Launch the first white paper of China Internet hospital (2016)

Source: Why did Internet hospital stand out in 2016-11-16? What is the stage of Internet hospital construction? What is the future development path of Internet hospital? How to realize the sustainable growth of Internet hospital? China Internet hospital white paper (2016) looks for the answers to the above questions along the evolution of "Internet + medical" 1、 According to the statistics of public information, by November 2016, the national Internet hospital army had expanded to about 36 Among them, 25 have realized the landing operation (PC or app service entrance has been provided), and the other 11 have publicly announced that they are under construction in 2016 It is believed that in 2017, more Internet hospitals will officially land to provide services As there is no clear and unified definition of Internet hospital, the name of cloud hospital and network hospital are included in the statistics in this report 2 Construction: in 2016, 31 Internet hospitals were started in a centralized way Since 2014, Guangdong Provincial Network Hospital, 2015 Wuzhen Internet hospital and a number of other advance forces landed, the construction of Internet hospitals has reached a peak, and 31 of them were started in 2016 3 Multi party cooperation has become the mainstream mode From the perspective of the main body of Internet hospital construction, internet medical enterprises, medical institutions and local governments represented by micro medicine and Ali health have become the mainstream mode, occupying more than half of the 36 Internet hospitals 13 IT service providers represented by dongrunxikang and Zhiye Internet participated in the construction 2、 The maturity evaluation of Internet hospitals 1 Although the maturity index of Internet hospitals was constructed in 2016, the maturity of each development is still uneven According to the current service practice focus of Internet hospitals, we extract five maturity indicators and make a preliminary inventory of the service maturity of 25 Internet hospitals that have been put into operation The five indicators are respectively medical service, medical qualification, connection breadth, connection depth and connection dimension The total score is obtained by adding non starring, half star and one star respectively, and the maturity is evaluated according to the total score 2 The top five Internet hospitals are Wuzhen Internet hospital, Sichuan micro medical Internet hospital, Gansu Internet hospital, Guangxi Internet hospital and Ningbo cloud hospital In terms of connection breadth and medical services, these five Internet hospitals have already connected to regions or even across regions across the country, and can provide online and offline closed-loop medical services Wuzhen Internet hospital can provide a national doctor resource connection platform At present, Ningbo cloud hospital has realized the hospital connection of regional units in the city In terms of connection depth, Wuzhen Internet hospital, Sichuan micro medical Internet hospital, Gansu Internet hospital and Guangxi Internet hospital began to evolve from online diagnosis and treatment services to providing data connectivity, data sharing and other services between electronic medical records In the connection dimension, Wuzhen Internet hospital has begun to practice the opening of medical insurance In terms of medical qualification, all of them can rely on the offline quick reception service provided by the physical medical institutions for the patients they serve The maturity evaluation only reflects the current main practice of Internet hospitals In the future, with the continuous improvement of the Internet hospital model, the maturity index and the evaluation of Internet hospitals will also be updated and iterated 3 The three echelons of Internet hospitals now 25 Internet hospitals can be roughly divided into three types, corresponding to different stages: hospital informatization, network hospital and Internet hospital (1) From the perspective of the construction of Internet hospital, Wuzhen Internet hospital and its regional landing Internet hospital currently take micro medicine as one of the main operators and Wuzhen Internet hospital as the central node In terms of the overall operation mode, the Internet hospital in each region basically realizes the rudiment of the Internet hospital service form (2) 12 Internet hospitals have entered the stage of networking, which are located in network hospitals or on-line hospital areas In general, the Internet hospitals in this stage are dominated by hospitals, with single or medical association as the construction core, extending vertically to the grassroots level The hospital takes the Internet as the carrier and technical means to form a comprehensive platform integrating various forms of medical services, which is commonly known as the online hospital area, and the representative hospital is the first Internet Hospital of Zhejiang University At the same time, there is also a network hospital platform jointly built by Internet, it service providers and medical institutions, represented by Ali health network hospital (3) The six hospitals in the information stage of providing convenient medical treatment process are generally led by the hospital The online services provided are focused on the convenient services or remote consultation services for optimizing the medical treatment process, which enhances the medical experience in the hospital or in the Medical Association Doctors who provide online services come from the hospital's own doctors Although the name of the Internet hospital is also named, but in terms of function, it is still in the stage of hospital informatization 3、 The first reason for the outbreak of Internet hospitals is that the industry has reached a new stage (1) the window period of entrepreneurship of internet light consultation is about to close The business model of light consultation has not been able to find a more reasonable cash flow model, the small scale of consultation payment, low conversion rate of value-added services and other charging models, the complete business closed-loop is difficult to form, the platform can not rely solely on the online model to support long-term development, so it is urgent to find a new extension model (2) The establishment of a complete business closed-loop needs offline entities as the starting point Under the existing policy system, the services provided by the consultation platform for patients are extremely limited, and online consultation, doctor-patient interaction, registration and referral are all peripheral behaviors of medical treatment Real diagnosis and treatment behaviors such as diagnosis, drug prescribing, inspection