卫生应急反应体系的比较分析,明确我国在体系建设方面存在的问题,并从建立预警预报机制、完善生物安全实验室管理体系、提高技术支撑能力和加强国际交流与合作等方面,提出加快我国公共卫生应急反应体系建设的建议,为我国新发和突发传染病的预防和控制提供支持。     

Big Data Analytics in Building the Competitive Intelligence of Organizations

Over recent years, organizations have started to capitalize on the significant use of Big Data and emerging technologies to analyze, and gain valuable insights linked to, decision-making processes. The process of Competitive Intelligence (CI) includes monitoring competitors with a view to delivering both actionable and meaningful intelligence to organizations. In this regard, the capacity to leverage and unleash the potential of big data tools and techniques is one of various significant components of successfully steering CI and ultimately infusing such valuable knowledge into CI strategies. In this paper, the authors aim to examine Big Data applications in CI processes within organizations by exploring how organizations deal with Big Data analytics, and this study provides a context for developing Big Data frameworks and process models for CI in organizations. Overall, research findings have indicated a preference for a rather centralized informal process as opposed to a clear formal structure for CI; the use of basic tools for queries, as opposed to reliance on dedicated methods such as advanced machine learning; and the existence of multiple challenges that companies currently face regarding the use of big data analytics in building organizational CI.     

Becoming an intellectual monopoly by relying on the national innovation system: the State Grid Corporation of China's experience

This paper examines the origins of global leaders under intellectual monopoly capitalism. State Grid Corporation of China (SGCC), the leading firm in artificial intelligence applications for the energy sector, became an intellectual monopoly relying heavily on China's national innovation system –particularly public research organizations and public funding, and innovation and energy policies. SGCC is unique because it did not rely on technology transfer from global leaders, unlike other national champions from developing or emerging countries. We provide evidence that contributes to thinking that SGCC first became a national intellectual monopoly and only afterwards expanded that monopoly globally. We empirically study SGCC's innovation networks. We proxy them using big data techniques to analyze the content, co-authors and co-owners of its publications and patents. Results also suggest that SGCC is capturing intellectual rents from its increasingly transnational and technologically diverse innovation networks by leveraging its national innovation system.     

Clinical chemistry and laboratory medicine in Croatia: regulation of the profession

Heterogeneity exists across Europe in the definition of the profession of clinical chemistry and laboratory medicine and also in academic background of specialists in this discipline. This article provides an overview of the standards of education and training of laboratory professionals and quality regulations in Croatia. Clinical chemistry in Croatia is almost exclusively practiced by medical biochemists. Although term Medical biochemist often relates to medical doctors in other European countries, in Croatia medical biochemists are not medical doctors, but university degree professionals who are qualified scientifically. Practicing the medical biochemistry is regulated by The Health Care Law, The Law of the Medical Biochemistry Profession and The Law of the State and Private Health Insurance. According to the law, only medical biochemists are entitled to run and work in the medical biochemistry laboratory. University degree is earned after the 5 years of the studies. Register for medical biochemists is kept by the Croatian Chamber of Medical Biochemists. Licensing is mandatory, valid for 6 years and regulated by the government (Law on the Health Care, 1993). Vocational training for medical biochemists lasts 44 months and is regulated by the national regulatory document issued by the Ministry of Health. Accreditation is not mandatory and is provided by an independent, non-commercial national accreditation body. The profession has interdisciplinary character and a level of required competence and skills comparable to other European countries.     

我国国家临床研究网络组织结构研究

构建国家临床医学研究网络是完善医学科技创新体系建设的重要内容,是促进我国临床医学研究发展的重要举措。欧美等国家的临床研究起步较早,已形成各具特色的临床研究网络。采用文献调研法总结国际典型国家临床研究网络的组织结构及功能特点,结合我国医学科技管理结构的特点,提出我国应建立多层级结构、功能完善的国家临床研究网络的建议。     

