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The "2021 Internet Hospital Report" was released, with data analysis of 1,140 and 109 full-dimensional surveys, revealing these core trends

 Last Update: 2021-09-19
 Source: Internet
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With the normalization of the epidemic, online medical resources are continuously increasing
.
According to data from the National Health Commission, as of June 2021, there are more than 1,600 Internet hospitals nationwide

As the epidemic accelerates the admission of public Internet hospitals, what new changes have occurred in Internet hospitals? After a large number of public Internet hospitals have entered, how do they operate Internet hospitals? What innovations do companies have in terms of models? The future What changes might happen?

Arterial Network Eggshell Research Institute and Yinchuan Internet + Medical Health Association jointly launched the "2021 Internet Hospital Report"
.
The report conducted a questionnaire survey on 109 Internet hospitals, and based on the information of 1140 Internet hospitals, starting from Internet hospitals gradually moving from peripheral tools to the core of medical care, it studied the service models and construction points of Internet hospitals, with a view to bringing new references to the industry

Overview of Internet Hospitals in 2021

According to data from the National Health Commission, as of June 2021, there are more than 1,600 Internet hospitals nationwide
.
From the earliest Internet hospitals that appeared in 2014 to more than 1,600 Internet hospitals today, new changes have taken place in policy development

The policy changes from directional to operational, and some areas have entered a new cycle

As of July 2021, 150 Internet hospital-related policies have been issued nationwide (except for Yinchuan, the other are national and provincial policies), and the policy system is getting better and better
.

However, judging from the introduction of the three major policies of guidance, supervision, and payment in various provinces, the industry has not yet entered a period of stability and is still in a period of expansion
.
At present, there are still some provinces that have not issued detailed supervision or payment policies, which are mainly implemented with reference to the relevant regulations of the National Health Commission or the National Medical Insurance Bureau.

A large number of policies are still in the trial period

Some Internet hospital policies have entered a new life cycle
.
Many of the previous regulatory policies are all trial policies, and subsequent adjustments need to be made based on actual conditions

Some Internet hospital policies during the trial period, data source: official websites of local health commissions and medical insurance bureaus

In addition, Internet hospital-related policies are evolving from directional to operational, and operational details are increasing
.
In the first half of 2021, Hubei and Hainan provinces issued policies related to prescription circulation, which stipulated detailed prescription circulation procedures

Online high-quality resources are growing rapidly, and real medical care has become a long-term demand

During the epidemic, a large number of public hospitals built Internet hospitals, and this trend will continue into 2021
.
However, users gathered rapidly during the epidemic, and the number of users declined after the epidemic

On the supply side, public hospitals with core resources are speeding up admission, and online medical supply is increasing

According to data from the National Health Commission, as of June 2021, there are more than 1,600 Internet hospitals nationwide
.
Artery Network Eggshell Research Institute has collected a list of 1,140 Internet hospitals through public channels (as of July 2021) to analyze their characteristics

From a longer timeline, Internet hospitals have entered the stage where hospitals dominate the majority since 2018
.
Data in the past three years shows that the ratio of hospital-led Internet hospitals to enterprise-led Internet hospitals has remained roughly between 7:3-6:4, and this ratio will continue to be maintained in the future
.

Leading party for newly-built Internet hospitals since 2014, data source: local health committees, official websites of hospitals, and maps of Eggshell Research Institute

Note: Some Internet hospitals whose establishment time is not clear are not included in the figure

Among the Internet hospitals led by physical hospitals, public hospitals dominate
.
In particular, Beijing and Shanghai, which have gathered a large number of high-quality medical resources, have also accelerated the pace of participation of Internet hospitals, and a large number of top hospitals have joined them
.
In 2021, Beijing will build an Internet hospital supervision platform, which has the prerequisites for approving Internet hospitals.
A batch of hospitals that originally only opened Internet diagnosis and treatment services will be connected with the supervision platform to declare Internet hospital qualifications
.
According to incomplete statistics, as of the end of July 2021, Beijing has 14 Internet hospitals and dozens of hospitals approved for Internet diagnosis and treatment services
.

