Internet Medical Series (iii): Has the interrogation been overturned?

November 3, in order to celebrate the September Spring Rain Doctor platform to activate more than 30 million users, spring rain staff each received a silver bracelet, this number has also aroused the industry's discussion of internet interrogation.

According to the data, Dr. Rain was founded in 2011. This time point needs to be paid attention to: has been concerned about Internet medical entrepreneurship of the arterial network founder Gubeni told NetEase technology, according to her observation, just from 2011, 2012, with the online "interrogation" function of the site and mobile app began to rise up, there are newly founded enterprises, There are also prior to doing other health-related business enterprises.

And as more and more participants enter, the upheaval of Internet interrogation may be brewing, and the exploration and development of practice is far beyond all our understanding of it.

Status quo: Avoiding the difference of "interrogation"

At present, we are familiar with the Internet "interrogation", with good doctor online and spring rain Doctor as the representative, the approximate mode is the user through the Web site or mobile app, to the Doctor counseling body condition.

Such enterprises generally avoid the word "interrogation", but only "consultation".

As early as 2001, the Ministry of Health issued the "Internet Medical and health information services management measures", which fourth stipulates that: Medical and health information services can only provide medical and health information advisory services, not to engage in online diagnosis and treatment activities. The use of the Internet to carry out telemedicine consultation services, belongs to the medical behavior, must comply with the Ministry of Health "on the strengthening of telemedicine consultation management notice" and other relevant provisions, only in the medical institutions with the license to practice the medical institutions.

Although this administration was abolished in 2008, the "Internet Health care Information Services Governance approach", which was officially implemented on July 1, 2009, continues to "not engage in online diagnostics and treatment activities". In August this year, the National Health Planning Organization issued the "Advice on the promotion of telemedicine services in medical institutions", direct telemedicine is defined as: "Telemedicine service is a medical institution (hereinafter referred to as the invitation) to invite other medical institutions (hereinafter referred to as invited), the use of communications, computer and network Technology (hereinafter referred to as information technology), Provide technical support medical activities for patients in this medical institution. ”

Good Doctor Online was founded in 2006, is an earlier Internet health consulting business. According to a good doctor online Vice President Hepo Memories, on the internet to do disease counseling, from the Internet BBS era began, the early years of several portal health channel also involved, health portal 39 health nets are doing, the most typical such as "Baidu Know", a lot of disease counseling, Baidu know that there are answers; but this period, The typical question is "who doesn't know who answered the question". Hepo remembers that there were already real-name doctors in the forum answering questions. Good Doctor Online is the first hospital doctor's information base, 2007 began to do healthy online counseling.

The "consultation" available for such applications is limited. NetEase technology interview with the industry insiders also generally believe that such a platform generally the top doctors are not high: because people generally use this kind of application is to ask colds questions, and the top doctors are more inclined to engage in "technical content" of the work.

This October, Gubeni made a study of Internet medical Innovation business model: Online inquiry, she has observed online "interrogation" applications include: Spring Rain Doctor, good doctor online, quick ask doctor, seek medical medicine, female private doctor, Purple Medical, 39 ask doctor, safe health housekeeper, etc.

She found that most of these applications were concentrated in the same way before the diagnosis, but found that some applications were being developed into segments such as female private doctors. In addition, video site 9158 has aroused her concern.

This October, 9158 parent company Pigeon Interactive announced the official entry into the online medical; According to media reports, 9158 of the play is: first from the Hong Kong market as a starting point, through the online, so that the mainland can enjoy the high-end medical resources in Hong Kong. Gubeni to NetEase Technology explained: "In foreign countries, video interrogation more mainstream." But video interrogation in mainland China has not been developed for reasons of domestic policy control. The ingenious thing about the 9158 move is that it starts in Hong Kong and its future development is worth observing. ”

NetEase Science and technology reporter in the interview learned that many enterprises are also seeking differentiation of competition.

November 2013 at the end of the test run, March 2014 officially online green Apple Mobile health, on the main after the "acquaintance Doctor", that is, online contact doctors and patients, has been online under the face. Green Apple Health CEO Jiayi told NetEase Technology, the pain point of the doctor-patient communication in the past is that doctors want to keep in touch with patients, and patients want to keep in touch with doctors, but if doctors give their cell phone numbers to patients, the number of people who call them is too much, and the Doctor's life will be greatly affected; Doctors generally do not want to leave contact with the patient, and "green apple Health" is hoping to "buffer" this contradiction, patients can get the doctor after the "two-dimensional code card", scan the code can enter green Apple health and doctors on the platform to maintain contact.

Jiayi that this kind of connection is a deeper interaction, for doctors, his patients are more targeted, more viscous to the platform; According to the said, green Apple Health in Shanghai, the coverage of the three hospitals is 100%, the director of the three hospitals, deputy chief physician accounted for about half of all doctors on the platform, The current platform is still active, some doctors even open more than 10 times a day, hundreds.