and surgery still need to be returned to offline hospitals It is inevitable to deepen the diagnosis and treatment process and open up the online and offline business closed-loop And the extension of business forms such as medical e-commerce, insurance, health big data, etc all depend on the opening of diagnosis and treatment links The second reason is that the national policy is clear quickly (1) the macro policy promotes "Internet + medical care", and the key link of local policy is ice breaking With the implementation of the national "Internet +" strategy, the policy guidance in the field of "Internet + medical care" is also clear In 2015, the guiding opinions of the State Council on actively promoting the "Internet +" action put forward specific development goals and requirements in the field of health care, namely, "by 2018, the Internet application in the field of health care will be more abundant, public services will be more diversified, and the allocation of social service resources will continue to be optimized" In 2016, the policy of "Internet + medical care" continued to increase At the national health and health conference held in August, President Xi Jinping emphasized the importance of basic medical services in his speech He put forward the concept of "setting up a big health and great health", changing the focus of disease treatment on the center of people's health, establishing and improving the health education system and improving the health literacy of the whole people On this basis, on October 25, the CPC Central Committee and the State Council issued the outline of "healthy China 2030" plan, which for the first time raised the outline of health care industry to the national level In December 2015, Tongxiang municipal government of Zhejiang Province approved the first Internet hospital in China, and launched the website platform of Wuzhen Internet hospital and Wuzhen hospital line app to provide online diagnosis and treatment services with follow-up as the core nationwide The hospital was supported by the central network information office, the national health and Family Planning Commission, the State Food and drug administration, the Zhejiang provincial government and the provincial health and drug administration At the same time, local medical insurance policies are also inclined to Internet hospitals On August 15, 2016, the Department of human resources and social security of Guizhou Province issued the report on the inclusion of telemedicine services in basic medical insurance Notice on issues related to fund payment, pointed out that in order to accelerate the development of telemedicine and further meet the medical needs of the majority of insured personnel, it was decided to include telemedicine service projects into the scope of basic medical insurance fund payment after research The Sichuan Provincial Development and Reform Commission and the Sichuan Provincial Health and Family Planning Commission also issued the notice on setting the price of internet medical service projects, breaking the problems of internet medical project price, medical insurance settlement, charging standards and so on from the policy level The third reason: market demand has been strongly promoting for a long time, China's high-quality hospitals are concentrated in the eastern coastal areas, especially in Beijing, Shanghai and Guangzhou According to the 2015 China Health and family planning statistical yearbook data, the top three hospitals in the East account for 46% and the West for 23%; high-quality medical resources are also concentrated in large hospitals, the service capacity of basic medical institutions is insufficient, and the acceptance of "first visit" is low It is normal for small diseases to enter large hospitals Large hospitals that were originally oriented to "treatment of acute and critical diseases, difficult and miscellaneous diseases and personnel training" are all suffering from large and small diseases For large hospitals with a small proportion of their own, the contradiction between supply and demand is increasingly tense, while general hospitals and grass-roots medical institutions are showing the opposite trend Under the "siphon effect", the pattern of tertiary hospitals as the core is difficult to change in a short time According to statistics, 66% of the first-class and below hospitals only undertake less than 20% of the outpatient and 13% of the inpatient, and the utilization rate of beds is also low However, the third level hospitals with the least proportion are becoming more and more saturated Moreover, the number of patients in tertiary hospitals continued to expand, with an increase rate of about 10% higher than that in other hospitals In the future, the imbalance between supply and demand of high-quality medical institutions and non core medical institutions will continue to intensify Internet medical service has been welcomed by users The scale of internet medical users in China is 152 million, accounting for 22.1% of Internet users Among them, the utilization rate of internet medical services in the pre diagnosis link is the highest - the total utilization rate of online medical care information query, online appointment registration and online consultation is 18.4% 4、 Where does Internet hospital come from? The emergence of Internet hospital is a great progress in the process of medical reform and an important transition from network hospital to intelligent hospital How to explore the integration of Internet and medical treatment? We believe that it is to form the ability to connect all abilities with the integration of medical services The supply of diagnosis and treatment services, the allocation of medical resources and the allocation of all elements of medical insurance are the three dimensions for Internet hospitals to return to the essence of medical care (1) Key points of diagnosis and treatment service evolution: Online instrumental assistance online diagnosis match and supply offline diagnosis and treatment service precise diagnosis + active health management because the essence of medical service is not only online medical service, but also seamless connection with offline medical image examination, surgery, consultation, etc Therefore, in the evolution stage of internet medical services, we should not only consider the depth and efficiency of online services, but also consider how to achieve seamless docking with offline medical services With online platform as the connecting point, we can effectively and accurately match and sustainably provide offline diagnosis and treatment services (medical imaging, surgery, offline consultation, etc.) In the future, with the interconnection of medical big data, pre prevention can be carried out to provide primary