摘要： 数字智能技术的发展不断推进医疗卫生事业的现代化，为生命健康提供愈益有力的支撑。关于医疗的数智化目标是替代以往的诊疗模式，还是提供补充性的手段，这一争论一直困扰着数智医疗的发展。本质上，替代与补充之争源自医患的不对称性。线上诊疗力图弥合这种不对称性，却反受其制引发了医患体验的错位。伴随人工智能技术的深化应用，一方面，数智医疗的内核从技术的拓展转向主体的拓展，虚拟诊疗主体所蕴含的创造性和不确定性，强化了替代与补充的定位；另一方面，人机融合带来知识、体验的广泛共享，也给弥合医患的不对称性带来新的可能。立足于中国式现代化，构建从互联网平台诊疗迈向社会共治的医疗场景，探明数智医疗主体的社会性角色，方可能超越替代或补充的竞争性定位，推进全民健康数智化建设。

关键词: 数智医疗, 互联网诊疗, 人工智能, 社会共治, 中国式现代化

Abstract:

The advancement of digital intelligence technology continues to drive the modernization of healthcare, providing increasingly robust support for public life and health. Whether the goal of medical digitalization is to replace traditional diagnostic and treatment models or to provide supplementary means has long been a contentious issue hindering the development of digital intelligence healthcare. Essentially, the dispute over replacement versus supplementation arises from doctor-patient asymmetry. While online diagnosis and treatment seek to bridge this asymmetry, they are often constrained by it, resulting in a misalignment of doctor-patient experiences. With the deepening application of artificial intelligence, the core of digital intelligence healthcare is shifting from technological expansion to the expansion of subjects. The creativity and uncertainty embedded in virtual diagnostic entities reinforce the dual positioning of replacement and supplementation. At the same time, human-machine integration enables the broad sharing of knowledge and experience, creating new possibilities for narrowing doctor patient asymmetry and offering a window to transcend the debate. By constructing a medical scenario of social co-governance grounded in Chinese-style modernization, and by clarifying the social roles of digital healthcare subjects, it becomes possible to move beyond the competitive framing of replacement versus supplementation and to advance the digitalization of healthcare for all.

Key words: digital intelligence healthcare, internet-based diagnosis and treatment, artificial intelligence, social co-governance, Chinese-style modernization