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Introduction: This study aimed to explore whether the establishment of county medical alliances can improve satisfaction with the vertical integration of healthcare systems among rural medical and healthcare service provider managers and service providers. Our study also sought to provide recommendations for the sustainable development of vertical integration in healthcare systems. Methods: A semi-structured interview with 30 healthcare service providers was employed in this research, and Nvivo software was utilized to analyze factors that influence vertical integration. From April to July 2021, a multi-stage random sampling method was used to select participants. The sample included two leading hospitals in medical consortia, 15 member units (healthcare service providers and medical staff), two county-level hospitals, and 15 township health centers/community healthcare service centers from non-medical consortia. Questionnaire surveys were conducted with these groups. Factor analysis was used to calculate satisfaction scores for healthcare service providers with the cross-institutional synergistic development of healthcare systems in both medical and non-medical consortia (denoted as M(IQR)). Propensity score matching was employed to reduce confounding factors between groups. The Mann-Whitney U test was used to compare satisfaction differences between groups. Results: The overall satisfaction scores for lead-county hospital managers, member institution managers, medical staff at the lead-county hospital, and medical staff at member institutions were 4.80 (1.00), 4.17 (1.17), 4.00 (1.38), and 4.00 (1.12), respectively. Lead-county hospital managers' satisfaction with cross-institutional collaboration, development capacity enhancement, and structure and resource integration in the Medical Alliance group showed higher satisfaction than the Non-Medical Alliance. Similarly, lead-county hospital medical staff in the Medical Alliance group reported greater satisfaction with collaboration efforts, supportive environment, and development capacity enhancement. Notably, while the Medical Alliance group's satisfaction scores were higher, the differences between the two groups were not statistically significant for lead-county hospital managers and medical staff. The Medical Alliance group did show statistically significant differences in member institution managers' satisfaction with collaboration, development capacity enhancement, and structure and resource integration. Additionally, medical staff of member institutions in the Medical Alliance group reported statistically significant higher satisfaction with collaboration, supportive environment, development capacity enhancement, healthcare service integration, and human resource development. Conclusion: To facilitate the establishment of county medical alliances, managers of leading county-level hospitals should adopt a healthcare system integration strategy. This strategy involves evolution from being a member of a single institution to a coordinator of cross-institutional vertical integration of medical and healthcare services. Additionally, revamping remuneration and appraisal systems for members of county medical alliances is necessary. This will encourage cooperation among healthcare institutions within the three-tiered system and their medical staff, ultimately facilitating the provision of integrated services.

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To alleviate the contradiction in healthcare resources, the Chinese government formally established the framework of a hierarchical medical system in 2015, which contains the following brief generalities: " separate treatment of emergencies and slows, first-contact care at the primary, two-way referral, and upper and lower linkage, ". This study systematically summarizes and models the connotations of China's hierarchical medical system and a sample of 11,200 chronic disease patients in Tianjin, the largest port city in northern China, was selected for the empirical study to investigate the relationship between chronic disease patients' policy perceptions of the hierarchical medical system and their preference for healthcare. We found that under the strategy of separate treatment, improving the healthcare accessibility, drug supply, and lowering the cost of medical care would have a positive impact on increasing the preference of patients with chronic diseases to go to the primary hospitals. Under the two-way triage strategy, improving the level of physician services, referral convenience and treatment Standards have a positive impact on chronic disease patients' preference for primary care; The impact of the hierarchical medical system on the preference for healthcare differed between groups, focusing on differences in health literacy level, age and household type; The role of " upper and lower linkage " is crucial in the hierarchical medical system and it plays a part in mediating the influence of the " separate treatment of emergencies and slows" design and the "two-way referral " order on the treatment preferences of chronic disease patients. The results of the study provide a reference for the further development of a scientific and rational hierarchical medical system in the future.

