Digital Medical Consortiums Break the 'Connected but Not Integrated' Barrier to Advance a New Tiered Healthcare Delivery Model
As a key initiative for implementing the tiered diagnosis and treatment system in China, the development of medical consortiums is being accelerated. On April 13, the National Health Commission held a special press conference on expanding high-quality medical resources, promoting their decentralization, and achieving balanced regional distribution. The conference introduced the tightly integrated urban medical group as a model for building urban medical consortiums and announced the ongoing selection of pilot cities across China.
In accordance with the “Work Plan for Pilot Construction of Close-knit Urban Medical Consortia” issued by six departments, including the National Health Commission, 2–3 prefecture-level cities (or districts in municipalities directly under the Central Government) will be selected in each province to integrate regional medical resources, implement a scientifically rational and grid-based layout of close-knit urban medical consortia, and advance supply-side structural reform of healthcare services.
In previous efforts to build medical consortiums, issues such as difficulties in resource integration, suboptimal two-way referrals, and challenges in information interoperability and sharing often led to a situation where entities were “connected but not integrated.” Innovative practices of digital-based medical consortiums have offered new solutions to these problems. Meanwhile, in pursuit of the long-term goal of establishing an integrated healthcare service system, the high growth potential of digital medical consortiums provides a robust platform and effective leverage for achieving various objectives in a phased manner.
In Ningxia, China’s first “Internet + Healthcare” demonstration zone, digital healthcare has seen significant development. Not long ago, the Department of Cardiology at Shizuishan No. 2 People’s Hospital treated a hypertensive patient whose blood pressure remained poorly controlled despite antihypertensive medication. To help identify the underlying cause, the hospital leveraged its partnership with WeDoctor’s “National Physician Collaboration Network” to consult specialists from Peking Union Medical College Hospital. A new treatment plan was formulated through a joint outpatient consultation involving physicians at both primary and tertiary levels. Following the new regimen locally, the patient achieved good blood pressure control.
It is reported that the hospital can connect with thousands of top specialists from Grade A tertiary hospitals across China via the WeDoctor platform. Through joint outpatient consultations, specialists provide online guidance on treatment plans, which are then implemented locally by primary care physicians. This approach facilitates the expansion and decentralization of high-quality medical resources, enabling local residents to access premium healthcare services nationwide without leaving their homes.
This is one illustration of how the development of digital healthcare promotes the construction of China’s tiered diagnosis and treatment system. Leveraging medical consortia as vehicles, digital hospitals lead or participate in the establishment and operation of urban medical consortia, county-level medical communities, cross-regional specialty alliances, and telemedicine collaboration networks. This approach effectively facilitates the expansion and downward distribution of high-quality medical resources, promotes balanced regional allocation, enhances the service capacity of primary healthcare institutions, and ensures that patients are truly “retained” at the primary level while grassroots facilities are fully capable of “managing” their care.
As a globally leading digital health platform, WeDoctor leverages its network of digital hospitals established across China to pioneer and implement digital medical consortia. Under the guidance of relevant government authorities, WeDoctor deeply engages in the construction and operation of regional close-knit medical consortia, utilizing digital solutions to address the persistent challenge of “connected yet unintegrated” operations within current consortia. By deeply integrating online and offline medical resources, WeDoctor delivers value-based healthcare services to local residents that span multiple scenarios, support diverse payment methods (including basic medical insurance, commercial insurance, and out-of-pocket payments), and encompass supply chain solutions.
“Digital Hospital” is an innovative healthcare service entity that integrates a digital platform with medical service capabilities. Driven by a robust digital infrastructure, it possesses health insurance accreditation and the ability to export standardized clinical pathways, enabling the creation of a “cloud platform” that achieves full interconnectivity among medical care, pharmaceutical, and health insurance data. Industry analysts note that the close-knit digital medical consortium led by digital hospitals introduces new technological and model-based advancements to regional medical and public health service systems. Its advantageous characteristics—“integrating medical care, pharmaceuticals, and health insurance; strengthening primary care; and safeguarding public health”—will significantly accelerate the realization of the goal to build a resilient, high-quality, and efficient integrated medical and public health service system.