Of course, there are also a number of outstanding private hospitals participating in the construction of Internet hospitals
.

The overall leading party of Internet hospitals, data source: local health committees, official websites of hospitals, and maps of Eggshell Research Institute

In terms of the level of physical hospitals, tertiary hospitals are still dominated
.
Among the 865 physical hospitals, 639 are tertiary hospitals, accounting for 74%, of which 488 are tertiary hospitals
.
According to the "Statistical Bulletin of China's Health Development in 2020", there are 2,996 tertiary hospitals nationwide in 2020, of which 1,516 are tertiary hospitals
.
Based on this calculation, 21% of tertiary hospitals have Internet hospitals, and nearly one-third of tertiary hospitals have Internet hospitals
.

On the demand side, the epidemic has attracted a large number of users in the short term, and the long-term demand after the epidemic is substantial medical treatment.

During the epidemic, Internet hospitals attracted a large number of users, but users need to form longer-term habits that Internet hospitals can solve actual medical service needs and produce substantive results, not just consultations to soothe emotions and answer doubts
.

According to the 46th "Statistical Report on China's Internet Development Status" by the China Internet Network Information Center, as of June 2020, the number of online medical Internet users in China has reached 276 million, accounting for 29.
4% of the total Internet users
.
Affected by the epidemic, users' demand for online medical treatment continues to increase, which further promotes the online development of China's medical industry
.

According to the statistics of the 47th and 48th "Statistical Reports on Internet Development in China" released by the center, as of December 2020, the scale of online medical netizens has dropped to 215 million; as of June 2021, the scale of online medical netizens is 239 million.
Although there has been a rebound, it is still not as large as the number of users caused by the epidemic
.
This also intuitively reflects that online medical care contains irrational short-term needs during the epidemic
.

Changes in the scale of online medical netizens, data source: China Internet Network Information Center, Eggshell Research Institute

In the "Internet Diagnosis and Treatment Platform's Re-examination Experience Survey of Tuberculosis Patients" conducted by the Beijing Chest Hospital affiliated to Capital Medical University, I chose to participate in online consultations from February to June 2020, and complete the entire process of Internet diagnosis and treatment and drug delivery.
131 cases of tuberculosis patients who met the criteria for re-examination were taken as the subjects of the survey and a questionnaire survey was conducted
.
The results show that 26% of patients will give priority to online diagnosis and treatment after the epidemic, and 25.
2% of patients will choose on-site medical treatment after the epidemic
.
The user's medical habits have not yet been fully transferred online
.
The survey also found that more than 50% of patients hope to obtain follow-up consultation or remote prescribing and delivery services through Internet diagnosis and treatment, and only 42.
5% of patients hope to obtain pre-treatment consultation.
It can be seen that users expect to receive online medical treatment.
Substantial results
.

Internet hospital market

With a total financing amount of 23.
4 billion and frequent large-scale financing, the industry is expected to usher in a wave of listings

In the past year (statistics will start in August 2020), there have been 16 financing mergers and acquisitions in the primary market of the Internet hospital field (based on the Internet medical platform that built the Internet hospital), with a total financing amount of 23.
4 billion yuan
.
In addition, JD Health was IPO on the Hong Kong Stock Exchange in December 2020, becoming the first Internet medical company to be listed for profit
.

Different from the first year of Internet healthcare in 2014, this round of capital enthusiasm is not reflected in the number of projects, but in a single amount.
Large amounts of funds are concentrated in a few projects, and about half of the financing events are in the C round and beyond.
The effect is further manifested
.
For most of these projects, the whole process of medical, pharmaceutical and insurance services has been established, and the online and offline layouts have been coordinated
.
Different advantageous businesses have formed differences .

While the primary market is hot, companies are enthusiastic about sprinting into the secondary market
.
In 2021, WeDoctor, Dingdang Kuaiyao, and Zhiyun Health will successively submit listing applications to the Hong Kong Stock Exchange
.
In August 2021, Yuanxin Technology also launched an IPO
.

