互联网诊疗量占线下门诊量30%,北京大学肿瘤医院是怎么做到的?
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/9SHqfMCol0py08M0EJzVUHEfpqr2ObnJKeXZ0wubSq9h8rFDb8Rib2LbGQqQxcCicZYFXL14712H0IkAgMxws2kA/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">“<span style="color: black;">咱们</span>的互联网诊疗不是做<span style="color: black;">弥补</span>,而是要做部分替代。”这是北京大学肿瘤医院信息部<span style="color: black;">专家</span>衡反修在介绍互联网诊疗建设思路时,反复强调的一句话。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">做为</span>肿瘤<span style="color: black;">行业</span>高水平的三甲医院,北京大学肿瘤医院今年加速推动互联网诊疗服务。在线复诊正式上线近1个月<span style="color: black;">败兴</span>,单日的互联网诊疗量已占线下门诊量的30%。并且这30%均是进行了<span style="color: black;">详细</span>治疗<span style="color: black;">办法</span>的复诊,或开处方、或开检验<span style="color: black;">检测</span>,不<span style="color: black;">包括</span>线上咨询。尽管在复工复产的大趋势下,比例近期有所下降,但总量依旧<span style="color: black;">连续</span><span style="color: black;">提高</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">北京大学肿瘤医院到底是怎么做到的?<span style="color: black;">咱们</span>到院内实地<span style="color: black;">拜望</span>,从信息部<span style="color: black;">专家</span>、临床<span style="color: black;">大夫</span>、<span style="color: black;">病人</span>等不同视角和体验,梳理出了医院建设互联网诊疗的路径与经验。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">为何</span>力推互联网诊疗?</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">在复旦版2018年度肿瘤科声誉排行榜上,北京大学肿瘤医院排名第五。<span style="color: black;">做为</span>国内肿瘤<span style="color: black;">行业</span>最权威的医疗<span style="color: black;">公司</span>之一,北京大学肿瘤医院在发展互联网诊疗的动力上,面临着来自医院门诊结构、<span style="color: black;">病人</span>结构等内部<span style="color: black;">原由</span>,<span style="color: black;">亦</span>面临着来自疫情防控、政策推动等<span style="color: black;">外边</span><span style="color: black;">原由</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">内因:<span style="color: black;">病人</span><span style="color: black;">存活</span>期延长,复诊<span style="color: black;">病人</span>比例高</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">北京大学肿瘤医院现有34个临床科室、14个医技科室和17个<span style="color: black;">基本</span><span style="color: black;">科研</span>科室。医院的肿瘤学是国家重点学科,肿瘤科、病理科是国家临床重点专科,<span style="color: black;">另外</span>还有多个北京市重点学科以及北京市中医管理局重点学科。医院还设有恶性肿瘤发病机制及转化<span style="color: black;">科研</span>教育部重点实验室、恶性肿瘤转化<span style="color: black;">科研</span>北京市重点实验室。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">在肿瘤学<span style="color: black;">基本</span>理论<span style="color: black;">科研</span>、<span style="color: black;">平常</span><span style="color: black;">重点</span>肿瘤的临床诊断与治疗、胃癌、食管癌高发区现场的预防<span style="color: black;">干涉</span><span style="color: black;">科研</span>等<span style="color: black;">行业</span>,北京大学肿瘤医院均有创新与领先的成绩,在国内外颇具影响。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/9SHqfMCol0rleMxC9mSq5r9I6cicGnicyHs9CzVIWvWHQ1g2EnZtD57OLicMIMPtR1ic4TwE0TYln7Rayxz9qaLKxw/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">北京大学肿瘤医院</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">随着医院<span style="color: black;">科研</span>能力、诊疗能力和整体知名度的<span style="color: black;">连续</span><span style="color: black;">提高</span>,其医疗服务量<span style="color: black;">亦</span>节节攀升。2019年门诊量超过73.7万人次,手术量1.6万台,出院人次数8.9万。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">“<span style="color: black;">日前</span><span style="color: black;">咱们</span><span style="color: black;">通常</span>把肿瘤<span style="color: black;">亦</span><span style="color: black;">做为</span>慢性病看待,但它又存在特殊性。”北京大学肿瘤医院头颈外科<span style="color: black;">大夫</span>孙俊勇<span style="color: black;">暗示</span>,感冒、<span style="color: black;">平常</span>慢性病<span style="color: black;">已然</span>有了高度标准化的诊疗路径,而肿瘤还是一个充满未知的<span style="color: black;">行业</span>,<span style="color: black;">广泛</span>认为肿瘤的<span style="color: black;">危害</span>比其他<span style="color: black;">疾患</span>高,采用的<span style="color: black;">大都是</span>专家型诊疗方式。