[Viewpoint] The fog of medical service disruptive innovation

The transformation of medical services is a huge challenge in all countries of the world, especially with the acceleration of aging and the rejuvenation of slow patient groups. The medical system is already overwhelmed, and the original medical service system has reached a point where it cannot be changed. With the advancement of technology and the innovation of business models, medical services are ushered in a period of great change.

It is undeniable that part of the medical service is becoming lighter and lighter by technology, which is different from the traditional heavy asset model. However, the light assets of medical services do not have so-called subversive innovations, but only the original models are useful supplements. Many emerging models cannot replace or reorganize the original models, but only gradually embed the original in the process of evolution. system.

First of all, from the perspective of service capabilities, the core medical services are irreplaceable. The innovation of light assets can only be turned around in the periphery, it is difficult to penetrate the medical field, and the original service model cannot be changed. Take the fast clinics in the United States as an example. On the surface, such services have effectively solved some of the minor illnesses and have replaced the functions of some family doctors. However, this is the result of the real rise of the policy of the payer. The US health care reform has promoted a large number of users who were originally uninsured, but in order to reduce the price and make it more affordable, these are mainly set for high-level quotas for small businesses and individuals. This has made it impossible for a large number of newly insured users to use the previously expensive family doctor services that require an appointment to queue up, thus flooding into fast clinics that are relatively inexpensive and do not require queuing, which also facilitates accelerated replication of such models. Therefore, this type of model is only a supplement to the original family doctor, and the main users are completely different from the users in the original system. If the result is to understand the market, there will be a very large deviation.

Secondly, from the perspective of service depth, the service of light assets is more likely to appear as a supporting role, and more is to integrate with the original medical services. Taking chronic disease management as an example, in the case of less involvement of third-party management companies, chronic disease management is more commonly carried out by US basic medical doctors, especially family doctors, but because insurance does not pay for such management, family doctors Just use it as part of the treatment and provide the necessary advice. However, in addition to medical treatment, family doctors do not provide more value-added services, which leads to the original chronic disease management is not ideal. Because the nature of chronic disease management is anti-human, it requires long-term daily management through the role of a coach, and doctors lack such time and energy. On the surface, providing such services online does seem to be a light asset. Moreover, with the coverage of insurance for the cost of control, the coverage of third-party chronic disease management, similar health management institutions develop faster. However, it does not mean that the heavy manpower of chronic disease management is not light. The single service is only an aid to diagnosis and treatment. It is not the medical itself, nor can it leave the core medical services. Such services are very shallow, from some kind of In the sense, it is very dependent on the diagnosis and treatment services.

Urine Analyzer

Urine analyzer is an automated instrument for determining certain chemical components in urine. It is an important tool for automated urine inspection in medical laboratories. This instrument has the advantages of simple and fast operation. However, improper use of urine analyzers and many intermediate links and influencing factors directly affect the accuracy of automated analysis results, which will not only cause errors in experimental results, but even delay diagnosis. Therefore, operators are required to understand the principles, performance and precautions of automated instruments. And the knowledge of influencing factors and other aspects are fully understood, and the correct use of automated instruments can make the results obtained by the urine analyzer more reliable and accurate.
application
In the 1950s, a single dry chemical test strip method was used to measure protein and glucose in urine, and the changes in the color of the test strip were observed with the naked eye and compared with the standard plate to obtain the corresponding values. In the 1980s, due to the high development and widespread use of computer technology, automated urine analyzers also developed rapidly, gradually developing from semi-automatic to fully-automated. Urine analyzers are often divided into two categories according to the test items: â‘  8-11 screening combined urine test strips mainly used for newly diagnosed patients and health examinations. The eight test items included protein, glucose, PH, ketone bodies, bilirubin, urobilinogen, red blood cells (occult blood) and nitrite; in addition to the above eight tests, urine leukocyte test was added to the nine test items. On the basis of 9 of the 10 urine analyzer testing items, the urine specific density test was added. 11 testing items have added vitamin C testing. â‘¡It is mainly used for the observation of the curative effect of the diagnosed diseases, such as the combination test strip of PH, protein and occult blood (red blood cells) for kidney disease; the combination test strip of PH, sugar and ketone body for diabetes; the combination of bilirubin and urobilinogen for liver disease test tape.
principle
This type of instrument is generally controlled by a microcomputer, and the color change on the test strip is measured semi-quantitatively by using a spherical integrator to receive dual-wavelength reflected light. There are several reagent pads containing various reagents on the reagent strip, each of which reacts independently with the corresponding components in the urine, and displays different colors. The depth of the color is proportional to a certain component in the urine, and there is another in the reagent strip" Compensation pad", as the urine background color, compensates for the errors caused by colored urine and instrument changes.
Put the reagent strip with urine adsorbed in the colorimetric tank of the instrument, and the various reagent pads that have produced chemical reactions on the reagent strip are illuminated by the light source, and the reflected light is received by the spherical analyzer, and the photocell of the spherical analyzer is reflected. Irradiate with dual-wavelength light (measurement light passing through the filter and a reference light), and the selection of each wavelength is determined by the detection item.
The instrument automatically calculates the reflectance according to the following formula, and then compares it with the standard curve, and automatically finds and prints the corresponding results of various components. If the content of a certain component in the urine is high, the reflected light of the corresponding reagent pad is dark, otherwise it is strong.
Reflectance fraction: R(%)=Tm.Cs/TsCm×100%
In the formula, R(%) is the reflectivity; Tm is the reflection intensity of the reagent pad to the measurement wavelength; Ts is the reflection intensity of the reagent pad to the reference wavelength; Cm is the reflection intensity of the calibration pad to the measurement defect length; Cs is the calibration pair. Reflection intensity at the reference wavelength.

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