Judging from the current financing rounds and business maturity of major companies, the industry is expected to usher in a wave of listings
.

Revenue growth of medical and health services, enhanced medical attributes

Looking at several Internet medical companies that have issued performance reports or submitted prospectuses in 2021, medical e-commerce revenue is still the main source of income at present, but companies are expanding the layout of Internet hospitals, strengthening medical and health service capacity building, and service categories.
The growth of income has accelerated
.

Enhance offline localized service capabilities and deploy Internet hospitals in multiple locations to become the mainstream

Building and operating Internet hospitals in multiple places has become an important way for Internet medical companies to strengthen offline medical resource connections, improve localized service capabilities, and enhance offline traffic conversion.
It is also a basic prerequisite for opening local medical insurance payments
.

The construction and operation of Internet hospitals in multiple places has the following values for Internet medical companies:

First, strengthen the connection of offline medical resources
.
China's medical resources are mainly concentrated in offline public hospitals.
Cooperating with public hospitals to build Internet hospitals will help promote the online medical resources and improve the diagnosis and treatment capabilities of Internet medical platforms
.

Second, it can improve the localized service capabilities of Internet hospitals
.
Although Internet medical companies can break through space restrictions and serve patients across the country, their offline service capabilities are relatively weak.
When patients need offline inspections, surgical hospitalizations, etc.
, the platform is difficult to meet; Internet hospitals are deployed in many places to strengthen cooperation with local medical institutions Cooperation can connect offline service projects for patients nearby, forming a service capability that integrates online and offline
.

At the same time, it can promote the mutual conversion of online and offline traffic
.
On the one hand, there is a huge flow of patients in offline hospitals, and cooperation in the construction of Internet hospitals can transfer some of these patients to online, especially patients with common diseases and chronic diseases
.
On the other hand, Internet hospitals can also import online traffic to offline, realizing precise diagnosis and referral of symptomatic patients for offline hospitals or departments
.

Finally, due to the localized nature of medical insurance, setting up an Internet hospital in the corresponding overall planning area is also a prerequisite for connecting to the local medical insurance payment
.

Pharmaceutical sales account for a high proportion, and it is still necessary for survival and development in the short term

The sales of pharmaceutical e-commerce or other forms of pharmaceutical equipment occupy an important position in the income of the Internet medical platform
.
According to data released by the National Health Commission, at the end of 2017, public hospitals within the pilot cities for comprehensive reform of public hospitals accounted for 31% of the total medicines (excluding Chinese herbal medicine pieces), which has reached a reasonable level
.

Compared with offline medical services, current Internet medical services mainly consist of online consultations, re-diagnosis of common and chronic diseases and purchase of medicines, which are less connected to inspections and other offline items.
For platforms that provide both medicine and medicine, medicines Naturally it will take up a larger proportion
.
Pharmaceutical and device sales are a mature business model that can bring companies a sustained and stable cash flow.
It is also an important model for companies to survive before the emergence of mature Internet medical business models
.

Revenue from medical and health services is growing rapidly, and increasing medical investment has become a consensus

Although in the financial data disclosed by various companies, pharmaceutical sales account for a high proportion, it can also be seen that increasing investment in medical and health service resources and enhancing service attributes have become a consensus, and part of the investment has been reflected in revenue growth.
On
.

Increasing investment in medical and health services is an inevitable move for Internet medical services to meet user needs
.
Since the industry is still in its infancy and the capacity building of medical and health services has just started, not all companies have shown considerable financial data
.
As time goes by, the ability accumulation at this stage will become the driving force for the company's subsequent growth
.

The effect of industrial clusters is apparent, and the investment cost is reduced

It is difficult for the Internet hospital to become an industry alone, but because of its connection value, it can connect companies in multiple sub-sectors such as medicine, equipment, insurance, consumer medicine, consumer health, etc.
Therefore, an industrial ecology can still be formed around the Internet hospital
.
At present, industrial clusters have been formed in Ningxia (Yinchuan), Hainan, Tianjin and Sichuan (Chengdu), and the cluster effect has initially appeared
.
From the perspective of advantageous conditions, it belongs to a policy-based industrial cluster
.

