NHC Allows Online Prescriptions to Be Delivered by Qualified Third Parties After Pharmacist Review
On July 12, VCBeat (WeChat ID: vcbeat) learned that the National Health Commission had published on its official website the “Notice on Deepening the Implementation of ‘Internet + Healthcare’ Convenience and Benefit Activities” (hereinafter referred to as the “Notice”), which constitutes the first national-level detailed implementation rules for “Internet + Healthcare.”
It proposes 30 specific measures across 10 categories of “Internet + Healthcare” initiatives designed to enhance convenience and public benefit, including more worry-free medical consultation services, more convenient payment and settlement services, greater assurance in medication services for patients, more precise public health services, more considerate family doctor services, full coverage of telemedicine services, wider accessibility of health information services, more efficient emergency treatment services, more beneficial government data-sharing services, and simplified examination and testing services. Furthermore, it sets clear objectives for the “Internet + Healthcare” work of secondary-level and tertiary healthcare institutions over the next two years.
VCBeat has reviewed the “Notice” and summarized the key points as follows.
The “Notice” points out that we should accelerate the construction of smart hospitals, leverage internet information technology to redesign and optimize clinical workflows, integrate all stages from pre-consultation through consultation to post-consultation, and improve patients’ healthcare experience. By 2020, medical institutions at Level II and above should universally provide online services such as time-slot appointment scheduling, intelligent patient guidance and triage, waiting reminders, and query of laboratory and imaging test results.
The "Notice" requires that all localities establish and improve online appointment-based diagnosis and treatment service platforms, integrate and interconnect various service terminals, accelerate the realization of shared appointment slots, and gradually increase the proportion of appointment slots available online as well as the proportion of diagnosis and treatment services provided through appointments. By 2020, appointment time slots were to be specified within one-hour intervals, with priority reservation of appointment slots for primary healthcare institutions within medical consortia, so as to promote initial consultations at the primary care level, facilitate two-way referrals, and centrally address the difficulty of registering for medical appointments.
Furthermore,“The Notice” further clarifies the scope of services for internet hospitals, requiring them to actively provide online follow-up consultations for certain common and chronic diseases, as well as follow-up management and remote guidance, while ensuring medical quality and information security, with a view to gradually enabling patients to undergo rehabilitation at home.Healthcare institutions with the necessary conditions are encouraged to further expand mobile nursing, online vital signs monitoring, and home monitoring services; promote the application of intelligent medical imaging recognition, pathological classification, multidisciplinary consultations, and intelligent voice technologies in various healthcare scenarios; and thereby improve the efficiency of medical services.
It is worth noting that, with regard to the industry’s highly anticipated “prescription outflow” policy,The “Notice” clearly sets the tone by encouraging qualified medical institutions to promote the development of “smart pharmacies,” achieving seamless integration between prescription systems and pharmacy dispensing systems to facilitate timely medication pickup for the public. After online prescriptions are reviewed by pharmacists, medical institutions and pharmaceutical distributors may entrust qualified third-party agencies with delivery services.This regulation serves as a timely boon for the newly finalized “Wuzhou Model.”
“The Notice” requires achieving interconnectivity and integration between existing public health information systems and residents’ electronic health records, improving the management network for age-related chronic diseases such as hypertension and diabetes, as well as foodborne illnesses, with a focus on providing services including online health status assessments, monitoring and early warning, medication guidance, follow-up tracking, and health management. Meanwhile, it calls for innovating internet-based maternal and child health service models, advancing the digitalization of maternal and child health handbooks, and providing comprehensive healthcare services throughout the reproductive journey for women and children.
In terms of family doctor services,The “Notice” requires that hospitals at the secondary level and above designate specific personnel to serve as liaisons, establish green channels for patients referred under contracted arrangements, leverage information technology to expand referral pathways from family doctors to higher-level facilities, and provide high-quality referral services. Furthermore, by relying on the development of medical consortia and utilizing methods such as remote consultations and online counseling, higher-level hospitals should strengthen technical support for primary care institutions, accelerate the enhancement of service capabilities of family doctor teams, and ensure that family doctors truly act as “gatekeepers” of residents’ health.
In terms of medical consortium development,The “Notice” points out that the lead hospitals of medical consortia shall establish telemedicine centers to provide services such as remote consultations, remote imaging, remote ultrasound, remote electrocardiography (ECG), remote ward rounds, remote monitoring, and remote training to medical institutions within the consortia. In addition, the “Notice” promotes the model of “primary-level examinations with higher-level diagnoses,” expands functions such as medical imaging, remote ECG, and laboratory testing in primary healthcare information systems, and actively applies intelligent clinical decision support systems to enhance the capacity and efficiency of primary healthcare services.
