Article(id=1321169655314625514, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321169578152014376, articleNumber=null, orderNo=null, doi=10.11847/zgggws1147112, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1739721600000, receivedDateStr=2025-02-17, revisedDate=1746633600000, revisedDateStr=2025-05-08, acceptedDate=1753372800000, acceptedDateStr=2025-07-25, onlineDate=1792920991972, onlineDateStr=2026-10-25, pubDate=1760025600000, pubDateStr=2025-10-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792920991972, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792920991972, creator=13701087609, updateTime=1792920991972, updator=13701087609, issue=Issue{id=1321169578152014376, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='10', pageStart='1153', pageEnd='1280', issueExtLink='null', onlineDate='null', pubDate='1760025600000', pubDateStr='2025-10-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792920973575, creator='13701087609', updateTime=1792920973575, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1274, endPage=1280, ext={EN=ArticleExt(id=1321169655553700843, articleId=1321169655314625514, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Evolutionary trends, transformation drivers, and development paths of Internet-based diagnosis and treatment, columnId=1320431897281413811, journalTitle=Chinese Journal of Public Health, columnName=Public Health Forum, runingTitle=null, highlight=null, articleAbstract=

As a product service scenario empowered by Internet technology for doctor - patient interactions, Internet-based diagnosis and treatment (IBDT) holds significant value in promoting the balanced allocation of high-quality medical resources. However, the IBTD service system has not yet formed a closed loop for sustainable development in China. As people′s health care demands keep increasing, China′s IBDT service system needs to build a deep-rooted health care service chain, transforming from a single passive diagnostic and treatment approach to comprehensive proactive health management. On the basis of literature review and theoretical deduction, this paper finds that the realization of this transformation relies on the joint efforts from the macro policy level, meso functional level, and micro technological level. And the symbiotic evolution of the internal ecosystem and external environment of IBTD is the key to its successful transformation. At the level of internal ecosystem, the synergistic development of multiple service subjects is the core for maintaining the sustainable development of IBTD, in which digital intelligence empowerment is the major path for the digital transformation of IBDT. Specific suggestions include establishing a community-centered digital medical community for core clinical services and remote joint clinics; enriching the service hierarchy and constructing a full-process service chain of proactive health management covering pre-diagnosis, in-diagnosis, and post-diagnosis closed-loop services to provide patients with comprehensive and continuous diagnosis and treatment services; and establishing an appropriate bilateral incentive mechanism to satisfy the interests of multiple subjects and achieve the incentive compatibility between physicians and patients. At the level of external environment, it is necessary to create an IBDT-friendly external environment from the political, economic, social, and technological aspects, thus providing opportunities and external driving forces for the digital and intelligent transformation of IBDT.

, authors=Yuxin LIU, Zhiyong LIU, Yan ZHANG, Mingfang HUANG, Ran WEI, authorsList=Yuxin LIU, Zhiyong LIU, Yan ZHANG, Mingfang HUANG, Ran WEI, authorCompany=null, correspAuthors=Mingfang HUANG, authorNote=null, correspAuthorsNote=, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1321169657973814258, articleId=1321169655314625514, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=互联网诊疗演进趋势、转型驱动与发展路径研究, columnId=1320431897449185973, journalTitle=中国公共卫生, columnName=公共卫生论坛, runingTitle=null, highlight=null, articleAbstract=

作为互联网技术赋能医患交互的重要场景，互联网诊疗具备促进优质医疗资源均衡配置的应用价值，但其服务体系当前在我国仍未能形成可持续发展的生态闭环。在人民群众医疗服务需求日趋增长的当下，我国的互联网诊疗服务体系需构建深入基层的大健康产业链，实现从单一被动诊断治疗到全面主动健康管理的数智化转型。本文基于文献回顾和理论推演方法研究发现，这一转型的实现有赖于宏观政策层面、中观功能层面和微观技术层面的共同驱动，并且互联网诊疗的内部生态与外部环境的共生演进也是促使其转型取得成功的关键。在内部生态层面，实现多元服务主体间的协同是维持互联网诊疗可持续发展的核心要义，其中数智赋权和数智赋能是实现互联网诊疗数智化转型的两大路径。具体建议包括：建立以基层为中心的数字医共体，以此为主体深耕核心诊疗业务、开展远程联合门诊；同时丰富服务层级，搭建涵盖“诊前—诊中—诊后”闭环服务的主动健康管理全流程服务链，为患者提供全面的连续性诊疗服务；建立合理的双边激励机制，满足多元主体的利益诉求，实现医患之间的激励相容。在外部环境层面，需要从政治、经济、社会和技术方面打造友好互联网诊疗的外部环境，为互联网诊疗的数智化转型提供条件机遇与外驱动力。

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刘雨鑫（1996—），博士在读，研究方向：互联网医疗

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刘雨鑫（1996—），博士在读，研究方向：互联网医疗

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Evolution of Internet-based diagnosis and treatment models

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项目	远程医疗	在线问诊	线上线下一体化服务	数智医疗
服务对象及内容	为偏远地区的基层疑难杂病 患者提供远程会诊服务	为轻微疾病患者提供在线健康咨询与疾病诊疗服务	为常见病、慢性病复诊患者 提供覆盖诊前、诊中、诊后的 线上线下一体化服务	为全人群提供多元化、精细化、个性化、智能化的全周期健康管理服务
医药险生态建设	线上—线下医药险融合	互联网医疗药事保障与医保 支付制度缺失	初步实现“医疗—医药—医保” 全链路在线化	打造“云医—云药—云险”闭环
核心阻遏	操作流程繁琐，服务便捷性、 即时性、经济性不足	无法实现诊治一体化的全过程服务，诊疗质量与安全难以 保证	服务主体、服务内容与服务 对象较为单一	处于早期应用探索阶段，智能化医疗技术的推广扩散较为 缓慢

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互联网诊疗模式演进表

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项目	远程医疗	在线问诊	线上线下一体化服务	数智医疗
服务对象及内容	为偏远地区的基层疑难杂病 患者提供远程会诊服务	为轻微疾病患者提供在线健康咨询与疾病诊疗服务	为常见病、慢性病复诊患者 提供覆盖诊前、诊中、诊后的 线上线下一体化服务	为全人群提供多元化、精细化、个性化、智能化的全周期健康管理服务
医药险生态建设	线上—线下医药险融合	互联网医疗药事保障与医保 支付制度缺失	初步实现“医疗—医药—医保” 全链路在线化	打造“云医—云药—云险”闭环
核心阻遏	操作流程繁琐，服务便捷性、 即时性、经济性不足	无法实现诊治一体化的全过程服务，诊疗质量与安全难以 保证	服务主体、服务内容与服务 对象较为单一	处于早期应用探索阶段，智能化医疗技术的推广扩散较为 缓慢

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