Spotlight: COVID-19, China, & Telemedicine

A key element of China’s COVID-19 response strategy has been the adaptation of pre-existing initiatives, coupled with expanded use of emerging technologies to encourage telemedicine. Cities across the country are applying telemedicine both to limit the spread of the virus and to help with local shortages of healthcare providers, many of whom have been re-tasked with COVID-19 response. Medical resources can now be accessed online to relieve the burden of hospitals and continue helping patients unable or unwilling to make in-person visits.

Prior to the outbreak of COVID-19, China had outlined an ambitious plan for building a nationwide telemedicine network. The “Internet+ healthcare” initiative, which began as early as 2018, allowed medical institutions to provide online diagnostics for some common and chronic diseases and other services. Although the market had responded rapidly, with various healthcare service platforms and technology companies springing up, uptake was limited by patient and physician skepticism as well as systemic barriers such as the lack of reimbursement offered through these channels.

In response to COVID-19, the ‘Internet+ healthcare’ initiative was redeployed with the mandate of relieving the burden on public hospitals. Addressing a key structural barrier to online services, the National Health Commission announced guidance on promoting ‘Internet+’ reimbursement during the COVID-19 crisis,¹ improving the reimbursement policy for qualified online medical services. Online services provided by designated public hospitals in Wuhan (and later Zhejiang, Jiangsu and Guangdong provinces) could now be reimbursed at the same rate as parallel offline services.²

Online healthcare service platforms also benefited from this change in policy. On February 26th, WeDoctor became the first online-only healthcare provider to be open for medical insurance payment by the Wuhan Medical Security Bureau.^3,4

Tianjin Medical Security Bureau also updated the reimbursement channel for WeDoctor.⁵  Services and prescriptions for ten types of severe chronic diseases, such as hypertension, diabetes, chronic severe hepatitis, and cirrhosis are now reimbursable online.⁶

These measures helped close the loop for online healthcare services in China, covering teleconsultation, drug prescription, reimbursement, and drug delivery, which highly improved the practical use of telemedicine.

Accelerating the utilization of emerging technologies, including 5G technology, has enabled China to go beyond traditional telemedicine capabilities. China has begun utilizing telemedicine not only to tackle the impacts of COVID-19, but also to expand the level of diagnoses made and the number of conditions, and thus, people treated.

Prior to the COVID-19 outbreak, 5G’s application in remote medical services was largely theoretical in China. With government support, local hospitals in Wuhan, such as Huoshenshan and Leishenshan Hospitals, cooperated with two leading technology companies, Huawei, ZTE and Big 3 telecoms (China Telecom, China Mobile, and China Unicom). The purpose of this collaboration was to deploy industrial Internet of Things (IoT) applications and 5G robots.¹⁴ Remote CT scan, remote nursing, real-time multidisciplinary consultation, and surgery have been realized thanks to these technologies.

On March 2nd, the 5G mobile CT module was first put to use in Huangzhou General Hospital in Huanggang City, Hubei Province. On the same day, West China Hospital of Sichuan University carried out a remote CT examination for 106 patients in Huangzhou General Hospital through the 5G+ Remote CT system.¹⁵ This was the first time that COVID-19 was diagnosed by a 5G+ remote CT system across the province. 5G Robots have also shouldered the responsibilities of disinfecting hospitals and delivering medical supplies.¹⁷

This pandemic has reinforced the position of 5G by providing a need to accelerate 5G application rapidly. Thus, 5G networks and data centers have been put at the top of China’s spending plans as they develop a ‘new infrastructure’ for a post-COVID-19 life. Currently, China Mobile provides 5G coverage in 50 cities and plans to build at least 250,000 5G base stations in 2020. China Unicom and China Telecom have also cooperated to build 50,000 5G base stations across the country. China is expected to maintain a leading role in 5G application.¹⁸