Internet initiative gives patients net profit

China's hospitals are increasingly turning to online technology to provide better services, as Wang Xiaodong reports.

Like many patients, Huang Li (not her real name) used to get up early and wait in line for two hours or even longer at big hospitals to see a senior doctor.

But recently she discovered a better alternative, one that allows her to sit in front of her home computer chatting with a doctor from the hospital via a video link and paying her bills online. A day later, the drugs prescribed by the doctor are delivered to her home.

Huang, a resident of Hangzhou, Zhejiang province, who has chest pains related to heart disease, had her first online diagnosis on Dec 10 with a doctor from the Second Affiliated Hospital of Zhejiang University's School of Medicine.

"Her condition is stable and she can continue to take the same medicines as before," said Wang Jian'an, a doctor specializing in cardiac disease at the hospital, after checking the test results that Huang scanned and uploaded. Wang had previously diagnosed Huang and prescribed drugs for her in person.

"It used to take about half a day for me to go to the hospital and finish seeing a doctor," Huang said. "Now I can just sit at home and finish the entire process in just a few minutes."

According to the Zhejiang Provincial Health and Family Planning Commission, the 59-year-old was one of the first patients to use online medical services after the Wuzhen Internet Hospital, China's first Internet hospital, opened on Dec 7.

Clinical services have increased rapidly since the WIH, based in Wuzhen, Zhejiang province, opened, according to Zhang Gui-min, a marketing director for the We Doctor Group, which operates the hospital.

By late January, the WIH had linked with more than 1,900 hospitals - including the Second Affiliated Hospital at Zhejiang University's School of Medicine - across China which provide more than 4,400 online diagnoses on average every day, Zhang said.

At the brick-and-mortar Wuzhen Hospital, dozens of doctors from different hospitals provide remote consultations and diagnoses on the Internet. But its major function is that it acts as a platform that links doctors and patients across China via the Internet, so registered patients and doctors from across the country can communicate directly online, Zhang said.

"We are planning to work with local health authorities so a similar Internet hospital can be set up in every provincial area of China to help patients undertake all the work it is possible to conduct online," Zhang said.

Emerging trend

Encouraged by China's top leadership, Internet-related technologies have rapidly been utilized to boost the development of various sectors, including health, in recent years. Hospitals have also welcomed these technologies, aiming to improving services for patients. Intensifying the merger of health services and Internet technologies has become a popular trend, according to officials and analysts.

"The Internet is becoming more involved in medical services and the integration of the Internet and medical care services offers great potential," said Song Shuli, spokeswoman of the National Health and Family Planning Commission, China's top health authority.

"The use of new technologies can help us to improve management and services. We will continue to expand and improve services and promote 'remote' and 'mobile' medical care."

According to a report released by the China Internet Development Foundation in January, mobile Internet technology was widely adopted in medical care services in major cities in China last year, helping residents to access services such as clinical registration, pay medical bills, check medical reports and interact with doctors online.

Last year, nearly 400 hospitals connected with Alipay, a popular online payment platform, according to the report. The hospitals have provided more than 50 million online services, such as making appointments and paying for clinical registration, since the project was established in May 2014. The move has reduced the time patients need to see a doctor, the report said.

Before the WIH was set up, several other hospitals, including Guangdong No 2 Provincial People's Hospital, had already started offering partial online services. But unlike the WIH, the other hospitals usually provide online services individually and are not linked with other establishments in a network.

For years more big hospitals, mostly in larger cities such as Beijing and Shanghai, have been offering services, such as staff training and technical guidance, to smaller hospitals in less-developed regions. For example, the China-Japan Friendship Hospital in Beijing has been offering such online services since 1998 to grassroots hospitals in the west of the country, according to the hospital.

In January, an online hospital, jointly established by Wuhan Central Hospital, in Wuhan, Hubei province, and AliHealth - which has the e-commerce giant Alibaba as its majority shareholder - opened for service, according to a report in Economic Information Daily. Doctors from Wuhan Central Hospital conduct online video diagnoses and provide electronic prescriptions whereby the drugs will be delivered to patients, the report said.

More online hospitals, mainly aimed at patients living in remote villages in Hubei, may be built by the company in the future, the report said.

Sharing resources

WIH shares online resources with guahao.com, a popular Internet service that allows patients to register and consult doctors online and is also operated by the We Doctor Group. This means the number of registered patients and doctors for the Internet hospital could reach more than 110 million, said Zhang, from the group.

In addition to offering patients greater convenience, such as shortening diagnosis times, the Internet hospital also has a number of advantages that traditional brick-and-mortar hospitals cannot provide, he said.

"Doctors with different types of expertise can form groups and share their expertise online when giving diagnosis and treatment to gravely ill patients, which is difficult to achieve at traditional hospitals," he said.

Patients can register by logging onto the Internet or via a mobile phone app. Once registered, they can choose doctors and make reservations, consult a doctor via a video link and receive electronic prescriptions.

