The mutual recognition of inspection and test results will be implemented from March 1, and medical institutions will usher in great changes!

On February 18, the "Administrative Measures for the Mutual Recognition of Inspection and Test Results of Medical Institutions" jointly issued by the National Health Commission and the National Medical Insurance Administration was officially announced, and it is scheduled to be officially implemented on March 1.

Inspection and testing are an important part of medical services. The mutual recognition of inspection and test results between different medical institutions will help improve the utilization rate of medical resources, reduce medical expenses, improve the efficiency of diagnosis and treatment, and further improve the medical experience of the people.

The document stipulates that if the existing test results meet the conditions for mutual recognition and meet the needs of diagnosis and treatment, no repeated inspection and test shall be allowed. Medical institutions should carry out mutual recognition of inspection results in accordance with the principle of "taking quality and safety as the bottom line, taking quality control as the premise, reducing the burden on patients as the guide, meeting the needs of diagnosis and treatment as the foundation, and taking the judgment of the doctor as the standard". Work.

This means that the originally isolated and closed inspection resources will be effectively used, and more importantly, the interests of public medical institutions will be redistributed. This is the cheese that has been used in hospitals since the implementation of zero-addition of drugs in public hospitals.

The "Administrative Measures" is divided into 7 chapters and 39 articles, and clarifies the requirements for mutual recognition of inspection results of medical institutions from the aspects of organizational management, mutual recognition rules, quality control, support and guarantee, and supervision and management.

The "Administrative Measures" divides the responsibilities of relevant departments, and at the same time, clarifies the basic requirements for mutual recognition, proposes specific situations that can be re-examined, and requires medical personnel to strengthen doctor-patient communication. If it is confirmed, an explanation shall be made, and the purpose and necessity of the re-inspection shall be fully informed.

In terms of medical insurance, the "Administrative Measures" require that medical security departments at all levels should actively promote the reform of payment methods, guide medical institutions to actively control costs, strengthen the vertical analysis and horizontal comparison of medical service behavior, and strengthen the performance evaluation and assessment mechanism for the use of medical insurance funds. At the same time, the total budget of the medical insurance fund shall be reasonably determined, and the total regional budget and the total budget of a single medical institution shall not be reduced due to mutual recognition of inspection results.

Qualified medical institutions may incorporate the mutual recognition of inspection results carried out by medical staff into their performance distribution and assessment mechanism.  Encourage medical security agencies at all levels to take the mutual recognition of inspection results carried out by medical institutions as the evaluation standard for designated medical insurance institutions.

Administrative Measures for the Mutual Recognition of Inspection and Test Results of Medical Institutions

Chapter 1 General Provisions

Article 1: In order to further improve the utilization rate of medical resources, reduce the medical burden of the people, and ensure the quality and safety of medical care, in accordance with the "Basic Medical Care and Health Promotion Law of the People's Republic of China", "The Law of the People's Republic of China on Physicians", "Regulations on the Administration of Medical Institutions", " These Measures are formulated in accordance with relevant laws and regulations such as the Regulations on the Supervision and Administration of the Use of Medical Security Funds, the Measures for the Administration of Medical Quality, and the Measures for the Administration of Clinical Laboratories in Medical Institutions.

Article 2 The “examination results” as mentioned in these Measures refers to the images or data information obtained by examining the human body by means of ultrasound, X-ray, MRI, electrophysiology, nuclear medicine, etc.; The material from the human body is tested in biology, microbiology, immunology, chemistry, blood immunology, hematology, biophysics, cytology, etc., and the obtained data information. The inspection results do not include the diagnostic conclusion issued by the physician.

Article 3 These measures are applicable to medical institutions at all levels and types.

Article 4: Medical institutions shall carry out inspections and inspections in accordance with the principle of "taking quality and safety as the bottom line, taking quality control as the premise, reducing the burden on patients as the guide, meeting the needs of diagnosis and treatment as the foundation, and taking the judgment of the visiting physician as the standard". Mutual recognition of results works.

Chapter 2 Organization Management

Article 5 The National Health Commission is responsible for the management of the mutual recognition of inspection results in medical institutions across the country. The National Medical Insurance Administration, within the scope of its responsibilities, promotes the mutual recognition and support of the inspection results of medical institutions across the country. Local health administrative departments are responsible for the management of mutual recognition of inspection results of medical institutions within their respective administrative regions. Local medical security departments shall, within the scope of their duties, promote the mutual recognition and support of the inspection results of medical institutions within their respective administrative regions. The State Administration of Traditional Chinese Medicine and the military health department are responsible for the management of mutual recognition of inspection results in traditional Chinese medicine and military medical institutions within their respective scope of duties.

