Online healthcare services through pandemic and beyond

Against the backdrop of the COVID-19 pandemic, online healthcare services have become increasingly advantageous in meeting the medical needs of the people, while lowering the risk of infection and cost of time caused by cross-regional mobility. Thus, the national and local authorities have issued relevant documents providing new opportunities for the growth of the online healthcare services industry.

The general office of the National Health Commission issued three documents successively in February 2020, setting out requirements on the development of online healthcare services as part of COVID-19 containment efforts.

(1) The Notice on Strengthening Information Support for Prevention and Control of Novel Coronavirus Pneumonia, issued on 3 February, calls for efforts to “actively carry out telemedicine services” and “bring discipline to internet-based diagnosis and treatment advisory services” as ways of strengthening information support for prevention and control of the pandemic.

(2) The Notice on Improving Internet-based Diagnosis and Treatment Advisory Services in COVID-19 Containment, issued on 6 February, set out requirements on the role, organization and development of internet-based diagnosis and treatment advisory services during COVID-19 containment. The notice also requires the scientific organization of internet-based diagnosis and treatment advisory services by taking such measures as: establishing an internet-based diagnosis and treatment service platform; encouraging healthcare organizations to provide internet-based diagnosis and treatment advisory services; and guiding the public towards using internet-based diagnosis and treatment advisory services in various ways.

(3) The Notice on Strengthening Medical Services Management to Meet the Basic Healthcare Needs of the Masses during the COVID-19 Outbreak, issued on 17 February, re-emphasized the need to effectively provide internet-based diagnosis and treatment advisory services, strengthen online medical guidance, and give full play to the combination of “internet and healthcare”, as required by the previous 6 February notice.

Later, the State Council’s General Work Team for the Joint Prevention and Control Mechanism against Novel Coronavirus Pneumonia issued the Notice on Launching Online Services to Further Strengthening the COVID-19 Containment Work in Hubei province, on 26 February. With respect to COVID-19 containment in Hubei province, the notice required efforts to strengthen telemedicine services, set up a remote consulting platform, bring discipline to online diagnosis and treatment services, and fully harness the unique advantages of internet hospitals, and online diagnosis and treatment.

In addition to the above-mentioned macro policies on online healthcare services, the National Healthcare Security Administration and the National Health Commission jointly issued the Guidelines for Advancing “Internet Plus” Medical Insurance Services During COVID-19 Containment, on 2 March. In terms of the specific issue regarding medical insurance payment for online healthcare services, the notice made it clear that, during the outbreak of COVID-19, local authorities may extend the payment of medical insurance funds to cover the online follow-up services regarding common diseases and chronic diseases provided by qualified online medical service providers to insured persons in accordance with relevant regulations.

Before the central government document was issued, local authorities in Zhejiang, Tianjin, Jiangsu, Shanghai and Wuhan had issued relevant notices announcing their plan to try including online diagnosis and treatment services into the coverage of medical insurance during the outbreak of COVID-19.

The above documents called for faster and stronger efforts to develop online healthcare services, creating opportunities for the growth of the online healthcare services industry. Given a variety of factors, however, whether the industry can have sustained policy support and achieve long-term growth remains to be seen in practice.

All the above documents were specifically issued to fight COVID-19, and the relevant initiatives, requirements and opinions are all ultimately aimed at containing the virus. They will remain in effect only during the pandemic. There will be uncertainties as to whether the online healthcare services will still receive policy support after the coronavirus fades, and how to put such policy support into action.

The healthcare industry, due to its special nature, always remains high on the priority list for administrative supervision. The above documents also have stressed that discipline should be brought to the development of online healthcare services, apart from encouraging it.

According to the Administrative Measures for Online Diagnosis and Treatment (Trial), the Administrative Measures for Internet Hospitals (Trial), and the Management Standards for Telemedicine Services (Trial), promulgated in 2018, online healthcare services must be based on brick-and-mortar healthcare organizations, and shall exclude initial consultation.

Essentially, an online healthcare service is only a limited online extension of brick-and-mortar hospitals. How to define the roles of other types of players in the online healthcare industry, explore operating modes other than the platform built jointly with healthcare organizations, and encourage various forces to promote the development of the online healthcare industry, hinges upon China’s healthcare system reform in the bigger picture.

Nevertheless, online healthcare services manifest an increasingly sharper edge in an era of booming internet technologies. This industry is poised to grow overwhelmingly, although its development pace and direction remain to be seen in practice.

Jiang Tao is a partner at Merits & Tree Law Offices