Yinchuan Internet + Healthcare Association Issues New Rules: No Promotional Content Allowed on Medication Display Pages of Internet Hospitals' Convenient Clinics

VCBeat (WeChat ID: vcbeat) has learned from the official WeChat account of the Yinchuan Internet + Medical Health Association that, in order to regulate conduct within the internet + medical health industry regarding online pharmaceutical services and ensure a baseline of safety, the Yinchuan Internet + Medical Health Association recently issued the “Implementation Standards for Convenient Outpatient Services in Internet Hospitals.” This initiative, built upon the “Self-Discipline Convention on Standardized Pharmaceutical Management and Services Provided by Internet Hospitals,” calls for industry self-regulation.

Since its inception, the Yinchuan Internet + Medical Health Association has issued industry initiatives, calling on the sector to “refrain from adopting medical advertising models that harm patients’ interests and to avoid engaging in business activities suspected of involving pharmaceutical kickbacks.” On December 13, 2018, the Association formulated China’s first “Convention on Privacy Protection for Internet Medical Services.” On February 19, 2019, it released the “Self-Discipline Convention on Standardized Pharmaceutical Care Management and Services Provided by Internet Hospitals” and organized all member units to sign it. The current implementation guidelines for convenient outpatient clinics mark the fourth initiative undertaken by the Association since its establishment to strengthen industry self-discipline.

The specifications primarily include the following key points:

1. Consultation Scenarios in the Convenient Outpatient Clinic of Internet Hospitals,This includes both the online consultation scenarios on internet hospital websites or client apps, and the "pharmacy-clinic" scenarios where patients consult and purchase medications at pharmaceutical e-commerce platforms or offline pharmacies.。

2. Internet HospitalIt is prohibited to use technical means to generate virtual consultation processes in the name of a physician and subsequently issue prescriptions.。

3. Prescription verification must be conducted in person by a licensed pharmacist.Prescription reviews shall not be conducted under the name of a pharmacist through technical means, to prevent such reviews from becoming a mere formality.。

4. Medication Display Page in the Convenience Clinic of the Internet Hospital,No drug promotional information or promotional display formats shall be presented., such as “Original Price ** Yuan/Anniversary Sale Price ** Yuan,” “Buy * Get * Free,” and “** Treatment Sessions Complimentary.”

To further advance the role of “Internet + Healthcare” in providing convenient and beneficial services to the public, continuously improve the medical service quality of internet hospitals, and steadily enhance patients’ sense of gain and well-being when seeking care at internet hospitals, the Yinchuan Internet + Healthcare Association hereby proposes the following implementation standards for the convenient outpatient services (also referred to as “convenience clinics” or “prescription renewal clinics,” hereinafter collectively referred to as such) provided by its member units:

(1) The Convenient Outpatient Clinic of the Internet Hospital is a service offered through internet hospitals. It does not constitute a full-fledged internet outpatient consultation; rather, it primarily addresses the prescription renewal needs of patients with chronic or common diseases whose conditions are stable.

(II) The convenient outpatient services of internet hospitals are limited to patients with chronic or common diseases who have already been diagnosed at physical medical institutions, have stable conditions, and do not require adjustments to their treatment plans. They do not accept first-time visitors or patients with unstable conditions.

(3) The convenient outpatient clinics of internet hospitals may only provide follow-up consultations. If a physician determines during the consultation that the patient does not meet the criteria for a follow-up visit, the encounter must be treated as an initial consultation, and no prescription shall be issued.

(4) The consultation scenarios for the convenient outpatient clinics of internet hospitals include both online consultations via the internet hospital’s website or mobile app, and the “pharmacy-clinic” model where patients consult and purchase medications through pharmaceutical e-commerce platforms or offline pharmacies.

It mainly includes the following stages

(1) Initiating a Consultation: After a patient initiates a consultation at the convenient outpatient clinic of an internet hospital, the physician must perform a clear action to accept the consultation. The consultation at the convenient outpatient clinic of the internet hospital must be conducted prior to issuing a prescription.

(2) Patients shall submit prior prescriptions (including electronic prescriptions) or medical records related to their own conditions, including consultation forms containing information such as patient allergy history and pregnancy history.

(3) For online patient consultations, there are channels for communication between patients and the attending physicians.