<span style="color: black;">因此</span>,<span style="color: black;">病人</span>更倾向于在出院后找自己的主治<span style="color: black;">大夫</span>复诊。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">疾患</span>的特殊性和<span style="color: black;">病人</span>心理的特殊性,使得医院除了收治新病人之外,还需为<span style="color: black;">海量</span>的复诊<span style="color: black;">病人</span>服务,且一名出院<span style="color: black;">病人</span>或手术<span style="color: black;">病人</span><span style="color: black;">必须</span>进行多次复诊。近年来,随着肿瘤诊疗技术的进步,<span style="color: black;">病人</span><span style="color: black;">存活</span>期越来越长,复诊<span style="color: black;">病人</span><span style="color: black;">亦</span>在<span style="color: black;">逐步</span><span style="color: black;">增多</span>。据医院统计,<span style="color: black;">日前</span>门诊中的复诊<span style="color: black;">病人</span>达87%。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">因为</span>号源有限,在复诊<span style="color: black;">病人</span>比例高的<span style="color: black;">状况</span>下,初诊<span style="color: black;">病人</span>的就诊机会就受到了挤压。若初诊<span style="color: black;">病人</span>难约号,<span style="color: black;">那样</span>,医院的<span style="color: black;">优秀</span>医疗资源难以<span style="color: black;">得到</span>充分释放。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">医院诊疗能力强、名气大,<span style="color: black;">同期</span>吸引了<span style="color: black;">外区</span>的疑难重症<span style="color: black;">病人</span>前来治疗。<span style="color: black;">外区</span><span style="color: black;">病人</span>前来<span style="color: black;">看病</span>,自然是舟车劳顿,尤其是出院后的复诊,耗时耗力<span style="color: black;">奔走</span>在北京与居住地之间,买机票、订住宿,提前到京等待,时间和经济成本都很高。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">复诊<span style="color: black;">病人</span>占比高、<span style="color: black;">外区</span><span style="color: black;">病人</span><span style="color: black;">看病</span>成本高,这两项<span style="color: black;">重要</span>指标<span style="color: black;">促进</span>医院急需利用互联网<span style="color: black;">加强</span>复诊效率。<span style="color: black;">有效</span>复诊既能方便<span style="color: black;">病人</span>,降低<span style="color: black;">病人</span>成本;<span style="color: black;">亦</span>能为新<span style="color: black;">病人</span>、尤其是疑难重症<span style="color: black;">病人</span>留出<span style="color: black;">更加多</span><span style="color: black;">看病</span>机会和时间,<span style="color: black;">提高</span><span style="color: black;">优秀</span>医疗的可及性。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">外因:疫情防控需求<span style="color: black;">作为</span>建设契机</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">除了内部<span style="color: black;">原由</span>外,外因<span style="color: black;">亦</span>是推动医院发展互联网诊疗的契机。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">今年疫情<span style="color: black;">败兴</span>,北京经历了几个防控形势严峻的<span style="color: black;">周期</span>:<span style="color: black;">首要</span>是1-2月与全国<span style="color: black;">一起</span>抗疫的<span style="color: black;">周期</span>,之后是3月境外输入防控<span style="color: black;">周期</span>,此后又经历了6月的新发地疫情防控。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">为了满足疫情<span style="color: black;">时期</span><span style="color: black;">病人</span>的就诊需求,北京加快了推动互联网诊疗发展的步伐,<span style="color: black;">持续</span><span style="color: black;">经过</span>北京协和医院、阜外医院、中日友好医院等一批知名医院的互联网诊疗资质。北京市<span style="color: black;">医疗保险</span>局还制定了互联网复诊项目价格和<span style="color: black;">医疗保险</span>支付政策,开展“互联网+”<span style="color: black;">医疗保险</span>服务,<span style="color: black;">知道</span>结算流程和规范。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">疫情进入常态化防控之后,北京二级以上医疗<span style="color: black;">公司</span>非急诊<span style="color: black;">亦</span>全面实施了预约常态化机制,改善门诊秩序,引导错峰就诊。<span style="color: black;">同期</span>继续鼓励互联网诊疗、在线结算、<span style="color: black;">药物</span>配送等服务。