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核心概念Concepts
预防结算Prevention Settlement 可结算证据Billable Evidence PSM 因果归因Causal Attribution
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🏥 医院解决方案Hospital Solution

让预防科室产生可结算的临床价值Making Prevention Billable for Hospitals

提前1-3年预测心脑血管风险,辅助医生在疾病窗口期主动干预,用PSM因果证据向支付方证明预防的真实价值。HIS无缝对接,两周内接入。Predict cardiovascular risk 1-3 years early, enable proactive intervention, and prove prevention value to payers with PSM causal evidence. HIS integration in under 2 weeks.

0.839
心血管预测 AUCCardiovascular AUC
1-3年
提前识别高危窗口Early risk identification
16
临床特征维度Clinical features
<2周
HIS平均接入周期HIS integration time
核心挑战Core Challenges

预防医学的三个结构性困境Three Structural Barriers in Preventive Medicine

发现太晚Too Late to Detect
传统体检一年一次,心脑血管事件往往在"正常"体检后数月内发生。医院缺乏对高危患者的持续动态监测能力。Traditional checkups happen once a year. Cardiovascular events often occur within months of a "normal" exam. Hospitals lack continuous monitoring for high-risk patients.
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效果无法量化Unquantifiable Outcomes
预防科室做了大量工作,但无法向院方、医保和商业保险证明干预真实降低了多少风险——没有因果证据,预防科室永远是成本部门。Prevention departments work hard but cannot prove intervention value to management, insurers, or payers. Without causal evidence, prevention stays a cost center.
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数据孤岛Data Silos
HIS、可穿戴设备、院外随访数据割裂,无法形成患者完整的健康轨迹,风险预测模型缺乏动态输入。HIS, wearables, and outpatient follow-up data are fragmented. No complete patient health trajectory means no dynamic risk prediction input.
ReHealth Core 解决方案ReHealth Core Solution

四步打通预防医学完整闭环Four Steps to Close the Prevention Loop

01
多维心脑血管风险预测Multi-Dimensional Cardiovascular Risk Prediction
基于16个临床特征(血压、血脂、血糖、BMI、生活行为习惯、家族史等),AUC 0.839的风险模型实时输出风险评分和SHAP特征重要性分析,支持实时推理(<200ms响应)。风险信号直接推送至医生工作站。16 clinical features, AUC 0.839 risk model with real-time SHAP attribution. Risk signals push directly to physician workstations with <200ms response.
AUC 0.83916维特征 FeaturesSHAP归因 Attribution<200ms
02
个性化干预方案生成Personalized Intervention Generation
基于患者风险因子自动生成针对性干预建议,覆盖药物、生活方式、数字健康工具三类干预路径,并记录完整干预轨迹。干预轨迹是后续PSM因果归因的原始数据基础。Auto-generate targeted interventions covering medication, lifestyle, and digital health tools. Full trajectory logging feeds directly into PSM attribution.
药物干预Medication生活方式Lifestyle轨迹记录Tracking
03
PSM因果归因分析PSM Causal Attribution
通过倾向评分匹配(PSM)消除选择偏倚,量化干预的真实因果效应,输出ATT(平均处理效应)及95%置信区间。方法论符合NMPA真实世界证据(RWE)指南。PSM eliminates selection bias and quantifies true causal effect (ATT) with 95% CI. Methodology complies with NMPA Real-World Evidence guidelines.
PSMATT95% CINMPA RWE
04
可结算证据报告生成Billable Evidence Report Generation
生成标准化可结算证据报告(PDF + 结构化JSON),包含方法说明、匹配质量评估、效应量报告和适用范围声明,可直接提交给医保部门、商业保险公司作为预防项目申报依据。Generate standardized billable evidence reports (PDF + JSON) with full methodology, matching quality, effect size, and scope declaration — directly submittable to insurers and regulators.
PDF + JSON医保申报Insurance Submission标准化Standardized
接入流程Integration Process

