Policy-Backed, Tencent-Supported Electronic Health Card Platform Achieves 100% Coverage in Tertiary Hospitals Across Six Provinces and Submits IPO Prospectus

Thick water vapor hovered over the Xiang River as representatives from 27 provinces and municipalities gathered in Changsha this autumn and winter to jointly explore the development and application of China’s national electronic health card.

Medical cards serve as essential credentials for patients seeking care at hospitals, storing their complete medical histories. However, significant incompatibility persists among the various medical cards issued by different hospitals, creating substantial barriers to patient information exchange and mutual recognition. Although a small number of cities have implemented unified medical card systems, they have not abolished individual hospital-specific cards, resulting in patients holding multiple medical cards.

In light of this, on December 21, 2018, the National Health Commission issued the “Opinions on Accelerating the Promotion and Application of Electronic Health Cards” (hereinafter referred to as the “Opinions”), proposing the establishment of a nationally unified electronic health card. This initiative aims to enable residents to access cross-institutional and cross-regional health services through a single card and receive medical care under their real names, thereby helping to resolve issues such as “one card per hospital, redundant card issuance, and lack of interoperability” among medical institutions across different regions.

On November 25, Changsha hosted the National Exchange Meeting on the Development and Application of Electronic Health Cards, aiming to help regional health authorities and medical institutions clarify their strategies for electronic health card implementation and deepen the “Internet + Healthcare” initiatives for public convenience and benefit.

In fact, the national rollout of electronic health cards began as early as seven years ago.

In February 2012, the former Ministry of Health issued the Administrative Measures for the Lifecycle of Resident Health Cards, promoting the implementation of a “one-card-for-all” system for residents seeking medical care at healthcare institutions of all levels and types. Jinzhou City was designated as one of the first cities to issue Resident Health Cards. In May of the same year, ten provinces and municipalities directly under the central government, including Hebei, Heilongjiang, Shanghai, and Jiangsu, were selected as the second batch of pilot regions for the development of the Resident Health Card system.

At the end of 2016, the state officially launched pilot programs for the application of electronic health cards. Adopting national standard QR code technology and Chinese commercial cryptography algorithms, the electronic health card generates a unique, nationwide universal electronic health QR code for each resident. This supports the healthcare industry’s reform and development needs, including health connectivity services, system interoperability, and data sharing. With a single card, patients can access medical services across different hospitals and regions.

The Electronic Health Card is a medical information card that records residents' healthcare data from birth to death. It supports "compatible use" and "linked registration" with various resident healthcare service media, such as hospital visit cards, maternal and child health care cards, planned immunization cards, as well as identity cards, social security cards, and bank-hospital co-branded cards.

In September 2017, the National Electronic Health Card was first issued in Jiangsu Province, officially entering residents’ lives.

On the first anniversary of its launch, the General Office of the National Health Commission officially issued the “Opinions on Accelerating the Promotion and Application of Electronic Health Cards.” This has elevated the electronic health card to a new level.

On May 8, 2019, the Report on Promoting the Development of “Internet + Healthcare” released by the National Health Commission showed that electronic health card pilots had been launched in 28 provinces across China, and 161 prefecture-level cities had implemented a unified medical visit card for regional healthcare institutions.

According to statistics from the Statistical Information Center of the National Health Commission, as of October 31, 2019, a total of 11 provinces and municipalities—Hebei, Guangdong, Fujian, Chongqing, Zhejiang, Jilin, Beijing, Hunan, Gansu, and Shaanxi—had issued more than 10 million electronic health cards. Among them, Jilin, Chongqing, and Fujian ranked top three in terms of issuance coverage among their permanent residents, with rates of 99%, 98%, and 95%, respectively.

Among the 44 hospitals under the administration of the National Health Commission, 17 have already enabled acceptance of the Electronic Health Card, while 7 are undergoing system upgrades. Provinces such as Jilin, Hunan, Sichuan, and Guangdong have basically completed the construction of acceptance environments for these nationally administered hospitals within their respective jurisdictions.

Electronic Health Cards Are Becoming the Prevailing Trend, with Regions Accelerating the Upgrade of Healthcare Institutions’ Acceptance InfrastructureTianjin, Inner Mongolia, Jilin, Hunan, Gansu, and Qinghai have taken the lead in this initiative, achieving 100% coverage of Electronic Health Card acceptance at all tertiary hospitals within their respective regions.

Additionally, as of the end of October 2019, a total of 60 electronic health card registration and management platforms had been built and deployed across various regions, with 58 of them already operational. Among the operational platforms, 40 have achieved direct system connectivity with the national-level platform.

The future is bright, but the path is tortuous. The development of new things always undergoes a process from imperfection to perfection. The same holds true for electronic health cards.

Currently, the development of electronic health cards faces numerous challenges. Tang Xuejun, a researcher at the Statistical Information Center of the National Health Commission, believes that there are three main issues in the current development of electronic health cards. First, some medical institutions still have an unclear understanding of the functional positioning of electronic health cards; second, the application of convenient and beneficial services for electronic health cards needs to be expanded and standardized; third, the quality of data connectivity work in the electronic health card management system needs improvement.

