Faster and easier: Digital technology streamlines hospital services

Digital technology and a patient-oriented service format have streamlined services at Shanghai Chest Hospital.

Patients who need regular screening and follow-up checks on their lung nodules or after-surgery checks at the hospital can finish the service with just one service through one reservation.

Previously such a service requires three reservations and three hospital visits. For patients from other provinces, the process would have been much more troublesome and time-consuming.

Under routine practice, patients should reserve an outpatient visit and come to see the doctor, who prescribes a CT scan and other necessary tests. After paying the bill, patients should reserve the CT check, which is usually arranged one or two days later. After undergoing scanning and other tests, patients should reserve another outpatient service to see the doctor, who reviews the results and gives medical instruction.

For patients who need regular monitoring or after-surgery management, it is a practice which must be repeated every three, six or 12 months depending on their condition.

"If the doctor is a leading expert, the reservation will be much more difficult due to expert's popularity and limited quota," said a female patient surnamed Shen from Jiaxing, Zhejiang Province. "It can take half to one month to fulfil the whole process. For patients from other provinces like me, it is extremely tiring and troublesome, let alone the cost and time we have to spend during the whole process."

At Shanghai Chest Hospital, a leading hospital for heart, lung, esophagus and trachea disease treatment in the nation, about 55 to 60 percent of patients are from other provinces, especially the Yangtze River Delta region.

Moreover, 60 percent of patients at the outpatient department are those coming for regular check for lung nodules or after-surgery examination.

According to the hospital, it conducts about 15,000 lung nodule surgeries in 2020. About 30.5 percent of patients are from Shanghai, 20.7 percent from Jiangsu Province, 18.6 percent from Zhejiang Province and 8 percent from Anhui Province. Which means nearly 80 percent of patients come from the Yangtze River Delta region.

Among patients with lung nodules who don't need surgery at present but require regular monitoring, those from other provinces cover half of the total quantity.

"In fact, the practice is not only a waste to patients' time but also a waste of limited medical resources, as many of doctors' precious outpatient time are wasted on patients coming for regular monitoring and simple consultation," said Zheng Ning, Party secretary of the hospital.

The hospital decided to break the routine practice and bring more convenience to patients by condensing the regular follow-up service from three hospital visits to only one.

The current reservation system in local hospitals only provides outpatient reservation within one month and test reservation within three months. "Our new one-day system is a tailor-made system offers up to one-year reservation and outpatient service system," he said.

The trial is now only available for patients needing after-surgery checks and those needing regular monitoring on lung nodules, as they only require a CT scan and other simple checks but cover a large quantity of outpatient service.

"To combine the three hospital visits within one was not easy," said Zheng. "But thanks to the development of digital technology and communication and coordination of different departments, we managed to streamline the process."

The hospital introduced the new service in June and made adjustments in line with feedback from patients and medical staff gradually. It is the first hospital in the city to introduce such one-day service.

"It is a big reform to the routine health service," Zheng said.

Under the new practice, doctors make reservations for patients for the next hospital visit and prescribe all necessary checks like a CT scan in the system after finishing the current one.

Patients will receive a short message one month ahead of the doctor's arrangement and make a reservation on the hospital's WeChat account. The system will remind the patient three days ahead of the reserved date. Patients can make one change of the date of reservation.

On the day, patients go to the hospital at the designated time to pay the bill for checks, and undergo a CT scan and other biological tests in the morning. Doctors are available to meet the patients in the afternoon to check all test results and give follow-up direction.

If the patient needs a regular hospital visit next time, the doctor will make the arrangement in the system and patients just repeat the whole process next time. All the process is finished within one day.

"For patients from the Yangtze River Delta region, we can leave home in early morning and arrive at home just in the evening," Shen, a patient from Jiaxing, hailed the new service. "I enjoyed the one-day service today and it is extremely convenient."

A patient from Liyang, Jiangsu Province, said her cost on hospital visits is greatly reduced thanks to the one-day service.

"I have to spend 1,000 yuan to hire a vehicle and a driver from my hometown to Shanghai for a hospital visit each time," said the patient surnamed Lei. "The transportation from my home to Shanghai is over three hours, so we have to stay for one or two days for each hospital visit. The whole cost for each after-surgery check is costly for me.

"I am very happy to learn that the three visits have been combined into one. It is my first time to enjoy the service today. It is very convenient and economic for patients like me."

Officials said public hospitals are always criticized for crowding and long waiting times. The new service is really patient-centered and patient-friendly and help these problems.

Since patients have reduced their hospital visits, the outpatient hall and waiting room will also become less crowded. It is also an effective measure under the current requirements for COVID-19 prevention and control.

The practice is also welcomed by doctors, who are released from simple and repeated service to give more time and service to patients who need surgery or detailed consultation.

Dr Cheng Xinghua from the hospital's oncology department, said the new service makes medical service more organized, as leading doctors can spend more time and energy on complicated cases or patients who need surgery.

"The number of patients who just come to me for prescribing a CT scan has greatly reduced under the new practice, while more outpatient time is left for patients who needs to meet me for consultation," Cheng said. "We can make better use of professional ability during limited service time."

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