China's National Health Commission Officially Defines Smart Hospital Development Direction

On March 18, the General Office of the National Health Commission issued the Notice on Printing and Distributing the Graded Evaluation Standard System for Smart Hospital Services (Trial). In accordance with the basic service content that should be covered in the pre-diagnosis, during-diagnosis, and post-diagnosis stages for patients, and in combination with hospital informatization construction and the internet environment, the National Health Commission has identified five categories comprising a total of 17 evaluation items.

On the 21st, three days later, the National Health Commission held a special press conference on information-based quality control and smart hospital construction. In response to widespread public concern over smart hospital development, Jiao Yahui, Deputy Director of the Bureau of Medical Administration and Hospital Management under the National Health Commission; Wang Yongjun, Executive Vice President of Beijing Tiantan Hospital; and Zhou Jianxin, Vice President of Beijing Tiantan Hospital, provided in-depth interpretations of the objectives, definitions, and connotations of smart hospital construction. Below are the key points compiled by VCBeat (WeChat Official Account: vcbeat) based on the live transcript from China.org.cn:

Technology Transforms Lives: The Rapid Advancement of Information Technology Has Had a Significant Impact on the Health Sector. In Recent Years, the Integration of Information Technologies Such as the Internet, the Internet of Things (IoT), and Big Data with Healthcare Has Propelled Hospital Informatics Construction into a New Phase. The National Health Commission Has Earnestly Implemented the Important Decisions and Deployments Made by the CPC Central Committee and the State Council Regarding the Development of “Internet Plus,” Focusing on the Following Key Areas:

First, promote the informatization of medical institutions with electronic medical records (EMR) as the core. Comprehensively assess the application level of EMR systems in medical institutions, and guide these institutions to develop their EMR systems in a scientific, rational, and orderly manner. Standardize the documentation specifications for the front page of medical records, disease classification codes, surgical procedure codes, and medical terminology. The Chinese version of the International Classification of Diseases, 11th Revision (ICD-11) was compiled and published, striving to achieve the “four unifications” for standardized management of clinical data.

Second, implement the “Opinions of the General Office of the State Council on Promoting the Development of ‘Internet Plus Healthcare’,” carry out the Action Plan for Further Improving Medical Services, and leverage information technology to address the “pain points” and “bottlenecks” encountered by the public in accessing medical care. Promote the healthy, rapid, and high-quality development of internet-based diagnosis and treatment services, internet hospitals, telemedicine services, “Internet Plus Pharmaceutical Care,” and “Internet Plus Nursing Services.”

Third, we have strengthened the development of smart hospitals by issuing a hierarchical evaluation standard system for hospital smart services, promoting the use of intelligent and information-based tools to improve medical quality and efficiency, and enhancing refined and informatized management. Fourth, we have applied information technology to strengthen medical administration. The National Health Commission has established the national electronic registration system for medical institutions, physicians, and nurses, the Hospital Quality Monitoring System (HQMS), the Blood Management Information System, and the Clinical Application Management Platform for Medical Technologies, thereby strengthening interim and ex-post supervision and increasing the level of informatization in medical management.

Through continuous exploration and development in recent years, phased achievements have been made.

First, the process is more convenient. Medical institutions, especially tertiary hospitals, leverage information technology to provide patients with services such as appointment scheduling, waiting reminders, in-hospital navigation, inquiry of examination and test results, price estimation and payment, and health education. These efforts have aimed to achieve “four reductions”: fewer patient visits to the hospital, reduced repetitive queuing within the hospital, shorter total outpatient waiting times, and a decrease in the average length of stay.

Second, services are more efficient. By adopting mobile health apps, medical institutions have made “healthcare at your fingertips” a reality. Healthcare professionals use mobile rounding systems, mobile order entry, mobile nursing devices, and intelligent, dynamic wireless monitoring equipment, thereby reducing spatial constraints on healthcare delivery. The use of voice-to-text for medical record documentation, comprehensive early-warning alerts, and intelligent clinical decision support during diagnosis and treatment has significantly improved service efficiency.

