The future of telemedicine: A perspective from China

Dr Jeffrey Staples, Group Chief Operating Officer of United Family Healthcare in China, shares how UFH utilises telemedicine and how it can shape the future of healthcare.

Telehealth is getting a lot of attention in Asia. It is seen as the most innovative way to continue to serve patients as it enables hospitals to provide services, through technology, despite geographical or physical limitations.

With 7 hospitals and 18 clinics in China, United Family Healthcare (UFH) also feels the impact of COVID-19 on its operations as confirmed by its Group Chief Operating Officer, Dr Jeffrey Staples. During the initial outbreak in China, many of the hospitals’ and clinics’ services were closed per government orders. While things are now largely back to normal, private hospitals throughout the country were not allowed to treat COVID-19 patients. They were also restricted in some of the other services that they could provide, including many elective procedures.

Dr Staples says that many facilities saw fewer patients due to concerns about the virus and hesitation to go to hospitals for a consultation or elective care. Even though people are “more relaxed now” because virus cases have significantly lowered in China, global concern remains as there is no vaccine available yet. Personally, Dr Staples believes that a vaccine cannot be expected to quickly end the spread of the virus, as it will take some time to develop, manufacture, and distribute enough for everyone’s access. Hence, fear and scepticism still remain in many parts of the world.

To address the new disrupted reality caused by the virus, UFH has been offering online consulting services since February. To date, UFH has teleconsultations in many specialties across multiple locations, including pediatrics, obstetrics and gynecology, internal medicine, orthopedics, ophthalmology, mental health centre, assisted reproduction, surgery, general practice, otolaryngology, neurosurgery, heart centre, sleep medicine centre, and dermatology, among others. 

In an effort to provide the community with access to their doctors, UFH piloted a teleconsultation program in partnership with different vendors. Sooner or later, UFH is keen to either develop their own platform or secure a long-term partnership with one of the larger digital platforms in China, such as Tencent, Alibaba, or WeChat. Dr Staples acknowledges that telemedicine will become the new normal for the healthcare industry and will likely be a significant growth-driver for healthcare moving forward: “I think what COVID-19 has done is it has pushed everybody towards digitalization like we are doing right now.  Everybody has been watching this space and thinking about it, but the disruption caused by COVID-19 has forced us to act very quickly.”

UFH currently offers telemedicine consultation services at no charge because their main objective is to help patients access care despite various restrictions. “Across the group, we have done maybe 4,000 or 5,000 telemedicine consultations and we are looking at how we can continue to do this in the long term to better meet our patients’ needs, and whether or not we should charge for it,” Dr Staples adds.

Telemedicine is likely here to stay, and the ultimate challenge for healthcare systems will be how to provide high quality, personalized service that can be monetised.  According to Dr Staples, UFH looks at telehealth from two different strategic perspectives. The first is to provide service to existing patients. The second is to help them provide easier access to more patients and enlarge their patient catchment area. From the pilot program, UFH found that “existing patients who use [telemedicine] have a very high conversion rate to making an appointment with a doctor”. From the new patients they get, the conversion rate is somewhat lower.  This is particularly true for new patients who are accessing UFH’s system via telemedicine from locations where the hospital does not have a physical presence.  

Despite its convenience, telemedicine has its limitations, including existing government policies and potential cybersecurity threats. 

Just like in other Asian countries where the government is instrumental in legitimising this kind of service, China also has its own rules largely designed to protect the patient. In China, doctors are not allowed to do a primary diagnosis or prescribe any treatment through most digital platforms. Hence, the consultation is limited to listening to the patient and giving advice. If a hospital wants to expand its teleconsulting operations to be able to make primary diagnoses, it needs to apply for an internet hospital license, which is a relatively new license category and is difficult to obtain.

An internet hospital in China must have a licensed hospital facility and is allowed to make a diagnosis, prescribe medication, order tests, and deliver medications through a partnership with a delivery company or a retail pharmacy. With internet hospitals, everything can be done remotely, and patients will just be required to go to the hospital for laboratory tests and/or imaging studies. To get a license, a hospital has to have certain clearly defined digital infrastructure capabilities, and this is where partnerships can be made with digital platforms like Alibaba, Tencent, and the like.

Cybersecurity is another challenge faced by the industry, which is accentuated by the push into telehealth. As healthcare providers become increasingly digital, the potential risk of someone hacking into their system and accessing confidential medical and financial information increases significantly.  As of writing, China has been strictly monitoring healthcare organizations in the country and their data security and is taking proactive measures to ensure that healthcare organizations strengthen their cyber-security capabilities.

Despite these restrictions, the healthcare industry is confident that telemedicine will soon be a big wheel of digital health in Southeast Asia. If there’s anything good to come out of this stressful time, it is the opportunity to try out innovative solutions that otherwise remain just ideas.