Shandong to Build Prescription Transfer Platform and Promote 'Cloud Emergency Care' as Part of 2020 Internet+Healthcare Agenda

VCBeat (WeChat ID: vcbeat) has learned that, in order to implement the spirit of the “Opinions of the General Office of the State Council on Promoting the Development of ‘Internet + Healthcare’” (Guo Ban Fa [2018] No. 26) and accelerate the construction of a national demonstration province for “Internet + Healthcare,” Shandong Province recently formulated and issued the “Action Plan for Promoting the Construction of Shandong Province as a Demonstration Province for ‘Internet + Healthcare’ (2019–2020).”

The overall goal is that by 2020, significant progress will have been made in information sharing and business coordination across healthcare, pharmaceuticals, medical insurance, and health-related fields. New models and formats of healthcare services, driven by cloud computing, big data, the Internet of Things (IoT), mobile internet, and artificial intelligence technologies, will be thriving. A preliminary “Internet + Healthcare” service ecosystem covering the entire population and the full life cycle will take shape, with the construction of demonstration provinces for “Internet + Healthcare” leading the way nationwide.

"The Plan" mainly includes seven major tasks:

In terms of enhancing convenient medical services: In 2020, medical institutions at the secondary level and above widely launched internet-based diagnosis and treatment services, vigorously promoted service process reengineering based on emerging technologies, and steadily advanced innovative applications of electronic health cards. In 2020, medical institutions within medical consortia took the lead in achieving mutual recognition of examination and test results with a single order.

In terms of enhancing medical treatment capabilities: Promote the “Cloud Emergency” comprehensive treatment service and establish a telemedicine service system.

Optimizing Settlement and Payment Services: Advancing “Internet+” Medical Insurance Settlement Services and Promoting Direct Settlement for Cross-Regional Medical Care.

Strengthening Drug Supply Assurance: Establishing a Prescription Circulation Platform for Information Sharing Among Beijing, Tianjin, Hebei, Shandong, and Liaoning.

Strengthening Public Health Management: Open Access to Residents' Electronic Health Records and Promote Convenient, Effective Online Contracted Services.

Enriching Health Management Resources: Innovating “Internet+” Health Management Services and Establishing an Online Health Consultation Information Platform.

Promoting the Development and Application of Big Data in Healthcare: Accelerate the development of healthcare big data and vigorously advance artificial intelligence technologies in healthcare.

The seven major tasks are as follows:

1. Promote the development of “Internet + Healthcare Services.” Leverage the strengths of leading enterprises to build operational platforms for internet hospitals. Encourage the establishment of internet hospitals based on medical institutions, and support licensed physicians in providing “Internet + Healthcare” services. By 2020, medical institutions at Level II and above shall universally offer online diagnosis and treatment services. (Responsible department: Provincial Health Commission)

2. Optimize medical service processes. Vigorously promote the reengineering of service processes based on emerging technologies. By 2020, medical institutions at the secondary level and above generally provided online services such as time-slot appointment-based diagnosis and treatment, intelligent patient guidance and triage, waiting reminders, point-of-care settlement, mobile payment, and appointment for medical record copying. (Responsibility: Provincial Health Commission)

3. Steadily advance the innovative application of electronic health cards. Implement real-name appointment-based diagnosis and treatment, and promote the province-wide adoption of electronic health cards. By 2020, achieve “one-code access” for cross-regional and cross-institutional medical and health services, with real-name consultation rates reaching over 90% in tertiary hospitals and over 80% in secondary hospitals. (Responsible department: Provincial Health Commission)

4. Enable the viewing and sharing of examination and test results. Vigorously promote mutual recognition of examination and test results across hospitals (“One Report Accepted Everywhere”), and actively implement cloud-based digital imaging services (“Cloud Films”) for medical institutions based on the Provincial Universal Health Information Platform. By 2020, medical institutions within medical consortia will take the lead in achieving mutual recognition of examination and test results. (Responsible entity: Provincial Health Commission)

