Xuanwu Hospital Advances Smart Healthcare with Internet Hospital Initiative, Files IPO Prospectus
By Luo Mei, Nie Guanghong
In the current era of information explosion, informatization plays a significant supporting role in healthcare. "Informatization + Healthcare," or "Internet + Healthcare," has become a highly trending topic. However, how can hospitals effectively implement information technology? How can such technology support medical quality, the substantive aspects of medical care, and healthcare management?
On November 5, at the HIMSS Asia Pacific Conference held in Brisbane, Australia, Xuanwu Hospital of Capital Medical University was awarded the 2018 HIMSS Asia Pacific “ICT Excellence Award,” becoming the only institution in Asia to receive this honor this year.
Recently, VCBeat (WeChat Official Account: vcbeat) conducted an exclusive interview with Liang Zhigang, Director of the Information Center at Xuanwu Hospital, Capital Medical University, to seek his insights on the aforementioned questions. Drawing upon Xuanwu Hospital’s initiatives in smart healthcare, Director Liang also shared his perspectives on hospital informatization construction and the future development direction of Xuanwu Hospital.
Xuanwu Hospital, established in 1958, is a large Grade III Class A general hospital that focuses on clinical care and research in neuroscience and geriatrics, with a specialty in the treatment of cardiovascular and cerebrovascular diseases.
Xuanwu Hospital has spent over two decades and invested more than 100 million yuan in its medical information technology infrastructure; however, its existing hardware facilities can no longer meet the growing demands for healthcare services. This year, with the introduction of new healthcare reform policies, investment in informatization within China’s healthcare sector is continuously increasing. Xuanwu Hospital is also persistently advancing its digital transformation and informatization initiatives.
This year, the Special Outpatient Clinic, the Healthcare Department for Senior Cadres, and the China International Neuroscience Institute at Xuanwu Hospital were put into operation. Meanwhile, the hospital has established a comprehensive and standardized diagnosis and treatment system for Alzheimer’s disease, Parkinson’s disease, stroke, epilepsy, movement disorders, and cerebrovascular diseases of the brain and spinal cord, thereby developing distinct advantages and specialties. Its performance assessment rankings are among the top of municipal hospitals in Beijing.
In the interview, Liang Zhigang first summarized the three stages that China has undergone in the process of healthcare informatization development:
Phase I: The 2015 phase of “Mass Entrepreneurship and Innovation,” primarily characterized by the exploration of business models.
Phase II: In 2016, the state implemented strict regulatory controls over the “Internet + Healthcare” model;
Phase III: 2018 marked a turning point, as national policies were liberalized to permit the establishment of internet hospitals anchored by physical hospitals.
In Liang Zhigang’s view, in addition to top-level design such as national policy guidance, it is essential to strengthen decision support and quality management in clinical practice, thereby enabling the true implementation of smart healthcare.
Smart hospitals should prioritize clinical needs in their informatization development. It is essential not only to emphasize the role of artificial intelligence in building smart hospitals but also to highlight the importance of “Internet + Healthcare.”
Artificial intelligence is no longer an abstract concept. Liang Zhigang stated that the topic healthcare professionals should currently be discussing is how to leverage technological means and innovations to intervene in the disease diagnosis and treatment environment, providing support and assistance to physicians, and managing the entire process of diagnosis and treatment, care management, and quality and safety assurance.
By leveraging medical artificial intelligence technologies and reengineering information system workflows, Xuanwu Hospital has established a smart healthcare system, namely the Smart Hospital.
Liang Zhigang told us that the construction of Xuanwu Hospital’s smart hospital was driven by clinical needs. Xuanwu Hospital has established the following philosophy: informatization should first serve patients, as the essence of hospital operations is to provide efficient and high-quality medical services to them. Second, it should serve healthcare professionals by providing comprehensive business workflows and robust technical support. Finally, it should assist the hospital in operational management. Therefore, informatization must achieve standardization and process reengineering.
Liang Zhigang introduced several highlights of Xuanwu Hospital’s smart healthcare initiatives:
I. HIMSS, or Healthcare Information and Management Systems Society, is a concept originating from the United States and serves as the primary rating standard for healthcare informatization. This evaluation system, often described as "promoting development through assessment," involves planning the overall layout of hospital information systems in accordance with international standards. It ensures that such informatization better supports medical practice, enhances medical quality and management, improves patient satisfaction, and guarantees high-quality and efficient healthcare services.
Through its comprehensive HIMSS implementation, Xuanwu Hospital has gained a clear understanding of its overall healthcare informatization. In 2017, Xuanwu Hospital achieved HIMSS EMRAM Stage 7 certification.
II. Medication Safety.Xuanwu Hospital has established a hospital-wide outpatient and inpatient order entry system, enabling the timely detection of irrational drug use, off-label or excessive dosing, and contraindicated medications. The hospital is also implementing real-time prescription review to address the professional transition of pharmacists following the implementation of zero-markup drug pricing policies. This shift transforms pharmacists from managers of drug sales into clinical advisors, thereby fully realizing their professional value and role. Furthermore, Xuanwu Hospital independently maintains all its medication databases to ensure drug safety and rational use.