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">在政策和主管<span style="color: black;">分部</span>推动下,基于疫情防控<span style="color: black;">状况</span>,<span style="color: black;">本来</span>就有互联网诊疗建设需求的北京大学肿瘤医院顺势而为,着手进行流程设计、系统搭建、资质申请、<span style="color: black;">医疗保险</span>对接等工作。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/9SHqfMCol0rleMxC9mSq5r9I6cicGnicyHIffuzKWR6ZLmnXEra9IUhibNchOzGV4JFoibgYeZmyXM5jaQdTZUfiahw/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">疫情<span style="color: black;">时期</span>防止人群聚集,北京大学肿瘤医院门诊大厅的座椅每隔一个位置<span style="color: black;">才可</span><span style="color: black;">运用</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">互联网诊疗<span style="color: black;">怎样</span>定位?</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">北京大学肿瘤医院在4月<span style="color: black;">获准</span>互联网诊疗服务资质之后,于6月上线互联网诊疗服务。上线初期,<span style="color: black;">重点</span>聚焦在功能完善、流程优化方面。衡反修介绍,在前期,互联网复诊功能<span style="color: black;">重点</span>依靠肿瘤<span style="color: black;">病人</span>、临床<span style="color: black;">实验</span><span style="color: black;">病人</span>在病友群内相互转告。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/9SHqfMCol0rleMxC9mSq5r9I6cicGnicyHOkqt0fa9ibWCd3EmlWgL9CNvANib1DcyskTMBMicnXjRld8yKceojXuDQ/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">北京大学肿瘤医院互联网诊疗的推动进程,动脉网制图</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">6月24日,北京大学肿瘤医院实现了互联网诊疗<span style="color: black;">医疗保险</span>支付。当天<span style="color: black;">医疗保险</span>支付在西院区上线,在线复诊量就达到了西院区总门诊量的33%。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">经过前期磨合,医院于7月15日正式推出互联网诊疗服务,并<span style="color: black;">经过</span>医院<span style="color: black;">微X</span>、院内展板推广。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/9SHqfMCol0rleMxC9mSq5r9I6cicGnicyHfPHUOAhHJjtibQfcicTV1txmr8tUAVpoKjHTVqfa6UoUJiaOicLvliatnsw/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 北京大学肿瘤医院门诊大厅内,互联网诊疗的宣传展板</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">线上门诊开诊<span style="color: black;">败兴</span>,在线复诊<span style="color: black;">病人</span><span style="color: black;">逐步</span><span style="color: black;">增多</span>,由每日几十例增至数百例。<span style="color: black;">截止</span>8月7日,全院共有20个科室125位<span style="color: black;">大夫</span>出互联网门诊,已累计完成超过7400位<span style="color: black;">病人</span>的线上复诊。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">平均<span style="color: black;">每日</span>有超过25位<span style="color: black;">大夫</span>,<span style="color: black;">包含</span>知名专家、教授在线为复诊<span style="color: black;">病人</span><span style="color: black;">供给</span>服务,单日诊疗量近400人次,占医院日均门诊量近20至30%。并且这是<span style="color: black;">处理</span>了<span style="color: black;">病人</span><span style="color: black;">实质</span>需求的问诊量,不<span style="color: black;">包含</span><span style="color: black;">病人</span>因挂错号等<span style="color: black;">原由</span>,只进行了简单交流的咨询量,这种<span style="color: black;">状况</span>医院<span style="color: black;">亦</span>对<span style="color: black;">病人</span>做退费退号处理。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">今年<span style="color: black;">败兴</span>,武汉因抗疫<span style="color: black;">必须</span><span style="color: black;">亦</span>大力发展了互联网医疗。据湖北日报<span style="color: black;">报告</span>,武汉市卫健委统计的数据<span style="color: black;">表示</span>,5月中旬,武汉连续6日的网上诊疗量达到8626人次,占线下诊疗量的7.4%。随着疫情防控常态化,线上诊疗量呈下降趋势,而线下诊疗量正逐步回升。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">相比之下,北京大学肿瘤医院在常态防疫<span style="color: black;">时期</span>,互联网诊疗量仍<span style="color: black;">逐步</span><span style="color: black;">提升</span>,且占总门诊量的比重高。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">从衡反修的介绍中能看出,北京大学肿瘤医院的互联网诊疗做了两个最基本的定位。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">首要</span>,定<span style="color: black;">位置于</span><span style="color: black;">处理</span>实质性的复诊,例如开处方、开检验<span style="color: black;">检测</span>等,而不是轻问诊、在线咨询。