Amid Ambiguity Surrounding Internet Hospitals, Operators and Tech Providers Offer Clarity

In recent years, numerous internet hospitals have been established, and the industry has conducted various comparative analyses of the internet hospital model. However, concepts and policies regarding internet hospitals, as well as the procedures for establishing one, remain unclear. To address this, reporters from VCBeat (WeChat ID: vcbeat) interviewed many industry insiders and, using Qilekang Internet Hospital and Kingdee Medical’s Internet Hospital Work Platform as case studies, interpreted this widely debated new phenomenon from the perspectives of internet hospital operators and technology providers.

VCBeat (WeChat ID:vcbeat) It was previously reported that Guangzhou Liwan District Central Hospital partnered with Qilekang to jointly establish the “Liwan Qilekang Internet Hospital.” To our knowledge, this appears to be the only internet hospital founded by a pharmaceutical e-commerce company (excluding Alibaba Health).

At that time, reporters primarily conducted a comparative analysis of Liwan Qilekang Internet Hospital and more than ten mainstream internet hospitals that had previously launched, focusing on their business models (Qilekang Enters the “Internet Hospital” Space: What Are the New Innovations?). At a more fundamental level, however, there has been no detailed explanation of what an internet hospital actually is.

According to the "Internet Hospital Special Edition" released by HIT Expert Network at the 2016 China Hospital Information Network Conference, the earliest internet hospital established in China based on a public hospital was the Shenzhen People's Hospital Internet Hospital in 2013. This predates by one year the launch of the Guangdong Second Provincial General Hospital Internet Hospital (also known as the "Guangdong Internet Hospital") in 2014, which claimed to be the first internet hospital in China licensed by the health and family planning authorities.

The table above provides statistics on internet hospital projects since 2013. Most institutions are engaged in similar activities, primarily emphasizing online consultation services and electronic prescriptions. In a broad sense, the definition of “internet hospitals” should also encompass “web-based hospitals” and “cloud hospitals.” However, there are significant differences in naming conventions: some are called “Internet Hospitals,” others “Web-Based Hospitals,” and still others “Cloud Hospitals,” with each nomenclature warranting further explanation regarding the specific institutional characteristics.

It is widely recognized within the industry that “Internet Hospitals” refer to medical institutions that have launched remote diagnosis and treatment services or related businesses. If an institution merely establishes remote video terminals in select communities and pharmacies, utilizes fixed data-collection devices, and provides online consultations based on this technical infrastructure—but does not support mobile terminals—it cannot be considered true mobile healthcare. In contrast, “Cloud Hospitals” refer to a consortium of hospitals that leverages internet technology to integrate dispersed medical institutions, encompassing hospitals at various levels, including municipal and district central hospitals as well as primary healthcare facilities.

How does Qilekang, which operates the “Liwan Qilekang Internet Hospital,” interpret the concept of an “Internet Hospital”?

A relevant executive from Qilekang told VCBeat (WeChat ID: vcbeat) that there is currently no unified definition of “Internet Hospital,” as it remains a government-led exploratory initiative without clear standards. In their view, an “Internet Hospital” is a platform that leverages internet technology to seamlessly integrate and organically connect information among doctors, patients, testing institutions, hospitals, pharmaceutical companies, and payment providers, thereby creating a new healthcare ecosystem. Its functions include patient management, real-time communication, tiered diagnosis and treatment, and online consultations. Its significance lies in transcending temporal and spatial constraints, breaking down barriers between hospitals, and maximizing the value of physicians. These multi-dimensional benefits align closely with the objectives promoted by healthcare reform policies. Internet Hospitals are expected to assume broader responsibilities and achieve more efficient allocation of medical resources.
 

How to Establish an Internet Hospital? Which Departments’ Approvals and Oversight Are Involved in This Process? Does It Require Licenses Issued at the National or Provincial Level? These Aspects May Be Less Familiar to Many.