The Internet hospital itself has the characteristics of breaking through the space limitation, but it still has certain advantages in forming an industrial cluster
.

First, the concentration of approvals is conducive to policy breakthroughs
.
Looking back to 2018, the development history of Yinchuan Internet Hospital was carried out under the cycle of enterprise gathering-institutional innovation
.
In 2018, Internet hospitals were officially recognized by the policy.
After the successive introduction of Internet hospital management measures in various regions, they faced the status quo of inconsistent examination and approval standards and inconsistent progress in the implementation of medical insurance
.
Under the basic framework of the "Internet Hospital Management Measures (Trial)", some provinces and cities have a conservative attitude towards corporate Internet hospitals, with a small number of approvals, and such approvals have not been passed
.
Even in areas that are open to corporate Internet hospitals, there are big differences in their approval rules, especially in the physical medical institutions they rely on, and this is often related to the cost of enterprise investment in construction
.

When enterprises form clusters, they can find a balance between the common demands of the enterprises and the detailed approval rules, so as to ensure the smooth implementation of the policies and the satisfaction of the reasonable demands of the enterprises as much as possible
.

Secondly, the medical equipment industry related to Internet hospitals has formed a scale effect
.
Doctor practice and patient consultation can be carried out online, but the resulting circulation of medicines and equipment must rely on offline entities
.
Therefore, the Internet hospital industry cluster is expected to form a scale in the circulation and storage of pharmaceutical equipment to support the sustainable development of the industry
.

Internet hospital operation

In the current stage of Internet hospital development, in addition to paying attention to the industry’s “what has been done”, it should also pay attention to “how it is doing” at the same time.
For this reason, this report investigates the current status of Internet hospital operations
.
The survey was conducted on Internet hospitals that have been built and put into operation across the country.
A total of 114 online questionnaires were distributed and 109 valid questionnaires were retrieved
.

Resource reconstruction, process reorganization, Internet hospitals move towards the core of medical care

New functional departments are created, and the physical walls are breaking

The survey shows that nearly half of the hospital-led Internet hospitals have established a separate work department to be responsible for Internet hospital affairs.
Physical hospitals are not limited to doctors who use their own hospitals to practice.
Corporate Internet hospitals are keen to recruit full-time doctors, and medical resources break the trend of physical space flow.
Significantly
.

Among hospital-led Internet hospitals, 49% of Internet hospitals have established a separate department responsible for Internet hospital work.
Nearly half of the hospitals are managed by the information department or medical department, and 8% have other conditions, such as telemedicine centers and outpatient departments
.
In physical hospitals, the functional departments responsible for the operation of Internet hospitals are playing an indispensable role
.

The operating department of a hospital-led Internet hospital, mapping by Eggshell Research Institute

The service content has been separated from a single item to multiple integrations, gradually moving towards the core of medical care

When the Internet hospital was born, it promoted the flow of medical resources through online services and improved the efficiency of doctor-patient connection, which has achieved great results
.
At present, Internet hospital services are extending from online to offline, and the degree of online and offline integration is deepening, which can bring more substantive services to patients
.

Online scene service content of two types of Internet hospitals, drawn by Eggshell Research Institute

The survey shows that among the services that extend from online to offline, drug delivery accounts for the highest proportion, and most hospital-type Internet hospitals and enterprise-type Internet hospitals can provide it
.
In terms of inspection appointments, home care appointments, and inpatient appointments, hospital-type Internet hospitals have done more explorations.
Limited by their own resources, enterprise-type Internet hospitals have not many connections in these links
.

The disease diagnosis and treatment process is composed of multiple links.
Online services can show advantages in some links, and the combination with offline services can exert greater energy
.