其次,不同于许多公立医院将互联网诊疗看作锦上添花、线下<span style="color: black;">弥补</span>,北京大学肿瘤医院将线上视为线下的替代,<span style="color: black;">期盼</span>逐步将<span style="color: black;">更加多</span>复诊<span style="color: black;">病人</span>转移到线上。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">这两个定位既出于<span style="color: black;">病人</span>需求、诊疗特征的<span style="color: black;">思虑</span>,<span style="color: black;">亦</span><span style="color: black;">由于</span>医院<span style="color: black;">期盼</span>将有限的资源用于<span style="color: black;">病人</span>实质性的医疗诊治,而不是仅仅做<span style="color: black;">意见</span>性的咨询服务方面。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/9SHqfMCol0rleMxC9mSq5r9I6cicGnicyHqxZoyW3TRnrJQnBIJSR9pPqw9dxictjTIeRGEhEwGqeol8SGzyyQuxQ/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 北京大学肿瘤医院的互联网诊疗项目,资料<span style="color: black;">源自</span>:医院官微,动脉网制图</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">同期</span>,通过互联网开具的<span style="color: black;">检测</span>检验项目,医院<span style="color: black;">亦</span>做了严格界定。常规项目如血常规、生化、CT、超声等<span style="color: black;">能够</span>在线上开具,而病理、基因检测、化疗处方签等<span style="color: black;">繁杂</span>项目,出于诊疗安全<span style="color: black;">思虑</span>,暂时不<span style="color: black;">供给</span>线上开具。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">功能和流程<span style="color: black;">怎样</span>最大限度优化?</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">在<span style="color: black;">知道</span>了互联网诊疗定位的<span style="color: black;">基本</span>上,医院在系统搭建过程中,<span style="color: black;">重点</span>从<span style="color: black;">病人</span>和<span style="color: black;">大夫</span>两个用户端去<span style="color: black;">思虑</span>流程设计与优化。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">病人</span>端线上线下一体化就诊基本形成</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">日前</span>,<span style="color: black;">病人</span><span style="color: black;">经过</span>互联网就诊的流程如下:</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/9SHqfMCol0rleMxC9mSq5r9I6cicGnicyHktKiaMvdZopjVGNFl3mzG3zJ3l1H8VuFuk3lAUTpl7S5LGfLlr8o8YA/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 北京大学肿瘤医院互联网诊疗的<span style="color: black;">病人</span><span style="color: black;">看病</span>流程,资料<span style="color: black;">源自</span>:医院官微,动脉网制图</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">全部</span>流程大致分为5个<span style="color: black;">过程</span>:</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">线上预约。</span></strong><span style="color: black;">医院提前<span style="color: black;">1星期</span>放号,<span style="color: black;">病人</span><span style="color: black;">按照</span><span style="color: black;">大夫</span>排班预约;预约成功后,可收到短信和APP推送提醒。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">在线就诊。</span></strong><span style="color: black;">线上号源半日有效,就诊当日准备好手机,<span style="color: black;">保证</span>网络通畅,<span style="color: black;">能够</span>在任何场合候诊。就诊时,<span style="color: black;">大夫</span>可在线开处方,<span style="color: black;">亦</span>可开出<span style="color: black;">检测</span>检验。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">检测</span>预约。</span></strong><span style="color: black;"><span style="color: black;">倘若</span><span style="color: black;">大夫</span>开具了检验<span style="color: black;">检测</span>,系统会自动为<span style="color: black;">病人</span>预约<span style="color: black;">检测</span>检验时间,<span style="color: black;">病人</span><span style="color: black;">亦</span>可<span style="color: black;">按照</span>自己的安排,在APP更改预约时间。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">缴费。</span></strong><span style="color: black;">非北京<span style="color: black;">医疗保险</span><span style="color: black;">病人</span>线上线下均可缴费,北京<span style="color: black;">医疗保险</span><span style="color: black;">病人</span>除了医事服务费可线上完成,其他需到医院缴费。同时,缴费时限有限制。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">检测</span>取药。