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Introduction: Medical alliances are essential for constructing an hierarchical diagnosis and treatment (HDT) system; therefore, it is crucial to promote such alliances and evaluate their effectiveness in this regard from the medical staff perspective. This study thus investigated and analyzed the evaluations of medical staff in China concerning the effect of medical alliances on promoting HDT with the intention to encourage further establishment of medical alliances and HDT under China's new medical reform. Methods: A total of 616 medical staff personnel from 3 medical alliances in Fujian Province were surveyed, and data were analyzed using SPSS 20.0 software. Results: The level of medical institutions, posts and satisfaction with their medical alliances influenced the evaluation of medical alliance effectiveness in resolving the problem of expensive medical services. Primary medical institutions are more inclined toward policy formulation and related work; thus, the interests of primary hospitals can be guaranteed. However, tertiary hospitals must provide additional workforce, material, and financial resources to support primary hospitals. Discussion: Therefore, it is necessary to coordinate the interests of the medical staff at different levels of medical institutions. The study makes a significant contribution to the literature because it highlights the effect of medical alliances in promoting hierarchical diagnosis and treatment.

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At present,China's multi-level Traditional Chinese medicine(TCM)Medical Alliance has been gradually formed,the sinking effect of resource sharing is obvious.The level of medical services homogenization has been improved,the operation guarantee mechanism has been continuously improved,and the diagnosis and treatment capacity of each member unit has continued to improve.However,in the construction of various regions,there are still government departments'weak cognition and planning of TCM Medical Alliance,and the characteristics are insufficient.It is recommended to strengthen the functional positioning and connotation construction of TCM Medical Alliance,improve the operation and management mechanism,and give full play to the"baton"role of performance evaluation,so as to effectively promote the sinking and balanced distribution of TCM high-quality resources.

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Objective To understand the status quo of hierarchical diagnosis and treatment effect of medical alliance in Beijing and explore the influencing factors.Methods The convenience sampling method was used to select 26 vertical medical alliances,and the weighted TOPSIS method was used in combination with the index system established in the previous study to evaluate the effect of hierarchical diagnosis and treatment.The factors influencing the effect of hierarchical diagnosis and treatment in medical alliances were summarized through interviews with insiders,and the rank sum test was used to explore the factors influencing the effect of hierarchical diagnosis and treatment in medical alliances.Results The medical alliance B,A2 and A3 ranked high,and the implementation effect was relatively good in the four dimensions of"primary care first consultation,dual-way referral,acute and slow treatment,and vertical linkage";The C2,A8 and F2 medical alliances ranked low,and the implementation effect in the dimensions of"dual-way referral","acute and slow treatment"and"vertical linkage"was significantly lower than that of other medical alliances.The analysis results showed that the differences in the support intensity and core hospital level of different medical alliances were statistically significant(P＜0.05),which affected the hierarchical diagnosis and treatment effect of medical alliances.Conclusion While strengthening the information construction and improving the initiative of grassroots and the signing rate of family doctors,it is necessary to improve the support of core hospitals to promote the sinking of resources.Core hospitals should optimize resource allocation according to local conditions and promote hierarchical diagnosis and treatment.

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Objective To explore and analyse the factors influencing the acceptability of"Internet medical alliance"among medical staff by UTAUT model,with a view to providing a basis for the sustainable development of"Internet medical alliance".Methods A questionnaire survey was conducted among medical staff participating in the"Internet medical alliance"in municipal hospitals,count-level hospitals,township health centers,village clinics and community health service centers.SPSS 20.0 and Amos 17.0 software were used to statistically describe the acceptance of"Internet medical alliance",and a structural equation model with behavioral intention and satisfaction as dependent variables was constructed.Results In the range of independent variables,the 841 follow-up subjects had the highest individual creativity score at(3.88±0.67),followed by social influence at(3.86±0.66)and the lowest perceived risk score at(3.52±0.78).Of the dependent variables,the behavioural intention score was(3.86±0.68)and the satisfaction score was(7.72±1.88).Conclusion Facilitation,individual creativity,self-efficacy,performance expectations,effort expectations,having heard of"Internet medical alliance"education level and perceived risk were key factors in the behavioral intention and satisfaction of medical staff to participate in"Internet medical alliance".

