Apr 15, 2020 05:18 PM

Blog: From Crisis Comes Opportunity in Online Health Care

A rehabilitation therapist in Nantong, East China’s Jiangsu province, consults by video with a patient’s family members on March 11.
A rehabilitation therapist in Nantong, East China’s Jiangsu province, consults by video with a patient’s family members on March 11.

Liu Junling is chairman and CEO of 111 Inc., a digital and mobile health group in China.

The nationwide fight against Covid-19 has had many heroes, from frontline medical workers to mobilized soldiers and police who have had to manage the quarantine of an entire province and one of China’s major cities — Wuhan, the “Chicago” of China for its roles in transport and industry. The true heroes, of course, are the ordinary people — the “laobaixing” or “old hundred names” — who are in quarantine and suffering fear and isolation in order to protect their loved ones and the world.

From our perspective, Covid-19 represents an enormous opportunity to “serve the people.” One of the most basic facts of the nationwide imposition of controls on individual movement is that the sick have few alternatives. If they experience Covid-19 symptoms, they can head to hospitals that could be already overburdened with others like them seeking confirmation of the illness and care. If they are merely suffering from a range of common diseases they are helpless. If they are in the middle of a 14-day quarantine because of a sick family member or neighbor, they are in big trouble.

That is where we stepped in. The impact of this is very real. There is no doubt that the Chinese public is turning to online health care in a big way in the midst of crisis.

During Lunar New Year holiday, we saw a surge of downloads of our online pharmacy app. From Jan. 25 to Feb. 7, the number of users on our app increased more than fivefold from the period of Jan. 11 to Jan. 24. Meanwhile, the number of users with cardiovascular, endocrine and neurological chronical diseases increased by three times.

Our online consultations increased rapidly with individual doctors providing as many as 300 consultations per day, with the help of artificial intelligence (AI) technology. Currently, we have 2,000 doctors on our Internet hospital platform, serving users all over China. The consultations cover health education, guidance on medications, and e-prescriptions. The drugs are delivered to people’s communities or homes through our offline pharmacy network.

There are limitations to what we can do, of course. Public insurance is not yet widely available for online services, which is one reason we are providing free consultations and drug refills at the height of the crisis. But there is every sign that online-to-offline health care is enabling China to make up for the gaps in its existing system, particularly in primary care.

On March 2, the National Healthcare Security Administration and National Health Commission jointly released guidance on the promotion of “Internet plus” medical insurance services during the prevention and control of Covid-19, promoting the reimbursement of qualified online medical consultations services of common diseases and chronic diseases and e-prescription filings for re-visiting patients. The guidance also urges cooperation between the provincial Healthcare Security Administration and Internet hospitals on direct online settlement by medical insurance.

Instead of having small-scale clinics and general practitioners who screen patients and refer them to specialists, the lack of widespread primary care institutions means that anyone with a cough or a cold goes straight to a hospital. That has produced the long lines and crowded wards that we have all witnessed on TV in recent weeks, as tens of thousands of cases of Covid-19 were confirmed in Hubei alone.

China began a dramatic reform of its health care system starting in 2009, and its Healthy China 2030 plan envisions much greater investment in primary health care as a means of addressing the twin burdens of the rising incidence of chronic disease and a surge in health expenditures. Online health care offers a transformational means of bridging the gap between the higher standards now common in Chinese cities and substandard primary care especially in rural areas. The Covid-19 public health crisis has given us a chance to demonstrate to both policymakers and the public just how well we can fill the gap.

The outbreak of Covid-19 has been a horrific national and international disaster. It has shown us the limitations of China’s health care system but it has also opened up a new pathway that could make it possible to skip intermediate stages of development, much as mobile technology made it possible for China to avoid the enormous costs of investment in rolling out national fiber-optic networks for telephony. Out of tragedy comes learning and change. We believe the success of the online-to-offline model during the Covid-19 crisis will have a lasting imprint on China’s health care system.

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The views and opinions expressed in this blog section are those of the authors and do not necessarily reflect the editorial positions of Caixin Media.

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