国际比较视野下机器人在医疗卫生领域的应用政策研究

新冠肺炎疫情的暴发加速了机器人在医疗卫生领域的应用,而中国机器人发展仍处于"婴儿期".通过对近年来美、日、欧盟、中涉及医疗卫生机器人的相关政策进行比较分析,发现应用政策差异主要体现在机构设立、项目开展、平台建设、法规伦理研究4个方面.研究发现,与美、日、欧盟比较,中国在上述方面存在明显差异:顶层设计过于依赖战略目标和资金支持,忽略人才培养、科技创新等软实力配置,项目审批程序多、速度慢;政策制定中有政府过度参与的迹象,同时医疗大数据管理和数据平台的建设尚处于萌芽期;社会包容性以及相应制度化标准的政策力度不足等.借鉴先进国家和地区的经验,得出对中国发展医疗卫生机器人的启示:政府需要在加强顶层设计、培养人才、面向市场定向开发、大数据平台建立和法规及伦理研究等方向进一步加强探索,抢占新一代机器人的技术制高点,以期实现智慧医疗的愿景.     

Global human burden and official development assistance in health R&D: The role of medical absorptive capacity

We investigate country-level determinants of Official Development Assistance (ODA) in health R&D with a focus on levels and types of human suffering as well as levels and types of medical absorptive capacity. Using latest data from a range of sources and various tests on large numbers of countries in receipt of health R&D ODA, we find support for the central assertions that human burden has a direct positive impact on receipt of health R&D ODA and that medical absorptive capacity in the recipient country moderates this relationship. The relationship between human burden and health R&D ODA receipt does not hold for countries low in medical absorptive capacity. Additional analysis reveals: (1) medical absorptive capacity that involves regular patient contact has the strongest moderating effect on the burden – funding relationship, (2) receipt of health R&D ODA under low levels of medical absorptive capacity explained not by human burden but by small country bias, and (3) the importance of nurses to health R&D ODA in countries with high levels of human suffering and health R&D ODA but voids of doctors and clinical trials.     

论加强中医院校大学生医患沟通能力培养的重要性

随着医患关系日趋紧张,提高在校大学生医患沟通能力显得越来越重要。本文主要针对中医院校的大学生,基于中医科患者的心理特点,阐述并论证了培养其医患沟通能力的重要性,指出医患沟通教育是适应现代高等医学教育发展的需要,是医学模式转变的需要,是保障医生自身身心健康的需要,是建立和谐医患关系的需要。     

医学生临床实习管理工作的思考

临床实习是培养医学生实践能力和职业精神的重要环节,是医学生向职业医师转变的桥梁,是医学教育的最后一站。临床实习期间的教学质量直接影响到学生毕业、就业及以后的执业考试,所以必须引起重视。临床实习期间规范的管理是提高医学人才质量的保障。     

Scientific misconduct at an elite medical institute: The role of competing institutional logics and fragmented control

The incidence of revealed fraud and dishonesty in academia is on the rise, and so is the number of studies seeking to explain scientific misconduct. This paper builds on the concepts of competing logics and institutional fields to analyze a serious case of medical and scientific misconduct at a leading research institute, Karolinska in Sweden, home to the Nobel Prize in Medicine.By distinguishing between a market-oriented, a medical and an academic logic, the study analyzes how various actors ? executives, research leaders, co-authors, journal editors, medical doctors, science bloggers, investigative journalists and documentary filmmakers ? sustained or tried to expose the misconduct. Despite repeated warnings from patient-responsible doctors and external academic reviewers, Karolinska protected the surgeon, Paolo Macchiarini, until a documentary film at the Swedish national public TV exposed the fraud which led to public inquiries and proposals for a new national ethics legislation.The analysis illustrates the power of a market-oriented logic focused on brand and image at the research institute and at a leading journal, but also the perseverance of the logics of scientific scrutiny and medical care among practicing doctors and independent academics although the carriers of these logics were less well organized than the carriers of the market-oriented logic. Furthermore, the analysis shows the problem of fragmented control in the academic institutional field. The discussion of remedies compares the Karolinska case, where media actors were instrumental in sanctioning the perpetrators, with a similar instance of medical misconduct at Duke in the US where the government agency (ORI) intervened and shows the limitations of both types of actors. The conclusion highlights the importance of studying misconduct management and institution-building in different fields to develop effective remedies.