In China, relationships between patients and practitioners are strained. This issue is largely due to the overload of 3A hospitals: the waiting time there before seeing a doctor is very important (sometimes a whole day) and time of a consultation is very short.
The development of telemedicine is one of the solutions being considered by the industry to to improve the provision of healthcare and thus appease the relationship between patients and practitioners.
The bad doctor-patient relationship is one of the main issues in Chinese hospitals
According to the NHFPC, the number of attacks on medical personnel declined slightly over the last four years in the country but acknowledges that incidences remain too common.
Security incidents in Chinese hospitals are common
- In 2014, 1425 people were arrested and 4,599 security incidents were reported in hospitals in China, reports Xinhua, theofficial press agency of China.
- In 2015, a reportpublished by the CMDA said that nearly 60% of medical staff in China had faced verbal abuse and about 14% had been physically assaulted.
Result: In July 2016, the Chinese central government ordered armed police officers in hospitals to prevent any violent attacks against doctors or medical staff.
“Patients get frustrated when a consultation lasts only a few minutes after they have waited in line for hours,” Chen Penghui, a doctor from Fujian Medical University First Hospital, told Xinhua this summer.
How telemedicine can ease tensions
By reducing patient wait times
In Chinese big cities, patients sometimes have to wait for five-seven hours or more to get an appointment and hope to see a doctor in the early evening, reported national media regularly.
One of the priorities of privates companies which has invested in the healthcare sector is to minimize patient wait times.
- In 2010, Tencent spent over € 80 million for Guahao, an online health service created to make an appointment via a smarpthone. The service already lists 900 Chinese hospitals.
- In 2014, Alibaba launched Alipay « Future Hospital », a mobile service which allows users to ask for a medical appointment by selecting a practitioner and a date remotely.
Thanks to this device, a visit can last an hour or less, said in June 2014 to Businessweek the communications director of the Guangzhou Women and Children’s Medical Center, the third most populous city in the country which is one of the first to test the application.
- Public sector: launched in 2011, the online booking system (OBS) will be mandatory in Beijing by January 2017 in 3A hospitals.
By improving access to care in rural areas
China’s urban population exceeded for the first time the number of rural dwellers in 2011. In 2014, about 749 million people had lived in urban areas and 619 million in rural regions of China, reported Statista, a satistics portal.
Nowadays, “over 80% of the medical institutions are concentrated in cities and high-qualified health care providers overwhelmingly reside in urban areas,” said the international magazine Nursing Sciences (No. September 2014).
The « Family doctor programs » were introduced in the early 2010s in several Chinese provinces in order to decrease the attendance of major hospitals and ensure equal access to care. In 2013, Luzhai County was chosen as a pilot zone to test the program in China’s Guangxi Zhuang Autonomous Region.
> families from rural areas sign a contract with general practitioners in the township clinics. Practitioners offer one-on-one service for patients, providing basic care and health consultations.
In Xi’an City (Shaanxi Province), more than 2.5 million local residents have signed up with family doctors. In Liaoning province, more than 50% of the rural population has joined the program.
Ali Health (Alibaba’ healthcare subsidiary) launched in this context a mobile application in Beijing to connect doctors of basic medical institutions and residents. Thus, patients need only to use their phone to communicate with a doctor.
“Does [telemedicine] solve the problems happening within China’s strained public hospitals? Absolutely not. But, it does create the possibility for breathing room, and at a bare minimum offers the possibility of some respite for certain types of patients whose care can reasonably be delivered outside the public hospital system,” explained to Forbes (March 2015) Benjamin Shobert, expert in the Chinese and Southeast Asia healthcare market.
Telemedicine: the Chinese government begins to legislate
A uniform telemedicine service network in progress
The PHFPC encourages the creation of platforms which simplify the connection between patient and practitioner.
In August 2014, the NHFPC introduced in a document some guidelines about the development of telemedicine services in China. In 2015, he went further by publishing the Technical Guideline for Telemedicine Information System Construction (2014), a plan to create a a uniform national telemedicine service network in the country.
The Technical Guidance highlights various problems: telemedicine devices already set up in China were independently built, without compatible design and technical standards, and often lack connectivity with hospitals and regional healthcare platforms or with each other.
The construction of this national network will focus on openness, uniformity, inter-connectivity and geographical equality.
Briefly
The Chinese government has invested about RMB 16.36 billion (€ 2.18 billion) in telemedicine in 2014 (latest figures). Balance at the end of that year:
- 72 million Chinese users consulted a doctor online, reports the Chinese Perspective magazine.
- 50% of provincial level hospitals and 42% of primary hospitals has buil up telemedicine centers in China, according to a report made by Research and Markets (Telemedicine and Online Healthcare Industry in China, 2015)
“Without doubt, telemedicine continues to garner robust attention, both within China and from international partners, placing China squarely on track to become one of the largest telemedicine markets in the world,”analyzes a group of US experts in a story published on the platform of Foley & Lardner LLP.