Doctors provide consultation in a remote clinic room at Wuzhen Internet Hospital in Zhejiang Province.

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Haodaifu Online, a Chinese provider of online diagnosis services, recently released its strategic plan for 2018 that focuses on people in smaller cities and remote areas by allocating medical experts to further train the doctors there in their spare time. It aims to improve diagnosis and treatment at the town level so that patients can remain in their hometowns, thus establishing a hierarchical medical system. The move has drawn wide attention.

Zhou Fude, director of nephrology at Peking University Hospital, has learned firsthand about the difficulties of medical care at village or town level though continuous work there and his administrative experience in the Xinjiang and Inner Mongolia autonomous regions. He said that many patients need urgent treatment, but their diseases may worsen because local doctors lack medical experience and capabilities.“Traditionally, medical teams have been dispatched to provide medical resources in villages and towns. In this way, experts attract a massive number of patients and conduct plenty of surgeries. When the doctors leave, patients are gone,” Zhou said.

Wang Hang, CEO of Haodaifu Online, said better utilizing doctors’ spare time can create additional medical services without increasing the number of doctors. At present, internet medical platforms enable doctors to serve patients anywhere and anytime on a smartphone app. These platforms also establish a payment mechanism. In this context, doctors would receive legitimate rewards and have an incentive to contribute private time to society.

In the first 10 months of 2017, doctors contributed a total of nearly 1.7 million hours of their spare time on the Haodaifu platform. Of them, 72 percent were from Grade III hospitals, the highest level. Doctors usually go online from 5 p.m. to 10 p.m. and the peak hour arrives at 9 p.m. every day.
Assuming that each doctor works for eight hours a day, 1.7 million hours equals the work of 568 doctors, creating another Grade III hospital with fixed assets exceeding 1 trillion yuan, Zhou said. Doctors spent about 200,000 hours writing 180,000 online articles to disseminate medical knowledge. They also offered 27.56 million consultations mainly through pictures, words and phone calls. “Our triage system is highly sophisticated. Many doctors claim that their patients on Haodaifu Online are more targeted than those in hospital clinics,” Wang said.

The combination of internet and medical care has enabled an efficient platform for communication between doctors and patients. However, the service will be more effective if a part of it can be allocated to people from villages and towns, granting them access to experts. Therefore, Wang decided to focus on medical care in 2018, which explains the great attention that it received.

In the context of medical reform and hierarchical treatment, experts  from the Grade III hospitals are expected to diagnose and treat complicated and severe diseases while providing remote consultation and diagnosis, thus forming a model of “village and town level examination, higher level diagnosis and local treatment.” In this way, patients can receive professional diagnosis without having to shuttle between different places, and they still will be reimbursed through local medical insurance, which helps them save money, time and energy. Local doctors can learn from experts and improve their proficiency. Local hospitals can receive more patients and businesses. Also, it is possible for health management departments to achieve hierarchical medical care in which patients can receive treatment for critical diseases at primary hospitals.

Multiple groups benefit from the situation and that’s what hierarchical medical care needs the most, Wang said. He put forward two aims for the next year. One is to open remote clinic services with 50,000 experts at higher levels and the other is to improve the capacity to provide services to villages and towns, thus covering 80 percent of Chinese counties.  People can benefit from the diagnosis of Grade III hospitals.

Meanwhile, Haodaifu Online has set up an expert platform so that doctors at different levels can form expert panels on phone apps and make a full use of their time. Currently, 4,353 expert panels have been established and have started receiving orders. Doctors at lower levels respond to the patients first and they can ask those at higher levels for help at any time when they have tough cases.

Local governments, like Pengyang County have welcomed such moves. Pengyang is situated in a mountainous area in the southern part of Ningxia Hui Autonomous Region. Shi Jinlong, deputy director of Pengyang County, said Pengyang is a target of domestic anti-poverty work and suffers from poverty caused by disease. Its inconvenient traffic increases medical costs, and people there have no way to resolve the current problems due to a grievous lack of medical resources. At this point, Pengyang County introduced the model of expert panel and signed family doctors, whose technologies are supported by Haodaifu Online.

The model provides regulated and professional management services for patients with chronic disease. General medical practitioners may consult the advice of experts through remote clinics, Shi said.

Doctors also support the strategy. Zhou said that remote consultation used to be expensive and inefficient because it required applications of local hospitals and conferences of doctors. “Now, doctors can use a smartphone to operate a remote clinic system in their spare time. The efficient and coordinated model can benefit more patients across the country,” Zhou added.

 

The article was translated from China Youth Daily.

(edited by MA YUHONG)