China's New Internet Healthcare Regulations Favor Serious Medical Platforms Like WeDoctor and Haodf
The long-awaited internet diagnosis and treatment regulatory policies have finally been implemented, imposing strict constraints on the previously unregulated industry. This marks a significant boon for the digital health sector, which remains steadfastly committed to delivering serious medical services!
On October 27, the National Health Commission released the “Detailed Rules for the Supervision of Internet-Based Diagnosis and Treatment (Draft for Comments)” (hereinafter referred to as the “Draft”), which sets forth detailed provisions on the supervision of medical institutions, personnel, business operations, quality and safety, and regulatory responsibilities, drawing significant attention from the industry.
In recent years, spurred by a series of favorable national policies, internet healthcare has flourished, giving rise to a diverse array of new business models. These include the digital health sector, represented by platforms such as WeDoctor and Haodf, which focuses on delivering serious medical services; the pharmaceutical e-commerce sector, offering online sales of health supplements, over-the-counter (OTC) medications, and prescription drugs; and the AI-driven consultation and light-touch diagnosis sector, providing basic health advisory services. While collectively driving the digital transformation of healthcare, these sectors are also exploring standardized norms for industry development.
Evidently, the crux of this Draft Opinion lies in clearly defining the previously ambiguous and conflated boundaries of internet healthcare, thoroughly dismantling the prior state of ambiguity among “medical services, pharmaceuticals, and technical services,” so that medical practice remains with medicine, pharmaceuticals with drugs, and technology with technical support. Evidently, the crux of this Draft OpinionIt lies in clearly defining the previously blurred and confused boundaries of internet healthcare, thoroughly breaking the previous ambiguous situation among “medical services, pharmaceuticals, and technology,” adhering to the principle that “medical services remain medical services, pharmaceuticals remain pharmaceuticals, and technology remains technology,” thereby returning internet healthcare to its essence of “serious medical care.” With this as a pivot point, from a deeper perspective, this undoubtedly holds significant importance for further promoting the long-term sustainable development of China’s internet healthcare, and even for establishing a “health-centered” health maintenance system through digitalization.
China’s development of internet-based healthcare is at the forefront globally, with its digital health industry ranking as the second largest in terms of investment scale, surpassed only by the United States. This achievement is closely tied to the country’s consistent policy encouragement and support.
As early as October 2016, the “Outline of the ‘Healthy China 2030’ Plan” explicitly proposed to “develop internet-based health services.” In April 2018, the “Guiding Opinions on Promoting the Development of ‘Internet Plus Healthcare’” called for accelerating the development of “Internet Plus Healthcare,” enabling patients to make fewer trips and enjoy greater convenience, while allowing more people to access high-quality medical services. Since then, a series of documents have been issued in rapid succession, providing relatively detailed regulations for internet healthcare and significantly promoting its rapid development.
The Draft Opinion upholds the state’s encouraging stance toward internet-based healthcare. Meanwhile, by strengthening regulatory oversight, it sends a new signal: online diagnosis and treatment services must achieve maximum “homogeneity” with those provided by physical medical institutions, thereby repositioning online diagnosis and treatment to focus on “delivering serious medical services.” This is primarily reflected in three aspects:
First, plug the online loophole of “using drug sales to subsidize medical services.”The Draft Opinion proposes to “prohibit practices such as ‘tongfang’ (aggregating prescription data for kickbacks) and ‘bufang’ (supplementing prescriptions),” stipulates that “the personal income of healthcare professionals shall not be linked to revenue from pharmaceuticals and medical tests,” and mandates the “separation” of internet-based diagnosis and treatment activities from drug sales. This aims to prevent online healthcare platforms from “distorting” clinical services into marketing tools for prescription drugs, curb the trend of “online drug selling,” and ensure that “medicines” serve their proper purpose as “medicines.”
Secondly, prevent the misuse of “AI technology.”The Draft Opinion explicitly states that “physicians must undergo real-name authentication prior to patient consultations to ensure that they personally conduct the consultations. Other personnel, artificial intelligence software, or similar entities are prohibited from impersonating or replacing physicians in conducting consultations.” This provision establishes regulatory boundaries for the application of AI technology in internet-based healthcare, restricting AI to physician-support functions such as triage and assisted diagnosis, rather than allowing it to replace human-led services, thereby ensuring that “technology” remains confined to its proper role as a tool.
Furthermore, we must eliminate the practice of passing off inferior products as genuine ones.The Draft Opinion imposes higher requirements on the digital capabilities of entities providing internet-based diagnosis and treatment services. For instance, it stipulates that “electronic prescriptions, prescription review records, and prescription evaluation records of medical institutions must be traceable, and data interfaces must be opened to provincial-level regulatory platforms,” and that “medical institutions shall have dedicated departments responsible for managing the medical quality, medical safety, pharmaceutical services, and information technology related to internet-based diagnosis and treatment, and establish corresponding management systems.” These provisions undoubtedly raise the overall entry barriers for the industry. Possession of appropriate internet healthcare infrastructure, along with relevant technical capabilities and operational management experience, will become essential prerequisites for compliant operations.
Data released by the National Health Commission shows that from 2015, when WeDoctor established China’s first internet hospital—the Wuzhen Internet Hospital—pioneering the new “Internet + Healthcare” model, to June 2021, the number of internet hospitals in China had exceeded 1,600, with approximately 500 newly added in the first half of 2021 alone.
Amid the vigorous development of the internet healthcare industry, various platforms have explored markedly different business models based on their underlying operational logic and commercial strategies. These include digital health platforms focused on “serious medical care,” pharmaceutical e-commerce platforms primarily engaged in online drug retail, and online consultation platforms specializing in lightweight medical inquiries.
