Evolution Theory Of "Touch Net" In Public Hospitals: From The "Test Water" To The "Player" Behind The Industry Changes

A new crown pneumonia epidemic sweeping the world has allowed Internet hospitals, which lingered on the edge of the market, to enter the mainstream field of vision in 2020.

Because of the constant addition of public hospitals and the layout of their strength, the balance of strength has been changed.

Under the strong attack of public Internet hospitals, many private platform based internet medical enterprises are still struggling to find profit models.

Despite the explosion of capital driven industry in 2014 and the false start of the 2015 policy, technology, capital and market drive, the whole industry is still in a dilemma.

During the outbreak of the new crown pneumonia, internet medical treatment has reduced the cross infection of patients and achieved the physical isolation of patients. Meanwhile, it has also broken the geographical restrictions of medical resources, and has provided enormous convenience for patients to seek medical treatment. It has become the second battleground for epidemic prevention. Under the impetus of regulatory authorities, many public hospitals have begun to concentrate on the layout of Internet hospitals, and public medical institutions have been making collective efforts to speed up the evolution of "touches".

There is no doubt that the entry of public hospitals with obvious advantages will break the original development pattern of interconnected medical care and will bring new competition to many private platform based Internet hospitals.

Evolution of public hospitals' access to network

At the policy level, the Internet health service has become the biggest signal.

In February 4th, the national health and Health Committee issued the notice on strengthening the information technology to prevent and control the epidemic of pneumonia caused by new coronavirus infection, and issued the notice of February 7th on the Internet consultation and consultation service in epidemic prevention and control, calling for the full play of the role of the Internet in the prevention and control of epidemic situation.

In February 23rd, Wuhan supported the "Internet +" medical service into the payment of medical insurance. In addition, Zhejiang, Tianjin, Jiangsu and Shanghai also included the Internet diagnosis and treatment into the scope of medical insurance payment. Before the outbreak, there were not many physical hospitals in the Internet hospitals.

In April 30th, the Guangzhou Municipal Medical Security Bureau issued the Circular of the Guangzhou Municipal Health Insurance Bureau, Guangzhou health and Health Committee, to do a good job in the notification of chronic diseases and Internet plus visits. In Guangzhou, chronic diseases can be prescribed for 3 months, not the past 1 months. Recently, the Guangzhou Municipal Health Insurance Bureau issued a notice that the long prescription dose of chronic diseases will continue to relax to 3 months, and the medical insurance payment channels for Internet referral will also be retained.

The Second Affiliated Hospital of Guangdong Medical University (hereinafter referred to as Guangzhou Medical second hospital) Internet hospital opened the free online consultation service of the Internet hospital fever clinic in January 27th. It was a hospital in Guangzhou for the online inquiry service earlier.

Lu Huijing, chief of information division of Guangyao second hospital, told the twenty-first Century economic report: "the document said," after the end of the new crown pneumonia epidemic, it began to be implemented. Although it is not clear when it will end, this document has given us a reassurance to these pilot units. " Lu Huijing also said that the trial run during the epidemic was "tearing away a hole and trying it out". It is expected that it will be rolled out after that.

Han Jianing, deputy chief physician of the Department of Cardiology, Guangzhou Medical second hospital, said that after the continuation of the prescription policy, doctors and patients would welcome "patients do not need to run more hospitals, and do not worry about failing to hang up." doctors can also reduce the pressure on the site. Online word consultation (Internet medical consultation service) is what we do in our spare time, which is also very convenient and will not delay many jobs. Make time.

It is understood that in the early stage of promoting internet medical services in many public hospitals, doctors participating in the platform consultation work will receive different degrees of subsidy.

During the epidemic period, the change of access to medical services accelerated the pace of public hospitals accessing the Internet hospitals. With the effective containment of the domestic epidemic situation, the slow disease prescriptions gradually returned from the Internet to the offline clinics.

Han Jianing has been involved in providing Internet inquiring service since last year. She felt that after May, the out-patient clinic has basically recovered to the usual rhythm, and the number of released sources will soon be hung up. Correspondingly, the number of online consultation visits has also decreased.

Lu Huijing introduced that the consultation volume of the Internet Hospital of Guangyi second hospital was several times higher than usual in the initial stage of the epidemic. At present, it is obviously less. On the one hand, the peak of the new crown pneumonia has passed since the initial stage of the epidemic; on the other hand, many elderly people, especially those with chronic diseases, are more accustomed to come to the hospital for on-site enquiries when the field clinic is restored. The second hospital of Guangyao is located in the core of Guangzhou Haizhuqu District. In the old urban area, there are more senior citizens in the urban area, and the number of outpatients has been restored to 7000 persons / days.

"Most of the people who like Internet inquiring are young people who do not bother to go to work on the Internet. But the retired elderly have no such time cost. They may not be familiar with the operation of smart phones. Another part of the elderly who are willing to use Internet inquiring is 80 or 90 years old. Because of the inconvenience of coming to hospitals, most of them are online counseling business assisted by their families and children."

