The doc­tor’s in

The emer­gence of e-med­i­cal plat­forms en­ables pa­tients in China to ac­cess high-end ser­vices from across the globe. Wang Xiaodong reports.

China Daily (USA) - - FRONT PAGE - Li Bo from Wuhan con­trib­uted to the story. Con­tact the writer at wangx­i­aodong@chi­nadaily.com.cn

E-med­i­cal plat­forms are emerg­ing as a seam­less way of let­ting pa­tients in China get ac­cess to high-end med­i­cal ser­vices from across the globe.

For the past eight years, An Jian­hua, a 57-yearold from Hu­nan province, has been trou­bled by a mys­te­ri­ous, rare ail­ment: When sum­mer comes, she of­ten sweats on the right side of her body, while the left side re­mains dry, caus­ing em­bar­rass­ment and dis­tress.

“Sum­mer has be­come a night­mare for me,” she said. “I have to try tostay in an air-con­di­tioned room when­ever pos­si­ble to pre­vent my left side from be­com­ing too hot be­cause of the lack of sweat­ing, which could re­sult in heat stroke. When­ever I go out, I al­ways take a hand­ker­chief with me to wipe away the sweat onmy right side.”

Over the years, An con­sulted doc­tors in a range of spe­cial­ties, in­clud­ing gen­eral medicine, gy­ne­col­ogy, endocrinology and psy­chol­ogy, but none could pro­vide a clear di­ag­no­sis.

When she had al­most given up hope of find­ing help, a smart­phone app called Weiyi, which pro­vides on­line di­ag­noses, helped to iden­tify the right doc­tor for An’s com­plaint.

Af­ter ac­cess­ing the app, in early Au­gust An’s son se­lected the “pre­cise ap­point­ment” func­tion and sub­mit­ted de­scrip­tions of his mother’s ail­ment. Within a few min­utes, the sys­tem sug­gested Cao Xue­bing, a physi­cian at the Wuhan Union Hos­pi­tal, in the cap­i­tal of Hubei province, who has cured sim­i­lar prob­lems be­fore.

An booked an ap­point­ment with Cao, and the next day she con­sulted him via the app’s video link.

“Dr Cao said it’s pos­si­ble that the con­di­tion is caused by prob­lems withmy parasym­pa­thetic ner­vous sys­tem,” she said.

On Aug 23, An trav­eled to Wuhan and had a one-on-one meet­ing with Cao, who pre­scribed med­i­ca­tion.

“I did not ex­pect the app would help me to find the right doc­tor so eas­ily,” she said. “Dr Cao said he will keep in touch with me via the app while I con­tinue the med­i­ca­tion.”

Grow­ing trend

More than 20,000 pa­tients across China now use the on­line “pre­cise ap­point­ment” ser­vice pro­vided by the We Doc­tor Group, a dig­i­tal health­care ser­vice provider in Hangzhou, Zhe­jiang province, said Ye Qi­u­jie, the com­pany’s mar­ket­ing direc­tor.

“The ser­vice is in­tended to match pa­tients with the right doc­tors,” she said. “Our on­line med­i­cal groups will find ex­perts within five min­utes of re­ceiv­ing the in­for­ma­tion pro­vided by the pa­tient, such as med­i­cal records and a de­scrip­tion of the ail­ment.”

The We Doc­tors’ e-health plat­form uses in­ter­net tech­nol­ogy to pro­vide ser­vices such as reg­is­tra­tion, on­line con­sul­ta­tions and di­ag­no­sis, and dis­tri­bu­tion of med­i­ca­tion. It is linked to more than 1,900 ma­jor hos­pi­tals na­tion­wide, and has 110 mil­lion reg­is­tered users and 200,000 reg­is­tered doc­tors, ac­cord­ing to Ye.

Liu Yuanli, dean of the School of Public Health at Bei­jing Union Med­i­cal Col­lege, said on­line ser­vices will pro­vide ben­e­fits for mil­lions of pa­tients: “The in­te­gra­tion of in­ter­net tech­nol­ogy with med­i­cal care can re­al­ize au­to­matic and in­tel­li­gent col­lec­tion, stor­age, ex­change and shar­ing of in­for­ma­tion re­gard­ing di­ag­no­sis and treat­ment. It will help res­i­dents gain bet­ter ac­cess to high-qual­ity med­i­cal care ser­vices.”

In­no­va­tions in med­i­cal care through in­ter­net tech­nol­ogy have re­sulted in tan­gi­ble ben­e­fits to pa­tients, such as mo­bile­based di­ag­no­sis, he said. “It will ben­e­fit those liv­ing in sparsely pop­u­lated ar­eas in par­tic­u­lar, so they can also gain ac­cess to high-qual­ity health­care.”

Song Li, an of­fi­cial at the Na­tional Health and Fam­ily Plan­ning Com­mis­sion, said ru­ral res­i­dents will ben­e­fit the most: “The in­te­gra­tion of med­i­cal care with the in­ter­net will en­cour­age peo­ple in China’s western ar­eas, which are less de­vel­oped and have fewer med­i­cal re­sources, to seek med­i­cal ser­vices more ac­tively .”