In response to the aforementioned issues, Tang Xuejun also put forward several work recommendations. Tang Xuejun suggested that all provinces and municipalities directly under the Central Government should strive to achieve full coverage of electronic health card application construction in provincial capital cities and cities with independent planning status by the end of 2019, with a coverage rate of at least 60% in prefecture-level cities. Under the premise of ensuring security, efforts should be made to strengthen “headquarters-to-headquarters” docking cooperation with major mobile internet application channels.

In addition, each province and municipality directly under the Central Government should integrate with the construction and promotion of electronic health cards in their respective regions, and strive to prioritize the completion of the application environment for acceptance at hospitals administered by the National Health Commission as well as provincial and municipal people’s hospitals by the end of 2019, thereby playing a demonstrative role in driving broader adoption.

Third, all provinces and municipalities directly under the Central Government must prioritize efforts in standardizing the application and business processes of electronic health cards for public convenience and benefit, integrating these initiatives with internet-based medical and health services and the open sharing and application of health and medical data. The national government shall conduct comprehensive evaluations of the application levels of electronic health cards across provinces and municipalities at appropriate times and publish evaluation reports. It will strengthen card-usage monitoring, accelerate the modification and integration of mobile internet applications in medical and health institutions to support electronic health cards, enhance security monitoring and management of mobile medical service software applications (such as apps, official accounts, and lifestyle accounts), and improve technical capabilities for preventing and controlling security risks.

In addition, all regions should strengthen benchmarking efforts related to the development of electronic health cards, strictly adhering to the specifications outlined in the Guidelines for the Construction and Management of Electronic Health Cards, to ensure data interoperability with the national card management platform.

On January 21, 2019, the Statistical Information Center of the National Health Commission entered into a strategic partnership with Tencent for innovative applications of the Electronic Health Card. Leveraging WeChat as the channel for distributing and promoting the use of Electronic Health Cards, and adhering to national standards and specifications, the initiative has been fully implemented across six provinces in China.

He Bo, General Manager of Tencent’s Healthcare Division, stated that as a cross-platform tool, WeChat now boasts over 1 billion users, covers 33 administrative regions, and hosts more than 30,000 healthcare-related official accounts. Additionally, over 2,000 public tertiary hospitals across China have established official accounts and service accounts on WeChat, underscoring the platform’s significant influence.

“Open Connectivity, Application-Driven Development” is the development strategy for WeChat Electronic Health Cards.

How to Leverage the Open Linking Capabilities of WeChat and Electronic Health Cards? He Bo explained that the WeChat platform serves as a “connector,” linking individuals with healthcare institutions by leveraging Tencent’s social networking capabilities. Patients can achieve one-click registration for cross-regional medical consultations using their WeChat user IDs. Furthermore, WeChat acts as a “targeting lens,” enabling precise services for pregnant women, children, patients with chronic diseases, and oncology patients. It facilitates comprehensive offerings such as medical consultation, precise appointment scheduling, chronic disease management, health assessments, and health education, while also promoting family-centered health management through social connections.

Only when residents truly “use” the electronic health card does its existence hold meaning. The WeChat Electronic Health Card comprehensive solution establishes a unified identity authentication system based on multi-dimensional identity verification capabilities, enabling “three-step registration, cross-hospital interoperability, shared health records, and integration of multiple codes.” It builds an “information superhighway” for healthcare informatization, allowing residents to “access services with a single code” and enjoy integrated online and offline medical services, such as one-stop healthcare solutions for cross-hospital care, childhood immunization programs, and maternal and child health services.

Furthermore, to facilitate the construction and upgrading of electronic health cards in a manner that is “extensive, efficient, high-quality, and cost-effective,” the WeChat Electronic Health Card Open Platform provides designated medical institutions in partner regions with free tools for self-service integration, capability invocation, joint project debugging, and payment launch guidance. These measures aim to accelerate the go-live process for over 2,000 hospital service accounts and offer free plugin tools to medical institutions, thereby reducing upgrade costs.

Notably, to address diverse scenarios, the WeChat Electronic Health Card comprehensive solution proposes seven innovative applications.

For end-users, patients can quickly register and seek medical care by creating health records via facial recognition. Using WeChat ID as the primary index prevents duplicate registration for both new and existing users. Patients can take photos of their examination reports, which are then converted into electronic documents through OCR technology for easy storage. Additionally, family health management is provided based on user profiling, covering services such as childhood vaccination, daily healthcare for pregnant and postpartum women, and blood pressure and blood glucose monitoring for the elderly.

For regulatory authorities and healthcare institutions, there are three innovative applications: convenient card usage based on regional card packages, blockchain-based data sharing, and smart management tools based on mini-programs.