NetEase technology reporter after green apple health registration, randomly looked at the platform of the doctor, found that there are many famous doctors such as Wu; This is indeed different from some of the doctor resources on the platform, many platforms say doctors above the doctor accounted for a large proportion, but went into a random look at some of the famous hospital departments, The top doctors are not on the platform. But the stickiness and dynamism of these top doctors on the green Apple health platform is unclear.

Staring at the market is not a green apple, in fact, a good doctor online, registered network, medical treatment 160 are currently involved. Doctor 160 founder Lonning told NetEase Technology, after the diagnosis is a huge market. Before the establishment of medical treatment 160, Rhonin in 2005 founded the Shenzhen Ningyuan Technology Co., Ltd., the enterprise is the larger domestic hospital infection management software suppliers, Lonning I since 1998 the country to promote medical and health information at the beginning of the public hospital in Shenzhen. 160 medical treatment in the market after the play is to cooperate with the hospital after the management of the consultation. For example, they cooperated with Xiang-ya hospital, and the information management of all liver patients in Hunan Province was the system using Ningyuan technology. Lonning told NetEase technology that the patients who now manage with their systems are over 100,000.

For the future development, Lonning said, "The future of the Internet ' interrogation ' development, is certainly more and more in-depth, our industry accumulation and advantages will gradually highlight out." Now do the Internet medical enterprises, either the Internet companies to do in the medical field, or the medical enterprise in the direction of the Internet to do outside. The enterprise that grasps the medical core resources will win, and the whole industry will change in the next year or two. ”

Telemedicine: It's not that simple.

In the eyes of Feng She, president of the Tianjin Tele-Medical Association, telemedicine is a broader concept, he said: Telemedicine is a very broad concept, not a combination of simple it and medical technology, it is an industrial chain. ”

Feng She Undergraduate Study of Medicine, 2010 to study in the United States MBA; Before studying abroad, Feng She learned the data show: "The development of foreign telemedicine has a history of 40 years, our country started late", but when he arrived in the United States only to find that is not so. "Telemedicine has not been widely used in the United States for many years. The outbreak of telemedicine in the United States began in 2009, 2010 years, along with the gradual popularization of 4G network, since then many applications and ideas have become reality. "Feng She said.

He told NetEase Technology, the American Tele-Medical Association (ATA) is the world's largest NGO in telemedicine, and can see how complex the industrial chain of telemedicine is from the organization's composition. Members of the American Telemedicine Association include three U.S. operators At&t, Verizon (Willison), Sprint (splinter), America's top ten insurance companies, Google in the Internet, Microsoft, Cisco, Oracle, Qualcomm, EADS of remote conferencing systems, A variety of IT hardware and software manufacturers, network equipment providers, major hospitals, institutions, doctors, medical equipment companies, manufacturing industry, General Electric, Siemens, Panasonic, Philips and many other enterprises.

Feng She, the future of Tianjin Telemedicine Association will be for all interested in promoting telemedicine of individuals, medical institutions and companies open to create a good ecological system. The current state of the industry, with Feng She words is "chaos first opened", all parties in learning, groping among.

It is envisaged that the Tianjin Tele-Medical Association will conduct a professional exhibition with the American Telemedicine Association each year to exchange technology and ideas, and to work with the Government to promote the landing of telemedicine projects. "In the past, our telemedicine has not been popularized, there are reasons for not knowing it, and there are technical problems." The original network speed, bandwidth is not enough, the use of high cost, but now the objective conditions have changed greatly, China's 4G network is becoming popular, the United States has a good business model and experience can be used for reference. The future of telemedicine and the past is not a concept at all, it is not only remote interrogation, but through the Internet to make resources more reasonable configuration. "Feng She thinks.

The other side: The medical system is on the move.

In the field of telemedicine, medical systems are also being acted on, in addition to commercial exploration.

October 25, the Guangdong Provincial Network Hospital after one months of trial operation, officially on-line opening. This is the first nationwide access to health and family planning permission of the network hospital.

The first network hospital in Guangdong Province is based on the second People's Hospital of Guangdong province, third party Shenzhen Hua Tuo Online Network Co., Ltd. to provide network platform, in the Community Medical Center, rural Health room, large-scale chain pharmacies and other sites to establish network visits. The patient can go to the doctor of the second People's Hospital of Guangdong province on the line by video. After the consultation, the doctor prescribed on the computer, can immediately through the doctor point of the printer to print out, the patient can be prescribed at the point of treatment or other places to buy medicine.

Guangdong Province, the second People's Hospital development department director Zhang Shenming told NetEase Technology, now in the network hospital sat seven or eight doctors, 3 general practitioner, other doctors from all departments, currently involved in the department of Traditional Chinese Medicine, cardiovascular medicine, general Internal Medicine, endocrine division. "At present, young doctors, young people interested in the Internet, like to try new things." "Zhang Shenming said.