Emergency Medical Treatment,“The Notice” specifies that emergency treatment centers in hospitals at Level II and above shall achieve information interoperability and sharing with pre-hospital emergency care institutions, so as to provide integrated comprehensive treatment services.
The “Notice” requires advancing the one-net universal handling of government services, standardizing service items, optimizing service processes, implementing a model of “single-window acceptance, online processing, parallel handling, and time-limited completion,” and increasing the proportion of online transactions. In addition, it mandates the comprehensive rollout of “one-stop” services, including online registration for fertility services and electronic registration and approval for medical institutions, physicians, and nurses, to facilitate quick certificate issuance, information inquiries, and policy awareness for the public.
In terms of informatization in medical institutions,The Notice stipulates that by 2020, tertiary hospitals shall achieve interoperability and sharing of in-hospital medical service information; medical institutions that have passed professional medical quality control at the provincial or prefectural level shall implement mutual recognition of inspection and test results within their respective administrative regions, and achieve sharing of electronic health records (EHRs) and electronic medical records (EMRs) as well as mutual recognition of inspection and test results within medical consortia, thereby avoiding redundant examinations for patients; a “one-card” system for medical visits shall be implemented across medical institutions within prefecture-level cities, enabling patients to use an electronic health card for registration, consultation, inspections and tests, and information inquiries at any medical institution.
Notice on Deepening the Implementation of “Internet + Healthcare” Convenience and Benefit Activities
To the Health and Family Planning Commissions and Administration of Traditional Chinese Medicine of all provinces, autonomous regions, municipalities directly under the Central Government, and the Xinjiang Production and Construction Corps; to all departments and bureaus within the Commission and the Administration; to institutions directly affiliated with or associated with the Commission and the Administration; and to hospitals under the jurisdiction or management of the Commission and the Administration:
In order to thoroughly implement General Secretary Xi Jinping’s instructions on advancing “Internet + Healthcare” so that citizens need to make fewer trips while data does more of the running, thereby continuously improving the equalization, inclusiveness, and convenience of public services; to effectively address issues of concern and frustration to the public; and to ensure the effective implementation of the “Opinions of the General Office of the State Council on Promoting the Development of ‘Internet + Medical Health’” (Guo Ban Fa [2018] No. 26), enabling the general public to truly benefit from the innovations of “Internet + Medical Health,” the National Health Commission and the National Administration of Traditional Chinese Medicine have decided to launch an industry-wide campaign for convenient and beneficial “Internet + Medical Health” services. The specific measures for the comprehensive promotion of this campaign are hereby notified as follows:
I. More Worry-Free Medical Consultation and Treatment Services
1. Accelerate the development of smart hospitals by leveraging internet and information technologies to redesign and optimize clinical workflows, integrating pre-consultation, consultation, and post-consultation phases to enhance patients’ healthcare experience. By 2020, medical institutions at Level II and above should universally provide online services such as time-slot-based appointment scheduling, intelligent patient guidance and triage, waiting notifications, and access to laboratory and imaging test results, thereby reducing patients’ waiting times and unnecessary visits.
2. All regions shall establish and improve online appointment-based diagnosis and treatment service platforms, integrate and interconnect various service terminals, accelerate the realization of shared appointment slots, and gradually increase the proportion of slots available for online booking. Tertiary hospitals shall further increase the proportion of appointments for diagnosis and treatment services; by 2020, appointment time slots shall be specified to within one hour, and priority shall be given to reserving appointment slots for primary healthcare institutions within medical consortia, so as to promote initial consultations at the primary care level, facilitate two-way referrals, and centrally address the difficulty of registering for appointments.
3. Encourage the development of internet hospitals, and actively provide online follow-up services for certain common and chronic diseases, as well as follow-up management and remote guidance, while ensuring medical quality and information security, gradually enabling patients to rehabilitate at home and enjoy high-quality and efficient follow-up services without leaving their homes.
4. Medical institutions with the necessary conditions should further expand mobile nursing, online vital signs monitoring, and home monitoring services; promote the application of intelligent medical imaging recognition, pathological classification, multidisciplinary consultations, and intelligent voice technology in various healthcare scenarios; and improve the efficiency of medical services.
II. More Convenient Settlement and Payment Services
5. Healthcare institutions shall optimize payment processes and improve settlement models through multiple channels, such as self-service kiosks and mobile client applications. While ensuring information security, they shall strengthen cooperation with medical insurance agencies, commercial insurers, UnionPay, and third-party payment providers to offer patients a variety of online payment options. By 2020, hospitals at Level II and above shall generally provide “one-stop” settlement services, including mobile payments.