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Purpose: Community health centers (CHCs) are an important part of the healthcare system worldwide. Based on the dual process model of organizational capabilities, this study explores the relationship between organizational capabilities and the organizational performance of CHCs, as well as the role played by the medical alliance implementation effect. Methods: In this study, whole-group sampling was used to extract CHCs. All 135 CHCs in 8 of 16 districts of Beijing were selected as subjects. The organizational capabilities of the CHCs and the medical alliance implementation effect were evaluated using a questionnaire survey of 1957 managers and 3622 medical staff, respectively. A pathway analysis of the mediating role of the organizational capabilities of CHCs and the moderating role of the medical alliance implementation effect was conducted using Mplus 8.0. Results: The development capabilities had a positive impact on basic capabilities (ß = 0.878, P < 0.001), and core capabilities (ß = 0.952, P < 0.001), but had no direct impact on organizational performance. Basic capabilities positively affected organizational performance (ß = 1.163, P < 0.001), and core capabilities negatively affected organizational performance (ß =- 0.886, P = 0.004). Both basic capabilities (ß =1.022, P < 0.001) and core capabilities (ß =- 0.843, P = 0.005) played a mediating role in the relationship between development capabilities and organizational performance. The moderating role of the medical alliance implementation effect was not significant. Conclusion: This study found that strengthening the organizational capabilities of CHCs can effectively improve their performance, with the development of basic capabilities being a primary concern. The medical alliance implementation effect has not had a significant impact on organizational performance, and the cooperation between CHCs and high-level hospitals should be further promoted to give full play to the medical alliance's role and improve the organizational performance of CHCs.

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Background: Medical alliance plays an important role in promoting resource sharing, optimizing the allocation of medical resources, establishing a hierarchical diagnosis and treatment system featuring primary diagnosis at the grassroots level, a two-way referral system, separated treatment for acute and chronic diseases, and dynamic cooperation. Thus, comprehensive performance evaluation for medical alliance is a necessary research that involves a multi-attribute group decision-making problem. Objective: The aim of this paper is to develop a new multi-attribute group decision-making evaluation framework and new weight method to better efficaciously resolve the issues of evaluation for the medical alliance. Methods: Firstly, Archimedean copula and co-copula operational rules, called Archimedean co-copula, and the form of q-rung orthopair fuzzy Hamy mean aggregation operator based on Archimedean co-copula operational rules are also developed. Secondly, an extended q-rung orthopair fuzzy extended best-worst method satisfying multiplicative consistency is developed to originate the weight information of the attributes. The new weight method can integrate the membership and non-membership of assessment information, improve constancy for group decision making and get an extremely reliable weight consequence. Finally, a novel multi-attribute group decision-making framework is presented based on the proposed q-rung orthopair fuzzy Archimedean copula and co-copula Hamy mean aggregation operator and q-rung orthopair fuzzy Euclidean best-worst method. Furthermore, the new multi-attribute group decision-making method is applied to comprehensive performance evaluation for medical alliance in Shanghai, and the effectiveness of the new method is also demonstrated. Results: The results show that the proposed multi-attribute group decision-making method with Archimedean copulas-based Hamy operators and extended best-worst in this paper outperforms some existing methods and provides support for policymakers seeking the use of patient- and community-centered health evaluations to improve health services. Conclusion: The proposed method is a theoretical guidance method and a good reference for the evaluation of medical alliances of other regions in China.

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Background: We aimed to construct enteral nutrition nursing management system under medical alliance mode, and to explore the clinical application effect. Methods: Based on the training project of enteral nutrition nursing team of Chinese Association of Parenteral and Enteral Nutrition, the enteral nutrition nursing management system was constructed in June 2021. Using the convenient sampling method, 850 cases of enteral nutrition clinical practice were selected from medical alliance hospitals before and 6 months after the implementation of the system. The process indicators of enteral nutrition nursing quality were checked, and the reported outcome indicators were compared. Results: After the implementation, the implementation rate of enteral nutrition risk screening, the implementation rate of nutritional status assessment, and the correct rate of nursing measures of nurses in medical alliance hospitals were significantly improved (P<0.001). The frequency of aspiration, diarrhea and unplanned extubation was notably decreased (P<0.05). The mastery rate of enteral nutrition knowledge and the satisfaction rate of nursing work of patients were significantly higher than before (P<0.001). Conclusion: The established enteral nutrition nursing management system under the medical alliance model was effective and feasible, which was helpful to improve the level of enteral nutrition nursing management and the quality of enteral nutrition nursing in the medical alliance hospitals.

