Beijing to Unify Drug Formularies by End of March and Implement Medicine Separation Reform Across All Public Hospitals

The Beijing Municipal Health and Family Planning Commission recently held its 2016 work conference on health and family planning, proposing that the drug formularies of community health service institutions and tertiary hospitals be unified by the end of March at the earliest; all public hospitals will implement the separation of pharmaceutical sales from medical services this year; Beijing, Tianjin, and Hebei Province will improve referral appointment systems; and the authority to license foreign physicians will be delegated to district-level health and family planning commissions.

Community Patients' Electronic Health Records Will Be Integrated with Hospital Electronic Medical Records

Fang Laiying, Director of the Beijing Municipal Health and Family Planning Commission, stated that many patients with common and frequently occurring diseases are flocking to large hospitals, resulting in low overall efficiency in the utilization of healthcare resources. Therefore, Beijing will unify the drug procurement catalogs for public hospitals and community health service institutions to ensure continuity of medication across medical institutions at all levels, and will pilot multi-channel distribution of drugs for community health services in selected districts. It is reported that there are currently 847 “blank villages” lacking healthcare facilities in Beijing, with a plan to achieve full service coverage this year. By 2019, all villages in Beijing are required to establish village clinics, ensuring one village doctor per 1,000 residents.

Currently, Beijing has 43 medical consortia, with over 460,000 cases of two-way referrals. Among these, more than 440,000 cases were referred upward from primary healthcare institutions. To attract more patients with common illnesses to choose community health centers for their initial consultations, Beijing will implement a model in community health service institutions whereby upward referrals require prior signing of a family doctor contract, and such contracts necessitate the establishment of electronic health records. This initiative aims to promote orderly coordination between primary care facilities and secondary and tertiary hospitals in referral services. Priority access to appointment slots at Beijing municipal hospitals will be guaranteed for patients referred from community health service institutions.

Zou Jianrong, Director of the Primary Care Division of the Beijing Municipal Health and Family Planning Commission, explained that patients visiting community hospitals in the future can access priority services—such as appointment registration, scheduled consultations, health management, and convenient medication prescribing—through a signed agreement system. The electronic health records established by community centers for patients will be integrated with hospital electronic medical records. Consequently, patients will not need to carry paper-based test results when referred for further medical care.

Going forward, “health records” combined with “electronic medical records (EMRs)” will replace hospital visit cards and paper medical record books at all hospitals. Eighty percent of municipal hospitals will establish information integration platforms centered on EMRs. More than 80% of community health service centers will receive telemedicine services from higher-level hospitals.

Beijing plans to promote the citywide issuance and hospital-based use of the "Beijing Tong" all-in-one health services card. Meanwhile, it will establish a two-tier (municipal and district) population health information platform, as well as Beijing’s foundational database for population health information.

Separation of Pharmaceutical Sales from Medical Services in All Public Hospitals

The Beijing Municipal Health and Family Planning Commission revealed that all public hospitals, including those under municipal administration, central government agencies, and the military, will implement the separation of pharmaceutical sales from medical services this year. The Commission will also collaborate with the Municipal Development and Reform Commission to formulate a plan for adjusting medical service prices.

Currently, five hospitals in Beijing—Beijing Friendship Hospital, Beijing Tongren Hospital, Beijing Chaoyang Hospital, Beijing Jishuitan Hospital, and Beijing Tiantan Hospital—have piloted the separation of pharmaceutical services from medical services. This reform abolishes the 15% drug markup, as well as registration and consultation fees, and introduces a medical service fee. At these pilot hospitals, outpatient medical service fees are determined by physician rank: RMB 42 for general outpatient visits, RMB 60 for associate chief physicians, RMB 80 for chief physicians, and RMB 100 for renowned experts. The basic medical insurance provides a fixed reimbursement of RMB 40 per visit; therefore, the out-of-pocket expenses for insured patients are RMB 2, RMB 20, RMB 40, and RMB 60, respectively.

80% of High-Risk Pregnant Women Are Received by Large Hospitals

This year, Beijing is expected to have over 300,000 newborns. The tiered registration and diagnosis-and-treatment system for pregnant women will be strictly implemented to enhance the service capacity of primary and secondary midwifery institutions, increase the proportion of high-risk pregnant women treated at tertiary hospitals, and ensure smooth referral channels for critically ill pregnant women.

A relevant official from the Beijing Municipal Health and Family Planning Commission stated that when the “selective two-child” policy was implemented, the admission rate for high-risk and critically ill pregnant women at tertiary hospitals rose to 40%; this year, the proportion is set to increase significantly to 80%. Medical institutions are required to scientifically control cesarean section rates and reduce the average length of hospital stay.

All districts in Beijing will establish prenatal registration centers, improve monitoring and early warning mechanisms, formulate emergency response plans, and implement a monthly scheduling system to ensure that pregnant women deliver at appropriate medical institutions. Opinions on strengthening pediatric care in Beijing and implementation guidelines for optimizing and integrating maternal and child health services with family planning technical services will also be issued.

6Public Healthcare Institutions Transition to Rehabilitation Care

The Beijing Municipal Health and Family Planning Commission disclosed yesterday that Xicheng District’s Zhanlan Road Hospital, Chaoyang District’s Cuigezhuang Community Health Center, Chaoyang District’s Anzhen Community Health Center, Daxing District’s Hongxing Hospital, Changping District’s Nankou Railway Hospital, and Pinggu District’s Jinhaihu Town Community Health Center will be transformed into rehabilitation and nursing facilities to meet the demand for integrated medical and elderly care services.

Beijing will also establish a community-based rehabilitation service model, support social capital in developing nursing services and setting up nursing stations, and study the basic standards for intermediate care, long-term care, and hospice care services for the elderly in medical institutions. Currently, a number of hospitals in Beijing are already providing hospice care services. Within the year, Beijing will formulate and issue guidelines for the development of its rehabilitation medical service system. The requirement for tertiary hospitals to establish departments of rehabilitation medicine will be strictly implemented.

Beijing, Tianjin, and Hebei Enhance Referral Appointment Systems

The Beijing-Tianjin-Hebei region will establish shared imaging diagnostic centers and consultation centers, and improve the referral appointment mechanism. Databases for electronic physician registration, health supervision, and collaborative verification of maternity services for the floating population will also be mutually accessible, enabling mutual recognition among the three regions of clinical laboratory test results, continuing education credits, and qualification review standards and outcomes for pharmaceutical procurement products.

This year, Beijing will also finalize plans for relieving non-capital functions and promoting balanced development in the healthcare sector, formulate the "Plan for the Healthcare Service System in Eastern Beijing (2016–2020)," and enhance resource allocation and service capacity in the administrative sub-center through various measures, including new construction and joint initiatives by municipal and district authorities.

Delegation of Licensing Authority for Foreign Physicians to District Health and Family Planning Commissions

Beijing to Deepen Reform of Administrative Approval System. Authority for Licensing Foreign Physicians Will Be Delegated to District-Level Health and Family Planning Commissions; Specific Measures Are Still Being Formulated.

It has been revealed that, following Beijing Anzhen Hospital, Beijing Friendship Hospital will also explore the “franchising” of high-quality medical resources. Through this franchising model, Friendship Hospital will collaborate with social capital to establish its Shunyi Campus, which will have 1,000 beds. Beijing Municipality encourages and guides the development of privately run medical institutions, facilitates their integration with commercial health insurance, and establishes relatively stable financing channels for their growth.

Source: Beijing Daily