The invention relates to the technical field of the remote medical video communication, and specifically relates to an intra-frame fast coding method based on quality scalable video coding QSHVC. Themethod comprises the following steps: excluding the depth with small possibility by using relevance; judging whether a residual coefficient meets Laplace distribution by using a distribution fitting check method; if the residual coefficient meets the Laplace distribution, adopting an inter-layer ILR prediction mode, and skipping the intra-frame Intra prediction mode to realize the early termination; if the residual coefficient does not meet the Laplace distribution, traversing the inter-layer ILR prediction mode and the intra-frame Intra prediction mode, computing a rate-distortion value, andselecting an appropriate depth value through comparison. Through the fast coding method disclosed by the invention, the high computing complexity problem caused by a recursive quad-tree coding unit division in the coding is mainly solved. In the premise of guaranteeing the quality of the video, the coding speed is obviously improved, the method can be used for video conference, remote consultation, remote education, remote medical treatment and video on-demand.