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Objective:To explore the views of general practitioners (GPs) on developing special interests in the context of the county medical community.Methods:A survey was conducted using self-designed questionnaire from November and December 2019, among 49 general practice residents trained in the First Affiliated Hospital of Zhejiang University School of Medicine. Meanwhile, structured interviews were undertaken with 14 general practice residents.Results:Forty-nine valid questionnaires were collected with a response rate of 100.0%. All participants were from the county medical community units. The survey showed that 91.8% (45/49) of respondents were willing to develop special interests and 79.6% (39/45) chose one subject, and the top three subjects were endocrinology, gastroenterology and cardiology. The structured interviews demonstrated that most participants did not understand meaning of general practitioners with special interests (GPwSIs) clearly and were unable to distinguish GPwSIs from specialists; they were confused about the status, training mode, and assessment standards of GPwSIs. The interviews also showed that the demand for developing special interests for them was derived from the needs of patients for diagnosis and treatment, the target population of health care services, peer advice and personal interests.Conclusions:Most general practice residents are willing to develop special interests, and internal medicine is the first choice; however, their understanding of the GPwSIs is insufficient. The survey suggests that the position, training model, assessment and certification of GPwSI need to be further clarified.

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In order to achieve the goal of integration, homogeneity, a net and a center of medical groups in Hainan province, Hainan province built an integrated management information platform of urban medical alliances and county medical communities based on projects such as the provincial three medical linkage information platform in February 2022. The overall architecture of the medical alliance and medical community platform was divided into system integration layer, data center layer, service layer and application layer. The service layer included four major systems: unified operation management platform, business center, performance evaluation management platform and comprehensive supervision subsystem, which was the core hub connecting the data center layer and application layer, and also was the unified operation and closed-loop management platform of the medical alliance and medical community. As of November 2022, the platform had covered 31 medical alliances or medical communities in 19 cities and counties of Hainan province, achieving information exchange, personnel interaction, resource sharing, business collaboration, and data integration among member units, narrowing the gap between urban and rural medical and health services, which had preliminarily achieved homogeneous management of the medical alliances and medical communities throughout the province, for a reference for the integrated management of medical alliances and medical communities within the regional scope of China.

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Purpose/Significance To clarify the construction mode and key factors of data sharing in Chinese medical alliances,and to provide references for promoting data sharing in medical alliances.Method/Process Taking children's medical alliance of Yangtze River Delta as an example,Delphi method and qualitative interview method are used to explore the key contents and effect evaluation of specialty alliance construction,and the key factors of specialty alliance data sharing are defined based on the technology-organization-environment framework;SWOT analysis model is used to propose development strategies.Result/Conclusion Member hospitals are less satisfied with the construction effect of information interconnection.Key factors for realizing data sharing in specialty alliances include:support from government administrative departments,uniform and systematic compatibility of information standards,information security emergency response,patient privacy protection and informed consent,willingness of department directors to share,and internal communi-cation and compensation mechanism of alliances.

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The cross regional loose medical alliance is an important carrier in the current integrated development process of medical services in the Yangtze River Delta region. Smith policy implementation process model was used to analyze the development difficulties of cross regional loose medical alliances from idealized policies, policy implementation institutions, policy target groups, and policy implementation environment. Such medical alliances were formed under the background of integrated development in the Yangtze River Delta, with Shanghai′s tertiary public hospitals as leading units and medical institutions in Jiangsu, Zhejiang, and Anhui provinces as member units. Analysis showed that the policies for such medical alliances development had not yet clearly defined the organizational management mode, operational mechanism, and implementation path, and the corporate governance structure of medical alliance was immature; The policy implementation agencies were relatively lagging behind in the support of special funds and the formulation of related supporting policies; Participation of policy target groups was insufficient and their incentive mechanisms was imperfect; There were problems in the policy implementation environment, namely inconsistent medical and health service regulations and systems in different regions, different health financing capabilities of local governments, insufficient coordination of medical institution management concepts, and a lack of unified standards in information systems. Based on the above difficulties, this study proposed to strengthen the development planning and layout of cross regional loose medical alliances, and improve the corporate governance structure; To strengthen the government′s main responsibility and improving policy implementation capabilities; To improve the internal cooperation and operation mechanism of cross regional loose medical alliances, and enhance the sense of identity of the target group; To optimize the policy implementation environment and implement various support measures, so as to provide references for further promoting the coordinated development of high-quality medical resources in the Yangtze River Delta region.

