13 Chinese Hospital Presidents on 'Internet Plus': Anxiety Masks Opportunity

• VCBeat (ID: vcbeat)

Following the trends of “Internet + Healthcare” and “Internet + Physicians,” VCBeat has now turned its attention to “Internet + Hospitals.” The “2015 Evergreen Century Hospital Forum,” co-hosted by Health界 (Healthjie) and Wuhan Central Hospital, was held in Wuhan on November 26–27. A key theme of the forum was “When Hospitals Meet Internet+.” As a media partner, VCBeat participated throughout the event and conducted exclusive interviews with several hospital presidents.

Over the past year or more, much of the attention directed at internet healthcare has focused on the “internet” side. In particular, many projects with a strong internet orientation have hit walls, leading to laments about the conservatism and intractability of the healthcare industry—but this is not the whole truth. On the hospital side, which holds core healthcare resources, VCBeat has observed several important phenomena:

1. Faced with the harassment and clamor of the internet, hospitals generally feel anxious; they wish to accommodate it but do not know how, and they wish to resist it but feel that something is amiss;

2. Many hospitals have not only proactively embraced the Internet but also reaped significant benefits, leading them to hope for faster Internet-driven innovation and stronger policy support, thereby enhancing their managerial control capabilities;

3. Collaboration between hospitals and internet companies is the mainstream approach; it is less likely for hospitals to build their own in-house internet teams, as they prefer partnerships.

4. Hospitals possess a strong sense of responsibility and mission; internet-based products need to better understand the mindset of hospitals.

5. The implementation of healthcare reform policies and the evolution of internet-based healthcare require hospital management to keep pace with the times, seamlessly integrate with digital technologies, and advance through practice. For instance, tiered diagnosis and treatment, multi-site practice, and health insurance reimbursement are not insurmountable barriers.

Here are the key takeaways. VCBeat has carefully curated statements from hospital directors and senior executives. Many of these leaders come from century-old hospitals, so let us refrain from labeling hospitals or the medical sector as conservative. Instead, greater exchange, communication, and trust are the keys to overcoming challenges.

▲Wu Jixiang| President of Beijing Tongren Hospital, Capital Medical University

Wu Jixiang stated:In the era of “Internet+,” everyone is embracing the Internet; no one would refuse it.

“Let me share a brief story here: We all take photos. People of my generation remember Kodak and Fujifilm, but those have disappeared, replaced by digital cameras as we entered the digital age. The internet is similar; nowadays, no hospital can claim to be unrelated to the internet.”

I believe that with the advancement of technology, an unexpected era of the Internet will surely arrive. As for how the Internet integrates with healthcare, I hold that physicians must have direct contact with patients when providing medical care.“The internet can serve as a platform and tool for physicians, hospitals, and medical services, but it cannot replace the physical presence of hospitals or the clinical care provided by doctors to patients.”

VCBeat then posed a question to President Wu: As a hospital president, how do you view physicians’ multi-site practice? This is a crucial component of the “Internet + Healthcare” model.

Dean Wu stated that he is fully open to the practice of multi-site licensure, with Beijing Tongren Hospital taking a leading role in this regard. In foreign countries, hospitals typically employ both full-time and part-time staff, with part-time personnel working one or three days per week, among other arrangements. Beijing Tongren Hospital and Beijing Anzhen Hospital have established robust collaboration, allowing specialists from their respective departments of strength to practice across both institutions, thereby jointly enhancing the overall capabilities of both hospitals.

President Wu believes that,The Next Key Step in Healthcare Reform Is to Implement Tiered Diagnosis and Treatment, what are the challenges of tiered diagnosis and treatment? In China, larger hospitals have higher outpatient volumes, while primary care institutions and community health centers lack high-quality physicians, leading to a lack of public trust. In fact, the policy allowing physicians to practice at multiple sites aims to address this issue and pave the way for its resolution.Physicians from large hospitals can work in community settings and even establish private clinics.

