Since 1 July this year, the Ministry of health, sponsored by the joint publication of Chinese medical record basic specification for official purposes.
According to the norms, Chinese medical record refers to medical staff through the look, smell, ask, and check, secondary screening, diagnosis, treatment, care and other medical activities for relevant information, and to summarize, analyze and defragment the formation behavior of medical records.
The new code has been added to many more characteristic of traditional Chinese medicine clinic of the medical record basic requirements, such as in the traditional Chinese Gate (urgent) consultations for newly diagnosed, visits records should include four diagnostic methods of TCM; emergency treatment of patients with traditional Chinese medicine, staying at emergency should be included in a record four diagnostic methods of TCM, differentiation, and so on.
(1m1m responsible editor: gaohua)
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