Internet hospital in China: a cross-sectional survey. (December 2017) - Xie, Xiaoxu
Abstract: Background: Internet hospital is rapidly developing in China because it has the potential to provide widely accessible outpatient service delivery via internet technologies. To date, China's internet hospitals have not been systematically investigated. We aimed to describe the characteristics and to assess the health-service capacity of China's internet hospitals. Methods: For this cross-sectional study, we searched Baidu to identify internet hospital up to March 20, 2017, using search terms "Internet hospital", "web hospital", or "cloud hospital". All internet hospitals in mainland China were eligible for inclusion if they have been officially registered. Findings: We identified 68 internet hospitals, of which 43 have been put into use and 25 are under construction. Of the 43 established internet hospitals, 13 (30%) were in hospital information stage, 24 (56%) were in web-ward stage, and six (14%) were in full internet hospital stage. Patients accessed outpatient service delivery via website (n=32, 74·4%), app (n=18, 42%), or by an offline medical consultation facility (n=16, 37%) from the internet hospital. 25 of the internet hospitals (58%) asked doctors to deliver health services at a specific web clinics, whereas 18 hospitals (42%) did not. The consulting methods included video chat (n=26, 61%), telephone (n=8, 19%), and graphic message (n=12, 28%), whereas 13 (30%) internet hospitals do not offer online consultation at present. Only six internet hospitals are included in the coverage of health insurance. The median number of doctors available online was zero (IQR 0–5; range 0–16 492). The median consultation fee was ¥20 (IQR ¥0–200; range ¥0–1000; about US$2·90). Interpretation: Internet hospitals provide convenient outpatient service delivery. However, many of the internet hospitals are not yet mature, with various issues such as a scarcity of online doctors and incomplete coverage by health insurance. China's internet hospitals are heading in the right direction to improve how health service is effectively provided, but much more remains to be done. Funding: National Key Research and Development Program of China (2016YFC1000102, 2016YFC1000307) and National Natural Science Foundation of China (81602854).