At the recent 8th China Health Service Industry Conference and the 6th National Academic Conference on Health Management of the Chinese Medical Association, some experts criticized the excessive medical checkup chaos. In their view, the health checkup is regarded as a sunrise industry to really enjoy a ray of sunshine, there are still a lot of short boards need to be filled. First-class environment Second-class personnel Third-class service In recent years, health checkup centers have been favored by large public hospitals and social capital. On the one hand, hospital managers do not want to be absent in this area; on the other hand, compared with the high cost, high risk and high pressure on medical institutions, medical examination centers are more cost-effective, favored by social capital. According to statistics, since 2003, China’s health checkup organizations have rapidly increased from a few hundred to nearly 10,000, truly becoming a new industry. According to the 2012 Health Statistics Yearbook, the number of health checkups in China reached 368 million. First-class environment, second-rate personnel, third-rate service” is often used to describe some of the current health checkup institutions, which is specifically manifested in the lack of scientific explanations and individualized medical checkup package design recommendations before the physical examination, the lack of uniform and standardized professional service processes and paths during the physical examination, and the lack of health assessment and tracking management after the physical examination, which makes the “health output” of the health checkup a very important factor in the development of China’s health industry. The “health output” of medical checkups is greatly reduced, which also brings serious challenges to the current hot health checkup market. Chinese Medical Association Health Management Branch Chairman Wu Liuxin bluntly: “In a short period of time, the number of rapid increase, there is bound to be uneven development of the situation.” First of all, the health checkup hardware facilities are uneven, there is a “high and low” phenomenon: some of the instruments and equipment that have no evidence-based medical evidence in some of the physical examination organizations are “reuse”, while some of the equipment should be eliminated but still in use. For example, infrared mammography, which has been proved to be of no practical significance in breast cancer screening, and fluoroscopy, which has long been stopped by the competent authorities. Secondly, the level of specialization of medical personnel in medical check-up institutions varies. In large hospitals, the knowledge and technical level of the personnel of medical examination centers can be guaranteed. However, in certain medical check-up organizations, many of the medical check-up personnel are recruited from the community, and their level of specialization and technology is uneven, which will affect the accuracy of the results of medical check-ups. Again, there is the phenomenon of disorderly competition among a few organizations in the private medical check-up institutions, which has caused great negative impact on the medical check-up industry. “In the final analysis, the emergence of the above problems is due to the lack of regulation of health checkups in China.” Wu Liuxin said that on August 5, 2009, the Ministry of Health issued the “Interim Provisions on the Management of Health Checkups”, but the accompanying “health checkups and the implementation of the basic project directory and the rules and procedures” has not been introduced, “no rules is the same as the lack of operability”. Wu Liuxin emphasized that the important value of the health examination itself can not be denied. Health checkups focus on chronic non-communicable diseases and their risk factors for screening and risk screening assessment, and provide health guidance recommendations and health intervention programs. The biggest difference between this and a patient’s visit to the clinic is that it targets the asymptomatic population, further detects diseases through subtle clues, makes early risk assessment of diseases, and provides health guidance and health management programs, which is actually an embodiment of the concept of “treating the sick before they get sick”. Asked before the inspection after the tube are not done Compared to the management level of defects, the lack of personalization, and even the blind pursuit of “high” physical examination content is a health checkup by the public criticism of the more important reason. Reporters have been to a private chain of physical examination institutions to experience, in the sales reception, dressed in nurse uniforms, the staff just routinely ask a few symbolic questions, including personal medical history, whether smoking and other issues, and ultimately recommended packages will not be based on the answer to the answer and different. When pressed by the reporter, the staff said that the organization has only two packages for women, with the age of 50 as the boundary. In response to this phenomenon, the Chinese Medical Association Health Management Branch Director-designate, the PLA General Hospital Health Management Institute Director Zeng Qiang frankly admitted that China’s medical examination, “two ends” is not enough, one is a health check-up before the questionnaire survey, as well as for different answers to recommend a different physical examination program; the second is the physical examination after the health management. Zeng Qiang told reporters that the health checkup should take “1 + X” mode, 1 is the basic physical examination project, but also the formation of health checkup report and personal health management files must be project, including health checkup self-assessment questionnaire, physical examination, laboratory tests, imaging tests, physical examination report summary of the five parts of the report, involving the blood, urine and stool routine checks It involves blood, urine and stool routine examination, ear, nose and throat, dental and oral examination, gynecological examination, electrocardiogram examination, and so on. The “X” refers to the “Specialized Physical Examination Program”, which is a special screening program for individuals of different ages, genders and chronic disease risks. Jiang Mei, vice-chairman of Beijing Electric Power Hospital and vice-president of Beijing Health Management Association, suggests that medical checkups should be “body-specific”, with personalized and staged checkups based on the patient’s age, family history, lifestyle, and physique. Unit physical examination should be designed according to the different age groups of different physical examination content, pay attention to the scientific, weaken the welfare. “The greater value of physical examination lies in the discovery of health risk factors, timely intervention and effective health management.” Cui Qixiang, medical director of Ciming Physical Examination, cited an example that Ciming is promoting a special health management program for fatty liver, whereby subjects with fatty liver can wear a “watch-type” fatty liver quantitative detector, which can upload daily exercise, diet and other relevant information to the health management center, where staff will send different health recommendations to the subjects based on their dynamic information. According to the dynamic information of the examinee, the staff of the center will send different health suggestions to the examinee’s cell phone, reminding him/her to strengthen exercise, eat reasonably, and carry out lifestyle intervention in a timely manner. Liu Youqin, director of the physical examination department of Beijing Xuanwu Hospital, said that the health management of the workplace is