Research and Suggestions on the Development of Smart Hospital -Taking Hospital A in Liaoning for Example

Zhang Yuting，Liu Xiaoxi

(School of Business Administration，Shenyang Pharmaceutical University，Shenyang 110016，China)

Abstract Objective To study the development of smart hospital to better carry out medical services in the context of the popularization and application of the Internet and the traditional medical model facing the challenge of COVID-19 in 2020.Methods Literature research method was used to analyze the Internet medical mode，and field investigation was made to explore the application of smart medical treatment in hospital A during the pandemic.Results and Conclusion The smart medical platform built by hospital A provides convenient and fast services for patients，but it also exposes the problems in the construction of smart hospitals in China.This paper proposes some suggestions such as hospitals’ participating in the independent review of smart systems and optimizing their information systems.

Keywords:Internet;smart hospital;5G technology

1 The concept and background of“smart medicine”

1.1 Concept of smart medicine

With the popularization of the Internet and the emergence of public health emergencies，medical services in hospitals have rapidly shifted from the traditional mode to the new“Internet plus”way[1].The emergence of 5G has also improved the public’s understanding of Internet applications[2].Since smart medicine is based on various modern technologies，the communication between patients and doctors is not limited by time and space.With the development of economy and the improvement of people’s living standards，diversified，differentiated and personalized health demands also continue to grow.Smart hospitals based on Internet data information can not only promote economic development，but also improve the health of the public[3].Besides，it makes up for the shortcomings of traditional hospital mode，which greatly enhance China’s medical level.Therefore，it is both beneficial to save social resources and serve the public better[4，5].

1.2 Origin and development of smart medicine

The definition of“smart medicine”originated from the concept of“smart planet”proposed by the president of IBM on January 28，2009.In February of the same year，IBM proposed six fields that China would promote greatly，namely，smart electricity，smart medicine，smart city，smart transportation，smart supply chain and smart bank.Thus，smart medicine came into being.

In the process of government’s control of smart medicine，its development can be roughly divided into the following three stages.

(1) In the initial stage (2009-2015)，the gradual formation of the medical and health security system stimulated the budding of smart medicine.The main features of this stage were to deepen the reform of medical and health system and determine the policy orientation of medical security informatization construction.In 2009，the General Office of the State Council issued the“Opinions on Deepening the Reform of Medical and Health System”，requiring local governments at all levels to invest 850 billion yuan within three years for the informatization construction in medical and health systems.

(2) In the control stage (2016-2017)，artificial intelligence，big data on health，and other Internet assisted technologies developed rapidly.Against the background of imperfect system，some businessmen sought improper benefits through this，which exceeded the government’s tolerance.Therefore，the government quickly implemented policy control.In 2016，the General Office of the State Council issued the“Guiding Opinions on Promoting and Standardizing the Application and Development of Big Data in Health Care”，which put forward suggestions on the rational development of big data in this field.

(3) In the steady development stage (from 2018 to now)，the General Office of the State Council issued“Opinions on Promoting the Development of Internet Assisted Health Care”on April 28，2018.With the continuous implementation of supporting policies and the improvement of various modern technologies，smart medicine shows a steady trend of development.Since smart medicine is effectively combined with enterprises，hospitals，and pharmacies，various combination modes are also developing rapidly.Therefore，smart medicine has entered the golden stage.

2 Research methods

In this article，the application and practice of the domestic Internet based wise hospital service system are studied by the literature research method.Based on literature research，we experience the construction of wise hospital service system on the official websites，WeChat official platforms and their official Apps in some first-class hospitals.Field research method is used to explore the development of wise hospitals during the pandemic.

3 Wise hospital practice in hospital A

On October 18，2019，hospital A became the first to obtain the qualification of Internet medical service in Liaoning Province，which further accelerated the pace of hospital information service system.In 2020，the Internet based service system in hospital A was built and put into use，which included hospital’s APPs，Alipay official account，WeChat official account，and other online information service platforms.It is selected as the research object of this paper because it is at the forefront of Liaoning Province in the construction of Internet based services with extensive applications.

