Zhang Tieshan: China-Japan Friendship Hospital's 'Medical + Internet' Is Not About Disruption, But Rebirth

Over the past two years, amid the rise of internet healthcare, Zhang Tieshan, Director of the Information Management Department at China-Japan Friendship Hospital, has visited numerous internet healthcare companies, seeking future survival resources for his medical institution and physicians.

Zhang Tieshan stated that implementing the “Healthcare + Internet” model at China-Japan Friendship Hospital is by no means about being disrupted; rather, the hospital aims to undergo a rebirth. This rebirth entails traditional medical institutions taking proactive measures to leverage the internet as a tool for enhancing the quality and efficiency of medical services, thereby better serving patients.

Reject “Pseudo” Internet Healthcare

Not long ago, the “Notice Strictly Prohibiting Doctors from Collaborating with Commercial Companies on Appointment Registration and Additional Slot Allocation” issued by the Beijing Municipal Health and Family Planning Commission has had a series of far-reaching impacts. Collaborations between many physicians and internet healthcare companies have nearly ceased. Numerous hospitals have also developed resistance toward internet-based initiatives. Amidst this turbulent climate, China-Japan Friendship Hospital continues to proactively seek partnerships with internet healthcare firms such as Haodaifu and Weiyi Group. Zhang Tieshan pointed out that those who exploit additional appointment slots for improper gains represent “pseudo” internet healthcare. The essence of the internet lies in its ability to help address healthcare challenges.

Zhang Tieshan stated that the Commission for Discipline Inspection was the first department to issue a document prohibiting the practice of adding extra appointment slots. This policy aims to curb doctors from exploiting this mechanism to obtain illegitimate benefits, which must be explicitly banned. “The initial decision to open hospital appointment slots to the public was driven by its benefit to the general population.” Regarding how to implement this effectively, Zhang Tieshan outlined several key points. First, the process must be open, transparent, and subject to monitoring. Second, the entire workflow must be systematized. Finally, the value of appointment registration should be enhanced.

China-Japan Friendship Hospital's "Internet +” Active Exploration

In fact, China-Japan Friendship Hospital has never ceased its exploration of internet-based healthcare.

When hospitals connect to the internet, the most significant impact is seen in “appointment slot availability.”

Zhang Tieshan stated that registering at China-Japan Friendship Hospital is not difficult at all. Each day, patients can book from over 4,000 available appointment slots for the next five days. In fact, 80% of appointment registrations at China-Japan Friendship Hospital are made on-site. “Patients tend to believe that when health issues arise, they should seek out a doctor rather than a hospital. However, doctors are backed by medical institutions. While patients can only find doctors within hospitals, they may not necessarily find the most suitable one.” Zhang Tieshan believes that the core principle of internet-based healthcare is to use the hospital as a platform to directly connect patients with appropriate physicians.

Taking China-Japan Friendship Hospital as an example, after following the hospital’s official WeChat account, patients can directly locate and schedule an appointment with their preferred physician through the platform.

The Internet solves the problem of enabling information sharing and facilitating traditional information exchange.“Even before the patient arrived, I already knew who they were; even before a product was manufactured in the factory, I already knew who would need it. This is the advantage of digitalization.”

Furthermore, Zhang Tieshan believes that,Currently, the greatest advantage of the internet is that it has optimized the supply-demand relationship and production relations in the healthcare sector.In the healthcare sector, productivity refers to hospital physicians—a challenge that cannot be resolved by the internet for the time being. It takes over a decade to train physicians and many years to cultivate skilled nurses; likewise, hospital systems are built up gradually over time. Developing this productive capacity requires a long cycle. However, the internet can optimize supply-demand dynamics and production relations. This is precisely the primary demand traditional healthcare institutions currently have of the internet. “We do not advocate for physicians to directly provide consultations or make diagnoses online. We hope that more advanced technologies will emerge in the future to address this issue. This does not mean we reject it, but rather that such developments should align with the inherent laws governing the evolution of medical practice.”

Via the internet, physicians on the 14th floor can directly access radiological images acquired by the Radiology Department on the first floor and issue diagnoses to patients from the 14th floor. In fact, China-Japan Friendship Hospital had already been experimenting with this intra-hospital internet-based approach long ago.

In addition, Zhang Tieshan mentioned,Patient services and medical care are fundamentally different in nature. Patient services represent an area where the internet can make significant contributions, whereas medical care involves patient safety and dignity and is highly specialized; this responsibility should be undertaken by hospitals.As with China-Japan Friendship Hospital, which implemented health information systems internally at an early stage, a suitable pathway for extending these services from within the hospital to external settings has yet to be established.

Beyond Appointment Registration, the Internet Can Help Hospitals Do More

The internet can facilitate supply-side reforms in healthcare. First, it can help medical institutions improve areas where they are currently underperforming; second, it can enable them to undertake responsibilities they should be fulfilling but have not yet addressed. Since medical institutions possess a deeper understanding of the inherent principles of medicine, it is feasible for the internet to assist these institutions in advancing their informatization.

“Including payment, is there a way to allow patients to receive medical care at hospitals without paying out-of-pocket, while ensuring that the funds are still properly accounted for?” Zhang Tieshan believes that in the future, internet-based solutions and even commercial health insurance can effectively address this issue. Moreover, hospitals are willing to embrace such assistance.

Meanwhile, China-Japan Friendship Hospital has also explored an internal tiered diagnosis and treatment model. Currently, patients registering at the hospital are initially assigned to a general practitioner. This is not an issue, as the general practitioner can directly help schedule an appointment with the necessary specialist if a higher-level physician’s evaluation is required.

How can the human resources, time, beds, and equipment of doctors be optimized to the greatest extent? The current attempt by China-Japan Friendship Hospital is to have patients complete necessary examinations before their scheduled appointment time and go directly to the doctor with the results. If, for some reason, the examinations are not completed, the doctor can negotiate with the patient to adjust the appointment time.

Indeed, China-Japan Friendship Hospital has already explored team-based collaboration. “We have launched a joint outpatient clinic for neurology and ophthalmology. Patients with fundus lesions may require neurological evaluation, and we can provide one-stop solutions.”

On February 3, 2016, China-Japan Friendship Hospital integrated all interfaces from Alipay, Chunyu Yisheng, Baidu, China Mobile, Wen Yi, and Guahao.com into its own appointment registration platform. “Since I have made the appointment slots available online, I must connect all patient access points for registration.”

Furthermore, China-Japan Friendship Hospital has also undertaken process reengineering and standardization. “We aim to enable our patients to simply scan a QR code to find out their schedule for the next morning and afternoon, as well as identify their attending physician and primary nurse—all of these functionalities are achievable.”

The Internet directly connects patients with physicians. For instance, patients can search for “President Wang Chen” on Baidu Baike and book an appointment directly.

Currently, doctors at China-Japan Friendship Hospital set their own schedules in the backend system, rather than having them assigned by the hospital. This approach grants physicians greater autonomy and initiative.

“By leveraging the Internet, we integrate healthcare professionals and all medical resources to reduce the costs of the healthcare system. Through a more democratic approach, we enable broader access to these inherently scarce resources, thereby maximizing patient benefits. We are also committed to the continuous training of our physicians to enhance their professional capabilities and promote the robust development of our healthcare endeavors.”