China Launches 'Internet + Nursing Services' Pilot Program in Six Provinces Including Beijing and Shanghai

According to statistics from the National Bureau of Statistics, by the end of 2017, China’s population aged 60 and above reached 240 million, accounting for 17.3% of the total population. Among the elderly, 150 million suffer from chronic diseases, representing 65% of the elderly population, while approximately 40 million are disabled or partially disabled. The growing number of disabled, very old, and empty-nest elderly has led to a surge in demand for home-based nursing services among many seniors living with illnesses.

VCBeat has learned that, in order to standardize “Internet Plus Nursing Services,” ensure medical quality and safety, and support the implementation of the Healthy China Strategy, the General Office of the National Health Commission issued today the “Notice on Launching Pilot Programs for ‘Internet Plus Nursing Services’” (hereinafter referred to as the “Notice”). The Notice designates six provinces and municipalities—Beijing, Tianjin, Shanghai, Jiangsu Province, Zhejiang Province, and Guangdong Province—as pilot regions for “Internet Plus Nursing Services.” Other provinces are permitted to select pilot cities or areas within their respective jurisdictions to carry out pilot work based on local conditions. The Notice also releases a detailed pilot work plan, requiring all provinces and municipalities to formulate implementation plans tailored to their actual circumstances.

Prior to this, in June 2018, the National Health Commission, together with 11 other departments including the National Development and Reform Commission, the Ministry of Education, the Ministry of Civil Affairs, and the Ministry of Finance, issued the Guiding Opinions on Promoting the Reform and Development of the Nursing Service Industry to increase the supply of nursing services and accelerate the rapid development of the nursing service industry. In July 2018, three documents, including the Administrative Measures for Internet-Based Diagnosis and Treatment (Trial), were issued to further regulate internet-based diagnosis and treatment practices and ensure medical quality and safety.

For detailed pilot programs, please refer to:Notice of the General Office of the National Health Commission on Launching the Pilot Program for “Internet + Nursing Services”

In the pilot program, we identified the following key points:

1. Clarify the providers of “Internet + Nursing Services”

The service provider must be a physical medical institution that has obtained the "Medical Institution Practice License" and is capable of providing services such as home sickbeds and house calls, as determined by the health administrative departments in pilot areas based on local conditions. The dispatched registered nurses shall have at least five years of clinical nursing experience and hold a professional title of Nurse Practitioner or higher, and their credentials must be verifiable in the National Nurse Electronic Registration System.

2. Encourage the Use of Technological Means to Strengthen Nurse Management

Pilot medical institutions with the necessary conditions are encouraged to strengthen nurse management through biometric identification technologies, such as facial recognition, and to equip nurses with nursing recorders. An exit mechanism should be established for nurses who have violated relevant laws and regulations or have records of professional misconduct.

3. Clarify the Target Population for “Internet + Nursing Services”

Priority nursing services—including chronic disease management, rehabilitative care, specialized nursing, health education, and palliative care—are provided to individuals with limited mobility, such as the very elderly or disabled older adults, patients in the rehabilitation phase, and those in the terminal stage of illness.

4. Service offerings focus on high-demand, low-risk categories

Pilot regions shall, in light of local conditions and based on thorough investigations into public service needs as well as comprehensive assessments of environmental factors and practice risks, organize the development of their local “Internet + Nursing Services” project lists. In principle, service items should be those with high demand, low medical risk, and ease of operation and implementation. A combination of “positive lists” and “negative lists” may be used to clearly define these services, thereby effectively ensuring medical quality and safety.

5. Pilot medical institutions may conduct initial consultations for service recipients to assess their suitability for internet-based services.

Pilot medical institutions shall conduct an initial consultation with applicants prior to providing “Internet + Nursing Services,” assessing their disease conditions, health needs, and other relevant factors. If the assessment determines that “Internet + Nursing Services” are appropriate, the institution may dispatch nurses with the corresponding qualifications and technical competencies to provide the relevant services.

6. Ensure information security and enable independent development of information systems

Pilot medical institutions may independently develop internet-based information technology platforms or establish collaborative mechanisms with qualified third-party information technology platforms. Internet-based information technology platforms shall be equipped with the facilities, information technology infrastructure, technical personnel, and information security systems required for the provision of “Internet + Nursing Services.”

Basic functions shall include, at a minimum: authentication of service recipients’ identities; collection and storage of medical records; location tracking of service personnel; protection of personal privacy and information security; full-process traceability of service activities; and statistical analysis of workloads. The buying, selling, or disclosure of personal information is strictly prohibited.

7. Clear Responsibilities and Authority

Clarify Responsibilities Related to "Internet + Nursing Services". Pilot medical institutions and third-party internet information technology platforms shall enter into cooperation agreements, which must clearly define their respective responsibilities, rights, and interests regarding medical services, information security, privacy protection, nurse-patient safety, and dispute resolution. When implementing "Internet + Nursing Services," pilot medical institutions shall sign agreements with service recipients, informing patients of the service content, procedures, mutual responsibilities and rights, and potential risks, and shall obtain signed informed consent forms.

8. Mitigate risks through rigorous qualification reviews, location tracking, and insurance coverage.

Pilot regions and pilot medical institutions shall summarize the experiences and practices from earlier explorations of “Internet + Nursing Services” in certain localities, and draw on risk prevention and safety management measures adopted in “Internet +” initiatives across other industries.

Service recipients may be required to upload identity information, medical records, family doctor signing agreements, and other documents for verification; requirements shall be specified regarding the qualifications of nurses providing “Internet + Nursing Services,” as well as the scope of services and service items.

Internet information technology platforms can purchase or share personal identity information from the public security system, or conduct verification and authentication through biometric recognition technologies such as facial recognition;

Pilot medical institutions or internet information technology platforms shall, in accordance with the agreement requirements, provide nurses with a mobile APP-based location tracking system, equip them with nursing work recorders to ensure that service activities are fully documented and traceable throughout the process, install one-touch alarm devices, and purchase liability insurance, medical accident insurance, and personal accident insurance, so as to effectively safeguard nurses’ professional safety and personal security, and prevent and respond to risks.

Establish mechanisms for preventing and managing medical disputes and risks, and formulate emergency response plans. Meanwhile, ensure unobstructed channels for complaints and evaluations, accept public oversight, and safeguard the health rights and interests of the public.