Spotlight: COVID-19, China, & Telemedicine

Quarantining, social distancing, and the ‘new normal’ are the buzzwords of this pandemic, but isolation is posing a mounting concern for patients unable to visit doctors face-to-face in order to receive treatment, diagnosis, follow-ups and more. Out of necessity, a large proportion of healthcare providers and patients have turned to telemedicine to help fill the gap during this pandemic.

COVID-19’s impact on pharma is continually evolving. All insights expressed here were formulated based on the situation as of May 12, 2020.

How has China encouraged telemedicine uptake?

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.

WeDoctor logo
WeDoctor is one of the largest healthcare platforms in China, and was the first to be licensed for online diagnosis and treatment.
Telemedicine - COVID-19 and Telemedicine in China

WeDoctor: Online Healthcare & COVID-19

With support from government, both traditional hospitals and online healthcare platforms have also played an important role in providing COVID-19 related services to citizens.

A COVID-19 real-time rescue platform was launched on January 23rd by WeDoctor,7 providing free online consultation for COVID-19, psychological consultation, convenience clinics for patients, Traditional Chinese medicine consultations, and remote consultation among doctors.

WeDoctor by the numbers

Data as of April 26, 2020.

0 m
‘Visits’ to the WeDoctor platform have been recorded
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Doctors have used WeDoctor to provide consultations
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Consultation services have been provided on WeDoctor

In addition to opening this special rescue channel for Wuhan, WeDoctor has also provided streamlined, one-stop services including online prescription, medical insurance reimbursement, and medicine delivery for more than 50,000 people with other common diseases.8

WeDoctor is not the only example that integrated online healthcare services to help tackle the COVID-19 crisis. Consultation services have dramatically increased on other online healthcare platforms such as JD Health, Ali Health, Chun Yu Doctor, DXY and Ping An Good Doctor. WeDoctor and JD Health both provide free teleconsultation to COVID-19 patients overseas. The data gathered from these platforms suggest exponential growth in usage over the past few weeks.

Apart from online healthcare providers putting their resources to use, traditional offline hospitals have launched online clinics on their own apps as well, moving part of the functions of outpatient services online, such as consultation, chronic disease patient follow-up, as well as drug prescription and delivery. Patients were able to get medicine without stepping out of their homes, which is a gamechanger in the face of our attempts to quarantine, stay home, and stay safe.9-13

What has helped China utilize telemedicine quickly in the face of crisis?

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

‘Through remote 5G transmissions, we are able to control the CT scanners in remote hospitals, from a far distance, on a real-time basis.”

Physician, West China Hospital of Sichuan University

Conclusion

In China, it is safe to say that COVID-19 has facilitated significant innovation in online health delivery and, maybe, more importantly, has exposed millions of patients and physicians to the potential benefits of telemedicine. The pandemic has helped close the gap, at least temporarily, between what is technologically possible and the healthcare system’s openness to change established practices. As the pandemic continues and expands geographically, we will be looking for more examples of innovative technological concepts jumping from lab to real-life, providing critical real-world exposure and experience for innovators. In China specifically, we are interested to see if and how pre-existing partnerships between pharmaceutical companies such as AstraZeneca, Pfizer and Novartis and technology leaders such as Tencent, Alibaba, and DXY will respond to the new circumstances, potentially finding new traction for patient-centric programs and patient databases. Globally, we are looking at how different healthcare systems partner with pharmaceutical and technology leaders to innovate their own solutions to the ongoing challenge of delivering quality healthcare remotely.

It is important to note that despite these advancements, limitations persist both practically, in the ability to comprehensively diagnose and treat patients remotely, and structurally, with questions relating to the long-term reimbursement status and regulation of online medical services still looming. Looking beyond the exceptional circumstances of the current pandemic, the biggest question is how patients and physicians will value telemedicine offerings once in-person care resumes. We expect the future of telemedicine lies less with better stand-alone services and more with a more holistic integration of telemedicine technologies and practices with the traditional healthcare system.

