Shared bicycles, many people ride them through the streets; shared power banks can be rented in small shops on the streets; shared wheelchairs have also entered many hospitals... In recent years, a series of shared The emergence of things changes people's way of life. Nowadays, medical institutions at all levels have begun to set up shared Chinese medicine pharmacies, saving residents the "trouble" of cooking Chinese medicine in counties.

The emergence and development of shared traditional Chinese medicine pharmacies are the result of the two-wheel drive of market demand and policy support, and have paved a new way for the development of grassroots traditional Chinese medicine. Recently, reporters visited a number of medical institutions to see how shared Chinese medicine pharmacies are developing in the county.

Demands and policies jointly "point out"

After a series of processes such as prescription review, adjustment and review, the barrels containing Chinese herbal medicines will be sent to In the automatic water adding area, the mechanical arm's automatic water adding operation is precise and flexible. After the Chinese medicinal materials in the medicine bucket are fully soaked, they will be sent to the decoction machine and packaging machine, and finally converted into packages of Chinese medicinal liquid. Subsequently, these traditional Chinese medicine liquids are quickly distributed to patients through the logistics system.

This coherent and efficient process is a scene that occurs every day in Jinjiang Traditional Chinese Medicine Hospital of Fujian Province (Zimao Campus), and it is also a technological "landscape" in the hospital's shared traditional Chinese medicine pharmacy. This not only provides patients with unprecedented convenient and efficient services, but also improves the utilization efficiency of traditional Chinese medicine resources through centralized procurement and intelligent decoction.

A major function of the shared Chinese medicine pharmacy is the decoction of Chinese medicine. Substituting traditional Chinese medicine for decoction is nothing new for most patients, and many Chinese medicine pharmacies in hospitals can provide this service. Due to its convenience, the decoction service is increasingly favored by patients. "Especially for those families who are not familiar with the decoction process, it is recommended that they use the decoction service, which not only saves worry but also ensures that the medicinal materials are decoctioned scientifically and rationally." The person in charge of the pharmacy department of many medical institutions said that although the machine More and more traditional "small medical pots" are used for decoction, but the necessary steps have not been reduced.

In the context of the increasingly strong demand for decoction services, shared Chinese medicine pharmacies have emerged - it allows the decoction service to be expanded and extended. It is no longer just for patients of a medical institution, but is County-level medical institutions take the lead and cover the entire county medical and health institutions, providing full-process services such as prescription reception, prescription review, dispensing, review, decoction, packaging, and distribution. In other words, other medical institutions no longer need to configure traditional Chinese medicine pharmacies, and all related work will be done by shared traditional Chinese medicine pharmacies.

At the end of 2023, the National Health Commission and other departments jointly issued the "Guiding Opinions on Comprehensively Promoting the Construction of a Close-knit County Medical and Health Community", proposing specific suggestions on the rational establishment of county medical communities and improving the service capabilities of traditional Chinese medicine. Require. Among them, there are two encouraging opinions worthy of attention - encouraging qualified county-level traditional Chinese medicine hospitals to take the lead in establishing county medical communities; encouraging qualified regions to rely on county-level traditional Chinese medicine hospitals to establish traditional Chinese medicine supply centers, traditional Chinese medicine preparation centers and shared traditional Chinese medicine pharmacies .

At a time when development is in full swing, the "Key Tasks for Deepening the Reform of the Medical and Health System in 2024" recently issued by the General Office of the State Council once again "points out the topic" and encourages qualified county-level traditional Chinese medicine hospitals to take the lead in establishing compact counties. Medical community. Against this background, more and more traditional Chinese medicine hospitals are emerging in the construction of county medical communities, and the construction of shared traditional Chinese medicine pharmacies has also ushered in spring. This not only provides opportunities for the development of traditional Chinese medicine services, but also provides opportunities for the construction of county medical and health service systems. Infused with energy.

The critical moment became a "magic weapon"

As early as 2016, the Anxi County Traditional Chinese Medicine Hospital in Quanzhou City, Fujian Province had a decoction machine and tried to Dedicated to the construction of shared Chinese medicine pharmacy. In 2017, Li Zhaohui, the newly appointed director of the hospital, encountered several thorny problems: grassroots medical and health institutions were under great pressure to operate traditional Chinese medicine pharmacies, but they were not willing to give up this business; if the county traditional Chinese medicine hospital wanted to achieve full coverage of distribution within the county, We also face many difficulties.