The service content of two types of Internet hospitals extended to offline scenarios, drawn by Eggshell Research Institute

Due to the accelerated integration of online and offline services of Internet hospitals, the previous single service links can better form a combination.
After packaging, a continuation of services can be formed for a certain disease, such as chronic disease management service package, specialized disease management service package, and whole disease management packages and other services
.
At present, there are a large number of Internet hospitals that can provide continuation services.
Among them, corporate Internet hospitals provide more such services
.

Research shows that 51% of corporate Internet hospitals can provide 10 or less continuation medical services, while only 9% do not provide such services
.
In hospital-type Internet hospitals, as many as 43% of Internet hospitals do not have such services
.

For hospital-type Internet hospitals, since medical service items and prices are subject to approval, such services are usually provided in cooperation with a third party
.
And enterprise-type Internet hospitals can improve the conversion of patients' payment through service packages, so they are more active
.

From the perspective of the content of continuation services, the completeness of services provided by corporate Internet hospitals is relatively high.
Consultation, follow-up visits, delivery of medicines, health records, follow-ups, hardware devices, etc.
are all involved.
Inspection and testing are the links that need to be supplemented.

.
The continuation services of hospital-type Internet hospitals have yet to be developed.
Although they are involved in multiple service links and the coverage is relatively average, the depth of involvement is not deep enough
.

Operational effectiveness: Hospital-led Internet hospitals have a long way to go

On the surface, the overall service volume of the current hospital-type Internet hospital is not high.
Compared with the investment of millions of dollars, it is indeed difficult to generate considerable returns in the short term, but this is also a must in the development of the industry.
Way
.

Patient habits have not yet been developed.
Hospital-type Internet hospitals are mainly public and have core medical resources.
They not only have the opportunity to obtain broader development opportunities in the growth of the industry, but also shoulder the important task of encouraging patients to go online and cultivating patient habits
.

The average daily diagnosis and treatment volume and prescription volume of hospital-led Internet hospitals, drawn by Eggshell Research Institute

Most of the enterprise Internet hospitals are small Internet hospitals
.
Due to the large gap in scale and business volume of enterprise Internet hospitals, in this survey, the diagnosis and treatment and prescription data options of enterprise Internet hospitals have also been set separately, with less than 100, hundreds, thousands.
.
.
as the option dimensions
.
From the survey results, small Internet hospitals with an average daily diagnosis and treatment volume and prescription volume below 100 accounted for the highest proportion, at 40% or more
.
A small number of corporate Internet hospitals have an average daily diagnosis and treatment volume of more than 10,000 person-times, mainly Internet hospitals from leading Internet medical companies
.

Daily average diagnosis and treatment volume and prescription volume of enterprise-led Internet hospitals, map by Eggshell Research Institute

Payment structure: Hospital-led medical insurance has a high coverage rate, and enterprise-led medical insurance requires commercial insurance support

In this survey, 43% of Internet hospitals have achieved medical insurance payment.
Although the overall coverage rate is not more than half, considering the time when the medical insurance policy was introduced and the online time of most Internet hospitals, it has shown that medical insurance coverage has been rapid
.
In contrast, the overall coverage rate of commercial insurance is extremely low, only 5%, which is huge
.

The overall payment composition of Internet hospitals, drawn by Eggshell Research Institute

In terms of breakdown, the medical insurance coverage rate of hospital-type Internet hospitals is much higher than that of enterprise-type Internet hospitals, and enterprise-type Internet hospitals need to further accelerate the improvement of commercial insurance payment
.
Research shows that 53% of hospital-type Internet hospitals can realize medical insurance payment, while only 23% of enterprise-type Internet hospitals are concentrated in a few large enterprises
.
In terms of commercial insurance, 11% of enterprise-type Internet hospitals can achieve reimbursement, which is higher than that of hospital-type Internet hospitals
.