</span></strong><span style="color: black;"><span style="color: black;">病人</span>到医院<span style="color: black;">检测</span>和取药可在同一天进行,<span style="color: black;">外区</span><span style="color: black;">病人</span><span style="color: black;">亦</span>可在当地购药和做常规<span style="color: black;">检测</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/9SHqfMCol0rleMxC9mSq5r9I6cicGnicyHqibtSwFOyCK44hBuTbF2Mov9r7c9S9ecGibm2wChvNgO9roMAvSOrouw/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 医院大厅的互联网诊疗自助服务机,是线上线下流程的连接点(如<span style="color: black;">检测</span>单打印)</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">至此,<span style="color: black;">病人</span>端的线上线下流程基本形成。<span style="color: black;">医疗保险</span>支付因北京均未实现脱卡结算,只能<span style="color: black;">运用</span>实体卡片,<span style="color: black;">因此</span><span style="color: black;">必须</span><span style="color: black;">病人</span>到院结算。<span style="color: black;">另外</span>,影像类<span style="color: black;">必须</span>依靠<span style="color: black;">大夫</span>经验来判断的<span style="color: black;">检测</span>,医院仍<span style="color: black;">意见</span><span style="color: black;">外区</span><span style="color: black;">病人</span>每年回医院<span style="color: black;">检测</span>一次。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">大夫</span>端操作<span style="color: black;">方便</span>,<span style="color: black;">没</span>需改变原有习惯</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">“后台功能要始终围绕<span style="color: black;">大夫</span>需求来进行。<span style="color: black;">倘若</span><span style="color: black;">大夫</span>用得不顺手,互联网诊疗推动就很难。”衡反修<span style="color: black;">暗示</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">医院信息部与信息化服务商协同进行技术<span style="color: black;">研发</span>与对接,例如:信息部负责线下HIS改造、原来医院<span style="color: black;">病人</span>线上服务平台——“北肿云病历”APP服务商(北京嘉和美康)负责互联网诊疗线上<span style="color: black;">研发</span>……<span style="color: black;">最后</span>,互联网诊疗平台与HIS、LIS、PACS等系统打通,<span style="color: black;">大夫</span>接诊时仅多了视频、图文的聊天窗口,处方、检验<span style="color: black;">检测</span>等只需在原有的HIS门诊<span style="color: black;">大夫</span>站系统中操作,并一键发送给<span style="color: black;">病人</span>。<span style="color: black;">病人</span><span style="color: black;">亦</span>能在APP上查收处方、<span style="color: black;">检测</span>结果等<span style="color: black;">要紧</span>信息,快速、直接的医患对接得以实现。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">7月30日,孙俊勇在网络诊室接诊时,左侧是装有医院原有信息系统的电脑,右侧是装有摄像头、进行互联网诊疗的电脑。右侧电脑上,<span style="color: black;">表示</span>了<span style="color: black;">病人</span>的预约、报到、就诊状态,以及视频和文字对话框。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/9SHqfMCol0rleMxC9mSq5r9I6cicGnicyHiamZpqod6OImc7sRGq3ibrGQAzlpuww3EjDN66NNl5KNiaEuRkibljNeXQ/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 北京大学肿瘤医院头颈外科<span style="color: black;">大夫</span>孙俊勇在网络诊室接诊</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">一名甲状腺癌手术的<span style="color: black;">病人</span>复诊时间到了,孙俊勇点击视频图标,<span style="color: black;">火速</span>就与患者接通了对话。<span style="color: black;">病人</span>的手术周边位置近期<span style="color: black;">病痛</span>,孙俊勇<span style="color: black;">指点</span><span style="color: black;">病人</span>移动摄像头,查看之后初步判断问题不大,<span style="color: black;">意见</span><span style="color: black;">彩超</span><span style="color: black;">检测</span>。随后,孙俊勇在左侧电脑上开出<span style="color: black;">检测</span>单,一键发送给了<span style="color: black;">病人</span>。“对<span style="color: black;">大夫</span><span style="color: black;">来讲</span>,<span style="color: black;">没</span>需改变原有习惯。视频问诊、文字交流<span style="color: black;">亦</span>很简单,就像在网上聊天<span style="color: black;">同样</span>。”孙俊勇<span style="color: black;">暗示</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">同期</span>,<span style="color: black;">因为</span>互联网诊疗平台与医院原有系统的高度互通,<span style="color: black;">大夫</span>在线上接诊时,还可为<span style="color: black;">病人</span>安排一系列的需求。