It can improve convenience and access to services in resource-poor areas and provide continuous support

Healthy China 2030, a blueprint for the future of China's healthcare system that was announced by President Xi Jinping in October 2016, aims to make quality healthcare available throughout the country and also emphasizes a rapidly growing role for primary health clinics and family doctors. However, as of now, the medical system is still dominated by very large tertiary hospitals in large cities.

Telemedicine, medical support given over internet connections, has the potential to make seeing a doctor more convenient and more timely for patients and to alleviate the pressure on big hospitals. It also could provide improved access to medical services that often are not consistently available in distant rural communities. It is also used to save lives in critical care in emergency situations. But it faces some technological, organizational and legal barriers.

In 2014, China issued comprehensive guidelines to regulate and support the industry. In 2015, the National Health and Family Planning Commission issued a plan to create an interoperable, uniform service network in China, designed to allow Chinese patients and medical institutions to use telemedicine services throughout the country.

With this encouragement, telemedicine in China is expected to grow by 15 percent per year, according to iData Research. Private companies and public hospitals alike are jumping into this market.

At present, telemedicine cannot completely replace the traditional face-to-face treatment services. The main dispute over telemedicine is whether to establish a clinical relationship online, without examining the patient in person first.

The implications and effects of telemedicine are vastly different for different subjects and diseases. At first, telemedicine was mainly used in those areas that are less dependent on physical examination, such as psychiatry and dermatology. In some cases, like acute abdomen problems, it is difficult to diagnose without palpation.

Telemedicine can make the overall healthcare system better in three ways:

First, it can improve convenience and timeliness. For example, making an appointment through the internet may reduce the waiting time for the patient to line up, although it cannot increase the doctor's service volume. Mobile phone apps can allow the patient to integrate his or her health management by registering online and paying bills or accessing other "integrated" services.

Second, it can improve access to services in resource-poor areas. Through business-to-business, business-to-consumer and other long-distance online consultation methods, the service accessibility in rural and resource-poor areas can be greatly enhanced. Instead of face-to-face treatment, telemedicine can be fully applied to some subjects such as dermatology, psychology, pathology and imaging diagnosis. Development of telemedicine education and training will also improve the service of primary doctors.

Third, it can provide continuous support to patients with chronic diseases. There is a possibility to enhance, and even replace, the traditional model of chronic disease management. If doctors and patients have already established face-to-face relationships of diagnosis and treatment offline, subsequent consultation of some chronic diseases can be done via the internet. Patients can get the needed frequent advice about managing their disease. Coordinating between general practitioners and specialists, primary health facilities and hospitals could be much easier, thus giving chronic disease patients the support or treatment they need, when they need it.

Due to development of the mobile internet, internet of things technology and smart devices, the relationship between doctors and patients may become continuous, uninterrupted and intelligent. Meanwhile, patients will be more involved in disease management and the treatment process in the future.

In China, Internet Plus healthcare services will play an important role in improving the medical experience, the quality of medical services and service accessibility in resource-poor areas. Internet Plus is one of the prerequisites to achieve integrated health services that includes prevention, treatment, rehabilitation and health management throughout one's life.

Telemedicine will play an important part in making the goals of Healthy China 2030 a reality.

The author is deputy dean of the department of Health Security Policy Research of the National Health Development Research Center of the National Health and Family Planning Commission. The views do not necessarily reflect those of China Daily.

(China Daily European Weekly 11/10/2017 page9)