Third, management is more refined. Currently, many hospitals have achieved closed-loop management of work processes by establishing comprehensive operational management systems, medical waste management systems, intelligent linen management systems, intelligent equipment monitoring systems, and intelligent energy control systems. This is equivalent to equipping the hospital with a “smart steward,” thereby enhancing the scientific level of hospital management.

Overall, the development of medical services in China is at a critical stage of transition from “informatization” to “smart healthcare.” This shift holds positive significance for improving medical quality and efficiency, optimizing the allocation of medical resources across regions, and enhancing patients’ experience in seeking medical care. Moving forward, the National Health Commission will continue to promote informatization in the health sector, strengthen policy research, and identify and publicize advanced practices and typical experiences. In celebration of the 70th anniversary of the founding of the People’s Republic of China, efforts will be made to establish informatization and smart hospital construction as key drivers for the high-quality development of medical services, thereby continuously enhancing the public’s sense of gain.

The concept of “Smart Hospitals” has been proposed globally for only about a decade. Hospitals worldwide have undertaken varying degrees of exploration, applying internet technologies and artificial intelligence to various aspects of healthcare services. China’s explorations in this area are largely synchronized with global efforts.

The National Health Commission recently issued the evaluation standards for grading smart hospital services. The primary focus is to clarify what constitutes a “smart hospital,” including its definition and connotations. Over the past decade, various stakeholders have explored different priorities and directions in this field. Therefore, it is essential to establish a unified understanding of the term “smart hospital.” Specifically, does the mere use of wearable devices qualify a facility as a smart hospital? Or does the adoption of internet technologies, along with the establishment of internet hospitals and the provision of online diagnosis and treatment services, suffice? It is necessary to first delineate the scope. The scope of smart hospitals defined by the National Health Commission mainly encompasses three major areas:

The first domain is “Smart Healthcare” for medical professionals. The construction of information systems centered on electronic medical records (EMRs) has been promoted nationwide in China since 2010. Internationally, it is common practice to implement tiered classification based on EMRs to guide development. Merely entering medical records into a computer does not constitute true EMRs; it is also essential to assess whether the EMR system interoperates with other systems, such as imaging and laboratory testing. In summary, “Smart Healthcare” refers to the development of information systems for use by healthcare providers, with EMRs at their core.

The second area is “smart services” for patients. Last year, the General Office of the State Council issued the Opinions on Promoting the Development of “Internet Plus Healthcare.” Upon entering many hospitals, one can see all-in-one kiosks and self-service terminals, along with mobile-based services such as online payment, appointment registration, scheduled consultations, and information alerts, as well as derivative services like parking information notifications. These constitute smart services for patients, making healthcare access more convenient and efficient.

The third domain is “Smart Management” for hospital administration. The earliest hospital management system was the Hospital Information System (HIS). Currently, numerous systems support hospital management, including those for finance, billing, and supply chain management. These systems cover the management of a wide range of items such as pharmaceuticals, medical consumables, laboratory reagents, medical waste, and patient linens, and even extend to utility management (water, electricity, and gas) for hospital facilities. A key aspect of refined hospital management is precise cost accounting. With this approach, every physician can monitor the overall operational performance of the entire hospital via their mobile phone or office computer. Taking the Office Automation (OA) system as an example, this domain is built upon refined, information-driven hospital management.

Furthermore, the National Health Commission will implement a tiered management system for hospital smart services this year. While electronic medical records are currently classified on a scale of Levels 0–8, smart services are rated on a scale of Levels 0–5. Healthcare informatization is a capital-intensive sector, and differences in design philosophy often lead to significant variations in return on investment. Therefore, tiered management should serve as a strategic guide, enabling hospitals to maximize the efficacy of limited funds, ensure interconnectivity across all smart service components, and form an integrated, cohesive system.

In addition, pilot programs for the establishment of urban medical groups will be launched in 100 cities this year outside of hospital settings. The National Health Commission intends to integrate these smart “Internet+” approaches into medical consortia. Through the pilot initiatives in 100 urban medical groups, information technology-supported systems for telemedicine, consultations, education, and two-way referrals will be established within the medical consortia. This will genuinely explore and achieve patient transitions from primary care institutions to higher-level hospitals, enabling interconnected, interoperable, and shared health information, thereby allowing medical consortia to provide patients with continuous, integrated diagnosis and treatment services.