▲ Wang Yipeng| Vice President of Peking Union Medical College Hospital

When it comes to “Internet+,” President Wang stated that high-quality medical resources in our country are primarily concentrated in large hospitals. He suggested that internet companies should give more thought to how they can leverage internet-based methods to maximize the advantages of these premium medical resources. The goal should be integration and mutual benefit, rather than disruption or competition. Consider this: if these leading hospitals were to develop their own internet products, how would internet companies cope with such competition?

Regarding the issue of physicians practicing at multiple locations raised by VCBeat, President Wang believes that maintaining an open mindset must be a principle adhered to by the hospital; however, to implement this effectively, all parties must pay attention to two key aspects.

First,Our situation differs from that of the United States. Chinese physicians are not independent practitioners; upon graduation, they are directly employed by medical institutions. This arrangement involves various aspects of physicians’ professional lives., such as capability enhancement, career advancement, insurance, and benefits. The relationship between physicians and hospitals is very close. If a physician chooses to practice at multiple locations, many hospitals may wonder whether the physician is no longer committed to the hospital. This is a minor hurdle currently facing multi-site medical practice.

Second, multi-site practice was not just liberalized today. In 2009, the National Health and Family Planning Commission launched pilot programs in Yunnan and Guangdong provinces, but the results were not particularly impressive. Now that internet companies are entering the field, what can they offer? Is it technology or resources? However, the key to multi-site practice still lies with physicians, and 95% of top-tier doctors are concentrated in large hospitals. Therefore, my view is thatInternet companies should establish better communication with hospitals to jointly leverage their respective strengths.

▲Huang Yong丨 Deputy Secretary of the Party Committee, West China Hospital of Sichuan University

Centennial hospitals have generally fared well in their development to date, largely due to heritage. Heritage fosters a culture that provides nourishment and depth, yet it can also produce adverse effects during the innovation process. The most difficult institutions to change are precisely those with strong operational performance, as they often struggle to implement timely technological innovations and service model innovations.
We have encountered “Internet+,” which is likely bringing about changes in scope and depth unseen in over a century. I personally believe this is a matter worthy of serious attention. Although everyone now speaks of embracing “Internet+,” the reality is that while some physicians have taken action, public hospitals as institutions have not made any significant moves. There are two reasons for this:

First, public hospitals may still have gaps in their understanding. While embracing change is a fundamental attitude, it is equally important to adopt the right approach in doing so.

Second, public hospitals view “Internet + Healthcare” from a different perspective than society at large; what needs to change is not only inter-institutional coordination, but more importantly, the promotion of upgrading in the healthcare industry.

Currently, our primary focus is on ancillary healthcare services, such as facilitating convenient access to medical care, streamlining patient registration, and simplifying payment processes; these efforts do not yet extend to the core provision of medical services. Truly conducting online diagnosis and treatment would still face significant limitations given the current state of technology.

▲Yao Shanglong| Deputy Director of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

Wuhan Union Hospital boasts a 149-year history and, like the other two “authentic” Union Hospitals—Peking Union Medical College Hospital and Fujian Union Hospital—carries the genetic imprint of Western cultural influence. They mark the entry of Western medicine into China and also represent the advancement of Chinese medicine.

Wuhan Union Hospital has always upheld the philosophy of benevolence and serving society. We hope to carry forward this fine tradition; however, as a century-old institution, it possesses both advantages and drawbacks, making it challenging to transform entrenched traditions.In the Internet Era, No Change Means No Future.

The future era may not have universities,It is entirely possible to attend university online; it is only a matter of time., so I believe that with the advent of the Internet, it is impossible not to change the future.

▲Chen Haixiao| Director, Taizhou Enze Medical Center (Group), Zhejiang Province

As we head to Beijing, what matters more: the highway or the cars traveling on it? Obviously, the cars. Our hospitals and doctors are the cars, while the internet is the highway. We need to “shift gears” to embrace it, as it will provide hospitals and doctors with greater opportunities to leverage their capabilities. However, achieving true disruption may still take time.

Medicine is a century-old discipline, serving the ultimate goals of humanity.. Medicine is a critical pillar; therefore, in the face of various scientific disciplines, including internet technology, the medical field must remain open, embrace these advancements, harness them to serve our purposes, and integrate them with medical practice.

