2016 Jing-Jin-Ji Hospital Leaders Forum: How Big Data Supports Regional Healthcare Integration

On May 7, the 2016 Forum for Hospital Presidents on Medical Collaboration in the Beijing-Tianjin-Hebei Region, jointly organized by the Capacity Building and Continuing Education Center of the National Health and Family Planning Commission and the Beijing Health Talent Exchange Service Center, was held in Beijing. The forum was co-organized by Wujie Advanced Studies and Yidu Cloud.

With the advent of the “Internet Plus” and big data era, big data is profoundly transforming people’s thinking, production, and lifestyles, and the healthcare sector is no exception. The Beijing-Tianjin-Hebei region possesses distinct advantages in medical resources and has accumulated abundant healthcare big data resources. Within the overarching framework of coordinated development in the Beijing-Tianjin-Hebei region, it is essential for medical institutions across these areas to achieve interconnectivity of data and information, leverage complementary strengths, and foster collaborative efforts, thereby truly realizing the optimized allocation of medical resources in the Beijing-Tianjin-Hebei region.

Coordination of Medical Resources in the Beijing-Tianjin-Hebei Region

The orderly relief of Beijing's non-capital functions is the strategic core of the coordinated development of the Beijing-Tianjin-Hebei region. Currently, among outpatients at medical institutions in Beijing, 69% are local residents, while 31% come from other regions. Among these non-local patients, the largest proportion originates from Hebei Province, with over 8.2 million patient visits annually from Hebei to Beijing for outpatient and emergency care.

Currently, in Beijing’s six central urban districts, Dongcheng and Xicheng no longer approve the establishment of medical institutions with inpatient beds, nor do they approve any increase in the total number of medical institution beds or expansion of construction scale. In the four districts of Chaoyang, Haidian, Fengtai, and Shijingshan, the construction of new comprehensive medical institutions is prohibited within the area enclosed by the Fifth Ring Road. Lei Haichao, Deputy Director of the Beijing Municipal Health and Family Planning Commission, stated that beyond the scope of resource decentralization within Beijing’s urban areas, plans have been made and initiatives launched for collaborative efforts including counterpart cooperation, technical support, and entrusted management.

Lei Haichao stated that the earliest and most smoothly advanced collaboration between Beijing and Hebei is arguably the partnership with Hebei Yanda Hospital. Beijing Chaoyang Hospital was the first to support Yanda, followed by several other hospitals that joined to provide comprehensive assistance and improvement. There are also cooperative projects in traditional Chinese medicine and oncology with Cangzhou, Hebei. Additionally, Beijing Children’s Hospital has taken over the management of Baoding Children’s Hospital. You’an Hospital has engaged in deep coordination and cooperation of medical resources with hospitals in Hebei.

By the end of 2015, 150 medical institutions in Beijing had established various forms of cooperation with 100 hospitals in Hebei Province. Wu Xiangtian from the Planning Department of the National Health and Family Planning Commission stated that the goal is to reduce the growth rate of out-of-province patients seeking medical care in Beijing by 2020, basically complete Beijing’s decentralization tasks by 2030, achieve balanced regional allocation of healthcare resources, and essentially realize shared health benefits.

For patients, redundant examinations across different hospitals clearly increase the public’s burden. Shen Changhong, Inspector and Deputy Director of the Tianjin Municipal Health and Family Planning Commission, stated that promoting the mutual recognition of test results since early 2015 has not only facilitated access for the public but also saved a substantial amount of medical insurance funds.

Shen Changhong introduced that by March, a draft work plan for the mutual recognition of laboratory test results among Beijing, Tianjin, and Hebei Province had been essentially formulated. Currently, 166 hospitals have been preliminarily selected, including 103 in Beijing, 38 in Tianjin, and 25 in Hebei Province, all chosen according to strict screening criteria. The mutually recognized tests cover 19 biochemical items, 3 immunological items, and 5 blood cell parameters.

As the healthcare and pharmaceutical system reforms continue to advance, they have injected strong momentum into promoting the coordinated development of medical and health services across the three regions, while also presenting certain challenges. For instance, there is a significant disparity in the funding levels for basic medical security among Beijing, Tianjin, and Hebei Province. Whether for urban employees, urban residents, or participants in the New Rural Cooperative Medical Scheme, the per capita funding level in Hebei Province is far lower than that in Beijing and Tianjin. Furthermore, the Beijing-Tianjin-Hebei region is home to 617 pharmaceutical manufacturers, accounting for one-seventh of the more than 4,000 pharmaceutical enterprises nationwide. With the coordinated development of these three regions, what issues will centralized drug procurement face? Wang Xuetao, Deputy Inspector of the Department of Pharmaceutical Policy under the National Health and Family Planning Commission, stated that under the current bidding methods, procurement is conducted on a provincial basis. Does coordinated development necessitate a transition to a regional basis? And if so, does this require the unification of bidding and procurement platforms? Additionally, with over 610 enterprises, even assuming each enterprise offers only 10 product varieties, there would still be more than 6,000 varieties. The mutual recognition of corporate qualifications and drug evaluation results are all issues that need to be considered in the process of coordinated development.

Data Sharing and Integration

Difficulties cannot hinder the pace of coordinated development. Beijing, Tianjin, and Hebei have jointly formulated a specific action plan for coordinated development for 2015–2016. The plan includes jointly promoting electronic registration and information sharing for physicians and nurses across the three regions, with mutual recognition of qualifications; aligning policies on drug tendering to advance regional joint procurement and achieve more favorable tender prices; establishing a shared medical imaging diagnostic center for the three regions; and creating channels for appointment scheduling and referral systems across Beijing, Tianjin, and Hebei. Lei Haichao, Deputy Director of the Beijing Municipal Health and Family Planning Commission, suggested that the three regions open their health and family planning databases to one another to promote data interoperability, sharing, and joint utilization.

Lei Haichao stated that a major issue at present is that while extensive data collection and reporting are taking place, these data remain inaccessible; tens of millions of healthcare workers are unauthorized to utilize them. Establishing a pilot program in the Beijing-Tianjin-Hebei region would play a leading, driving, and demonstrative role in opening up health and family planning population data across China.