“Queue for three hours. See a doctor for three minutes.” This Chinese internet quote encapsulates some of the difficulties involved in accessing healthcare services. But in reality, in China, the situation can be even more challenging.
For Wang, a 71-year old widower living alone in Wuzhen, a small rural town in eastern China’s Zhejiang province, it actually takes over five hours to meet a doctor given the time too spent commuting between his home and the hospital.
Worse still, he has to do it every day; as a long-term diabetes patient, Wang has no choice. Literally, he spends nearly half of his time awake on accessing healthcare services.
Wang is just one of the hundreds of millions of rural residents in China who find it difficult – very difficult – to access basic healthcare services. While 80% of the country’s population live in under-developed rural areas, they share only 20% of healthcare resources available across the nation, according to the World Bank.
Such an uneven distribution of medical resources remains one of the biggest challenges to Beijing’s push to improve its healthcare system. It accentuates other structural problems such as insufficient healthcare research and development, weak private-hospital penetration and low-quality healthcare services.
As the world delves deeper into the digital era, healthcare startups are using new technologies to tackle that imbalance and disrupt the way healthcare services are distributed across the world’s most populous country.
WeDoctor is at the forefront of this wave of disruption.
“We are determined to use technology to improve the efficiency of China’s healthcare system,” said Jerry Liao Jieyuan, founder and chairman of WeDoctor, an eight-year-old healthcare solutions provider and the operator of China’s first internet-based hospital.
WeDoctor was founded in 2010 under the name of Guahao – ‘registration’ in Chinese. Clearly, Liao saw the opportunity to resolve the common practice of onsite registration by allowing patients to book their appointments online, thereby saving hours of queuing for every patient.
However, online registration involves more than just setting up a platform as there was initially no incentive for hospitals and clinics to share their registration quotas with third-party healthcare platforms. Aside from the related data-privacy issues, they also risked losing their patients since the platform could redirect them to other healthcare organisations.
According to Liao, he spent six months persuading the director of Huashan Hospital, a top-tier hospital group based in Shanghai, to offer 5% of its quotas to the platform. By sharing its database with WeDoctor, the hospital was able to reduce its overall queue time and arrange check-ups more efficiently.
The partnership showcased how hospitals can benefit from better management of their patients, spurring more than 260 hospitals to sign up as WeDoctor partners over the following year.
Since then, WeDoctor has expanded nationwide connecting to more than 2,700 hospitals and 240,000 doctors in 30 provinces across China. The platform covers over 40% of China’s top-tier triple-A hospitals.
WeDoctor is now China's largest private healthcare platform with an estimated market value of $5.5 billion. The firm, which raised $500 million from AIA and New World Development in May, counts Tencent, Hillhouse Capital and Goldman Sachs among its shareholders.
Apart from registration, the process behind follow-up consultations and prescriptions can also be streamlined with the help of technology, Liao told FinanceAsia.
“Many patients do not need to return to the hospital for follow-up consultation and this can be replaced by remote video conferencing,” Liao said. “Similarly, artificial intelligence could help analyse physical condition and write prescriptions based on a patient’s doctor review.”
In 2015, WeDoctor started China’s first internet-based hospital in Wuzhen to provide follow-up consultation and prescription services. Without serving any first-time patient, the hospital operates by offering services to returning patients redirected from WeDoctor’s network hospitals.
Wuzhen Internet Hospital serves around 60,000 patients per day and is now China’s largest hospital by daily patient count.
Liao believes online consultation can effectively ease the pressure on overcrowded hospitals by handling half of China’s patients in the future, leaving around 35% for general hospitals and 15% for top-tier hospitals.
IMBALANCE IN MEDICAL QUALIFICATIONS
Another problem within China’s medical system (and one WeDoctor indirectly hopes to address) is the huge disparity of qualifications.
According to the Organisation for Economic Co-operation and Development, nearly half of China’s doctors do not have an undergraduate degree. Understandably, most of the well-trained doctors work in first-tier cities and many rural doctors have less experience and education.
Such an imbalance in medical qualifications implies that rural people do not receive the best diagnosis and treatment even when they can access a doctor.
As part of China’s medical reform, Beijing has attempted to incentivise high-quality doctors to work in less developed areas, but the results have been insignificant and many doctors have turned away due to the poor working conditions and increased workload.
In order to raise the overall healthcare standard for rural residents, China plans to establish a three-tier healthcare system by 2020, according to which patients will be organised based on the characteristics of their illness – a sort of triage system.
According to these guidelines, all patients will be assigned to a primary hospital consisting of small and outpatient clinics. Patients with more serious illnesses will be directed to mid-tier hospitals while those requiring specialist care will be assigned to top-tier hospitals.
WeDoctor plays an important role in the process by helping patients match the relevant doctors based on their medical records and test reports. As a result, rural residents can increasingly also enjoy quality healthcare services that they could not typically access.
MEDICAL DATA SHARING
As it stands, information sharing and data management are the key to the success of the new healthcare system.
“The success of China’s medical reform hinges on an effective system to share information and data,” Liao told FinanceAsia. “It involves the sharing of data between a huge network hospitals and patients, drug manufacturers, insurance companies, payment companies and so on.”
To this end, China’s State Council unveiled guidelines in April on the sharing of data on third-party healthcare platforms and encouraged hospitals to provide online diagnostic services for some common and chronic diseases. It was the first time Beijing recognised the importance of using internet and technology in the provision of public health services – a scheme officially known as Internet Plus Healthcare.
As China’s leading healthcare platform, Liao believes WeDoctor is tasked with innovating new products and services through technology and leading the government in terms of regulation.
“When we set up Wuzhen Internet Hospital, the government has no idea about it because an internet-based hospital never exists,” Liao told FinanceAsia. “But now [the Wuzhen hospital] is an official reference for other internet-based hospitals.”
As with many new industries, the government tries to clamp down on some of them because it finds it hard to regulate. To this end, WeDoctor has been working closely with the Chinese government to educate officials about the technological breakthroughs it has innovated and the benefits they can bring to the entire healthcare system.
Liao believes WeDoctor could act as a role model in other areas of technological innovations in the healthcare industry.
“We are happy that the government has recognised online consultation as we have been working hard on this area,” Liao said.
“When the government supports your work, you get more incentive to work on new innovations. That is certainly good for the sector as a whole.”