两周内完成HIS接入HIS Integration in Under 2 Weeks

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需求对接Requirements
确认数据字段和接入方式Confirm data fields and integration method
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API接入API Integration
标准RESTful,支持HIS/HL7Standard RESTful, HIS/HL7 support
测试验证Testing
沙箱环境,数据质量评估Sandbox environment, data quality assessment
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正式上线Go Live
风险信号推送至工作站Risk signals push to workstation
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归因结算Attribution
定期生成PSM因果证据报告Regular PSM causal evidence reports
价值对比Value Comparison

ReHealth Core vs. 传统预防体系ReHealth Core vs. Traditional Prevention

维度Dimension传统体检/预防科室Traditional PreventionReHealth Core
风险监测频率Risk Monitoring每年1次Once a year实时连续监测Real-time continuous
高危识别窗口Early Detection事件发生后After the event提前1-3年1-3 years early
干预效果量化Effect Quantification无法量化Cannot quantifyPSM因果证据PSM causal evidence
支付方可接受证据Payer-Accepted Evidence无标准化证据No standard evidence可结算证据报告Billable evidence report
HIS对接HIS Integration数据孤岛Data silos标准API,<2周接入Standard API, <2 weeks
数据安全合规Data Compliance依赖院内措施Relies on internal measures联邦学习,数据不出域Federated learning, data on-premise
常见问题FAQ

医院合作常见问题Hospital Partnership FAQ

ReHealth Core 如何与医院现有HIS系统对接?How does ReHealth Core integrate with existing HIS systems?
提供标准 RESTful API,支持与主流HIS系统对接。平均接入周期不超过2周,无需医院自建数据团队。支持JSON/HL7 FHIR数据格式,可实时推送风险信号至医生工作站。We provide standard RESTful APIs compatible with major HIS systems. Average integration under 2 weeks, no in-house data team needed. Supports JSON/HL7 FHIR with real-time risk alerts to physician workstations.
患者数据如何保障安全?How is patient data kept secure?
采用医疗级联邦学习架构,患者原始数据始终留存于医院本地服务器,仅上传经差分隐私处理的模型梯度。满足《个人信息保护法》《数据安全法》《网络安全法》三法合规要求。Medical-grade federated learning: raw patient data stays on-premise at all times. Only differentially-private model gradients are uploaded. Compliant with PIPL, Data Security Law, and Cybersecurity Law.
医院如何用PSM证据向医保申报预防项目?How can hospitals use PSM evidence for insurance submissions?
ReHealth Core 生成符合NMPA真实世界证据(RWE)指南标准的PSM因果报告,包含ATT效应量、置信区间、匹配质量评估等完整要素,可直接作为医保谈判和预防项目申报的证据支撑材料。ReHealth Core generates PSM causal reports compliant with NMPA RWE guidelines, including ATT, confidence intervals, and matching quality assessment — directly usable for insurance negotiations and prevention program submissions.

准备好了解更多?Ready to Learn More?

联系我们,了解ReHealth Core如何帮助您的医院打通预防结算闭环。Contact us to learn how ReHealth Core can close the prevention-to-settlement loop for your hospital.

相关解决方案Related Solutions
核心结论Key Takeaway

DRG/DIP改革让预防科室第一次有机会从成本中心变为利润来源。但医院必须能向支付方提供可量化的因果证据——不是"患者更健康了",而是"干预使心血管事件发生率下降了X%(ATT=-0.087,p<0.001)"。ReHealth Core 是连接预防效果与支付结算的基础设施。DRG/DIP reform gives prevention departments their first real opportunity to become profit centers. But hospitals must deliver quantifiable causal evidence to payers — not "patients got healthier," but "intervention reduced cardiovascular event rates by X% (ATT=-0.087, p<0.001)." ReHealth Core is the infrastructure connecting prevention outcomes to payment settlement.