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Background: Primary healthcare doctors in China often experience problems with occupational burnout, a condition known to relate to high job stress and low wages. In China, many medical alliances have recently been established in rural areas, where village physicians work as healthcare gatekeepers. However, burnout in village physicians in the context of medical alliances remains underresearched. Methods: This cross-sectional survey was conducted among 100 village physicians practicing at village clinics in Qiandongnan prefecture, Guizhou province, China. An online questionnaire was distributed to assess physicians' demographic characteristics and work situations. Burnout was measured using the Oldenburg Burnout Inventory (validated Chinese version). A multivariate linear model with stepwise procedure was used to estimate the effects of factors of interest on burnout, focusing particularly on actions within the medical alliance that involved respondents' clinics, such as training and support for village physicians provided by higher-level facilities. Results: The overall response rate was 79%. The mean burnout score was 38.09 (standard deviation, 4.55; range, 25-47). The multivariate analysis showed that fewer working years and too much farming work were significantly related to exacerbation of burnout. Greater medical services in the total workload and greater support from higher-level facilities were associated with burnout alleviation. Conclusion: Close connections and interactions across medical alliance member facilities could facilitate reduction in burnout for village physicians practicing as primary care gatekeepers.

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Background: Promoting technology diffusion and utilization is a key measure to address the great disparity in technical capacity within integrated health systems. However, even the effectiveness and appropriateness regarding technology has been widely recognized, its diffusion and utilization are still stagnant. The mechanisms that influence the technology from being recognized to being widely applied in practice remain largely unknown. Purpose: Taking hepatic contrast-enhanced ultrasound (CEUS) as an example, this study aimed to investigate the comprehensive influencing mechanism of organizational atmosphere and organizational practice on the knowledge, attitude, and practice toward diffusion and utilization of hepatic CEUS in the medical alliance. Methods: Based on the integration of organizational ready for change (ORC) and knowledge-attitude-practice (KAP), a structured questionnaire was developed. A multistage random sampling method was applied to investigate physicians who directly use CEUS working at the liver disease-related departments of sampled health institutions. Structural equation modeling (SEM) was used to verify the proposed hypotheses, and determine the relationship between the factors. Results: In total, 292 physicians were included. SEM results demonstrated that knowledge influenced both attitude and practice, while attitude positively predicted practice. Organizational practice and organizational atmosphere associated positively with each other. Organizational atmosphere positively affected the physicians' attitude toward CEUS diffusion and utilization (ß = 0.425, p < 0.001), while organizational practice positively affected corresponding knowledge (ß = 0.423, p < 0.001) and practice (ß = 0.275, p < 0.001). Additionally, there was a partial mediating effect between organizational practice and physicians' CEUS diffusion and utilization behavior. Conclusion: By verifying the influencing mechanism of organizational atmosphere and organizational practice on the physicians' KAP of hepatic CEUS diffusion and utilization, this study benefit tailoring strategies for promoting technology diffusion and utilization within medical alliance. It is recommended to develop an organizational atmosphere of advocating technology innovation, establish organizational support mechanism (SM) with multiple concrete supporting countermeasures, and so on.

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This work investigates the performance and inter-sectoral interaction mechanism of China's largest vertically integrated care network, the national medical alliance (NMA). The data collected derive from the China Health Statistics Bulletin and the China Health Statistical Yearbook for the period 2009-2018. The data include 64 observation indicators for five medical sectors in the NMA, namely, tertiary hospitals (THS), secondary hospitals (SHS), community health centres (CHCS), township hospitals (TsHS) and professional public health institutions (PPHIS). This research combines complex systems theory with a multilevel structural dynamic factor model, and yields two main results. First, although the trend for the NMA's global factor is increasing, the evolutionary paths for sectoral factors differ substantially. Among the sectoral factors, the sectoral factor of THS continued to decline, and neither the sectoral factor of CHCS nor the sectoral factor of TsHS has significantly improved. Then, the interaction mechanism between the various NMA sectors is investigated. While a close relationship has been formed between THS and CHCS and between SHS and CHCS, there remains no close two-way relationship between either THS and TsHS or THS and SHS. Thus, going forward, to reach the policy expectations, China's NMA implementation must consider the interaction between different constituent sectors.