1. Promote the “Cloud Emergency” comprehensive treatment service. The 120 dispatch and command systems of all cities, counties (cities, districts) shall be uniformly integrated into the “Cloud Emergency” comprehensive treatment service system. By 2020, the six major centers for chest pain, stroke, trauma, critical maternal care, critical pediatric and neonatal care, and cancer were initially established, achieving integrated comprehensive treatment services for emergency patients. (Responsibility: Provincial Health Commission)

2. Establish a telemedicine service system. Build provincial- and municipal-level centers for remote consultation, pathology, and medical imaging. By 2019, telemedicine services shall cover all medical consortia and county-level hospitals across the province. By 2020, coverage shall extend to township health centers and community health service institutions, with efforts made to reach village clinics. (Responsible departments: Provincial Health Commission, Provincial Development and Reform Commission, Provincial Department of Finance, and Provincial Big Data Bureau; the department listed first is the lead department, as applies below.)

1. Advance “Internet+” medical insurance settlement services. Accelerate the integration and interoperability of medical insurance information systems, gradually expand online payment functionalities, and promote one-stop settlement. Establish service items and pricing for “Internet+” medical services (including telemedicine). Formulate medical insurance payment policies to gradually include eligible internet-based diagnosis and treatment services within the scope of medical insurance coverage. For basic medical services provided via the internet, implement standardized pricing in accordance with basic medical service price items; for special-needs medical services that meet personalized and high-level demands, adopt market-regulated pricing. (Responsibility: Provincial Healthcare Security Administration, Provincial Health Commission)

2. Promote direct settlement of medical expenses for cross-regional healthcare. Continue to expand the network of designated medical institutions, gradually include more primary healthcare facilities in the direct settlement system for cross-regional medical care, and further improve the direct settlement of hospitalization costs across provinces for migrant workers and individuals engaged in “mass entrepreneurship and innovation.” Vigorously implement intelligent auditing and real-time monitoring of medical insurance, shifting from post-event supervision to pre-event and in-process oversight by embedding rules such as clinical pathways, rational drug use, and payment policies into hospital information systems, thereby strictly regulating medical practices and expenditure. (Responsible entities: Provincial Healthcare Security Administration; Shandong Bureau of the China Banking and Insurance Regulatory Commission)

1. Establish a prescription circulation platform. Promote real-time data exchange, integration, and collaborative application among the provincial drug centralized procurement platform, the provincial population health information platform, healthcare institutions’ Hospital Information Systems (HIS), and the computer systems of designated retail pharmacies under medical insurance. Accelerate the development of drug traceability systems for drug manufacturers, distributors, and healthcare institutions. By 2020, basically achieve the goal of collaborative application under the “Three-Medical Linkage” framework (medical care, medical insurance, and pharmaceuticals). (The Provincial Health Commission, Provincial Medical Insurance Bureau, Provincial Drug Administration, and Provincial Public Resource Trading Center shall be responsible according to their respective duties.)

2. Information sharing among Beijing, Tianjin, Hebei, Shandong, and Liaoning. Collaboratively carry out business applications for multi-source data collection, supply monitoring, and usage monitoring of shortage drugs. By 2020, establish a monitoring and early warning system for shortage drugs, initiate the construction of a drug usage monitoring system in public hospitals, and strive to achieve information sharing on pharmaceutical and medical consumable procurement across the five provinces and municipalities. (The Provincial Health Commission, the Provincial Healthcare Security Administration, the Provincial Public Resource Trading Center, and the Provincial Medical Products Administration shall be responsible according to their respective duties.)

1. Open access to residents’ electronic health records (EHRs). Promote the interconnection and integration of the EHR database with electronic medical record (EMR) databases and public health information systems to comprehensively record and manage residents’ health information. By 2020, residents in county-level areas will be able to conveniently access their own EHR information. (Responsibility: Provincial Health Commission)

2. Promote convenient and effective online contract signing services. Enable family doctors to provide online health consultations, chronic disease follow-ups, health management, and extended prescription services to contracted residents. By 2020, secondary and tertiary hospitals shall reserve 20% of appointment slots for family doctors two days in advance, and establish green referral channels for contracted patients through information technology means. (Responsible departments: Provincial Health Commission, Provincial Big Data Bureau)