The dilemma faced by Li Zhaohui was similar to that encountered by pilot institutions in other provinces at the same time. He is well aware that in order to play the role of shared traditional Chinese medicine pharmacies, we must rely on the construction of county medical communities and strengthen infrastructure construction. In 2018, the hospital's number of decoction machines increased from 4 to 12, and a shared Chinese medicine pharmacy began operation. In 2020, according to business needs, the number of decoction machines in the hospital increased to 42. The real "highlight moment" for shared Chinese medicine pharmacies came during the fight against the new coronavirus epidemic.

When the epidemic hit, the preventive decoction of traditional Chinese medicine became a popular product, and the supply exceeded the demand for a while. "At that time, there were also related companies producing Chinese medicine decoctions, but the packaging was relatively simple and did not indicate the specific prescriptions and taking methods, resulting in low public recognition. The Chinese medicine decoctions produced by medical institutions made them feel at ease." Li Zhaohui said.

The reporter observed in many medical institutions that whether they provide decoction services or use shared Chinese medicine pharmacies, most medical institutions give full play to their professional advantages in pharmaceutical services: pharmacist review, professional dispensing and standardized decoction. Cooking ensures the rational use of medicines from the source; standardized labels on the decoctions allow the public to clearly understand the important information of the decoctions, so that they can use them with more confidence.

¡°During the epidemic in Quanzhou, the machines worked 24 hours a day, setting a record of producing 300,000 bags of COVID-19 prevention traditional Chinese medicine in five days.¡± Li Zhaohui said frankly that the production capacity of Anxi County Traditional Chinese Medicine Hospital at that time surprised many colleagues. In recent years, some medical institutions have successively visited Anxi for investigation and understanding of the operation mechanism of shared traditional Chinese medicine pharmacies.

The shared traditional Chinese medicine pharmacy has become a "magic weapon", opening up the "last mile" of traditional Chinese medicine services in Anxi County. Li Zhaohui said that the hospital is equipped with 42 decoction machines, 14 packaging machines, an automatic transmission system and related supporting software, which can meet the decoction requirements of first decoction and then lowering, automatic first decoction and second decoction. The most remote village in the area is nearly 100 kilometers away from the county hospital of traditional Chinese medicine. After the hospital completes the decoction of traditional Chinese medicine, it can deliver the medicine to your door within 2 hours in urban areas and to grassroots outlets within 24 hours in towns.

"The advantages of traditional Chinese medicine in preventing and treating diseases have been more widely used. At present, the cost of each decoction of traditional Chinese medicine in our hospital is 3.3 yuan, and inpatients can be 100% reimbursed; outpatients only need to pay 6 yuan out of pocket / delivery fee. As of March this year, our hospital has distributed a total of 3.6 million packages of traditional Chinese medicine pieces, of which approximately 1 million packages will be delivered in 2023, which is 15.6 times that of 2017," Li Zhaohui said.

The reporter learned that Anxi County Hospital of Traditional Chinese Medicine also regularly analyzes the county¡¯s demand for traditional Chinese medicine materials and conducts centralized bidding and procurement by sharing data from the traditional Chinese medicine pharmacy platform. "The purchase amount of Chinese medicinal materials in our hospital in 2023 will exceed 27 million yuan, an increase of 5.5 times compared with 2017. Since 2019, our hospital has completed 4 tenders for traditional Chinese medicine pieces, taking advantage of its large single purchase quantity and strong bargaining power to effectively Reduce procurement costs." Li Zhaohui presented such a set of data.

Anxi County Traditional Chinese Medicine Hospital improves the supply quality of traditional Chinese medicines by strictly reviewing enterprise qualifications, establishing complete purchase records, regularly evaluating drug suppliers, and implementing the last-place elimination system. The hospital has also established a Chinese medicine quality control center to combine traditional and modern analysis methods to test Chinese medicine pieces to ensure quality and efficacy.

New technology brings new changes

In Fujian Province, the shared Chinese medicine pharmacy of Anxi County Traditional Chinese Medicine Hospital has become a "model room", with some successful The experience has also been replicated in other county medical communities. Walking into the Traditional Chinese Medicine Intelligent Shared Service Center of Jinjiang Hospital of Traditional Chinese Medicine (Zimao Campus), a screen is scrolling with various information. In addition to equipment status, dosage of pieces, etc., you can also see the receipt of each prescription. time, as well as every specific operation being performed on the medicinal materials, etc.