一位<span style="color: black;">病人</span>复诊时,<span style="color: black;">大夫</span>开出处方的<span style="color: black;">同期</span>,<span style="color: black;">发掘</span>她本该<span style="color: black;">定时</span>进行的大<span style="color: black;">检测</span>还没做,<span style="color: black;">因此</span>开具了<span style="color: black;">检测</span>单。<span style="color: black;">病人</span><span style="color: black;">期盼</span>大<span style="color: black;">检测</span>完成后,能在线下面诊,当面沟通<span style="color: black;">检测</span>结果。<span style="color: black;">大夫</span>查看号源后,又立即为<span style="color: black;">病人</span>预约了<span style="color: black;">近期</span>的线下号源。并提醒<span style="color: black;">病人</span>,<span style="color: black;">能够</span>在线下就诊当天的上午到医院做<span style="color: black;">检测</span>,下午找<span style="color: black;">大夫</span>看结果。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">亦</span><span style="color: black;">便是</span>说,短短几分钟的视频交流,<span style="color: black;">大夫</span>为<span style="color: black;">病人</span><span style="color: black;">处理</span>了开药、约<span style="color: black;">检测</span>、约下次面诊的一连串问题。而在过去,这些问题可能<span style="color: black;">必须</span><span style="color: black;">病人</span>往医院跑几趟。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">尽管受到<span style="color: black;">医疗保险</span>结算、<span style="color: black;">检测</span>项目特殊性等客观<span style="color: black;">原由</span>影响,<span style="color: black;">病人</span>仍需<span style="color: black;">定时</span>到医院,但整体上看,<span style="color: black;">病人</span>体验有<span style="color: black;">显著</span>改善、<span style="color: black;">大夫</span>操作<span style="color: black;">方便</span>,医院已在现有<span style="color: black;">前提</span>下进行了最大程度的流程优化,这<span style="color: black;">亦</span>是互联网诊疗量能在短期内快速<span style="color: black;">提高</span>的<span style="color: black;">原由</span>之一。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">药物</span>配送、<span style="color: black;">大夫</span>移动问诊等功能将完善</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">因为</span>互联网诊疗定位单纯、<span style="color: black;">大夫</span>操作简单,<span style="color: black;">因此</span>,医院<span style="color: black;">没</span>需配备单独的运营团队。<span style="color: black;">平常</span>工作中,由衡反修带领的信息部协调后续的功能<span style="color: black;">研发</span>,以及收集<span style="color: black;">大夫</span>需求和<span style="color: black;">病人</span>反馈进行系统功能优化。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">日前</span>,北京大学肿瘤医院的互联网诊疗还只是开了一个头,衡反修<span style="color: black;">已然</span>列出了接下来急需完善的功能<span style="color: black;">名单</span>。例如:</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">药物</span>配送。<span style="color: black;">因为</span>部分肿瘤<span style="color: black;">药品</span>需<span style="color: black;">经过</span>冷链物流配送,这项服务要在<span style="color: black;">保证</span><span style="color: black;">药物</span>配送安全的<span style="color: black;">基本</span>上进行。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">大夫</span>问诊的移动化。<span style="color: black;">日前</span><span style="color: black;">大夫</span>只能在工作时间从PC端接诊,<span style="color: black;">大夫</span>移动端打通后,还能随时利用碎片时间接诊。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">增多</span>互联网诊疗的入口,<span style="color: black;">增多</span><span style="color: black;">微X</span>小程序、PC端,让<span style="color: black;">病人</span>有<span style="color: black;">更加多</span><span style="color: black;">选取</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">另外</span>,<span style="color: black;">经过</span>技术和流程的升级,来<span style="color: black;">加强</span>医患效率,例如人脸识别核对<span style="color: black;">病人</span>身份、线上知情同意签署、自助出入院等等。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">大夫</span>功能完善后,线上线下流程将进一步结合,<span style="color: black;">增多</span><span style="color: black;">大夫</span>和<span style="color: black;">病人</span>的<span style="color: black;">运用</span>动力。