In such an ecosystem, coupled with the pandemic-driven explosive growth of the industry over a short period, many platforms lacking necessary qualifications entered the market, sparking public controversy over internet-based healthcare. Prejudices such as “internet healthcare relies on drug sales” and “internet healthcare consists merely of lightweight consultations” have emerged one after another. Prior to the release of the Draft Opinion, Jiao Yahui, Director of the Bureau of Medical Administration and Hospital Management under the National Health Commission, remarked that internet-based healthcare is a double-edged sword: while it brings convenience to the public, it also harbors certain risks, primarily concerning qualifications and quality. Qualifications plus quality equal safety.
The timely release of the “Draft Guidelines” clearly takes into account the current irregularities in internet healthcare, such as ambiguous positioning, fragmentation, and even borderline practices. By regulating internet healthcare according to the standards of formal medical practice, it ensures service safety, raises industry entry barriers, and guarantees service quality, thereby returning internet healthcare to its essential nature as a medical service. This development has evidently ushered in a “spring” for major platforms in the digital healthcare sector.
Of course, to a large extent, this is also a consensus reached based on industry practices. In the digital healthcare sector, some pioneers have continuously expanded the value dimensions of internet-based medical services by providing professional and rigorous digital healthcare solutions to the public, thereby establishing a solid foundation for their value proposition.
Take WeDoctor, China’s largest digital healthcare service platform, as an example. Over the past few years, it has devoted substantial resources to building foundational infrastructure, establishing a comprehensive “network” of digital healthcare infrastructure. By developing robust systems for operations, management, services, and security technology, WeDoctor has achieved deep interoperability with medical institutions within its service regions, integrated high-quality medical service capabilities, gradually enabled health insurance payment integration, and begun empowering commercial health insurance. It is this decade-long accumulation of expertise that has enabled the company to provide users with professional, end-to-end medical care and health management services.
Since its inception in Wuzhen, WeDoctor has established 31 internet hospitals across China, 18 of which have integrated with the national medical insurance payment system. Furthermore, it has forged deep connections with more than 7,800 hospitals nationwide, covering over 95% of China’s Grade A tertiary hospitals. The platform boasts more than 280,000 registered physicians and over 240 million registered users. WeDoctor’s Internet Hospital is the first internet hospital platform in China to integrate with the medical insurance payment system and the first to launch city-level digital chronic disease management services covered by medical insurance. This model has been rapidly replicated and implemented in multiple cities, providing residents with services such as online follow-up consultations, chronic disease management, home delivery of medications, and online medical insurance payments.
The innovative practices of WeDoctor demonstrate the demand for and recognition of digital service platforms engaged in serious medical care, spanning from the government and the industry to the general public.
The previously issued policies and the “Draft Guidelines” have increasingly clarified the positioning of internet-based healthcare, thereby delineating with greater precision the state’s top-level design for healthcare reform and its strategic direction for industry guidance. Particularly in the current context, as the era of population aging arrives and public health demands continue to rise, the role of internet-based healthcare in facilitating the orderly flow of medical resources is becoming ever more prominent.
Recently, the Leading Group for Healthcare Reform of the State Council issued the “Implementation Opinions on Deepening the Promotion of Sanming’s Experience in Fujian Province and Furthering Healthcare System Reform,” which mentioned “medical consortia” 16 times. The development of medical consortia has become the central focus of China’s healthcare reform. Therefore, leveraging digital tools to drive the reform of tiered diagnosis and treatment represents a critical opportunity for internet healthcare to make a decisive turnaround and truly unlock its substantial value.
As a pioneer in digital healthcare reform, WeDoctor has charted a practical and viable path:Leveraging internet hospitals as hubs, establish an internet-based medical consortium to integrate medical insurance, commercial insurance, and supply chain systems. This will create a regional closed-loop healthcare system based on value-based payment, alleviating pressure on tertiary hospitals, enhancing the capabilities of primary care institutions, improving supply chain efficiency, and optimizing the performance of medical and commercial insurance payments, ultimately establishing a Chinese-style Accountable Care Organization (ACO).
For example, under the guidance of the Tianjin Municipal Health Commission, the Tianjin Primary Care Digital Health Consortium—a tightly integrated internet-based medical consortium led by Tianjin WeDoctor Internet Hospital in collaboration with 267 primary healthcare institutions—stands out as a highly representative model. Of breakthrough significance is its approach of using chronic disease management as an entry point to explore and implement payment methods such as “global bundled payments” and “disease-specific and capitation-based bundled payments” under medical insurance, thereby implementing a new health accountability system and driving the healthcare system’s transition from competing on “price differentials” to delivering “value differentials,” thus enhancing the overall efficiency of the healthcare service system.
At the 2021 National Conference on Promoting Experience in Deepening Healthcare Reform, Tianjin’s Primary Care Health Consortium was selected as one of the “Top Ten New Initiatives to Advance Healthcare Reform and Serve Public Health.” Zhan Jifu, the chief architect of the Sanming healthcare reform, once commented that the “Health Accountability System” established by Tianjin’s Primary Digital Health Consortium is highly aligned with the goals of Sanming Healthcare Reform 3.0, and its practical experience has demonstrated a strong exemplary effect, with noteworthy achievements.
The release of this Draft Opinion promotes the return of internet healthcare to its essence as “serious medical care,” while also opening up new possibilities for digital empowerment in the new round of healthcare reform. By leveraging digitalization to drive the coordinated development of medical services, health insurance, and pharmaceuticals (“Three-Medical Linkage”), it aims to genuinely enhance the accessibility, affordability, effectiveness, and transparency of healthcare services, thereby achieving the reform objectives of “alleviating pressure on large hospitals, strengthening the capabilities of primary-care institutions, improving payment efficiency, and enhancing the health indicators of the general public.”