In fact, the number of outstanding doctors in China is quite small relative to its enormous population. As a hospital director, I am also a physician.What I look forward to most is how the Internet, through artificial intelligence, can enable the low-cost replication of top physicians’ expertise.. This is a strong point of integration between the internet and hospitals; when we share common values, the two truly come together.

▲You Xiangdong| Vice President, The Second Affiliated Hospital of Zhejiang University School of Medicine

Our core values are patient-centricity and service excellence. "Internet + Healthcare" must return to its original intent; if it facilitates physicians' work and benefits patients, then regardless of the specific platform or mechanism employed, it is something that should be pursued.

Our hospital began offering telemedicine services in 2006 and launched smart healthcare initiatives in 2011. I believe that,“The hospital’s walls cannot hold everything in, yet relying solely on the internet is equally unreliable. Finding an optimal integration of the two is what we are currently contemplating.”

We are currently developing an online hospital, which serves as an excellent platform and lever to connect patients, healthcare professionals, and hospitals. It focuses primarily on the establishment of information systems, services, and platforms, while also integrating pharmaceutical distribution. This embodies the objectives and scope of “Internet + Healthcare Services.”

"Our doctors have already openly practiced at multiple sites."As time goes on, such phenomena will become increasingly prevalent. Public hospitals should adopt an open and inclusive mindset to address this trend. We must strengthen our disciplinary development, with managers primarily focusing on providing services and building platforms to attract more outstanding physicians and nursing management professionals. This is the core mission of our platform.

▲Gong Zhicheng| Deputy Secretary of the Party Committee, Xiangya Hospital of Central South University

I believe “Internet Plus” is a national strategy,The key is for every hospital leader and physician present to focus on developing their core medical technologies. Once a hospital strengthens its own capabilities, it will excel in any “Internet+” initiative.

For example, five-star or seven-star hotels built 10 or 20 years ago would struggle to survive if their services lacked core competitiveness.

▲Li Wenzhou丨Vice President of Wuhan Central Hospital

When it comes to hospitals meeting “Internet Plus,” the question is whether it should be framed as “Hospitals + Internet” or “Internet + Hospitals.” Although the two phrases differ only in word order, they reflect fundamentally different relationships. In this wave of innovation in the new era, hospital administrators must consider whether we should merely accommodate it, integrate with it, or achieve deep fusion with it.

I believe that, as the “Internet Plus” initiative has evolved to its current stage, physicians have become its most favored demographic.Because the internet has provided a brand that opens the doors of hospitals, transforming doctors from institutional employees into independent practitioners, hospital directors must carefully consider this issue.

From two perspectives, hospital doctors will go out, but more doctors will also come in. Hospitals should actively embrace the Internet and excel in management and brand building. In this way, I believe that not only will there be more doctors, but also more patients.

▲Wang Yifang丨Professor, Institute of Medical Humanities, Peking University

A century-old hospital values brand heritage, while the internet is a factor.# Returning to Fundamentals While Embracing Innovation“Internet + Healthcare,” convenient medical services, light consultations, long-term care, and the integration of medical and elderly care can bring about a significant revolution and resolve many conflicts between patients and doctors, as well as among doctors themselves.

A Harvard University professor authored a book arguing that the primary cause of doctor-patient conflicts is “care among strangers.” In traditional hospital settings, doctors and patients are strangers to each other, leading to mutual distrust. In contrast, internet hospitals do not involve such stranger dynamics. Online platforms allow patients to thoroughly understand physicians’ backgrounds, while doctors can also review patients’ information in advance. This transparency can effectively reduce doctor-patient conflicts.

Internet-based healthcare is not Internet medicine; therefore, healthcare addresses the whole patient, who encompasses physical, psychological, social, and spiritual dimensions. Hence,“Internet Plus” is merely the first step; tearing down institutional walls today is not something to fear.We typically refer to medical practice as "CARE." When physicians are not present, it is termed "service." The "Internet Plus" model delivers service, but the integration of service and CARE represents the future direction of medicine and returns to its fundamental essence.

▲Sun Xizhuo| President of Shenzhen Luohu People's Hospital

For hospitals, the internet is merely a tool—how can it be leveraged to achieve simplicity and convenience, including through cloud storage and data management? Who will put an end to the unchecked expansion of public hospitals?First, the impact of social capital. Second, the impact of the Internet.