As internet hospitals are government pilot initiatives, there is no standardized application model; requirements vary across different regions and their respective regulatory authorities. Taking Guangdong Province as an example, approval and authorization must be obtained from the health and family planning commissions at the district, municipal, and provincial levels. During its preparatory phase, Liwan Qilekang Internet Hospital underwent review and received approval and authorization from these three tiers of regulatory authorities—namely, the Liwan District, Guangzhou Municipality, and Guangdong Provincial Health and Family Planning Commissions—before successfully launching its services.
 

Regarding the specific operational models of internet hospitals, the following are the main types:

1. Represented by Wuzhen Internet Hospital, a model featuring virtual consultations by physicians online and patient inquiries via the internet;

2. Represented by the Second People's Hospital of Guangdong Province, a model in which physicians from a single hospital provide consultations and patients seek medical advice online;

3. Represented by the Community 580 Mobile Family Doctor Platform, which primarily focuses on community healthcare as its entry point;

4. The model represented by the Guangdong Hospital Association’s Cloud Hospital consolidates multiple Grade 3A hospitals and integrates resources from large hospitals, aiming to break down information barriers among these major medical institutions. 

 Regarding the model of Liwan Qilekang Internet Hospital, relevant officials have described it as a “composite” new pathway, emphasizing the maximized integration of medical resources at all levels.

This model will be implemented in three steps:

Step 1: In 2016, Liwan District Central Hospital was selected as a pilot site. Currently, physician resources are provided by Guangzhou Liwan District Central Hospital, with dedicated physicians offering consultations to ensure patients’ accessibility to online medical services.

Step 2: Gradually extend coverage to community health service centers and community hospitals in Liwan District, establishing a “hospital + community health service center” medical resource framework;

Step 3: Over a three-year period, establish a “Medical Consortium + Community Health Service Center” framework, break down information barriers between hospitals, and facilitate the rational flow of two-way referrals and high-quality medical resources across different hospitals.
 

From the perspective of current business operations of internet hospitals, there are still some industry constraints:

First, patients’ traditional concepts and habits regarding medical care remain one of the bottlenecks hindering the development of internet healthcare. On a positive note, the mobile health market is experiencing rapid growth at an annual rate of 50%, suggesting that these mindsets and behaviors will soon undergo significant change.

Second, reforms to the inherent healthcare system and the operational models of medical institutions will require more time. Based on the new policies announced as part of healthcare reform, the government is also actively exploring solutions. In the long run, these former obstacles will cease to exist.

What Qilekang aims to achieve is to leverage traditional medical resources as its foundation and utilize internet technology to address the healthcare needs of patients requiring follow-up visits and rehabilitation, thereby providing a platform for doctors to realize their professional value. Of course, among the three factors of physician resources, policy, and technology, it is undoubtedly policy breakthroughs that will accelerate the development of internet hospitals.

The case of Liwan Qilekang Internet Hospital interprets the concept of “Internet Hospital” from the operator’s perspective. Next, we will discuss Kingdee Medical to explore how this technology solutions provider for internet hospitals understands the term “Internet Hospital.”

Chen Dengkun, General Manager of Kingdee Medical, told VCBeat (WeChat ID: vcbeat) that there are two types of internet hospitals in their view: one is “Internet + Hospital,” a model that BAT companies aim to develop and dominate but have not progressed smoothly so far; the other is “Hospital + Internet,” which centers on hospitals’ digital transformation and has gradually become the mainstream.

Kingdee Healthcare’s understanding of internet hospitals primarily comprises four key components.

1. Mobile Transformation for Patients. This enables patients to enjoy a better medical service experience. Over the past three decades, hospitals have invested heavily in building hospital information systems; however, apart from self-service payment and printing receipts, patients have largely failed to benefit from other conveniences offered by these systems.