3. With meticulous design by the Department of Neurology and technical support from the Information Technology Department, a green channel for information processing was established for patients with acute ischemic stroke. This initiative deferred payment procedures and prioritized diagnostic and therapeutic interventions, thereby fully ensuring treatment priority for stroke patients. Leveraging a clinical decision support system based on the Mayo Clinic knowledge framework, the hospital provided end-to-end decision support for the management of acute stroke patients, intelligently reviewing the appropriateness of clinical interventions and medical orders. By integrating medical artificial intelligence with connotative quality control of acute stroke medical records, the hospital implemented procedural checks and real-time alerts to assess record quality, standardize clinical practices, and achieve closed-loop management covering pre-diagnostic, intra-diagnostic, and post-diagnostic phases of stroke emergency care.
Xuanwu Hospital received the Outstanding Achievement Award at the 2018 HIMSS Asia Pacific “ICT Outstanding Achievement Awards” ceremony, becoming the only institution in Asia to receive this honor that year. Xuanwu Hospital’s award submission featured the case study titled “Artificial Intelligence and Acute Care Green Channel Transformation: Creating a Closed Loop for Efficiency and Quality in Stroke Emergency Care.”
Liang Zhigang stated that the greatest demand for artificial intelligence in healthcare lies in clinical decision support. This is because medicine, strictly speaking, is not an exact science but a practical one, relying heavily on experience and accumulated knowledge. Aggregating and sharing such experience through big data modeling represents an area where information technology can play a significant role in disease diagnosis and treatment environments as well as in clinical decision support. Furthermore, high-quality medical resources are needed not only in major cities but also in remote areas. AI-assisted decision-making can help address disparities in medical services resulting from the uneven distribution of healthcare resources in China.
In addition, Xuanwu Hospital has streamlined its business processes. It has integrated the hospital’s rules and regulations with national policy and regulatory requirements into overall clinical practice, embedding them through information technology to ensure effective implementation.
Liang Zhigang stated that Xuanwu Hospital aims to build a comprehensive smart hospital, with information technology supporting everything from medical services to operational management. The role of IT in advancing healthcare represents the trend and strategic direction for Xuanwu Hospital’s future development.
It is reported that, as a next step, Xuanwu Hospital will represent Beijing in supporting the development of the Xiong'an New Area by building a fifth-generation smart hospital there, with full funding from the Beijing Municipal People's Government.
Liang Zhigang told us that smart hospitals do not have a single focal point; the definition of a smart hospital varies across different eras and stages. With technological advancements and medical progress, the concept of smart hospitals will continue to evolve. Healthcare professionals hope that in the future, an intelligent assistant will aid physicians in diagnosing any disease, with assistance covering laboratory testing, diagnosis and treatment, as well as medication management. All processes within hospitals will need to become more convenient, precise, and intelligent in the future. In Liang Zhigang’s view, this represents the future direction of smart hospital development.
Liang Zhigang also proposed that the construction of smart hospitals should incorporate internet hospitals, which may represent a future development trend.
The development of internet hospitals requires shared responsibility between hospitals and enterprises. However, the overall management of medical quality must be controlled by healthcare institutions themselves. Therefore, internet hospitals need public hospitals to leverage their clinical expertise to support social services, combined with high-quality medical products and services provided by enterprises. Only through such collaboration can effective implementation be achieved.
The development of Xuanwu Hospital’s internet hospital will continue to be carried out through a bidding process. Liang Zhigang repeatedly emphasized that overall medical quality management must remain the responsibility of the hospital, while enterprises need only provide technological solutions to address the shortcomings of public hospitals. A clear boundary must be drawn between the hospital and the enterprise, and companies must center their operations on medical services to maximize value creation.
"In general, the government handles regulation, hospitals provide medical care, and enterprises manage operations. Only by each party fulfilling its respective role can tiered diagnosis and treatment be effectively implemented."
Xuanwu Hospital’s construction of its medical consortium is also in the exploratory phase. It is reported that Xuanwu Hospital aims to start with specialized medical consortia and promote them step by step. Currently, the hospital is collaborating with community health centers through the National Health Commission to develop an integrated information system. Liang Zhigang stated that the development of medical consortia should be driven by disciplinary and academic advancement, as well as by the needs and behaviors of physicians. In the future, Xuanwu Hospital will integrate its information systems with those of surrounding medical consortia to achieve genuine information sharing and interaction, realize effective two-way referrals, and ensure a seamless continuum of care comprising patient sourcing before hospitalization, treatment during hospitalization, and rehabilitation after discharge, thereby truly establishing a robust medical consortium.
Liang Zhigang stated that the present moment represents an optimal era, with national-level policies encouraging healthcare professionals to leverage information technology for managing healthcare quality and enhancing medical standards through comprehensive disease intervention processes. Xuanwu Hospital still has a long journey ahead, which presents both challenges and opportunities for growth. The hospital will continue to utilize information technology to contribute to the development of the healthcare industry, capitalize on its specialized disciplines, better serve the public, and achieve mutual benefits.