In the Internet hospitals, there are still restrictions on the re visit and restriction of drugs. Han Jianing said that there are limited kinds of drugs that can be opened online. For example, some patients with chronic diseases have sleep disorders. When they prescribe drugs, they often need some sleeping pills at the same time, but sleeping drugs are psychotropic drugs and are not allowed to be opened in the Internet. The patients should be re examined and prescribed.

According to Lu Huijing, Guangzhou Medical second hospital is considering the appointment of inspection and nursing services into the scope of internet medical services.

"For example, some of the patients who have come back to the clinic, his indicators indicate that they need to do some checks to adjust the dosage accordingly, so that they can make an appointment online, and go to the clinic to check directly for the time." Lu Huijing said that such appointments are expected to be more popular among young people, but enteroscopy and gastroscopy also require on-site preparation and preparation. Nursing service is also an area where Lu Huijing believes that Internet health care can make a difference. "Some postoperative stoma care still needs professionals, and some specialist nurses in hospitals are actually very technical. Especially hospitals will send nurses to study and advance advanced technology professionally." If we can open the nursing appointment service in the Internet hospital, we can cooperate with the community hospital or play the specialty nurse's specialty. "The appointment of door-to-door nursing service can also be considered. If this piece can be straightened out, the home care in the future will not be a problem."

Lu Huijing also pointed out that all kinds of information registration system and appointment system in the epidemic prevention and control had unexpected effects on the extension of appointment registration and real name system. "Before we want to push the real name system, but many patients are not willing to cooperate. After the epidemic prevention and control war, everyone's acceptance has been improved and willing to cooperate." Lu Huijing said that during the epidemic period, the hospital asked for all the appointment registration, "this is not dare to think before, this period of time, we have a high degree of acceptance of appointment registration." Lu Huijing believes that these will lay a good foundation for the development of "credit seeking medical treatment" in the future. "Real name is the foundation of the credit system, plus the medical insurance system, and with the perfect credit system, the introduction of credit system in hospitals will not be far away from the real realization of" first pay after treatment ".

In January 11th of this year, as one of the first pilot provinces of the national medical insurance electronic voucher, Guangdong medical insurance electronic voucher was formally launched, and the province's on-line institutions exceeded 10000, covering 107 million of the insured users in the province, and the total amount of medical insurance accounts was over 300 thousand. As of the end of February, there were more than 500 designated hospitals and more than 3000 designated drugstores in Guangzhou to realize the electronic payment voucher payment service of medical insurance, and 3 million 600 thousand of the insured participants were activating the use of medical insurance vouchers. With the successive access of the Internet hospitals in major entities, more online medical insurance payment scenarios will be covered, and the "touch net" of public hospitals will be further accelerated.

What is the advantage of private Internet hospital platform?

The acceleration of public hospitals' Internet racetrack also aggravates the competition of traditional private internet medical platforms to a certain extent.

Doctors are the core resources of Internet hospitals, and public hospitals have natural advantages in this regard. Most doctors of platform Internet hospitals also come from public hospitals. When public hospitals have built Internet hospitals, the third party platform will produce more direct competition for doctors resources.

There are good doctors in grade 3 hospitals. Once the majority of public hospitals run Internet hospitals, the president does not want doctors to leave their own platforms. This is a challenge for the platform based Internet hospitals.

Duan Tao, former director of Shanghai First Maternal and Infant Health-Care Hospital and founder of the hospital in spring, had pointed out two aspects that might affect the construction of Internet hospitals in public hospitals.

First of all, there are many limitations in public hospitals. If the online inquiry fees are charged according to the medical insurance, it will be very cheap. According to the National Health Insurance Bureau's guidance on improving the "Internet +" medical service price and medical insurance payment policy, public medical institutions carry out the Internet referral service, which is provided by different levels of medical personnel, and all fees are charged according to the general outpatient inspection items. "The number of experts under the line is dozens of yuan, and the average number is ten yuan. In contrast, making Internet hospitals is not so cost-effective.

Secondly, if the public hospitals are Internet hospitals, a closed loop will be formed under the online and offline conditions, and the efficiency will be improved for the patients who have visited the hospital for a long time. But for the whole industry, or for patients to change a hospital, the efficiency is low. "For example, if you want to find a restaurant to eat, if every restaurant has APP, you may have to download dozens of APP to find what you like. But if the platform aggregates restaurants, it will be enough to open a APP, such as public comment. In this case, it is a waste for restaurants to build their own APP.

Insiders said that after the medical insurance payment was released to the internet medical service, the share of the third party platform could get the medical insurance payment was very small. If you want to get more shares, you must reduce the price and enhance the user experience. The competition means in the Internet field may be launched in the internet medical field in the future. But the needs of patients are at different levels. The platform may divide their services into two areas. One is to meet the above basic medical needs, to ensure the highest efficiency and the lowest cost. The other part is commercial health care, which has higher requirements for medical resources and hopes to have more choices. Platform based Internet hospitals complement this demand to become the most powerful competition point.

Differentiated service objects become the breakthrough point of platform Internet hospitals after the entry of public hospitals.

On the other hand, despite the rapid development of Internet healthcare in just a few months this year, further support for policies, more participation by public hospitals, and innovation models of enterprises, the industry is still at an early stage, and many links still need to be improved.

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