2019 was destined to be an extraordinary year. During this period, Tencent Healthcare engaged in efficient collaborations with multiple provinces, significantly enhancing the coverage of electronic health cards. Currently, WeChat Electronic Health Cards are available in 16 partner provinces, connected to over 600 medical institutions, with more than 5 million active users and a cumulative total of 25 million uses.

Qinghai is the birthplace of the WeChat Electronic Health Card. He Bo introduced that currently, the number of cards issued through the WeChat channel has approached 1 million. Jilin Province completed card management system integration and hospital rollout within one week, with 3.6 million card usages via the WeChat channel, making it the province with the fastest deployment of the WeChat Electronic Health Card. Currently, all Grade-A tertiary hospitals in Jilin Province are fully covered.

Hunan is the first province where the number of hospitals launching WeChat electronic health cards exceeded 100, making it the province with the highest card usage activity. Data shows that the number of card usages via WeChat channels in Hunan has surpassed 7 million. In Shandong Province, the number of card usages via WeChat channels reached 6 million, with 66 hospitals going live, indicating steady progress.

In addition, Gansu Province, Hebei Province, Heilongjiang Province, Ningxia Hui Autonomous Region, and Shenzhen City in Guangdong Province are also actively advancing implementation.

Xiangya Hospital of Central South University is among the first hospitals in Hunan Province to support the use of electronic health cards. Zhong Weijun, Director of the Information and Statistics Center of the Hunan Provincial Health Commission, stated that preliminary research revealed that all public hospitals at the secondary level and above in Hunan Province have established official WeChat accounts or service accounts. “Leveraging the WeChat platform to build a unified system for standardized integration, Hunan has a strong foundation.”

Notably, Xiangya Hospital of Central South University took the lead in introducing a WeChat facial recognition medical service system across the province.

Hospitals implement real-name registration and consultation systems; however, some patients forget to bring their ID cards when seeking medical care. In the past, such cases required obtaining a temporary identity certificate from the local police station, which was cumbersome. Hu Jianzhong, Deputy Secretary of the Party Committee of Xiangya Hospital of Central South University, stated, “Since November, with the deployment of WeChat facial recognition devices for medical services, patients can smoothly receive medical care at the hospital without needing to carry their medical cards or ID cards.”

According to statistics from Xiangya Hospital, 453,000 patients have registered and used the electronic health card since its launch seven months ago. As the first hospital in China to implement WeChat’s “face-scanning for medical care” feature, Xiangya Hospital has deployed the initial batch of kiosks, which enable services such as appointment registration, payment, and report inquiries.

In September 2017, Anhui Provincial Hospital, as one of the first national pilot hospitals, issued the first electronic health card in Anhui Province. In March 2018, Anhui Provincial Hospital successfully passed the comprehensive acceptance review of the pilot project, laying a solid foundation for the full-scale application of electronic health cards.

"One Card, One Chain" is a key feature of the electronic health cards issued by Anhui Provincial Hospital.

Recently, Tencent, in collaboration with Anhui Provincial Hospital and its medical consortium, launched the “Electronic Health Card + Blockchain” solution for the first time in Anhui Province. This initiative pioneers the integration of blockchain technology with electronic health cards, facilitating secure and efficient cross-regional and cross-institutional sharing of patients’ medical and health information among pilot sites.

Decentralization is a major feature of blockchain technology. Tencent and Anhui Provincial Hospital have organized a regional node system in a decentralized manner, using the Electronic Health Card ID as the patient master index to connect administrative departments and medical institutions, thereby achieving secure and efficient interconnectivity of healthcare information.

Furthermore, the distributed storage architecture of blockchain enables hospitals to maintain full control over their data; the asymmetric encryption mechanism ensures that data remains confidential. With public-key encryption, only hospital nodes possessing the private key can decrypt the information, thereby safeguarding data transmission security. In addition, blockchain technology guarantees data immutability and end-to-end traceability.

The "Opinions" emphasize the full implementation of real-name registration for medical consultations and a unified card system for healthcare services, encouraging the use of electronic health cards as the access point for "Internet + Healthcare" services and the "Three-Medical Linkage." If an individual patient is regarded as the smallest unit, pharmaceuticals, medical insurance, and medical care form a triangular structure surrounding the patient. Only by integrating these three sectors can healthcare services be better delivered to patients.

Intuitively, the transition of electronic health cards from physical offline cards to electronic virtual cards is of great significance for promoting streamlined service processes, ensuring the security of online applications, and reducing card issuance and usage costs, thereby facilitating the widespread adoption of resident health cards. At the national level, once residents use electronic health cards, their health information will be centrally stored in data centers across various provinces and municipalities. This centralization supports national efforts in prioritizing poverty prediction, enabling precise identification of impoverished populations, and providing priority services and health monitoring.

The electronic health card is a key measure in implementing the “3521 Project.” The National Health Commission has proposed that, by 2020, China should achieve near-universal coverage and integrated sharing of databases for population information, electronic health records, and electronic medical records across the entire population, and promote the nationwide adoption and application of electronic health cards.

Currently, there is not much time left until 2020.