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Background: Continuity is crucial to the health care of the internal migrant population and urgently needs improvements in China. Chinese government is committed to promoting healthcare continuity by improving the people-centered integrated care (PCIC) model in medical alliances. However, little is known about the driving mechanisms for continuity. Methods: We created the questionnaire for this study by processes of a literature research, telephone interviews, two rounds of Delphi consultation. Based on the combination of quota sampling and judgment sampling, we collected 765 valid questionnaires from developed region and developing region in Zhejiang Province. Structural equation models were used to examined whether the attributes of PCIC (namely coordination, comprehensiveness, and accessibility of health care) associated with continuity, and explored the moderated mediating role of respect. Results: The result of SEM indicated that coordination had direct effect on continuity, and also had mediating effect on continuity via comprehensiveness and accessibility. The hierarchical linear regression analysis showed that the interactive items of coordination and respect had a positive effect on the comprehensiveness (ß = 0.132), indicating that respect has positive moderating effect on the relationship between coordination and comprehensiveness. The simple slope test indicated that in the developed region, coordination had a significant effect on comprehensiveness for both high respect group(ß = 0.678) and low respect group (ß = 0.508). The moderated mediation index was statistically significant in developed areas(ß = 0.091), indicating that respect had moderated mediating effect on the relationship between coordination and continuity via comprehensiveness of healthcare in the developed region; however, the moderated mediation effect was not significant in the developing region. Conclusion: Such regional differences of the continuity promoting mechanism deserve the attention of policy-makers. Governments and health authorities should encourage continuity of healthcare for migrants through improving the elements of PCIC-coordination, comprehensiveness and accessibility of healthcare, shaping medical professionalism of indiscriminate respect, and empowering migrants to have more autonomy over selection of services and decisions about their health.

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Objective:To build a performance appraisal index system for medical specialty alliances, as a reference for promoting the development of the alliances in a connotation-based, high quality and sustainable manner.Methods:An index system was initialized by means of policy literature review and brainstorming, which was followed by two rounds of expert consultations to finalize the index system. Each index in the system was weighted through the analytic hierarchy process.Results:A performance appraisal index system of specialist alliances so developed comprised the six level-1 indexes of organization and implementation, hierarchical healthcare, influence capacity, talent cultivation, clinical research and academic research, as well as 31 level-2 indexes. The average scoring of importance and operability of all the indexes was>3.50, while the weights of organization and implementation(0.205 3), talent cultivation(0.178 8)and clinical research indexes(0.165 1)were higher than the rest.Conclusions:The performance appraisal index system of specialty alliances proves highly reliable and scientific, serving a desirable vehicle for the leaders of the alliance to develop cross-regional development of medical specialties.

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Promoting balanced distribution of medical resources and realizing high-quality sharing of basic medical services between urban and rural areas are an important part of common prosperity. Huzhou urban medical alliance was a new urban and rural of medical alliance mode based on level 4 vertical integration, which played an important role in the whole evolution process of the medical alliance. This medical alliance had not only broken through the " integration of counties" but also explored the " integration of cities" . It was a bridge connecting counties and cities, which was of great significance in narrowing the gap between urban and rural medical health services. The construction of urban medical alliance took digital transformation and systematic integration as two breakthroughs to comprehensively promote the upgrade of energy efficiency and benefit stacking of health governance. In 2021, the grass-roots medical utilization rate and county-level medical utilization rate were 72.7% and 90.6%. In 2020, the average hospitalization cost(8 726.7 yuan)and the average outpatient and emergency expenses(239.6 yuan)of public hospitals were 25.0% and 8.6% lower than the average level of Zhejiang Province, respectively. Although Huzhou city had broken through the restrictions of administrative divisions and actively promoted the construction of the medical alliance, and achieved phased results, there were still structural defects and institutional difficulties. In order to solve these problems, the author proposed to promote the improvement of governance structure and optimization of governance system through " three governance" and " three characteristics" , and then promote the high-quality development of urban medical alliances.

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Hierarchical diagnosis and treatment system is an important measure to rationally allocate medical resources and promote the homogenization of basic medical services. The medical alliance is an important service mode and service system of hierarchical diagnosis and treatment, whose role is to perfect the up-down linkage and meet the patient′s medical needs. Informatization construction is an important starting point to promote the services of the medical alliance. In order to solve the problem of connectivity, the medical alliance needs to establish a regional referral platform and realize the integrated service of all medical institutions. Renji Hospital, Shanghai Jiaotong University School of Medicine, has built a blockchain based referral system for hierarchical diagnosis and treatment, incorporating the S2B2C mode concept, and using the traceability, tamper proof and distributed accounting features of blockchain technology, realized independent storage of data in hospitals, realized real-time information sharing and interconnection, and provided a feasible solution for medical alliance management.