Once patients have paid the bills online, they wait until the drugs are delivered to their homes by courier companies, according to instructions on the hospital's website.

In addition to connecting hospitals nationwide through the Internet, the hospital also has offline operations, such as operating and testing centers. The hospital's first operating center was set up in Xiaoshan Hospital in Hangzhou, Zhejiang province, on Jan 17, so those who need surgery after preliminary online consultations can be transferred for treatment, Zhang said.

"We are building more such centers to meet the demand from the patients," he said.

"The online hospital can really help people in less-developed areas, where high-quality medical resources are scarce, so they can also get high-quality medical care by talking with doctors from top hospitals, just as long as they are connected on the Internet," Zhang said.

However, he added that Internet hospitals cannot completely replace traditional brick-and-mortar hospitals, as in most cases a doctor has to see a patient in person to provide better diagnosis and treatment.

"Online hospitals are primarily aimed at patients with common, chronic illnesses, such as hypertension and diabetes, or those who are familiar with their ailments and have to go to see a doctor for the same problem repeatedly," he said.

For example, a patient with hypertension who has to visit a doctor regularly for prescriptions, can consult a doctor online and have the correct medication delivered to them instead of going to a hospital, he said.

"A patient must first have been diagnosed at a brick-and-mortar hospital before they can have the online treatment," he said.

Wang, from the Second Affiliated Hospital at Zhejiang University's School of Medicine, said the benefits are manifold: "The Internet hospital is an innovative effort that will greatly benefit both patients and doctors. In particular it's suitable for patients with chronic diseases who are seeking re-examination. It will be more convenient for them and will also improve the doctors' efficiency."

According to the National Health and Family Planning Commission, China's hospitals and clinics provided nearly 5.7 billion clinical treatments during the first nine months of last year, a rise of 2.8 percent compared with the same period in 2014.

A large number of those patients have chronic diseases, such as diabetes, which require frequent re-diagnosis. That makes big hospitals even more crowded, according to Han Xiaofang, former director of Beijing Medical Reform Office.

Wang said: "I think Internet hospitals will become a trend. In the future, doctors will be able to serve patients both on and offline."

Security concerns

Zuo Xiaodong, vice-president of the China Information Security Research Institute, praised the online hospital for offering patients greater convenience, but was concerned about information security.

"Online medical platforms collect a large amount of data about patients, which also attracts insurance companies and other institutions in the medical industry," he said.

"Leaks of patients' private information may happen if these online platforms fail to protect the information properly," he said, urging platform operators to make strenuous efforts to ensure medical websites cannot be hacked.

Ning Fanggang, a doctor who specializes in treating burns injuries at Beijing Jishuitan Hospital, said it is not possible for online hospitals to replace their brick-and-mortar counterparts because the diagnosis and treatment of many diseases cannot be accomplished through online communications only.

Additionally, online medical services may put doctors and patients at risk if disputes arise between them, due to a lack of laws related to the services, he said.

"Online medical care services should complement the brick-and-mortar medical care services so they become more convenient," he said.

Cao Yin contributed to this story.

Contact the writer at wangxiaodong@chinadaily.com.cn

Online technology offers a new future for healthcare

The use of Internet technology has helped the Beijing Children's Hospital greatly ease the burden registering large number of patients - one of the thorniest problems the hospital has faced for many years, according to Ni Xin, the president of the hospital.

The BCH, established in 1942 and one of the best in China for the treatment of children's diseases, provides more than 10,000 clinical diagnoses per day on average, and more than 70 percent of the patients come from outside Beijing, he said.

"It used to be common to see parents waiting in line overnight before the registration window opened," he said.

The clinical building, designed to serve 3,000 patients, has been overcrowded for years, he said.

In June, the hospital adopted a system that encourages all patients to make reservations to see a doctor, except for emergency conditions, to relieve the problem, Ni said.

Patients can make reservations days, or even months, ahead - via the telephone, the Internet, WeChat (a popular instant-messaging platform) or a mobile app, he said.

The hospital is reducing the number of registration tickets issued on site, and eventually it will be possible to book all reservations online, he said, adding that Wi-Fi services are available in the hospital.

After the introduction of the measures, the congestion in the clinical hall has been greatly reduced, he said.

"Between 7 am and 8 am is a busy time, and the number of patients waiting in lines for registration often reached the peak," Ni said. "Now the number of patients waiting during this period has fallen by 451 per day."

The reduction has resulted in better experiences for doctors and patients, helped to lower the risk of clashes between them, and reduced traffic problems around the hospital, he said.

By the end of last year, all major hospitals in Beijing had opened services that allow patients to register for online diagnosis, according to the Beijing Municipal Commission of Health and Family Planning.

From top: Doctor Zhao Cunzhong from the Wuzhen Internet Hospital discusses a case with colleagues over the Internet. New technology and devices help doctors who practice Chinese traditional medicine to diagnose a patient online. A member of staff at the Wuzhen Internet Hospital demonstrates how to use an app to secure treatment. Photos By Zou Hong / China Daily And Provided To China Daily