(4) Physicians shall prescribe medications based on the patient’s condition.

(5) Pharmacists review prescriptions, and the pharmacy dispenses medications.

(1) Physicians providing services at the convenient outpatient clinics of internet hospitals must conduct genuine consultations and remain truly online, and they shall be held accountable for their clinical activities. Internet hospitals are prohibited from using technological means to generate virtual consultation records under a physician’s name for the purpose of issuing prescriptions.

(II) Physicians providing services through internet-based convenient outpatient clinics shall have a thorough and accurate understanding of patients’ medical records, including but not limited to:

1. Basic patient information, such as age and sex; when necessary, additional data including height, weight, and body surface area should also be provided;

2. The patient's diagnosis or relevant medical record information from a physical medical institution;

3. Inquire about the patient's past medical history, allergy history, and pregnancy history;

4. Inquire about the patient's recent necessary test and laboratory results, including but not limited to liver and kidney function.

(3) Physicians at the convenient outpatient clinics of internet hospitals, after reviewing the aforementioned information and conducting necessary consultations, may issue online prescriptions for identical diagnoses and shall be held accountable for such prescribing actions.

(4) Physicians practicing in the convenient outpatient clinics of internet hospitals shall ensure that prescriptions are written in a standardized manner, with reasonable drug administration methods, dosages, treatment durations, and combinations. They shall not prescribe narcotic drugs, psychotropic substances, injectables, or other medications associated with higher risks or subject to special national regulatory requirements.

(5) In accordance with the national "Measures for the Administration of Internet Diagnosis and Treatment (Trial)", when prescribing medications for young children (under 6 years of age) through internet-based convenient outpatient services, it shall be confirmed that the pediatric patient is accompanied by a guardian and a qualified physician in the relevant specialty.

(6) It is recommended that the dosage prescribed by convenience clinics of internet hospitals shall, in principle, not exceed a one-month supply. For medications used in the management of chronic diseases, physicians may appropriately extend the prescription duration in accordance with relevant national regulations; however, long-term prescriptions are prohibited for antibiotics and high-risk medications.

(7) Physicians staffing the convenient outpatient clinics of internet hospitals shall, in principle, not be responsible for interpreting patients’ prior laboratory and diagnostic test results. In cases where there are clinically significant changes in test indicators, physicians shall refrain from prescribing medications and should, in accordance with medical principles, advise patients to consult with specialists at the internet hospital or seek care at a brick-and-mortar healthcare facility.

(1) Pharmacists reviewing prescriptions from the convenient outpatient clinic of an internet hospital must be registered with the internet hospital. Prescription reviews must be conducted in person by qualified pharmacists; it is prohibited to use technical means to conduct reviews under a pharmacist’s name, thereby preventing the prescription review process from becoming a mere formality.

(II) Pharmacists reviewing prescriptions from the convenient outpatient clinics of internet hospitals shall conduct authentic prescription reviews. The review content includes: prescription format items, disease diagnosis, indications and contraindications, drug dosage and administration, drug interactions, and medication use in special populations, and they shall be accountable for the review results. For prescriptions that fail the review, pharmacists shall promptly contact the patient or physician to modify the prescription.

(3) The prescription system of internet hospitals shall include a corresponding “List of High-Alert Medications.” For medications on this list prescribed by physicians in convenience outpatient clinics, pharmacists must establish direct contact with patients via telephone or other means after completing the prescription review, to ensure that patients fully understand the proper usage and dosage, thereby guaranteeing medication safety. (See the List of High-Alert Medications in the Appendix.)

(4) Prescriptions issued by the convenient outpatient clinic of an internet hospital shall display a distinct identifier, such as "**Internet Hospital Convenient Outpatient Clinic Prescription".

(5) The drug display page in the convenient outpatient clinic of internet hospitals shall not contain any drug promotional information or promotional display formats, such as “Original Price ** Yuan/Anniversary Sale Price ** Yuan,” “Buy * Get * Free,” or “Free ** Courses of Treatment.”

(6) The convenient outpatient clinic of the internet hospital shall establish corresponding duty telephone numbers or online communication channels, enabling patients to immediately contact the internet hospital in case of medication-related issues or adverse reactions.

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