3.1 Construction of Internet-based service platform

In addition to the construction of online service platforms，other internet-based services can also be seen everywhere in hospitals，such as self-service registration machines，self-service billing printers and so on[6，7].Both online and offline service platforms have these four characteristics.Multiple diagnosis and treatment service platforms are interconnected to provide the public with independent choice of a medical platform.The Internet-based hospital service system will be upgraded to provide one-stop service from online consultation to home delivery.An Internet-based medical insurance payment system is set up to provide online medical insurance settlement.A login system of real name authentication and face scanning recognition is created to provide safe measures to protect the privacy of the public.

Since the outbreak of CONVID-19，hospital A has offered another 5 kinds of registration channels for patients.Therefore，these 6 kinds of registration forms enable the public to use residents’ health cards，ID cards，medical cards，bank debit cards for selfservice registration.Since the 5G-based hospital project has been successfully implemented，some wise service systems in hospitals are upgraded，including chronic disease management，prescription purchase and other services.It also conducted the overseas remote network ward round with the campaign of 2019 Chinese and foreign famous doctors face to face.Besides，the department of gynecology successfully completed remote real-time teaching conference for surgery based on the 5G，Da Vinci robot and live broadcast[8，9]More than 400 surgeries were made by remote control robots.The department of ultrasound successfully held the progress tour of clinical application of ultrasound elastography technology.The department of neurosurgery completed live broadcast of surgery，which later became the leader of the national neurosurgery robot demonstration project.Radiology experts taught some students in the medical imaging classes of belt and road countries.Micra pacemaker implantation was carried out in this hospital as well.Ophthalmic cataract surgery entered the era of 3D visualization.Warm immune-induction therapy for the treatment of viral warts was developed for the first time in this hospital.By means of operation based on Internet，many achievements were made，including the application of deep brain stimulation (DBS) in the treatment of epilepsy，implantation of extracorporeal membrane oxygenation (ECMO) assisted stents in myocardial infarction patients，robot assisted inguinal lymph node dissection for vulval cancer patients，robot-assisted radical cervical cancer for the mirror people，and Delta endoscopic surgery for cervical yellow ligament calcification and so on.

3.2 National policies during the COVID-19 pandemic

The outbreak of COVID-19 is like a big test，which not only tests the hospital’s pandemic prevention and overall management level，but also tests the ability and level of hospital informatization construction[10，11].Since the outbreak of the pandemic，the NHC has issued many notices，which can be grouped into the following aspects:(1) Pandemic prevention and control.On 3 February 2020，the NHC issued the“Notice on Strengthening the Prevention and Control of Novel Coronavirus Infections Supported by Information Technology”，requiring all localities to make full use of Internet technology to prevent and control the pandemic effectively.(2)Online consultation.On February 6，2020，National Health Commission released the“Notice on the Online Consultation Service in Pandemic Prevention and Control”，requiring local hospitals should carry out pandemic prevention and control as well as online consulting services.(3) Precise medical treatment.On February 26，2020，National Health Commission issued the“Notice on Further Implementing the Scientific Prevention and Control and the Management of Medical Service During the Pandemic”，requiring hospitals at all levels to make full use of network information service platform，reduce patients visit，and provide better service for patients during the pandemic.

4 Practice of Internet plus hospital A during the pandemic of COVID-19

Before the outbreak of COVID-19，hospital A had laid the foundation of online and offline integrated medical services，which formed an information service platform based on the previous service mode.Therefore，after the outbreak of novel coronavirus，hospital A can quickly meet the requirements of National Health Commission on strengthening data collection，analysis and application，actively carrying out remote medical service，standardizing online medical consulting services，strengthening basic government services and enhancing health security[12].

4.1 Practice approach in hospital A

During the pandemic prevention and control，hospital A actively used the Internet，5G and other information technologies to combat the pandemic，innovate diagnosis and treatment models[13]，improve service efficiency，reduce offline diagnosis and treatment pressure and cross-infection risk，which greatly quickens the precise policy implementation.Besides，hospital A provided multi-channel online and offline intelligent services for patients through the following channels.First，the official website of hospital A and its WeChat account released and updated the notice on the requirement for seeking medical treatment during the pandemic，so that the public learned the ways for medical treatment during the pandemic.Second，smart hospital operation and online clinic service bring more convenience for the public，which not only can solve some problems of the public such as fever，headache，but also alleviate the anxiety of patients.Besides，remote consultation，prescription，home delivery services effectively prevent the transmission of coronavirus.Finally，it is the live broadcast platform of Himalaya APP.The live free clinic is fully drawn on the popular form of selling goods on the Internet，which covers fever consultation，psychological counseling，chronic disease return visit，and free clinic，etc.The public can directly interact with the experts through the Himalaya APP，and the experts will give answers to the questions they raise in the live broadcast.The live broadcast can be watched through WeChat and Himalaya.In addition，the saved playback can be watched by the public.During the pandemic，hospital A launched a total of 16 special live broadcasts on the Himalaya APP platform from March 23，2020 to August 22，2021，each with different themes and experts，including breast cancer and kidney diseases.72 albums were released，including popular science lectures on hypertension，rheumatism and coronary heart disease.It made 1 137 voice announcements to educate the public about the diagnostic criteria for common symptoms in life，such as skin，voice，rhinitis，and teeth.It also informed the public about the ways to treat these diseases.