Differentiated positioning and cooperation between hospitals and enterprises to enhance the benefits of all parties

In hospital-type Internet hospitals, when third-party companies participate in operations, the overall diagnosis and treatment data is higher; since continuation services are an important service content for third-party operations, this survey also shows that hospitals that can provide continuation services Internet hospitals have higher operating data than hospitals without such operations
.
The cooperative operation of hospitals and enterprises is an important way for both parties to differentiate their positioning, fully embody the values of both parties and benefit from each other
.

Is there a third party involved in the comparison of the daily average diagnosis and treatment volume operated by the hospital-type Internet hospital, charted by the Eggshell Research Institute

The volume of diagnosis and treatment and the volume of prescriptions are only two of the dimensions to measure the operational effects of Internet hospitals, and they cannot be completely guided by this
.
Hospital-type Internet hospitals also need to integrate their own department conditions, the number of doctors and other factors to formulate operational measurement standards
.

At the same time, hospital-enterprise cooperative operation is also mainly applicable to general hospitals or other hospitals that need to strengthen the cultivation of patient habits
.
For hospitals with high frequency of patient follow-up visits and strong demand, the increase in diagnosis and treatment volume does not necessarily require hospital-enterprise cooperation
.
For example, in the Cancer Hospital of Peking University, with the information department leading the work of the Internet hospital, the online follow-up rate has reached 30%
.

Internet Hospital Research

Academic research is an indispensable part of the medical field, and emerging subdivisions need to disseminate scientific research results and exchange practical experience through papers
.
The accelerated construction of Internet hospitals and the accumulation of consultation data provide materials for research in this field, especially for retrospective studies
.

CNKI database search shows that since 2014, there have been 250 papers with Internet hospitals and Internet diagnosis and treatment as the main themes
.
Among them, the number of papers published in 2020 will reach its peak.
Judging from the number of publications from January to July 2021, the number of publications in 2021 is expected to be the same as in 2020
.

Who pays the most attention to Internet hospital research? Judging from the composition of the authors (based on the first author) of these papers, 67% are from hospitals and 22% are from universities
.
In addition, authors from research institutions, companies, health departments, and societies have published related papers on Internet hospitals
.
As the front-line personnel closest to patients, hospital workers are of course the people who research Internet hospitals the most
.

Among the authors from hospitals, which ones research Internet hospitals the most? Statistics show that among hospital authors, the information department accounts for the highest proportion; hospital managers (mainly deans and vice presidents) are also one of the main sources of papers; in addition , And 11% of clinicians participate in research related to Internet hospitals
.

Source of the author of the Internet Hospital paper, drawing by the Eggshell Research Institute

Although scientific research is mainly concentrated in medical institutions, universities and research institutions, its development can also bring value to the industry
.
For example, help practitioners growth, especially help doctors grow; to provide support for clinical work experience, cultivating talent for the industry and so on
.

In the future, Internet hospitals will be deeply integrated into the medical system
.

First, in the medical service system, Internet hospitals can become a hierarchical diagnosis and treatment platform, cooperating with physical medical institutions and referrals to each other
.
Internet hospitals accurately screen symptomatic patients, and when they need to be examined, operated or hospitalized, they are referred to a physical hospital for treatment, and after the in-hospital treatment is completed, they are transferred back to online rehabilitation management
.

Secondly, the logic of industry development has gradually changed from dimensions such as pure product sales and GMV data growth to truly solving patients' diseases and improving health conditions
.

At the same time, with the rapid development of the Internet medical industry, corporate Internet hospitals have produced many benchmarks
.
Since 2020, a large number of public Internet hospitals have been constructed, and more types of benchmarks will emerge in the future Internet hospitals
.

Internet hospital benchmarks will appear more in the Beijing, Shanghai, and Guangzhou regions, where high-quality medical resources are concentrated, large hospitals cover many patients from other places, and hospitals have a high degree of informationization
.
There will also be personal benchmarks in the industry, especially individuals who have been involved in Internet medical care in the early days.
They will bring third-party platform operation experience to public hospitals and promote the construction of Internet hospitals
.

The benchmarks generated in the public system to a greater extent represent the strength of the medical system, and therefore, can bring about deeper changes in the industry
.

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