Article 6: Local health administrative departments shall strengthen the organization and management of medical institutions within their respective jurisdictions, guide medical institutions and their medical staff to standardize the mutual recognition of inspection and test results, and strengthen the construction of regional platforms in accordance with the requirements of the functional guidelines for the construction of national health information platforms. Promote the exchange and sharing of inspection results by medical institutions in the jurisdiction.

Article 7: The medical quality control organizations (hereinafter referred to as quality control organizations) at all levels and specialties established or designated by the local health administrative departments in accordance with the "Medical Quality Management Measures" shall, under the guidance of the health and health administrative departments at the same level, formulate and improve this The quality evaluation indicators and quality management requirements of the inspection items shall be checked. Quality control organizations at all levels shall strengthen the quality management of inspection and inspection items in their respective regions, regularly carry out quality evaluation work in a standardized manner, and promote local medical institutions to improve inspection and inspection quality.

Article 8 Medical institutions shall strengthen the construction of hospital information platforms with electronic medical records as the core in accordance with the standards and specifications for hospital informatization construction. Establish and improve the mutual recognition work management system within the institution, strengthen personnel training, standardize work procedures, and provide necessary equipment, facilities and safeguards for relevant medical personnel to carry out mutual recognition work.

Article 9 The leading hospital of the medical alliance shall promote the interconnection of data and information within the medical alliance, strengthen the quality control of inspection and inspection, improve the level of homogeneity of inspection and inspection, and realize mutual recognition and sharing of inspection and inspection results.

Article 10 Medical personnel shall abide by industry norms, abide by medical ethics, conduct reasonable diagnosis and treatment, strive to improve their professional level and service quality, and fully recognize the inspection results that meet the conditions.

Chapter 3 Mutual Recognition Rules

Article 11 The inspection and inspection items to be carried out for mutual recognition shall have good stability and uniform technical standards, so as to facilitate quality evaluation.

Article 12: Meet the national-level quality evaluation indicators, and participate in the inspection and inspection items that have passed the national-level quality evaluation. The scope of mutual recognition is the whole country. Meet the local quality evaluation indicators, and participate in the inspection and inspection projects that have passed the quality evaluation of the local quality control organization, and the scope of mutual recognition is the area corresponding to the quality control organization. Where different regions jointly carry out inspection and inspection mutual recognition by signing agreements, the relevant regional health and health administrative departments shall jointly form or designate a quality control organization to carry out the relevant work. Those who have participated in the relevant quality evaluation and passed the agreement shall be mutually recognized within the area of the agreement.

Article 13 The sign of mutual recognition of inspection results of medical institutions shall be unified as HR. If the inspection and inspection items participate in the quality evaluation carried out by quality control organizations at all levels and are qualified, the medical institution shall mark its corresponding mutual recognition scope + mutual recognition logo. Such as: "National HR", "Beijing-Tianjin-Hebei HR", "Beijing Xicheng HR" and so on. Inspection and inspection items that fail to participate in the quality evaluation or fail to pass the quality evaluation as required shall not be marked.

Article 14 The provincial health administrative department shall instruct the medical institutions in its jurisdiction to uniformly check the format of the report form of the test results, and shall indicate the test method and reference interval used for the test results. Medical institutions are encouraged to issue inspection results that are mutually recognized within the same area in a report, and uniformly mark the corresponding area of mutual recognition and the mutual recognition logo on the report.

Article 15: Local health administrative departments shall guide quality control organizations at the same level to regularly sort out the list of mutually recognized items of medical institutions within their jurisdictions, and strengthen publicity and disclosure in accordance with relevant regulations, so as to facilitate medical institutions and the general public to inquire and understand.

Article 16: Medical institutions and their medical staff shall, on the premise of not affecting the diagnosis and treatment of diseases, mutually recognize the inspection and test results marked with the national or regional mutual recognition logo. Medical personnel are encouraged to mutually recognize other inspection and test results based on clinical practice and without affecting the diagnosis and treatment of diseases.

Article 17: If the existing inspection and test results provided by patients meet the conditions for mutual recognition and meet the needs of diagnosis and treatment, medical institutions and their medical staff shall not repeat the inspection and inspection.

Article 18: Medical personnel shall issue medical orders for inspection and testing according to the patient's condition. For inspection and inspection items that meet the conditions for mutual recognition, relevant fees shall not be charged again in the form of packaging with other items.

Article 19: In the following circumstances, medical institutions and their medical staff may re-examine relevant items:

(1) Due to changes in the condition, the inspection and test results do not match the patient's clinical manifestations and disease diagnosis, and it is difficult to meet the needs of clinical diagnosis and treatment;

(2) The inspection results change rapidly during the development and evolution of the disease;

(3) The inspection items are of great significance to the diagnosis and treatment of diseases (such as before major medical measures such as surgery and blood transfusion);

(4) The patient is in emergency, emergency or other emergency state;

(5) Appraisals involving judicial, disability and sick leave;

(6) Other circumstances that really need to be re-examined.