Integrating vertical healthcare service resources by establishing a tiered diagnosis and treatment system to build an integrated or unified healthcare service delivery system, thereby maximizing the cost-effectiveness of medical resource utilization, is a common practice in most countries worldwide. Recently, the General Office of the Communist Party of China Central Committee and the General Office of the State Council issued the "Opinions on Further Improving the Healthcare Service System" (hereinafter referred to as the "Opinions"), which sets the goal of forming an integrated healthcare service system by 2035. This will be achieved by accelerating the development of urban medical consortia and county-level medical communities to promote system integration. For the first time, the document explicitly states that "socially operated medical institutions are supported to take the lead in forming or participating in medical consortia."
At this year’s Two Sessions, NPC Deputy Lei Dongzhu highlighted the widespread challenges in the construction and operation of close-knit medical consortia. These include difficulties in resource integration due to multi-level administrative affiliations among member institutions; low recognition of primary-care hospitals’ capabilities, leading to a unidirectional flow in two-way referrals characterized by “easy upward referrals but difficult downward referrals”; and bottlenecks in processes caused by inconsistent medical insurance payment policies and inadequate informatization. These issues have hindered the effective implementation of tiered diagnosis and treatment.
The issuance of the “Opinions” has charted a clear course for the development of closely integrated medical consortia, while also providing policy support for digital health pioneers such as WeDoctor to participate more extensively in the construction of urban medical consortia across various regions, thereby facilitating the full realization of the potential of innovative digital medical consortium models in China.
To address the current “bottlenecks” and “pain points” in the construction of medical consortia, the Digital Medical Consortium employs a “three-pronged strategy” to systematically resolve these issues, achieving seamless integration of processes, services, data, and management, thereby establishing an integrated service model. First, the Digital Medical Consortium has obtained health insurance certification by ensuring equivalent quality and higher efficiency (i.e., homogeneous service quality and enhanced effectiveness), thus removing key “obstacles” to online-offline integrated services from the health insurance perspective. Second, it outputs standardized diagnosis and treatment protocols and leverages technologies such as artificial intelligence to empower rapid capability enhancement at primary healthcare institutions, thereby reinforcing the “downward deployment” of resources. Third, leveraging digital hospitals as pivotal nodes, it progressively covers regional digitalization across multiple levels, building a unified “cloud platform” for data, services, and management within the medical consortium, thereby establishing connectivity and sharing from the information technology perspective.
A digital medical consortium, built on a digital foundation, can achieve a full-process closed loop for online and offline services, facilitate the seamless vertical flow of medical resources, and rapidly establish standardized diagnosis and treatment protocols. This further enables the integration of public health, disease control and prevention, medical services, and health management, driving the transformation of medical consortia toward a mechanism that integrates medical care with prevention. It also creates a mature environment for reforms in health insurance payment methods, such as “pay-for-performance” and “capitation.”
Taking Tianjin’s urban medical consortium as an example, under the guidance of the Tianjin Municipal Health Commission and the Tianjin Municipal Healthcare Security Administration, Digital Hospital (Tianjin Weiyi Internet Hospital) has taken the lead in establishing a tightly integrated digital medical consortium covering 266 primary healthcare institutions across the city—the Tianjin Primary Digital Health Community. By leveraging an integrated “Four Clouds” platform—comprising Cloud Management, Cloud Services, Cloud Pharmacy, and Cloud Diagnostics—it has connected a unified medical and public health service system to provide residents with comprehensive online-and-offline healthcare services throughout the entire care journey. Furthermore, using chronic disease management as an entry point, it has innovatively explored and constructed a value-based healthcare service system featuring “payment for performance.”
Furthermore, the medical consortiums led by digital hospitals have demonstrated sustained capabilities in technological upgrading and model innovation. Bolstered by favorable policies and the deepening of digital “hyperlinks” across the healthcare value chain, it is anticipated that digital medical consortiums will accelerate their transition from regional pilot models to nationwide industrial opportunities. Leading pioneers such as WeDoctor will thereby gain greater scope for innovation and value creation, playing an increasingly significant role in China’s efforts to build an integrated healthcare delivery system.