若不是为了集成区块链技术，大连医科大学附属第一医院（下称大医一院）或许能提前半年上线互联网医院。
If it is not for integrated block chain technology, the University of Dalian Medicine Hospital I (hereinafter referred to as the Hospital I) may be able to access the Internet six months ahead of schedule.
“我院去年开始建互联网医院，到年底基本建成，今年1月底开始试运行。”大医一院信息部副主任于丹丹告诉健康界，9月17日，大医一院互联网医院正式上线。
“We started the construction of the Internet Hospital last year, and by the end of the year it will be almost complete and will be operational on a trial basis by the end of January this year.” In Dandan, the Deputy Director of the Information Department of the First College of Medicine told the health community that, on 17 September, the Internet Hospital of the First College of Medicine was officially launched.
除了中间的评审办照等环节，在东北地区首次尝试将区块链技术应用到互联网医院系统中，“从而作出一些创新”，是互联网医院延迟上线的重要原因。
In addition to the intermediate review process, the first attempt to apply block chain technology to the Internet hospital system in the north-east, “and thus to make some innovations”, is an important reason for the delay in the Internet hospital's access.
区块链是一个分布式的共享“账本”（交易）和数据库，具有防篡改、全程留痕、可追溯、集体维护、公开透明等特点，诞生已有十多年，此前主要应用在金融领域，目前在医健领域的应用还不多。
The block chain, which is a distributed and shared “book” (transaction) and database, has been in existence for more than a decade and has been primarily applied in the financial field and is currently under-used in the field of health care, with features such as tamper-proofing, backtracking, collective maintenance and transparency.
大医一院为何要应用区块链技术？具体是如何做的，中间遇到哪些难题？日前，带着这些问题，健康界对该院相关人员进行了采访。
Why do they use block chain technology? How do they do it, and what difficulties do they encounter? Today, with these questions in mind, the health community has conducted interviews with relevant members of the hospital.
图片来源：图虫创意
“病人感受不到区块链”
当病人通过微信小程序访问互联网医院服务时，“上链”开始。上链意味着用户的数据已经被记录在区块链节点上。一旦“上链”，信息的唯一性属性得到确认，变得不可被篡改。
When a patient accesss the Internet hospital service via a micro-mail program, the "uplink" begins. The upper chain means that the user data is recorded on the block chain node. Once the "uplink" is confirmed, the unique properties of the information become unalterable.
不过，从使用层面看，这与使用其他互联网服务并无任何区别，用户无法感知到背后的区块链技术。
However, at the user level, this is no different from the use of other Internet services, and users are not aware of the block chain technology behind them.
“简单说，区块链属于后台部分，对医院来说是一种数据安全技术，病人在互联网医院就诊环节中感受不到什么不方便。”大医一院信息部牛主任解释道。
“Simply put, the block chain is part of the backstage, a data security technology for hospitals, and patients do not feel any inconvenience in accessing Internet hospitals.” The Chief of the Information Department of the Grand Hospital explained.
但正因为“用户感受不到”，当初医院内部围绕“用不用区块链”展开了多次讨论，不乏一些质疑者。
But precisely because it was “not felt by the users”, there were many discussions within the hospital about the “use-of-block chain” and there were a number of questions.
质疑主要有两点。一是区块链作为一项医疗领域中的新技术，多数人对其并不了解能够给医院医疗工作带来什么帮助；二是病人使用过程中无感，应用效果很难评价。
The challenge is two-fold. First, as a new technology in the field of health care, most people do not know what can be of help to hospital care; and second, when patients are unconscious in their use, their application is difficult to evaluate.
“所以，我们信息部面临的压力挺大。”牛主任说，当时，院里对互联网医院建设应用工作非常重视，作为区域龙头医院，任何决策都是非常谨慎的，对于新技术的应用效果当然要求也很严格。
“Therefore, our information department is under considerable pressure.” The Director said that at that time, the Institute attached great importance to the use of Internet hospitals, and that, as regional flagship hospitals, any decision-making was very cautious and, of course, very demanding of the application of new technologies.
为了征求意见，医院相关部门多次开会讨论区块链技术应用，期间也有一些争论和方向问题。医院主管信息化的夏云龙副院长长期以来一直关注科技创新动态以及政策导向，研判医疗行业未来的发展趋势，希望通过探索应用人工智能、区块链等技术，为以后智慧医院的发展打好基础。
In order to solicit comments, hospital departments have met several times to discuss the application of block chain technology, during which there have been some controversy and directional questions. The Vice-President of the hospital’s informative nature has long been concerned with the dynamics of science, technology and innovation, as well as with policy orientation, and to identify future trends in the health sector, with a view to laying the groundwork for the future development of intelligent hospitals by exploring the application of technologies such as artificial intelligence, block chains, etc.
“所以，在院领导的支持下，信息部决定从数据安全的角度去探索区块链的应用，也为技术人员指明了开发的方向。”牛主任说，当初应用区块链技术最主要的想法是保障关键数据的可验证性，以及安全的数据存储传输和访问。
“So, with the support of the head of the court, the Ministry of Information decided to explore the application of the block chain from the point of view of data security, and also pointed out the direction of development for the technical staff.” The chief cow said that the primary idea of applying block chain technology was to guarantee the authentication of key data, as well as secure data storage transmission and access.
主导权在医院
经过多番调研，医院选择了某互联网巨头的区块链服务平台。平台提供的是一个开放、相对安全、弹性的区块链底层基础服务，并不是一套得来即用的方案，技术人员需要在此基础上进行再开发和应用运维。
After many studies, hospitals have chosen a block chain service platform for an Internet giant. The platform provides an open, relatively secure, flexible infrastructure service at the bottom of the block chain.
