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Digital Healthcare

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Healthcare Reform in China

Abstract

This chapter addresses the increasing role of digital healthcare in the overall Chinese healthcare system. As described in previous chapters, the healthcare system faces many issues, such as the confrontational relationship between doctors and patients, the poor access for populations in rural areas, the significant mark-up throughout distribution channels, a financially heavy burden for chronic diseases, poor quality of healthcare supply and inefficient hospital operation except Level 3 hospitals that have to deal with an over-demand. Many solutions have been proposed, such as the multiplication of healthcare suppliers, the establishment of general practitioners as gatekeepers for hospital admissions, the implementation of public health insurance schemes or the government support for reforms in favour of private health insurance and private healthcare providers. However, they have not proven sufficient to solve all problems yet. Digital healthcare is likely to play an increasing part in addressing these issues. One of the strengths of e-health is the quick and widespread adoption of mobile platforms. This may help solve access challenges, through online appointment registration systems, models of online-offline services, two-communication platforms between patients and physicians, sharing information through the Electronic Health Record (EHR) and Electronic Medical Record (EMR) systems, the generalized implementation of a DRG-based payment system, making patients more increasingly active actors in maintaining the health status, and improving the online drug market. On the flip side, this also raises many concerns regarding the confidentiality of personal medical data and the monopoly situation of some internet companies.

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Notes

  1. 1.

    China Mobile Internet 2013 Overview, Umeng Insight Report, March 2014.

  2. 2.

    “Notice on Reinforcing the Administration of Telemedicine,” Health Office Issue, No. 2, 1999.

  3. 3.

    The original notice from NHFPC with an English translation can be found at following address https://www.healthcarelawtoday.com/wp-content/uploads/sites/15/2014/09/China-Telemedicine-Opinions-Aug-29-2014.pdf. Accessed September 2017.

  4. 4.

    http://www.nhfpc.gov.cn/ewebeditor/uploadfile/2015/01/20150115100526329.pdf. Accessed September 2017.

  5. 5.

    Y. Su, J.L. Liu, Y., and X.M. Yi, “The Idea About the Mode of a Patient-Centered Modern Clinic,” Journal of Medical Postgraduates, Vol. 19, No. 1, 2006, pp. 74–78.

  6. 6.

    R. Guo, Z.M. Miao, G. Wei, S.C. Xing, and Y. Zhang, “The Present Situation and Suggestions of the Domestic Appointment Registration of Hospital,” Progress in Modern Biomedicine, Vol. 12, No. 7, 2012, pp. 1357–1360.

  7. 7.

    M. Huang, “Exploration and Practice about Outpatient Appointment Registration Service Mode,” Gansu Journal of Traditional Chinese Medicine, Vol. 24, No. 1, 2011, pp. 59–60.

  8. 8.

    X.Q. Yin, Z.Z. Huang, and L.J. Huang, “Design and Research on Appointed Outpatient Registration System in Modern Hospital,” Hospital Digitalization, Vol. 31, No. 12, 2010, pp. 48–53.

  9. 9.

    Y.X. Xu and H.X. Ding, “Current Situation Analysis of the Hospital Outpatient Appointment Services,” Clinical Medical Engineering, Vol. 19, No. 1, 2012, pp. 105–106.

  10. 10.

    X.Q. Yin, Z.Z. Huang, and L.J. Huang, “Design and Research on Appointed Outpatient Registration System in Modern Hospital,” Hospital Digitalization, Vol. 31, No. 12, 2010, pp. 48–53.

  11. 11.

    J.H. Chen, S.G. Tu, H. Xiong, and N.Z. Xu, “Practice of Mobile Phone Real-Name System Appointment Registration,” Chinese Nursing Research, Vol. 26, No. 1, 2012, pp. 170–171.

  12. 12.

    M. Huang, “Exploration and Practice about Outpatient Appointment Registration Service Mode,” Gansu Journal of Traditional Chinese Medicine, Vol. 24, No. 1, 2011, pp. 59–60.

  13. 13.

    W. Yu, X. Yu, H. Hu, G. Duan, Z. Liu, and Y. Wang, “Use of Hospital Appointment Registration Systems in China: A Survey Study,” Global Journal of Health Sciences, Vol. 5, No. 5, 2013, pp. 193–201.

  14. 14.

    “No More Long Queues in China’s Smart Hospitals,” China Daily, 8 December 2015.

  15. 15.

    McKinsey Analysis, 2015. https://fr.slideshare.net/fle864/20150402-chic-mc-k-e-health-in-china-vf. Accessed September 2017; http://www.iamwire.com/2015/09/practos-chinese-counterpart-guahao-raises-394m-1-5b-valuation-led-hillhouse-goldman/123356. Accessed September 2017; http://www.sramanamitra.com/2016/06/17/billion-dollar-unicorns-guahao-targets-chinas-healthcare/. Accessed September 2017.

  16. 16.

    “A New Face for China’s Plastic Surgery Industry,” South China Morning Post, May 2015. http://www.scmp.com/news/china/society/article/1799127/new-face-chinas-plastic-surgery-industry. Accessed September 2017.

  17. 17.

    Interviews in Beijing, October and November 2015.

  18. 18.

    China Mobile Health Market Research Annual Report 2012–2013, published by iiMedia Research Consulting. http://eng.hi138.com/computer-papers/internet-research-papers/201305/439592_20122013-annual-report-of-china-mobile-healthcare-market.asp#.VnENmtATH8s. Accessed September 2017.