6. Gradually promote the interoperability of multiple cards, such as residents' electronic health cards, social security cards, and medical insurance cards, to enable card-free medical consultations; expand the coverage of networked designated healthcare institutions; and advance the direct settlement of cross-regional medical expenses under basic medical insurance. Facilitate the sharing of patient visit information and settlement channels for medical insurance funds, thereby enabling convenient payment for out-of-pocket expenses and reimbursement from medical insurance funds.
III. Greater Peace of Mind for Patients Regarding Medication Services
7. After reviewing patients’ medical records, physicians are permitted to issue online prescriptions for certain common and chronic diseases for follow-up visits. Hospitals at Level II and above shall strengthen the informatization of their pharmacy departments, and healthcare institutions with appropriate conditions are encouraged to promote the development of “smart pharmacies” to achieve seamless integration between prescription systems and pharmacy dispensing systems, thereby facilitating timely medication pickup by the public. Upon pharmacist review of online prescriptions, healthcare institutions and pharmaceutical distributors may entrust qualified third-party agencies with delivery services.
8. Strengthen the coordination of medication management among medical institutions within medical consortia, and conduct online reviews of prescriptions extended to primary healthcare institutions. Clinical pharmacists in hospitals at Level II and above may leverage information technology to provide patients with personalized guidance on rational drug use and assist primary care personnel in improving their proficiency in rational medication practices.
9. Medical institutions at all levels providing traditional Chinese medicine (TCM) services shall leverage information technology to facilitate the decoction and delivery of TCM herbal pieces, thereby addressing issues such as prolonged patient wait times, inconvenience in herbal decoction, and difficulties in medication pickup.
IV. More Precise Public Health Services
10. By integrating with the regional population health information platform, achieve interconnectivity and integration between existing public health information systems and residents’ electronic health records; strengthen management networks for age-related chronic diseases such as hypertension and diabetes, as well as foodborne illnesses; and prioritize services including online health status assessment, monitoring and early warning, medication guidance, follow-up tracking, and health management.
11. Innovate internet-based models for maternal and child health services, advance the digitalization of the Maternal and Child Health Handbook, and provide comprehensive healthcare services throughout the reproductive journey for women and children. Prioritizing children included in the National Immunization Program, integrate existing vaccination information platforms, conduct public education on vaccination knowledge, and encourage regions with adequate resources to offer online vaccination appointment scheduling, vaccination reminders, and other related services.
12. Leverage the regional public health information platform to strengthen information management—including review of incidence reports, data analysis, and quality control—for patients with severe mental disorders, and precisely carry out follow-up assessments and classified interventions.
V. More Considerate Family Doctor Services
13. Accelerate the development and application of intelligent information platforms for family doctor contract services, promote convenient and effective online contracting, and establish long-term, stable contractual service relationships. It is essential to build a service interaction platform between family doctors and contracted residents, providing online services such as health consultations, follow-up visits for chronic diseases, health management, and extended prescriptions. This will transform service delivery models, enhance doctor-patient interactions, and improve the overall experience of contracted services.
14. Hospitals at Level II and above shall designate specific personnel to coordinate liaison, establish green channels for patients referred under contract-based arrangements, leverage information technology to expand referral pathways available to family doctors, and provide high-quality referral services.
15. Leveraging the development of medical consortia, increase technical support from higher-level hospitals to primary care institutions through remote consultations and online advisory services, accelerate the enhancement of service capabilities of family doctor teams, and ensure that family doctors truly serve as the “gatekeepers” of residents’ health.
VI. Full Coverage of Telemedicine Services
16. Comprehensively advance the construction of dedicated networks for telemedicine and implement projects to ensure the availability of diagnostic equipment at regional central hospitals providing telemedicine services. By 2020, achieve nationwide coverage of telemedicine services across all medical consortia and county-level hospitals, with gradual extension to community health service institutions, township health centers, and village clinics.
17. The lead hospitals of medical consortia shall establish telemedicine centers to provide services such as remote consultations, remote imaging, remote ultrasound, remote electrocardiography, remote ward rounds, remote monitoring, and remote training to medical institutions within the consortia. Tertiary hospitals tasked with providing counterpart assistance to nationally designated impoverished counties shall further improve the quality of telemedicine services, enabling the public to access high-quality medical care close to home.