Flora Tian, Deallus Senior Consultant, China

Flora is a Shanghai-based senior consultant with 8+ years of experience in the life science sector. In addition, she has 5+ years of corporation-level internal consulting experience to support corporate development strategy, focusing on China & the overseas markets landscape. Key expertise areas include NPP, international M&A support, international CI, commercial excellence, MCM, operation optimization, pricing and market access strategy, and product management. She also holds deep expertise in drug R&D and commercialization from preclinical, clinical stage to post-launch markets. Her therapeutic area experience is extensive, spanning Immunology, Oncology, Breast Cancer, Type 2 Diabetes Mellitus, Multiple Myeloma, and more.

Zoey Huang Deallus Associate

Prior to joining Deallus, Zoey was an MPH student majoring in chronic disease epidemiology at Yale University. Having been engaged in designing epidemiological studies on oncology, skin disease, and diabetes, she has learned how to dig deeply and quickly on different TAs in order to find the insights that make a valuable difference. She also has basic medical experiment experience in mesenchymal stem cells and inflammation. Since joining Deallus, Zoey has been the core researcher for the assessment of reimbursement landscapes and the identification of key trends in the Chinese pharmaceutical industry.

Lisa Kent Deallus Senior Associate

Lisa is a London-based Senior Associate with 2 years of experience working in commercial strategy, launch planning and lifecycle management. Drawing from her experience in the pharmaceutical industry in Germany, Lisa supports global pharmaceutical clients in key strategic decisions across therapy areas, including oncology, infectious diseases, rare diseases, neuroscience and personalized healthcare. More recently, she has overseen a range of COVID-19 projects, from telehealth to diagnostics, helping clients to adapt their strategies to drive success in the face of high uncertainty. Lisa holds a PhD in Cancer Drug Development and Masters in Immunology from the University of Cambridge, and a Bachelors in Medical Biochemistry from the University of Manchester.

Reach out to discuss with us further

Julie Munch Khan – Deallus Chief Commercial Officer

Julie Munch Khan, Chief Commercial Officer
juliemk@deallus.com
+44 7816 278 501

Peter Barschdorff Deallus Vice President

Peter Barschdorff, Vice President & Head of US Consulting
peter.barschdorff@deallus.com
+1 646 830 7170

References

  1. National Health Security Administration and National Health Commission jointly issued Guiding Opinions On Promoting “Internet+” Medical Insurance During The Prevention And Control Of COVID-19 2020.03.03
  2. National Health Security Administration released Guiding Opinions On Improving The Pricing And Reimbursement Standards For “Internet+” Medical Services 2019.8.30
  3. Wuhan opens the online reimbursed channel for WeDoctor Internet general hospital 2020.02.06
  4. National Health Security Administration gave online hospitals the right of online prescription, keeping designated pharmacies on their toes 2020.03.13
  5. Over 10 cities including Wuhan urgently opens reimbursement channel for online consultations – The bottleneck of telemedicine has been broken through 2020.02.27
  6. COVID-19 promotes telemedicine: online patient follow up was reimbursed to establish “medical connected Chengdu” mode 2020.03.04
  7. Over 40 thousand doctors were online and online platform had billions of hits: Revealing the technology behind telemedicine 2020.03.06
  8. See a doctor when quarantined: “internet+healthcare” 2020.04.07
  9. Online hospitals are booming: this Is the new opportunity after COVID-19 outbreak 2020.03.15
  10. Multiple hospitals start to provide online consultation services in our city 2020.03.25
  11. Multiple hospitals start to provide free online consultation services in Guangdong 2020.01.27
  12. Multiple hospitals start to provide free real-time online consultation services in Zhejiang 2020.01.27
  13. Multiple hospitals start to provide online consultation services in Shaanxi: will COVID-19 change our habit of traditional offline consultation? 2020.03.09
  14. Will telemedicine be popularized due to COVID-19?  2020.02.07
  15. Remote medical support has upgraded: 5G+ remote CT scan was applied in the diagnosis and treatment of COVID-19. 2020.03.04
  16. 5G-aided remote CT scans used to diagnose COVID-19 patients 2020.02.28
  17. Hot news: 12 robots provides 24 / 7 services, the first smart capsule hospital was delivered 2020.03.09
  18. China’s economy was hit hard by the pandemic. Its 5G ambitions could be crucial to its recovery 2020.03.28
  19. MNCs are managing to capture the attractive chronic disease management market, which is worth hundreds billions of RMB 2019.03.29

© Deallus Consulting Ltd 14.5.2020. Deallus is a trademark. All other marks are the property of their respective owners.