The shared Chinese medicine pharmacy has changed the working mode of the hospital¡¯s staff and set forth strict work standards. Every time before entering the work area, the staff must change their work clothes and then conduct full-body dust removal through the air shower system. Traditional Chinese medicine prescriptions from various medical institutions within the medical community will be transferred to the Traditional Chinese Medicine Intelligent Shared Service Center, where Wang Haiying, the person in charge of the center, will review the prescriptions. Many of the prescriptions come from primary medical and health institutions. Next to the trial area, the staff responsible for dispensing and dispensing review were busy at all times. After ensuring that all details were correct, they sent the medicine barrels one by one to the conveyor belt.

Wang Haiying took reporters all the way to the automatic water adding area of the assembly line. She introduced that there are many types of Chinese medicinal materials, such as fruits, seeds, rhizomes, leaves, etc. The amount of water added should not only take into account the type of Chinese medicinal materials, but also take into account whether the patient is an adult, child or elderly person, and the number of doses.

The reporter saw that barrels of traditional Chinese medicine residues were being transported away in the clean area of the center. Every time the staff completes the decoction of a prescription, they will immediately clean the equipment and prepare for a new round of decoction. This place was only completed and put into use at the end of last year, but it has become a "rising star". Huang Weixu, the person in charge of Jinjiang Traditional Chinese Medicine Hospital (Zimao Campus), said that the Traditional Chinese Medicine Intelligent Shared Service Center is equipped with more than 90 automatic decoction machines and 24 liquid packaging machines, and can provide decoction services for up to about 1,000 prescriptions per day.

This year, the General Office of the Fujian Provincial Party Committee and the General Office of the Provincial Government issued the "Implementation Plan on Further Deepening Reforms to Promote the Healthy Development of the Rural Medical and Health System", proposing to expand the supply of traditional Chinese medicine services in rural areas and promote county pilots to carry out sharing. Chinese pharmacy services. Anxi County's strengthening of shared traditional Chinese medicine pharmacies has become a vivid practice in the province to improve people's sense of health gain.

From a horizontal perspective, Anxi County is not a "lone traveler", and more and more counties have entered the pilot stage. From a vertical perspective, Anxi County Hospital of Traditional Chinese Medicine took the lead in establishing the Traditional Chinese Medicine Alliance and continuously expanded the "circle of friends", allowing shared traditional Chinese medicine pharmacies to cover 4 county-level medical institutions, 25 township health centers and community health service centers in the county, and through rural Integrated management extends to the village level.

The results of Anxi County¡¯s construction of shared traditional Chinese medicine pharmacies over the years have gradually emerged. Wang Qingnan, director of Hutou Hospital in Anxi County, said: "The county hospital of traditional Chinese medicine distributes 50% of the profits from the added profits of traditional Chinese medicine to the alliance units that entrust decoction, which stimulates the enthusiasm of grassroots to carry out traditional Chinese medicine diagnosis and treatment services. In addition, the county hospital of traditional Chinese medicine passes the name The sinking of traditional Chinese medicine has led to the development of township health centers, and the business volume of hospitals' traditional Chinese medicine clinics has increased significantly.

New concepts have given rise to many "trendy products"

Why can Anxi County Traditional Chinese Medicine Hospital allow shared traditional Chinese medicine pharmacies to penetrate deeply into the county? This has to mention the Anxi practice of Sanming Medical Reform. Li Zhaohui introduced that Anxi County promotes the construction of a close county medical community and implements a "dual hospital" system. The county Traditional Chinese Medicine Hospital also has "Take the lead". This reform method also echoes the encouragement of "county-level traditional Chinese medicine hospitals take the lead in forming county medical communities"

Based on the county's jurisdiction of 24 towns and a permanent population of 1.0036 million, Anxi. The county has established two general hospitals, the County Hospital General Hospital and the County Traditional Chinese Medicine Hospital General Hospital, which have combined 12 primary medical and health institutions to form a close county medical community. At the same time, with the support of the county medical and health information integration project, a county medical and health information integration project has been built. "Cloud General Hospital" realizes real-time sharing of medical information.

This series of reforms has removed obstacles to the development of shared traditional Chinese medicine pharmacies. The construction of a close medical community embodies the concept of "sharing" in its development. The latest statistics show that the utilization rate of traditional Chinese medicine preparations among inpatients in Anxi County Traditional Chinese Medicine Hospital has reached 90.44%, and the proportion of discharged patients treated mainly with traditional Chinese medicine has reached 23.23%. Support, the number of grassroots traditional Chinese medicine clinics in Anxi County will increase from 9 in 2017 to 25 in 2023, covering all township health centers in the county. Anxi County has also introduced a competitive incentive mechanism and explored the implementation of open competition for directors of public hospitals and township health centers. Currently, it has open competition for the directors of county hospitals, county hospitals of traditional Chinese medicine and 12 township health centers; it has implemented a target annual salary system to greatly enhance hospital management. Efficiency.