  19. 19.

    “Digital Diagnoses: A Remedy for the Mainland’s Healthcare Ills,” September 2013. http://economists-pick-research.hktdc.com/business-news/article/International-Market-News/Digital-diagnoses-a-remedy-for-the-mainland-s-healthcare-ills/imn/en/1/1X000000/1X09U8HV.htm. Accessed September 2017.

  20. 20.

    China National Health Development Researcher Center.

  21. 21.

    See details on online purchase drugs below in the chapter.

  22. 22.

    https://www.wsj.com/articles/alibaba-affiliate-wins-approval-to-start-private-bank-1411970203. Accessed September 2017.

  23. 23.

    https://healthintelasia.com/alihealth/. Accessed September 2017; http://technode.com/2015/04/24/alibaba-affiliates-future-hospitals-can-access-chinese-medical-data/. Accessed September 2017.

  24. 24.

    http://www.chinabiotoday.com/articles/20160219. Accessed September 2017.

  25. 25.

    McKinsey/DXY, 2012 Physician Survey, June 2011.

  26. 26.

    https://www.clinicalleader.com/doc/overview-of-ehr-systems-in-bric-nations-0001. Accessed September 2017.

  27. 27.

    http://paccentury.com/electronic-health-records-in-china/. Accessed September 2017.

  28. 28.

    https://www.forbes.com/sites/ywang/2014/09/02/tencent-buys-minority-stake-in-chinese-healthcare-website/#6026ea662e99. Accessed September 2017.

  29. 29.

    From the report, “Power to the Patient: How Mobile Technology is Transforming Healthcare,” The Economist Intelligence Unit, 2015.

  30. 30.

    mHealth is an abbreviation for mobile health, a term used for the practice of medicine and public health supported by mobile devices. Definition from Wikipedia: https://en.wikipedia.org/wiki/MHealth.

  31. 31.

    http://www.cnbc.com/2016/10/11/chinese-baidu-unveils-ai-health-chatbot-for-patients-and-doctors.html. Accessed September 2017.

  32. 32.

    http://www.chinadaily.com.cn/beijing/2014-07/31/content_18221458.htm. Accessed September 2017.

  33. 33.

    General Office of MOH of China: The Notice of the General Office of the Ministry of Health on the Promotion of Pilot Program of Building Electronic Medical Records as the Core Hospital Information. http://wenku.baidu.com/view/e098b6020740be1e650e9a9f.html. Accessed September 2017 (in Chinese); General Office of MOH of China: The Notice of the General Office of the Ministry of Health on the Issuance of the Second Batch of Electronic Medical Records Pilot Cities and Pilot Hospitals. http://wenku.baidu.com/view/e6226d0ebb68a98271fefae6.html. Accessed September 2017 (in Chinese); J. Lei, P. Sockolow, P. Guan, Q. Meng, and J. Zhang, BMC Medical Informatics and Decision Making, Vol. 13, 2013, p. 96.

  34. 34.

    “China’s Health Care Reforms, “ Health International, 10 Number 2010.

  35. 35.

    http://daxueconsulting.com/e-pharmacy-in-china/. Accessed September 2017.

  36. 36.

    Alibaba , Yunfeng Bought Control of Citic 21CN for $171 Million. https://www.bloomberg.com/news/articles/2014-01-23/alibaba-yunfeng-to-buy-control-of-citic-21cn-for-171-million. Accessed September 2017.

  37. 37.

    http://fortune.com/2016/02/21/cfda-ali-health-drug-monitoring/. Accessed September 2017.

  38. 38.

    http://www.wsj.com/articles/ali-health-swallows-bitter-pill-as-china-halts-drug-monitoring-system-1456144563. Accessed September 2017.

  39. 39.

    “Ali Health to Launch New Third-party Drug Tracking Platform,” Marbridge Daily, 10 May 2016.

  40. 40.

    “China Pharmacies Urge Abolition of Alibaba Health Drug Tracking Platform,” Reuters, 24 February 2016. http://mobile.reuters.com/article/idUSKCN0VX0UX. Accessed September 2017.

  41. 41.

    Interview in Beijing, November 2015. Name has been modified.

  42. 42.

    From the report, “Power to the Patient: How Mobile Technology is Transforming Healthcare,” The Economist Intelligence Unit, 2015.

  43. 43.

    “Power to the Patient: How Mobile Technology is Transforming Healthcare,” The Economist Intelligence Unit, 2015.

  44. 44.

    Zhou Dongxu, “Baidu Backtracks on Letting Private Firms Run Popular Forums,” CaixinOnline, 13 January 2016. http://english.caixin.com/2016-01-13/100899054.html; Belinda Cao and Stephen Stapczynski, “Baidu Retreats on Chinese Private Hospital Advertising Boycott,” Bloomberg, 6 April 2015.

  45. 45.

    The Relationship between the Branches of the Alibaba Group and Ali Health have been simplified here.

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  1. CNRS and Paris School of Economics (PSE), Paris, France

    Carine Milcent

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  1. Carine Milcent
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Milcent, C. (2018). Digital Healthcare. In: Healthcare Reform in China. Palgrave Pivot, Cham. https://doi.org/10.1007/978-3-319-69736-9_9

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  • DOI: https://doi.org/10.1007/978-3-319-69736-9_9

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