I believe that the primary focus of public hospital reform in 2015 should be tiered diagnosis and treatment. While this initiative has received significant attention from both central and local governments, its implementation has become increasingly challenging. I hope to avoid a mere formality and instead drive thorough and substantive progress.

Public hospital reform is a systematic project that ultimately relies on the government’s top-level design and social forces for its advancement. Public hospitals, physicians, and healthcare professionals are all key stakeholders in this process. Our current objective is to provide better services to patients.By leveraging all available resources to fulfill our responsibilities, we can make a modest contribution to the reform of public hospitals.

▲Ding Yitao| Honorary President, Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University

Tiered diagnosis and treatment should not be naively interpreted as tertiary hospitals simply referring patients to county-level hospitals; this is a matter of market competition. The real change lies in,Future models must be patient-centric and deliver high-quality services, which presents a significant opportunity for small and medium-sized hospitals.

The greatest obstacle to public hospital reform currently remains the need for further ideological liberation. The most heavily criticized aspect of public hospitals at present is their inefficiency. “Internet+” serves as a tool; its proper application will drive large-scale transformation in healthcare delivery models.

The internet continuously improves efficiency through online and offline integration, enabling rapid and precise medical care. Patient demands are evolving, and government policies are compelling change. Private hospitals will emerge as a significant force. It is crucial to remain sensitive to this trend and recognize these shifts.

▲Liu Jian| Former Party Secretary of Beijing Friendship Hospital, Capital Medical University

“Internet+” has an impact on governments, hospitals, and medical personnel.

For medical professionals, this platform enables them to directly engage in clinical practice. Although many barriers remain unbroken, it at least provides healthcare workers with an additional career pathway.

For hospitals,“Internet Plus” provides a second platform, enabling doctors and patients to communicate and interact directly online without going through hospitals, thereby breaking the monopoly that any single medical institution previously held over the sole platform.. Therefore, it will bring about changes to the traditional healthcare model.

For the government, every local administration is currently facing the same challenge: the rate of health insurance fund collection falls far short of the expenditure rate, making a deficit inevitable. In the future, the government’s primary task will be cost containment. “Internet + Healthcare” will be the government’s preferred approach. Treating the same condition incurs high costs at tertiary hospitals, lower costs at community hospitals, and even lower costs at internet hospitals.

“Internet+” as a new platform has delivered a powerful impact on the traditional healthcare model. What we can and must do is to utilize, harness, and refine it, rather than resist it.

▲Sun Changlin| Party Secretary of the Committee of Wuhan Central Hospital

In 2015, public hospitals experienced a period of anxiety. From the perspective of national top-level design, policies were proposed to implement tiered diagnosis and treatment, eliminate drug markups, and allow social capital to enter the healthcare market. However, there were no specific policies in place to detail how these measures would be implemented or to guide the development of public hospitals.

The government hopes to achieve the public welfare nature of hospitals with minimal investment, while the public expects to receive quality medical care at lower costs. How can public hospitals reduce their profit margins yet still ensure institutional development and motivate staff? This is an extremely challenging issue. Consequently, we are currently in a period of anxiety, which I believe will persist for some time.

The Greatest Change Brought by “Internet Plus”:

First, shift the hospital’s focus from a disease-centered diagnosis and treatment model to a health-oriented approach, thereby transforming patients’ healthcare experience and our service delivery methods.

Second, the current business model remains hospital-centric; in the future, it must genuinely shift to a patient-centric approach.

Special Note:

The sharing of valuable insights is not over yet. VCBeat will subsequently publish an exclusive interview with Yang Guoliang, Deputy President of Wuhan Central Hospital, a practitioner-leader in hospital administration. Wuhan Central Hospital is one of the best-performing public hospitals in China in terms of internet integration and healthcare informatization. Additionally, there will be practical insights shared by a highly approachable female hospital president with strong internet-minded thinking. Please follow VCBeat’s WeChat account: vcbeat, to watch later.

(Note: The above images of individuals are sourced from the conference or the internet.)