“我们不会只听平台厂商的单方面宣传，我们信息部组织了互联网医院的多方参与单位开了多次线上线下会议，讨论从何入手以及推进模式。”
“We will not listen to the unilateral propaganda of platform producers alone, and the Ministry of Information has organized a number of online and offline meetings of the multi-participating units of Internet hospitals to discuss where to start and how to move forward.”
据医院信息部技术副主任张滨介绍，集成了区块链平台的互联网医院信息系统，利用区块链技术对关键数据进行脱敏加密，共享在区块链服务平台，在确保数据的安全性与全程留痕的同时，采用多节点的去中心化模式，最大限度提高数据的防篡改安全性。
According to Zhang Bin, Deputy Technical Director of the Ministry of Information of Hospitals, the Internet Hospital Information System has been integrated into a block-chain platform, using block-chain technology to de-escalate key data, share a block-chain service platform, and use multi-point decentralized models to maximize data security against tampering.
虽然用的是厂商的云区块链平台，数据经过区块链平台加密，储存了关键的一部分，但完整数据依旧是保存在医院系统上，数据的所有权依旧属于医院，最大限度的保证了病人隐私权。
While a critical part of the data is stored using the manufacturer's cloud chain platform, which is encrypted through the block chain platform, the complete data remains stored in the hospital system, and the ownership of the data remains with the hospital, maximizing the patient's right to privacy.
互联网医院“上链”闭环
Internet hospital “uplink” closed
按照医院的部署和规划，互联网医院+区块链应用目前完成了第一阶段的开发，也就是“用户个人信息上链”。
In accordance with the deployment and planning of hospitals, the first phase of the development of the Internet hospital + block chain application, i.e. the “user's personal information chain”, has now been completed.
牛主任表示，在大医一院互联网医院完成用户信息的“上链”之后，接下来的还有很多工作要做，作为 “第一个吃螃蟹的”，如果应用效果很好，就会继续做下去。
The head of the cow said that, after the completion of the “uplink” of user information at the Internet Hospital of the Medical College, much remained to be done as & nbsp; the “first crab eater” would continue to do so if the application worked well.
于丹丹表示，互联网医院今年1月底试运行时，每天大约有100名医生在线，每天有100多人次的免费咨询。截至目前，互联网医院服务了近8000人次，接下来计划将在线医生数增加至300人左右。“我们互联网医院的建设分为三个阶段，第一阶段提药品处方及药品配送服务，第二阶段提供预约检验服务；第三阶段提供预约检查服务。”
According to Jordan, at the end of January, when the Internet Hospital was tested, there were approximately 100 doctors online and more than 100 free consultations per day. To date, the Internet Hospital has served nearly 8,000 times, with plans to increase the number of online doctors to around 300. “Our Internet Hospital is being built in three phases, with the first phase of prescription and distribution of medicines, the second phase of appointment testing, and the third stage of appointment screening.”
随着互联网医院应用的逐步推进，病人数量的增加，数据的积累，越发让医院感受到信息网络安全的重要性。
As the use of Internet hospitals progresses, the number of patients increases and data accumulates, the importance of information network security is increasingly felt in hospitals.
当用户信息、药品信息、处方流转、检查检验信息全部上链，药房、药店、检查检验机构，都可以接收到病人信息，机构管理和监管部门都能依据可信区块链平台，取得相应的管理信息，从而可以形成一个基于区块链的互联网医院生态闭环，提供安全可信的数据保证。
When user information, drug information, prescription flow, inspection and inspection information are all chained up, patients'information can be received by pharmacies, pharmacies and inspection and inspection agencies, and institutional management and supervision authorities can obtain the corresponding management information based on a credible block chain platform, which allows for the creation of an eco-closing zone of an Internet hospital based on a block chain to provide reliable data assurance.
医疗区块链的一盘“大棋”
如果只有一家医院部署了区块链，其实不能真正发挥区块链技术的作用。区块链最为重要的特征是“多节点”，而且节点越多越好。如果没有多节点，那么就无法实现分布式存储和防篡改。
If there is only one hospital with a block chain, it does not really function as a block chain technology. The most important feature of the block chain is the “multiple nodes” and the more the nodes are the better. Without more nodes, distributed storage and tampering will not be possible.
因此，既然要做医疗+区块链，就决定了必然要推动区块链在多家医院和机构的落地。
Thus, since the medical + block chain is required, it is necessary to promote the location of the block chain in a number of hospitals and institutions.
据了解，按夏云龙的设想，将区块链技术推广应用到医联体内多家医疗机构。在众多个区块链应用落地后，成就了区域内整个医疗+区块链网络中的多节点模式，医疗机构间的用户信息、处方流转、检查检验等业务数据将更加安全、高效，在供应商、服务商、监管机构也建立相应的节点后，最终可实现“互相关联，互相监督，数据共享”。
It is understood that the extension of block chain technology to several medical institutions within IMSH, as envisaged by Xia Yunlong, has resulted in a multi-node model in the entire network of medical + block chains in the region following the application of numerous block chains, and that operational data such as user information, prescription flow, inspection and inspection among medical institutions will be safer and more efficient, leading to “interlinkage, mutual supervision and data sharing” when suppliers, service providers, and regulators have also set up corresponding nodes.
这显然是一盘更大的“棋局”。未来所涉及的环节、准备的工作、面临的挑战也会更大。
This is clearly a bigger game of chess. The future will also involve more links, preparatory work, and challenges.
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