effective and affects a large group of people, and the health intervention for the group should be a key area of health management. She introduced the hospital in a unit for a period of 2 years of health management, for high-risk groups, to carry out a 3-month study class, high blood pressure, high blood sugar, high blood fat prevention and treatment of lectures, the development of one-on-one personalized guidance program, and 24 telephone guidance and 12 text message prompts. The unit’s employees who received the intervention lost an average of 5 kilograms in 3 months, and their blood pressure and blood lipids dropped, which was well evaluated by the employees. “Managing groups is more meaningful than managing individuals, and group health management can better address adherence issues.” Jiang Mei holds a similar view. Jiang Mei proposed that the current physical examination institutions “check more, less management” is also limited by the payment mechanism, after all, the current psychological counseling, exercise prescription, nutritional prescription how to charge are still need to establish a new payment mechanism. In addition, there is a need to strengthen the top-level design of the national health management strategy, the introduction of relevant policies and regulations, to open up the career path of health managers, to provide continuous training opportunities to enhance their professional competence. Industry organizations should take up their responsibilities The State Council’s Opinions on Promoting the Development of Health Service Industry, released in October 2013, suggests that by 2020, China will have basically established a health service industry system covering the entire life cycle, and that diversified health services, including health checkups, consulting and management, and physical fitness determination, will have been developed to a greater extent. The total scale of the health service industry has reached more than 8 trillion yuan, and has become an important force in promoting sustainable economic and social development. Ten years ago, health checkups were considered a luxury, but now they are widely recognized by society and the public. How to solve the current health check-up related equipment, personnel, environment, services, the lack of uniform standards and certification and other issues to promote the healthy development of the health check-up industry, Wu Liuxin pointed out that the industry organization should be responsible for regulating the industry’s heavy responsibility. Wu Liuxin said that the state should increase supervision, the introduction of appropriate laws and regulations, the industry association to develop a series of health checkup norms guide, including medical standards, technical standards, personnel standards. For example, the above provisions should be limited to the performance of the physical examination equipment can not be inferior to clinical diagnostic equipment, there is no clinical evidence-based medical evidence of the equipment can not be used for health checkups, but also to the operator’s technical ability to set the threshold. “Obviously, whether for the operator, or for the instrument precision, accuracy, early diagnosis of disease is actually more difficult than the diagnosis of disease, therefore, the requirements for people and things should naturally be higher.” Wu Liuxin told reporters that the recent “China Health Physical Examination Basic Project Expert Consensus” prepared by experts organized by the Chinese Medical Association Health Management Society within the industry and the people have a great response. “Because it is the first physical examination industry ‘quasi-normative’, which items are recognized must be checked, which items are needed for special populations, are clear at a glance.” In addition, the “consensus” also includes a “health checkup self-test questionnaire (for trial use)” and “health checkup report home page (for trial use)” two annexes. Wu Liuxin said that the self-assessment questionnaire can effectively solve some of the medical examination center “come up to check” shortcomings, while the first page of the medical examination report plays a unified standardization of medical examination information records and medical examination of the role of statistical content of big data. He further explained that: “the reason why China’s health checkups lack of medical evidence of the contents of the examination, and even health standards, are due to the lack of large-scale epidemiological survey data. And the current 368 million people in China’s physical examination data is difficult to use, mainly due to the patient data does not become a column, the examination catalog is not unified, the physical examination personnel personal health data is not registered or archived, the launch of the “Consensus” in fact, can partially solve this problem.” In the interview, Wu Liuxin admitted that whether to ensure the implementation of the Consensus determines whether the industry can really take the first step to standardize. “At present, from the perspective of the Society, ready for next year for the “Consensus” held a study class to unify the understanding, especially for the physical examination of the main operations involved in specialized training, such as ultrasound operations, interpretation of radiological images, medical testing package design and quality control. In addition, it is also hoped that we can join forces with large medical institutions to apply to the National Health and Family Planning Commission for a health checkup report homepage, through which we can standardize the reporting of information on medical checkup data and eventually submit the data to the relevant departments. In the future, we hope that the health statistics yearbook, can contain health physical examination industry massive data information report.” Wu Liuxin said that the next step of the Society hopes to start from the blood pressure standardized testing, joint China Hypertension Alliance, the use of unified standardized physical examination data to establish a large database, to understand the public hypertension knowledge rate, prevalence rate, control rate is actually how much. “In the future, we can also set a theme every year, including body mass index, blood lipids, etc., for statistical analysis, which will all be of great value to the development of medical health.” In the development of physical examination data, there are also pioneers in China began to try. 2009, Ciming Physical Examination began to once a year to publish China’s urban health white paper, each year for different groups of people to carry out questionnaire surveys and combined with physical examination data for health big data analysis. “Population-based health data analysis can provide a scientific reference basis for government health policy planning and decision-making.” Yu Shibei, director of the technical department of Ciming Physical Examination, said that since the release of the 3rd white paper, local governments in Shanghai, Guangzhou, Hefei and other places have also been involved in the process, and have paid great attention to and given strong support to the collection and analysis of health data of the population. Some industry experts also pointed out that the development of physical examination data involves the standardization of data collection, patient privacy protection and many other issues, not simple data collection and statistics. “The key to big data is data quality, and standardization is the foundation.” Yu Shibei said that good natural data collection is the basis of health big data analysis, which needs to be controlled from the sample size, the representativeness of the sampling group, and the scientific nature of data collection in 3 dimensions.