Guangdong Province, the second People's Hospital information division director Wu Pingyang told NetEase Technology, at present, the Guangdong Provincial Network Hospital to visit the point of 30, visiting points to pharmacies mainly to see a doctor is currently free, the future may charge a small amount of medical expenses. He told NetEase Science and technology, at present, the network hospital is mainly to solve some common diseases, chronic diseases, a simple condition of some patients, "such as some of the old patient, on their own condition is very clear, as long as every time to consult the doctor, prescribe medicine on it." Network hospitals can provide them with great convenience, so as not to run back and forth, line up. Wu Pingyang said, "If the condition is more complicated, need to do the examination, etc., still have to go to the hospital." ”

He also told NetEase Science and technology, medical activities even if there is a certain rate of misdiagnosis, the network of hospitals in Guangdong province, the whole process will be recorded in the system, if there are problems after the case can also be found.

At present, the operation cost of the network hospital is paid by the second People's Hospital of Guangdong province. Wu Pingyang told NetEase Technology, in the current 30 pilot, there are some pilot equipment is the hospital to install, there are some pilot pharmacies themselves installed. "Some pharmacies are optimistic about this market, because patients after the disease is likely to buy medicine in pharmacies." "Wu Pingyang explained.

The pilot run for two months, the patient is not much, the average daily multiplying people. Li Guan, deputy dean of the second People's Hospital of Guangdong province, said to the media, "at the end of the year, we strive to lay 10,000 network hospital visits." The long-term goal is 50,000 network visits. ”

Wu Pingyang told NetEase technology, Guangdong Province, the second People's Hospital to establish a network hospital, is to explore the quality of health resources to sink the method. Since 2012, in order to solve the situation of the patients in the big hospitals and the decline of the primary medical institutions, the state has reconstructed and perfected the grading diagnosis and treatment mode, promoted the Community family Doctor Service, and selected some cities to carry out the primary first consultation as the important content of the public hospital reform. October 9 This year, the National Health Planning Conference held a October routine, announced the drafting of grading system related documents, will gradually establish suitable for the current situation of the classification of diagnosis and treatment system. The provinces will set up at least one public hospital to reform the city and take the lead in the pilot grading system.

"The grading system is difficult to implement, and the quality medical resources need to be really sunk." So, our Cyber hospital is an attempt to see if this road can go through. Wu Pingyang said, "As for the cost of running the problem, we have to look at the future, if the package can work, can be promoted in a wider range, then this matter is not the second people's Hospital in Guangdong province." ”

At the China Wise Medical Conference this June, Yan Gang, director of emergency department of the first affiliated Hospital of Tsinghua University,/icu that the visualization of telemedicine will be a milestone in medical development through the flow of source resources instead of the flow of expert resources. This not only manifests in the disaster first aid, the sudden disease patient's treatment, It will also be reflected in the family management of the elderly, integrated services in the clinical field, regional medical services and first aid community. According to Yan Gang, some cities and regions in the country are carrying out the relevant pilot work.

At the same time, intelligent grading diagnosis and treatment has entered the field of policy research.

Cheng, director of Medical Innovation and new technology Research center of Health Development, National Health and Family planning Department, told NetEase Technology, "the future of new technologies will bring great changes in the current medical model, we are studying how the corresponding medical policies should adapt to this change." This is also one of the major research topics in the early research of the Thirteen-Five Plan of health and family planning in China. ”

He also told NetEase Technology, the center is doing a study is "intelligent grading diagnosis and treatment model" research, "We hope to use the wisdom of medical treatment to help the grading of the treatment policy, single administrative means is afraid to solve the basic problem of insufficient basic skills, It is necessary to solve the contradiction between the primary diagnosis and treatment ability and the need of information technology. ”

Cheng said that health reform into the deep waters, the implementation of any health care policy can affect the overall situation, the Government in the formulation and implementation of the process will be cautious; therefore, before the implementation of policy formulation, there will be forward-looking policy pilot research and evaluation.

The Research center of Health Development is carrying out the research of Intelligent Medical cooperative theory and practice model based on the application of modern new technology, and it is one of the achievements to construct the "intelligent grading diagnosis and treatment" model. The model includes "politics, technology, people, clothing," (Government, technology, talent, service, insurance, GTPSI) Five dimensions, the various dimensions of mutual support and synergy, its core objective is through various technical means and synergy mechanism to improve the primary diagnosis and treatment capacity, strengthen community and superior hospital cooperation, improve efficiency, reduce costs, promote equity; In order to achieve this goal, new technologies are needed to promote the system to specialization, standardization and intelligence, as well as synergy, and the current Internet medical, mobile medical and large data will provide a powerful means for constructing intelligent grading system; Cheng also said that information technology is also a double-edged sword, The State has recognized that encouraging the innovation of the medical model should be accompanied by strengthening patient privacy and information security supervision and guidance, as well as clarifying the relevant requirements of Internet practice, and the center is doing research work in this field.

Cheng also told NetEase Technology, currently they are conducting telemedicine standards and guidelines for research, the appropriate time will promote the pilot work.

(Responsible editor: Mengyishan)