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">经验总结</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">尽管北京大学肿瘤医院<span style="color: black;">做为</span>肿瘤专科医院,与同等级的综合医院和其他专科医院相比,有<span style="color: black;">许多</span>特殊性。但<span style="color: black;">咱们</span><span style="color: black;">经过</span>梳理其互联网诊疗的建设路径,仍然<span style="color: black;">发掘</span><span style="color: black;">有些</span>值得借鉴的经验。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">第1</span>,准确找到医院价值和<span style="color: black;">大夫</span>价值。</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">北京三级医院的医事服务费(即挂号费)普通门诊为50元,副<span style="color: black;">专家</span>医师、<span style="color: black;">专家</span>医师、知名专家分别为60元、80元、100元。<span style="color: black;">根据</span>国家<span style="color: black;">医疗保险</span>局规定,公立医疗<span style="color: black;">公司</span>开展互联网复诊,由不同级别医务人员<span style="color: black;">供给</span>服务,均按普通门诊诊察类项目价格收费。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">北京大学肿瘤医院的互联网门诊中,各个级别的<span style="color: black;">大夫</span>均有出诊,但医事服务费均为50元。<span style="color: black;">亦</span>就<span style="color: black;">寓意</span>着医院收入、高级别的<span style="color: black;">大夫</span>收入受到影响。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">线上线下复诊费的差距,是不少公立医院开展互联网诊疗积极性不高的<span style="color: black;">原由</span>之一。据衡反修介绍,北京大学肿瘤医院自上而下大力推动互联网诊疗,虽然复诊费有<span style="color: black;">必定</span>损失,但在复诊效率<span style="color: black;">提高</span>后,医院有更多资源收治初诊<span style="color: black;">病人</span>,尤其是疑难重症<span style="color: black;">病人</span>,<span style="color: black;">累积</span><span style="color: black;">更加多</span>病例有助于医院的学科建设,<span style="color: black;">从而</span><span style="color: black;">连续</span><span style="color: black;">提高</span>影响力。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">对<span style="color: black;">大夫</span>而言,<span style="color: black;">一样</span>如此。孙俊勇介绍,<span style="color: black;">大夫</span>经验<span style="color: black;">累积</span><span style="color: black;">必定</span>离不开对<span style="color: black;">海量</span>不同的<span style="color: black;">病人</span>诊疗。“<span style="color: black;">倘若</span><span style="color: black;">每日</span>最好的状态用在了简单的复诊,有可能初诊<span style="color: black;">病人</span>来时<span style="color: black;">已然</span>很疲倦了。”在孙俊勇看来,理想的状态是利用碎片时间做复诊,将精力最充沛的时段充分地留给初诊<span style="color: black;">病人</span>。“<span style="color: black;">这般</span>一来,不会三五分钟就把<span style="color: black;">病人</span>看完,而是能看更<span style="color: black;">长期</span>,让<span style="color: black;">病人</span>满意,<span style="color: black;">大夫</span><span style="color: black;">亦</span>能得到更好的成长。”</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">当医院和<span style="color: black;">大夫</span>都能清晰<span style="color: black;">认识</span>到一件事情给<span style="color: black;">自己</span>带来的价值时,推动过程自然更顺利。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">第二,切合<span style="color: black;">实质</span>,化繁为简。</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">互联网医疗经过近几年的发展,围绕在线复诊形<span style="color: black;">成为了</span>覆盖信息、<span style="color: black;">工具</span>、医疗、<span style="color: black;">药物</span>和保险的一系列服务。而北京大学肿瘤医院只<span style="color: black;">保存</span>核心的复诊以及<span style="color: black;">关联</span>的<span style="color: black;">药物</span>、<span style="color: black;">医疗保险</span>服务。这有利于集中精力快速梳理流程,并在后续进行深度优化。避免服务类型<span style="color: black;">太多</span>,<span style="color: black;">皆想</span>做,但可能都做<span style="color: black;">欠好</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">当然,这<span style="color: black;">亦</span>要取决于医院的专科特点,肿瘤医院重在<span style="color: black;">加强</span><span style="color: black;">病人</span><span style="color: black;">存活</span>率、<span style="color: black;">加强</span>术后生活质量,<span style="color: black;">病人</span>治病需求远大于消费需求。