Article 20 Qualified medical institutions may set up inspection and testing clinics, where medical imaging and radiation therapy professionals or medical laboratory and pathology professional licensed physicians will visit and provide disease diagnosis report services independently.

Article 21: Medical institutions and their medical staff shall strengthen communication between doctors and patients, and if the inspection and inspection items are not mutually recognized, they shall make explanations and fully inform the purpose and necessity of re-examination.

Chapter 4 Quality Control

Article 22 The instruments and equipment, reagent consumables, etc. used by medical institutions for inspection and testing shall meet the relevant requirements, and the instruments and equipment shall be verified, tested, calibrated, measured for stability and maintained in accordance with regulations.

Article 23: Medical institutions shall strengthen the quality management of inspection and inspection departments, establish and improve quality management systems, and take the quality management situation as an important indicator for the comprehensive objective assessment of the person in charge of the department.

Article 24: Medical institutions shall carry out indoor quality control in a standardized manner, and timely and accurately submit relevant quality and safety information such as the indoor quality control of their institutions to the health administrative department or quality control organization in accordance with relevant requirements.

Article 25 Medical institutions shall participate in the quality evaluation carried out by quality control organizations in accordance with relevant regulations. The inspection and inspection items that have been marked with the mutual recognition mark shall participate in the corresponding quality evaluation frequency not less than once every six months.

Article 26: Local health administrative departments and their entrusted quality control organizations shall, in accordance with relevant regulations, regularly conduct random checks on the inspection and inspection quality of medical institutions within their jurisdictions. The random inspection work should be organized and carried out in a "double random and one open" manner.

Chapter 5 Support and Guarantee

Article 27: Local health administrative departments shall strengthen the construction of inspection and inspection capabilities within their jurisdictions, and regularly organize personnel training, on-site inspections, and monitoring of results.

Article 28

(1) If the inspection and test results can meet the needs of diagnosis and treatment, the medical institution will charge the corresponding diagnosis and examination fee according to the door (emergency) diagnosis and examination, and there is no additional charge.

(2) If the inspection and test results meet the requirements for mutual recognition, but the mutual recognition of inspection and inspection results needs to be completed by the joint participation of the corresponding inspection and inspection departments, the inspection fee may be charged according to the price policy implemented by the hospital. Consultation fee.

(3) The inspection and test results meet the conditions for mutual recognition, but fall under the circumstances stipulated in Article 19 of these Measures and cannot play the role of auxiliary diagnosis. If it is really necessary to re-examine, the actual medical service fee will be charged.

Article 29: Medical security departments at all levels shall actively promote the reform of payment methods, guide medical institutions to actively control costs, strengthen vertical analysis and horizontal comparison of medical service behaviors, and strengthen the performance evaluation and assessment mechanism for the use of medical insurance funds. At the same time, the total budget of the medical insurance fund shall be reasonably determined, and the total regional budget and the total budget of a single medical institution shall not be reduced due to mutual recognition of inspection results.

Article 30 Qualified medical institutions may incorporate the medical staff's mutual recognition of inspection results into their performance distribution and assessment mechanism.

Article 31: Medical security agencies at all levels are encouraged to take the situation of mutual recognition of inspection results carried out by medical institutions as the evaluation criteria for designated medical insurance institutions.

Chapter VI Supervision and Management

Article 32: The local health administrative departments have the right to supervise and inspect the mutual recognition work carried out by medical institutions within their jurisdictions by means of consulting, records, etc., and medical institutions shall not refuse, hinder or conceal relevant information.

Article 33: The local health and health administrative departments shall conduct regular work assessments, and pursue relevant responsibilities in accordance with laws and regulations for medical institutions and their medical personnel that violate relevant regulations.

Article 34: Local health administrative departments shall make full use of informatization means to conduct real-time monitoring of the mutual recognition of inspection results and data sharing of medical institutions, and put forward improvement requirements for medical institutions with outstanding problems.

Article 35: For disputes arising from mutual recognition of inspection results, each responsible subject shall bear corresponding responsibilities in accordance with laws and regulations.

Article 36: For those who forge, alter, conceal, or alter inspection results resulting in adverse consequences, the offenders shall bear corresponding responsibilities in accordance with laws and regulations.

Chapter VII Supplementary Provisions

Article 37 The National Health Commission and the National Medical Insurance Administration are responsible for the interpretation of these measures.

Article 38 Each provincial health administrative department shall formulate specific implementation plans in accordance with these Measures and in light of the actual local conditions. Encourage qualified regions to jointly formulate implementation plans and promote mutual recognition of inspection results across provinces.

Article 39 These Measures shall come into force on March 1, 2022.