Under the guidance of the National Health Commission, the Beijing Municipal Party Committee and Municipal Government, the Beijing Municipal Health Commission, and the Beijing Municipal Administration of Hospitals, Tiantan Hospital has established the concept and direction of building a smart hospital centered on patients by introducing advanced technologies such as artificial intelligence, big data, cloud computing, and the Internet of Things.

Located on the second floor of the Research Building at Tiantan Hospital is a supercomputing center with a peak computing speed of 375 teraflops. The hospital has established a cloud-based data analytics platform and a medical consortium information platform. Leveraging wireless network coverage throughout the hospital, it tightly integrates Internet of Things (IoT) technology with clinical workflows, allowing for scalable expansion according to actual needs. The hospital’s servers employ storage virtualization technology to ensure information security and stability, all of which constitute the foundation of the “Smart Hospital.”

For patients, stepping through the doors of Tiantan Hospital means encountering a variety of “cutting-edge technologies.” For instance, the hospital offers fully self-service outpatient care. From purchasing medical record books and registering to obtaining queue numbers, undergoing consultations and examinations, printing reports, collecting medications, and issuing invoices, patients simply need to scan QR codes at various kiosks throughout the process. The system automatically schedules appointments, requiring patients only to arrive at the designated location at the appointed time and wait for their number to be called. This approach has largely eliminated the long queues of the past.

For another example, patients need only “shake” their smartphones, and the hospital-wide intelligent navigation system will automatically plot an appropriate route with meter-level precision. To accommodate elderly patients who are less familiar with electronic devices, the hospital has stationed numerous volunteers in the self-service areas and outpatient lobby to provide in-person assistance.

In hospital wards, each patient’s bedside is equipped with a tablet. This smart bedside interaction system not only provides inpatients with entertainment features such as digital television, but also enables them to access their medical records in real time, schedule examinations, and order nutritious meals. By leveraging Internet of Things (IoT) technology, the system also facilitates real-time monitoring of patients’ vital signs. Information such as physicians’ orders, infusion progress, and medication reminders is displayed in real time on large screens at the nursing station. Should a patient remain away from their bed for an extended period, the system immediately triggers an alert at the nursing station to help prevent accidents such as falls or fainting.

By leveraging these “cutting-edge technologies,” hospitals have also implemented functions such as infant anti-theft systems, medical quality control, and measures to prevent and crack down on “appointment scalpers.” Meanwhile, hospitals are exploring the application of advanced technologies—including big data, cloud computing, and artificial intelligence (AI)—in clinical practice. For instance, BioMind, the world’s first AI-assisted diagnostic product for neuroimaging, can automatically generate structured diagnostic reports within 3–5 seconds. Additionally, endovascular interventional surgical robots, exoskeleton robots, and medical AI robots are expected to achieve R&D breakthroughs and clinical translation in the near future.

In terms of refined operational management, Tiantan Hospital has also undertaken a series of initiatives. The hospital integrates information from building automation, security, fire protection, facility operations, and clinical workflows into an intelligent platform, enabling coordinated interaction across systems. In logistics management, systems such as elevator operations, lighting, and irrigation are all integrated through Internet of Things (IoT) technology, achieving intelligent, efficient management and safe services. The intelligence at Tiantan Hospital is further reflected in the comprehensive measurement and analysis of hospital operations by its information systems, providing decision-support services for hospital management.

Recently, Beijing Tiantan Hospital introduced a new patient-friendly service measure. By leveraging the Jingyi Tong platform, patients with chronic diseases can schedule follow-up appointments with the same physician who treated them previously. This avoids the need to consult different doctors at each visit, thereby eliminating repetitive medical history inquiries, ensuring better familiarity with the patient’s condition, and saving time. As a result, this initiative meets patients’ needs for continuous care.

Nearly six months have passed since Beijing Tiantan Hospital completed its comprehensive relocation. The hospital’s systems have been operating steadily and smoothly, with smart healthcare systems playing a significant role in enhancing patient services and hospital operations. This has initially realized the original vision of building a smart hospital, providing patients with convenient and high-quality care.