其他医院<span style="color: black;">亦</span>需<span style="color: black;">按照</span><span style="color: black;">病人</span>需求,<span style="color: black;">精细</span>制定互联网服务的范围。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">受疫情影响,全国医疗<span style="color: black;">公司</span>服务量整体下降,4月才<span style="color: black;">起始</span><span style="color: black;">逐步</span>回升。而北京经历了几次的疫情严控<span style="color: black;">周期</span>,医院线下服务受到的影响更加<span style="color: black;">显著</span>。在北京大学肿瘤医院<span style="color: black;">看病</span>的<span style="color: black;">病人</span>,<span style="color: black;">本来</span>大多来自北京以外的地区,衡反修介绍,疫情<span style="color: black;">败兴</span>,<span style="color: black;">外区</span><span style="color: black;">病人</span>比例下降,与北京本地<span style="color: black;">病人</span>的比例由原来的2:1降到了1:1。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">互联网诊疗既是医院开拓的新服务,<span style="color: black;">亦</span>是<span style="color: black;">逐步</span>恢复服务量的方式之一。接下来,随着<span style="color: black;">大夫</span>移动端接诊、<span style="color: black;">药物</span>配送等服务的开通,北京大学肿瘤医院的互联网诊疗量有望进一步<span style="color: black;">提高</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">在<span style="color: black;">这次</span>走访中,<span style="color: black;">咱们</span>还<span style="color: black;">发掘</span>一个有意思的现象:有<span style="color: black;">病人</span>预约了线上号源后,仍然在就诊当天来到了医院。一方面是认为见到<span style="color: black;">大夫</span>更踏实,另一方面是以为<span style="color: black;">必须</span>到医院就诊。互联网诊疗的<span style="color: black;">病人</span>教育、习惯培养,在疫情<span style="color: black;">时期</span><span style="color: black;">已然</span>取得了不小<span style="color: black;">发展</span>,但从这个细节来看,这方面仍有很长的路要走。不只是某一家医院<span style="color: black;">必须</span>培养,更<span style="color: black;">必须</span>行业<span style="color: black;">一起</span>的<span style="color: black;">奋斗</span>。</span><strong style="color: blue;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">*文中<span style="color: black;">照片</span>由动脉网拍摄。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><a style="color: black;"><span style="color: black;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></span></a></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">近</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">期</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">推</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">荐</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><a style="color: black;"><span style="color: black;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></span></a></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><a style="color: black;"><span style="color: black;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></span></a></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><a style="color: black;"><span style="color: black;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></span></a></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><a style="color: black;"><span style="color: black;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></span></a></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><a style="color: black;"><span style="color: black;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></span></a></p><span style="color: black;">声明:动脉网所刊载内容之知识产权为动脉网及<span style="color: black;">关联</span>权利人专属所有或持有。文中<span style="color: black;">显现</span>的采访数据均由受访者<span style="color: black;">供给</span>并确认。未经许可,禁止进行转载、摘编、复制及<span style="color: black;">创立</span>镜像等任何<span style="color: black;">运用</span>。</span><span style="color: black;">天空<span style="color: black;">暗中</span>到<span style="color: black;">必定</span>程度,星辰就会熠熠生辉</span><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;">
非常感谢您的邀请,我非常期待这个活动的到来,感谢您对我的认可。 楼主节操掉了,还不快捡起来! 在遇到你之前,我对人世间是否有真正的圣人是怀疑的。 我完全同意你的观点,说得太对了。
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