In addition, Anxi County has established a "basic examination + superior diagnosis + mutual recognition of results" mechanism. Two-way referrals within the general hospital have exceeded 31,000 people; a total of more than 17,000 people have been sent to the grassroots for consultation and guidance. , help branch hospitals to develop new technologies and new projects; promote county-level medical equipment and technology sharing and interoperability, allowing patients to bill and settle at the grassroots level and obtain inspection services from the main hospital.

In recent years, Kuidou Town, Anxi County. The health center's changes are eye-catching. There are only 5,000 permanent residents in the health center's jurisdiction, and its development was once in trouble. With the support of a close medical community, the health center has introduced Chinese medicine talents to provide traditional Chinese medicine services and business. Income has increased from 240,000 yuan in 2016 to more than 5 million yuan in 2023.

Since joining Anxi County Traditional Chinese Medicine Hospital in 2017, Li Zhaohui has always been "sensitive" to new ideas and new technologies. Reporters are here. The hospital saw a special vending machine. What was placed in it was not drinks, but plastic bottles containing multiple small packages of traditional Chinese medicine pieces, which can be used to make "beautiful soups" such as astragalus and angelica beef soup. , Gastrodia fish head soup, etc.

Coinciding with the purpose of building a shared Chinese medicine pharmacy, Li Zhaohui said that they are trying to bring such vending machines into communities near hospitals and strive to deliver more Chinese medicine services to residents' doorsteps. "We have also opened an online shopping mall and moved traditional Chinese medicine teas, soup ingredients, etc. online, many of which have become "trendy" and very popular." Li Zhaohui said.

Reporter¡¯s Notes

Use the ¡°barrel effect¡± to view shared Chinese medicine pharmacies

In the sharing economy Against the background of vigorous development, shared Chinese medicine pharmacies, as a new medical service model, embody the core concept of "sharing" and show advantages in improving efficiency and saving resources.

¡°In the past, we had to fill prescriptions, and our traditional Chinese medicine pharmacies either lacked this or that. Later, some doctors prescribed prescriptions and simply asked patients to go to pharmacies to buy them.¡± Wang Qingnan told reporters Describes the embarrassing scenes of operating a traditional Chinese pharmacy in the past. Since the establishment of a shared Chinese medicine dispensary in the county, the hospital no longer has a Chinese medicine dispensary, but the number of patients coming to see Chinese medicine doctors has increased. Today, traditional Chinese medicine services have become an important aspect of the hospital¡¯s development.

During the interview process, the heads of the leading medical institutions showed great confidence in the sustainable development of shared traditional Chinese medicine pharmacies. The construction of shared traditional Chinese medicine pharmacies provides a concrete means for public hospitals to maintain their public welfare and effectively control costs, so as to better serve the majority of patients. More and more people choose to share traditional Chinese medicine pharmacies, which also provides impetus for its sustainable development.

It is worth mentioning the co-frequency resonance effect between the construction of county medical communities and the construction of shared traditional Chinese medicine pharmacies. The two complement each other and jointly promote the improvement of primary medical service levels. The county medical community provides a broader development space for shared Chinese medicine pharmacies, and the construction of shared Chinese medicine pharmacies further strengthens the service function of the medical community and forms a positive interaction.

However, the promotion of shared Chinese medicine pharmacies is also hampered by many factors. As the "barrel effect" reveals: How much water a barrel can hold depends on the shortest piece of wood.

In remote areas, the resignation of a courier may temporarily turn a village into a logistics "isolated island", causing difficulties in the operation of shared traditional Chinese medicine pharmacies. Li Zhaohui said that this situation is not uncommon, and the hospital can only temporarily coordinate vehicles for distribution.

In addition, shared traditional Chinese medicine pharmacy equipment requires iterative upgrades, which is currently also an issue that must be faced during development. There are also further improvements in people's recognition of traditional Chinese medicine, overall planning of traditional Chinese medicine services in counties, and the application of information technology, which are all "planks" that affect the operation of shared traditional Chinese medicine pharmacies.

In order for shared traditional Chinese medicine pharmacies to benefit more people, the work of "making up for weak links" cannot stop. Only by comprehensively improving on the basis of continuously integrating resources and filling in shortcomings can shared traditional Chinese medicine pharmacies expand more "space" and achieve more efficient and wider coverage of traditional Chinese medicine services.

Enter the era of sharing, full of expectations - I hope that shared Chinese medicine pharmacies can settle in more counties and continue to incubate upgraded versions.

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