II. Mobility for Medical Personnel. Leveraging internet technology to enable mobility for three key categories of medical staff: general employees, management personnel, and hospital directors;

III. Mobilization of the Supply Chain. In addition to the patient-facing and healthcare provider-facing segments, another significant information flow involves pharmaceuticals, medical devices, and logistical supplies managed by suppliers. Following the elimination of drug markups in hospitals, there is a stronger rationale for bringing this platform into the open; internet-based initiatives can facilitate more effective procurement management and oversight.

IV. Cloud Hospital. Specific services include remote consultations and tiered diagnosis and treatment; however, progress in this area has been slow, primarily because the foundational work for the first three segments has not yet been adequately established.

In light of this, Kingdee Medical is accelerating the promotion of its Internet Hospital Work Platform, providing a systematic approach to help hospitals establish a robust technical foundation for comprehensive digital transformation.

On July 29, Kingdee Medical released “Cloud Hub,” a platform resembling an app navigation page, designed to aggregate various applications developed for hospital management. Built on cloud platform technology, it offers an open and compatible lightweight application platform that can interface with and integrate existing in-hospital systems. It also provides an open platform for lightweight app development by hospital IT departments or external developers, enabling hospital IT departments to independently manage and operate these applications.

The 454th Hospital of the Chinese People's Liberation Army is the first hospital in China to implement Kingdee Medical’s mobile workplace platform. Subsequently, the “Yunzhijia APP” was made available to all hospital staff, providing a unified mobile office portal for medical personnel, healthcare administrators, and hospital decision-makers by deeply integrating with the hospital’s internal IT systems.

Many hospitals that previously launched services such as appointment registration through small mobile health startups are gradually ceasing their partnerships with these companies, aiming to rebuild internet hospital services with the hospitals themselves as the central entities. InChen Dengkun, General Manager of Kingdee MedicalIt appears that mobile internet healthcare services must possess three key characteristics:

I. Hospitals are the main entities of “Internet+”.Shanghai Changhai Hospital Mobile Internet Hospital leverages a patient-facing mobile service platform to directly connect with patients, extending the hospital’s high-quality medical services to the mobile internet. By bridging the “last centimeter” in healthcare delivery, it ensures that everyone can access Shanghai Changhai Hospital’s medical services fairly and conveniently anytime, anywhere, thereby laying the foundation for a tiered diagnosis and treatment system.

2. “Independent Platform + Open Access,” No App Installation Required.The “mobile hospital” app model represented an early approach by hospitals to explore mobile healthcare services; however, the requirements to download, install, and register for dedicated apps created significant barriers to patient adoption. With advancements in mobile internet technologies, the “independent platform + open access points” model has emerged as the most advanced approach for hospital digitalization via mobile platforms and represents an inevitable trend for future development. By leveraging self-controlled middleware and deploying a patient-facing mobile service platform on the hospital’s private cloud, secure integration with open access channels such as WeChat is achieved, substantially lowering the threshold for patient use. Since launching its trial operation ten days ago, Shanghai Changhai Hospital’s Mobile Internet Hospital has accumulated over 20,000 users (nearly 26,000 as of 5:00 PM on July 21), preliminarily demonstrating that this low-barrier model has been warmly embraced by patients.

III. Closed-Loop Integration Across the Entire Process.Mobile Internet hospitals are not merely about appointment registration; rather, they provide a closed-loop service that seamlessly integrates the entire patient journey from in-hospital to out-of-hospital care, from outpatient to inpatient services, and from information flow to financial transactions, bridging medical treatment and health management. By enabling real-time connectivity across all stages—including appointment scheduling, payment processing, delivery of laboratory and diagnostic reports, payment of hospitalization deposits, daily billing updates, inpatient settlement, discharge summaries, patient feedback, post-consultation follow-ups, and health information dissemination—these platforms ensure smooth and efficient medical services. This significantly enhances the patient experience, fosters harmonious hospital-patient relationships, drives continuous optimization of hospital workflows, and consistently improves operational efficiency.