Op­ti­mized dis­tri­bu­tion

Ac­cord­ing to a guide­line re­leased by the cen­tral gov­ern­ment last year, in­ter­net tech­nol­ogy should be bet­ter adopted in sec­tors such as health­care, ed­u­ca­tion and trans­port to pro­mote op­ti­mized dis­tri­bu­tion of ser­vices and pro­vide the public with ac­cess to more-di­verse, higher-qual­ity ser­vices.

By the end of last year, the num­ber of users of on­line med­i­cal care ser­vices in China was 152 mil­lion, ac­count­ing for 22.1 per­cent of the coun­try’s ne­ti­zens, ac­cord­ing to a re­port re­leased in Jan­uary by the China In­ter­net Net­work In­for­ma­tion Cen­ter. The re­port noted that the most com­monly used ser­vices in­cluded ac­cess to in­for­ma­tion about med­i­cal and health­care ser­vices, ap­point­ments and on­line con­sul­ta­tions.

Mean­while, a re­port re­leased by the Boston Con­sult­ing Group said the ap­pli­ca­tion of in­ter­net tech­nol­ogy will re­sult in China’s dig­i­tal health­care mar­ket ex­pand­ing at “ex­po­nen­tial rates” in the next fewyears.

“New dig­i­tal tools and tech­nolo­gies will bring about epoch-mak­ing changes to China’s med­i­cal care in­dus­try,” said Ma­gen Xia, the lead au­thor of the re­port. “Ev­ery link in the whole med­i­cal care in­dus­try chain will be af­fected, in­clud­ing di­ag­nos­tic meth­ods .”

China will spend al­most 700 bil­lion yuan ($105 bil­lion) on dig­i­tal med­i­cal ser­vices by 2020, com­pared with 20 bil­lion yuan in 2014, the re­port said.

The in­te­gra­tion of the in­ter­net and health­care is still at the pri­mary stage in China, ac­cord­ing to Zhao Jie, chief of dig­i­tal med­i­cal care at the Chi­nese Health In­for­ma­tion As­so­ci­a­tion.

“There are nu­mer­ous in­ter­net-based med­i­cal care plat­forms, but al­most all of them are en­gaged in the mar­ginal ar­eas of med­i­cal care, and the ser­vices they pro­vide are lim­ited to reg­is­tra­tion and on­line ad­vice about non-se­ri­ous ill­nesses,” he said.

Ni Rong, an of­fi­cial at the Zhe­jiang Provin­cial Health and Fam­ily Plan­ning Com­mis­sion, said a lack of con­nec­tiv­ity be­tween hos­pi­tals poses a ma­jor chal­lenge to the devel­op­ment of dig­i­tal health­care.

“Dif­fer­ent hos­pi­tals’ data­bases are not shared, and ev­ery hos­pi­tal is try­ing to es­tab­lish its own on­line plat­form,” he said. “It’s a waste of re­sources.”

For Zhao, the lack of in­for­ma­tion ex­change and shar­ing is also a ma­jor prob­lem be­cause it af­fects the abil­ity of e-health­care plat­forms to treat pa­tients. “The so­lu­tion is to es­tab­lish a uni­fied plat­form for shar­ing in­for­ma­tion, so hos­pi­tals, pa­tients and doc­tors can be con­nected and data can be shared,” he said.

Ob­sta­cles

Many other ob­sta­cles still ex­ist, ac­cord­ing to Xia, from Boston Con­sult­ing.

“Reg­u­la­tory poli­cies on re­mote di­ag­no­sis and treat­ment, the on­line sale of pre­scrip­tion drugs and re­im­burse­ment of pa­tients who seek on­line ser­vices are still not clearly de­fined,” she said.

Some ex­perts have warned that the pro­vi­sion of ser­vices through third-party plat-forms may re­sult in prob­lems, such as in­ad­e­quate or in­cor­rect di­ag­noses, and re­spon­si­bil­ity may not be clear if ac­ci­dents oc­cur. Also, a guide­line pub­lished by the Na­tional Health and Fam­ily Plan­ning Com­mis­sion in 2014 re­stricts non-hos­pi­tal plat­forms from di­rectly pro­vid­ing re­mote med­i­cal care ser­vices.

Liu, from the Bei­jing Union Med­i­cal Col­lege, said that with the emer­gence of on­line med­i­cal care, the gov­ern­ment should strengthen su­per­vi­sion to elim­i­nate risks.

“With the emer­gence of new things, op­por­tunists also come,” he said. “In­vestors are pour­ing money into the sec­tor, but we should re­main cautious about the pos­si­ble risks that may bring.”

I did not ex­pect the app would help me to find the right doc­tor so eas­ily. Dr Cao said he will keep in touch with me via the app ... ”

An Jian­hua, a 57-year-old fe­male pa­tient from Hu­nan province

LONG WEI / FOR CHINA DAILY

A man con­sults a doc­tor via an in­ter­net telemedicine plat­form at a drug­store in Hangzhou, Zhe­jiang province, in May.

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