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. 2021 Jul 20;23(7):e22330.
doi: 10.2196/22330.

Policy Interventions, Development Trends, and Service Innovations of Internet Hospitals in China: Documentary Analysis and Qualitative Interview Study

Yunfeng Lai #  1 , Shengqi Chen #  1 , Meng Li  1 , Carolina Oi Lam Ung  1 , Hao Hu  1
Affiliations

Policy Interventions, Development Trends, and Service Innovations of Internet Hospitals in China: Documentary Analysis and Qualitative Interview Study

Yunfeng Lai et al. J Med Internet Res. .

Abstract

Background: Internet hospitals have been encouraged by the Chinese government to develop an innovative medical service model that mainly uses new internet-based technologies to increase access to health care and improve the quality and efficiency of health care delivery. However, the academic exploration of the institutional and sectoral development of internet hospitals in China is scarce in the existing literature.

Objective: This study aimed to investigate the policy interventions, development trends, and service innovations of internet hospitals in China. It is expected that the findings from this study will contribute to the further innovation of internet hospitals in China and provide references for the international development of internet hospitals for personalized digital health and patient-centric services.

Methods: This study analyzed official policies related to internet hospitals that were implemented by the government in China since 2005. The data of formally approved internet hospitals were collected from official websites to analyze development trends. In-depth semistructured interviews were conducted with 58 key stakeholders who represented comprehensive viewpoints about the service innovations of internet hospitals between March and November 2019.

Results: In total, 25 policies that promoted the development of internet hospitals in China were identified. These policies encompassed informatization infrastructure construction, medical resource integration, development model design, service model design, and payment model design. Of the 268 internet hospitals that had received an official license from the government, 153 public internet hospitals had been built mainly by medical institutions. Public tertiary hospitals were the main actors in founding internet hospitals that were created to provide services that targeted patients with common diseases or chronic diseases or patients living in remote and rural areas. Promoting convenient access to high-quality medical resources and saving patients' and their families' time were the key values of internet hospitals.

Conclusions: The policy interventions strongly promoted the development of internet hospitals in China. Public tertiary hospitals led the development of internet hospitals. However, internet hospitals in China have mainly played roles that are complementary to those of physical medical institutions. The service model of internet hospitals needs more distinguished innovations to provide personalized digital health and patient-centric services.

Keywords: China; digital health; health policy; internet hospital; medical service; public hospital.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
The main policy interventions in the history of internet hospitals in China. These policy interventions were created by the following 21 national ministries: the National Development and Reform Commission, the Ministry of Education, the Ministry of Science and Technology, the Ministry of Industry and Information Technology, the Ministry of Civil Affairs, the Ministry of Finance, the Ministry of Human Resources and Social Security, the Ministry of Natural Resources, the Ministry of Ecology and Environment, the Ministry of Housing and Urban-Rural Development, the Ministry of Commerce, the Ministry of Culture and Tourism, the NHC, The People's Bank of China, State Taxation Administration, the State Administration for Market Regulation, the General Administration of Sport of China, the China Banking and Insurance Regulatory Commission, the National Healthcare Security Administration, the NATCM, and the National Medical Products Administration. CFDA: China Food and Drug Administration; CPC: Communist Party of China; NATCM: National Administration of Traditional Chinese Medicine; NHC: National Health Commission; NHFPC: National Health and Family Planning Commission; NHSA: National Health Security Administration; OTC: over-the-counter; SC: State Council; SFDA: State Food and Drug Administration.
Figure 2
Figure 2
The evolution of policy options for internet hospitals in China. The numbers represent the number of policy documents. NATCM: National Administration of Traditional Chinese Medicine; NHC: National Health Commission; NHSA: National Healthcare Security Administration; NMPA: National Medical Products Administration; OTC: over-the-counter; SC: State Council.
Figure 3
Figure 3
The geographical distribution of internet hospitals in China.
Figure 4
Figure 4
Approval of internet hospitals in China. No internet hospitals that were founded by companies were approved between January 1, 2020, and April 15, 2020.
Figure 5
Figure 5
Proportions of internet hospital types. A: The proportions of internet hospitals developed by medical institutions and companies. B: The proportions of public internet hospitals and private internet hospitals. C: The proportions of internet hospitals established by different levels of medical institutions.
See this image and copyright information in PMC

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