4.2 Problems in the application of smart hospitals

From the construction of the smart service system in hospital A，it can be seen that the multiplatform brings high-quality medical services to the public with many advantages.However，problems in the application of smart hospital should also be solved.Firstly，information security should be guaranteed[14].The public is worried about the privacy of a large amount of medical data and patients’personal information gathered in the smart hospitals.The current information operation mode not only occupies a lot of information space but also increases the burden of patients[15].The second problem is patient satisfaction.For hospitals，improving patient satisfaction during offline treatment has always been a challenge，and the operation of smart service system in hospital A has made this challenge more difficult.Online outpatient service quality and service coverage are lower than offline ones.Hospitals and relevant departments should pay more attention to staff attendance and other issues.At present，artificial intelligence and remote video technology are the most widely used in hospital A.Due to the pandemic situation and the complexity of the disease，the current scientific and technological means are far from enough.Therefore，it is necessary to strengthen the scientific and technological innovation.

5 Conclusion and discussion

With the normalization of pandemic prevention and control and the coming of the 14th Five-Year Plan，the informatization development of smart hospitals will become the focus in the future.Therefore，hospital A should strengthen the application of informatization in supporting pandemic monitoring and analysis，innovating diagnosis and treatment mode[16，17].In view of the problems existing in the process of applying the smart system in hospital A and the requirement of the“14th Five-Year Plan”，hospital A should actively participate in independent evaluation of smart hospitals and continuously optimize the information service system while completing the top-level design，strengthening network security，improving patient satisfaction，and speeding up the construction of technology innovation[18].

The construction of smart service system in hospital A has a good leading role because it had made some achievements in this process.In addition，other hospitals can draw lessons from the achievements of hospital A by combining with their resources and capabilities.Therefore，they can have rational planning to promote the development of their smart service platforms.On the other hand，hospital A can serves as a warning.Other hospitals can comprehensively analyze the disadvantages in the construction of smart service platform of hospital A.For example，the rapid development of hospital A has the disadvantage that its patients cannot get the appropriate services.Therefore，similar problems should be avoided in the building of the development framework，and more precise strategies must be formulated to promote the good development of smart hospitals[19].

5.1 Actively participating in the evaluation of smart hospitals

The smart hospital evaluation system not only sets indicators for the infrastructure construction of the hospitals，but also evaluates the application and platform capacity of these hospitals.Broadly speaking，the evaluation of application capacity refers to the coverage of the application in smart hospitals，and the evaluation of platform capacity refers to the platform construction capacity of smart hospitals[20].Participating in the review of smart hospitals can make hospital A not only understand its construction of smart hospital but also interpret the requirement of the informatization.Therefore，it can focus on the public’s demands，summarize the problems in patients，medical treatment and services.Then，it will make improvement measures to promote the development of smart hospital and set a good example for other hospitals[21].

5.2 Optimizing the information service system for the public

While actively exploring innovative technologies，hospital A should also pay attention to the quality of service for the public[22].Only by understanding the requirement of the patients can hospital provide more comprehensive services and greatly improve patients’ medical satisfaction[23].Based on the“14th Five-Year Plan”，the state and the public have new requirements for the medical level.Therefore，hospital A should take patients as the core and information service platform as the basis to optimize the hospital information service platform.At present，hospital A is actively exploring smart service system，which includes electronic medical insurance card，5G technology，Da Vinci robot，surgical live broadcasting，remote consultation and others[24].In addition，it should integrate hospital A’s medical resources and emerging information technology to continuously optimize the information service quality of smart hospital.