18. Promote the “primary-level examination, higher-level diagnosis” model, expand functions such as medical imaging, remote electrocardiography, and laboratory testing in primary healthcare information systems, actively apply intelligent computer-aided diagnosis systems, and enhance the capacity and efficiency of primary medical services.
VII. Health Information Services Become More Widely Available
19. Promote the online inquiry and standardized use of residents’ electronic health records (EHRs). By 2020, achieve interconnectivity and data integration between the EHR database and the electronic medical record (EMR) database, thereby comprehensively recording and managing residents’ health information. Residents will be able to conveniently access their consultation records from different healthcare institutions, facilitating better self-management of health through dynamic linkage with their electronic health records.
20. Encourage medical and health institutions, as well as qualified third-party organizations, to establish internet-based health consultation platforms, standardize online medical and health information content, and provide citizens with safe and reliable “Internet+” health consultation services.
21. Establish online science popularization platforms to implement targeted health education, leverage the Internet to provide convenient services such as health education, push notifications on “Three Reductions and Three Improvements,” and health knowledge inquiries, promote healthy lifestyles, and enhance the health literacy of the entire population.
VIII. More Efficient Emergency Medical Services
22. Collaborate with local medical institutions to establish a coordinated information platform by 2020, integrating emergency care protocols for stroke, cardiovascular diseases, critically ill pregnant women, trauma, and other conditions, enabling immediate pre-hospital identification of patient conditions and triage for hospital transfer.
23. Emergency treatment centers in hospitals at Level II and above shall achieve information interoperability and sharing with pre-hospital emergency care institutions to provide integrated comprehensive treatment services.
24. Hospitals with the necessary conditions shall accelerate the integration of pre-hospital emergency vehicle-mounted monitoring systems with regional or hospital information platforms, strengthen patient information sharing, remote emergency guidance, and in-hospital emergency preparedness, so as to achieve seamless coordination between pre-hospital and in-hospital care.
IX. Government Data-Sharing Services Deliver Greater Benefits to the Public
25. Accelerate the integration and sharing of government information by connecting systems such as those for medical birth certificates, medical death certificates, and comprehensive population data to local government information-sharing and exchange platforms, and explore initiatives to link these systems with foundational databases on population and social credit.
26. Promote the “One-Net Universal Service” for government affairs, standardize service items, optimize service processes, implement a mechanism of “single-window acceptance, online processing, parallel handling, and time-bound completion,” increase the proportion of online transactions, and advance the integrated development of physical government service halls and online platforms.
27. Comprehensively implement “one-stop” services, including online registration for fertility-related services and electronic registration and approval for medical institutions, physicians, and nurses, to facilitate the public in obtaining certificates, querying information, and understanding policies efficiently.
10. More Convenient Examination and Testing Services
28. Vigorously enhance the construction and application of information technology in medical institutions. Hospitals at the secondary level and above shall improve the functionality of their hospital information platforms, integrate various internal system resources, implement centralized and unified appointment scheduling for examinations, and improve hospital management efficiency. By 2020, tertiary hospitals shall achieve interoperability and sharing of medical service information within the hospital; hospitals with the necessary conditions shall expedite this implementation.
29. Gradually connect all public hospitals to the regional national health information platform. By 2020, medical institutions that have passed professional medical quality control assessments at the provincial and prefectural levels shall implement mutual recognition of inspection and test results within their respective administrative jurisdictions. Furthermore, electronic health records (EHRs) and electronic medical records (EMRs) shall be shared, and inspection and test results shall be mutually recognized within medical consortia, thereby avoiding redundant examinations for patients.
30. By leveraging the promotion and application of residents’ electronic health cards as a key initiative, actively advance the integration of public service cards. By 2020, achieve “one-card” access for medical visits within prefecture-level city regions, enabling patients to use their electronic health cards for registration, consultations, examinations and tests, and information inquiries at any medical institution.
Health administrative departments and traditional Chinese medicine authorities at all levels must adhere to a people-centered development philosophy, strengthen leadership, refine implementation plans, clarify timelines, and carefully organize execution to ensure that various convenience-oriented and benefit-the-public measures are fully implemented. Medical and health institutions at all levels should accelerate the innovative application of internet information technologies, enhance their capacity to provide convenient services, further optimize service processes, and improve patients’ healthcare experiences. The National Health Commission and the National Administration of Traditional Chinese Medicine will strengthen work guidance and supervisory inspections, and, when appropriate, select and promote a batch of demonstration models for “Internet + Healthcare” convenience and public benefit initiatives, thereby continuously promoting the in-depth development and tangible effectiveness of such initiatives.