The average altitude of Naqu City is more than 4500, and the harsh living environment of high cold, hypoxia and sparsely populated areas has left the local medical and health service capacity lagging behind for a long time. Since the ninth batch of medical and health aid teams in Zhejiang Province entered Nagqu City in July 2019, in view of the dilemma of "weak county level, weak township level, and ineffective village level" of local medical and health care, learn from the experience of the construction of Zhejiang county medical community, focus on the top-level design of the city's medical and health system reform, comprehensively promote the integrated reform of county and township medical and health, and advance steadily through pilot projects, Actively explore and practice the way of strengthening medicine on plateau in Tibet. By the end of 2021, all counties (districts) under the jurisdiction of Naqu City have been built into medical communities, the unified operation mechanism of human resources, finance and materials has been gradually implemented, the medical service capacity at the county, township and village levels has been gradually strengthened, and the grass-roots public health services have been continuously standardized. In the past three years, the city has established two county-level second class hospitals and five second class hospitals; The number of outpatient, emergency and inpatient visits of medical and health groups in each county increased by more than 30% annually, and the number of operations and the rate of county visits increased significantly; More than 500 grass-roots medical and technical personnel were newly recruited, the enrollment rate of township hospitals increased from 36% to 95%, and the certificate holding rate of medical and technical personnel increased from 18% to 54%; Severe mental patients were fully included in standardized management.

We will focus on strengthening the design of systems, mechanisms and systems, and take the lead in the goal direction of county and township medical and health integration reform. Drawing on the experience of the reform of Zhejiang Medical Community, it led the formulation of the Opinions of Naqu City on Accelerating the Implementation of County Township Health Integration Reform, which clearly defined the main goal of "strengthening the county, linking the township and improving the village", and focused on building and strengthening the leading hospital of the medical community, central township hospitals, general township hospitals, village clinics The five in one county medical and health service system, such as itinerant medical service, strengthened the county medical service and public health capacity.

We will take the lead in promoting the pilot program of Zhejiang's assistance to Tibet, and create a successful model for the integrated reform of county and township health care. Zhejiang aided counties (districts), such as Bangor, Jiali, and Zeni, took the lead in carrying out pilot projects and actively explored reform experiences in pharmaceutical management, personnel compensation, and discipline construction. Especially in counties, the three-year reform has achieved a leap forward development of health care in the county: the size of the headquarters of the medical group has grown from more than 40 people to more than 250 people, the annual number of outpatient and emergency visits has increased from more than 30000 people to more than 80000 people, the number of open beds has expanded from more than 20 to 120, and the annual number of operations has grown from "zero" to more than 30 types, nearly 400 times; Township hospitals have completed the standardization construction in an all-round way, and village doctors have been fully integrated into the medical group system for integrated management. The "Naqu Ru Model" was recognized by the autonomous region as a replicable successful experience in the comprehensive medical reform of the whole region.

We will focus on grassroots supervision of business training, and promote the implementation of the integrated reform of county and township health care. Actively organize various special business training courses, hold on-site promotion meetings for comprehensive medical reform work (such as counties), focus on strengthening the training and guidance of reform ideas, objectives, requirements, working methods, etc., and set off a new upsurge of "learning, comparing, catching up, and surpassing" in the city. The "List of Key Tasks for the Integrated Reform of County and Township Health Care in Naqu City" was formulated and issued to define 64 key reform tasks. Monthly summary notification and work supervision were carried out, and annual assessment was carried out. The assessment results were included in the annual comprehensive performance assessment of the county governments, which strongly promoted the implementation of reform work in all regions.

We will focus on the overall construction of medical informatization, and strengthen the digital empowerment of county and township medical and health integration reform. Actively coordinate and strive for the autonomous region's subsidy of more than 35 million yuan. The city level will coordinate the construction of the county township integrated medical and health information project. In December 2021, the system of "one database, one platform, and three application systems" will be fully deployed and operated, basically realizing the full coverage of business application, linkage, monitoring, and management of medical service institutions at the city, county, and township levels, The medical and health system of Naqu City has officially entered the era of comprehensive informatization. At the same time, actively build the "Zhejiang Naqu telemedicine cloud platform", deeply implement the "Zhejiang Naqu telemedicine mental health center" project, comprehensively carry out the "Dingxiangyuan grassroots doctors empowerment" remote training plan, and fully leverage Zhejiang resources to empower Naqu digital.

In the next step, Zhejiang medical and health assistance team to Tibet will continue to learn from Zhejiang's experience, continue to deepen the achievements of medical and health county township integration reform in Naqu, focus on creating an "important window" for Zhejiang counterpart support, and wholeheartedly benefit the people of Naqu.