1. Innovate “Internet Plus” health management services. Accelerate the establishment of a life-cycle health assessment and consultation system and a health management service system, encourage the development of online-on-demand nursing, family doctor, and family pharmacist services, and support social capital in developing specialized health service institutions. By 2020, cultivate more than five large-scale health management enterprises (institutions). (The Provincial Development and Reform Commission, the Provincial Department of Industry and Information Technology, the Provincial Health Commission, the Provincial Healthcare Security Administration, the Shandong Banking and Insurance Regulatory Bureau, and the Provincial Disabled Persons’ Federation shall be responsible according to their respective duties.)

2. Establish an internet-based health consultation and information platform. Encourage medical and health institutions, as well as qualified third-party organizations, to provide diverse online medical courses and medical education. In 2020, comprehensively roll out the “Continuing Medical Education + Promotion of Appropriate Technologies” initiative for health poverty alleviation. (Responsible entities: Provincial Health Commission, Provincial Department of Education, Provincial Department of Human Resources and Social Security, Provincial Association for Science and Technology)

1. Accelerate the development of big data in health and medical care. Speed up the construction of the Northern Center for National Health and Medical Big Data. By 2020, basically complete the construction of a fully functional storage center at the Northern Center, and establish high-quality databases for 50 types of diseases and in 50% of counties (cities, districts). (The Provincial Health Commission, the Provincial Department of Education, and the Jinan Municipal People's Government shall be responsible.)

2. Vigorously develop artificial intelligence (AI) technologies for healthcare. Support the research and development of AI technologies, medical robots, bio-3D printing technologies, and wearable devices, to promote the digitalization, intelligentization, and miniaturization of medical equipment. By 2020, AI technologies in healthcare should be widely applied in hospitals at Level II and above. (The Provincial Development and Reform Commission, the Provincial Department of Science and Technology, the Provincial Department of Industry and Information Technology, and the Provincial Health Commission shall be responsible according to their respective duties.)

(1) Strengthen organizational leadership. All cities and relevant departments shall, in accordance with their assigned tasks, promote the effective implementation of various initiatives and advance the orderly development of “Internet + Healthcare.” By 2019, establish a work framework featuring Party committee leadership, government-led coordination, multi-stakeholder participation, resource sharing, and collaborative promotion, and conduct supervisory inspections as appropriate. (Municipal governments and relevant departments are responsible according to their respective duties.)

(II) Accelerate the integration and sharing of information. Establish a thematic database for medical and health services to expedite information integration and sharing. Relying on the provincial integrated online government service platform, promote the one-stop online handling of services. By 2020, achieve data access for relevant provincial departments and all prefecture-level cities. (The General Office of the Provincial People’s Government, the Provincial Big Data Bureau, the Provincial Public Security Department, the Provincial Department of Human Resources and Social Security, the Provincial Health Commission, the Provincial Administration for Market Regulation, and the Provincial Healthcare Security Administration shall be responsible according to their respective duties.)

(3) Standardize the supervision of internet-based diagnosis and treatment. Implement standards and norms such as the "Administrative Measures for Internet-Based Diagnosis and Treatment (Trial)" and carry out integrated online and offline supervision. Third-party institutions, such as internet medical and health service platforms, shall ensure that the qualifications of personnel providing services meet regulatory requirements and assume responsibility for the services provided. (The Provincial Health Commission, the Provincial Cyberspace Administration Office, the Provincial Public Security Department, the Provincial Market Supervision Administration, the Provincial Healthcare Security Administration, and the Provincial Big Data Bureau are responsible.)

(4) Establish an information security assurance system. Strictly enforce regulations on information security and the confidentiality of health and medical data, and strengthen information protection for critical information infrastructure and data application services. Sensitive data, such as patient information, shall be stored within China; where it is indeed necessary to provide such data overseas, a security assessment shall be conducted in accordance with relevant regulations. (Responsible entities: Provincial Health Commission, Provincial Cyberspace Administration, Provincial Department of Industry and Information Technology, Provincial Public Security Department, and Provincial Big Data Bureau)