Internet Hospitals in China: Cross-Sectional Survey

Abstract

BackgroundThe Internet hospital, an innovative approach to providing health care, 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.ObjectiveThe aim of this study was to describe the characteristics of China’s Internet hospitals, and to assess their health service capacity.MethodsWe searched Baidu, the popular Chinese search engine, to identify Internet hospitals, using search terms such as “Internet hospital,” “web hospital,” or “cloud hospital.” All Internet hospitals in mainland China were eligible for inclusion if they were officially registered. Our search was carried out until March 31, 2017.ResultsWe identified 68 Internet hospitals, of which 43 have been put into use and 25 were under construction. Of the 43 established Internet hospitals, 13 (30%) were in the hospital informatization stage, 24 (56%) were in the Web ward stage, and 6 (14%) were in full Internet hospital stage. Patients accessed outpatient service delivery via website (74%, 32/43), app (42%, 18/43), or offline medical consultation facility (37%, 16/43) from the Internet hospital. Furthermore, 25 (58%) of the Internet hospitals asked doctors to deliver health services at a specific Web clinic, whereas 18 (42%) did not. The consulting methods included video chat (60%, 26/43), telephone (19%, 8/43), and graphic message (28%, 12/43); 13 (30%) Internet hospitals cannot be consulted online any more. Only 6 Internet hospitals were included in the coverage of health insurance. The median number of doctors available online was zero (interquartile range [IQR] 0 to 5; max 16,492). The median consultation fee per time was ¥20 (approximately US $2.90, IQR ¥0 to ¥200).ConclusionsInternet hospitals provide convenient outpatient service delivery. However, many of the Internet hospitals are not yet mature and are faced with various issues such as online doctor scarcity and the unavailability of health insurance coverage. China’s Internet hospitals are heading in the right direction to improve provision of health services, but much more remains to be done.

A Profile of eHealth Behaviors in China: Results From a National Survey Show a Low of Usage and Significant Digital Divide

“…Despite these limitations, the current study reports the first national survey on eHealth behaviors in China and one of the first from middle- and low-income countries. The low adoption rates of eHealth behaviors and significant digital divide suggested that the general Chinese population might not yet be ready for the “Internet hospitals” or “intelligent healthcare” ( 4 , 5 ). Literature from high-income countries suggested that the ubiquitous Internet access has created a persistent digital divide and the eHealth movement has exacerbated health disparities ( 12 ).…”

“…The Chinese government is encouraging all healthcare agencies to utilize China's robust telecommunication infrastructure to assist in national healthcare reform initiatives; an increasing number of government-sponsored Internet hospitals and eHealth interventions have been established ( 4 – 6 ). However, a closer look at the data from the burgeoning eHealth initiatives revealed that most eHealth interventions were pilot projects conducted in major metropolitans; ( 5 , 6 ) and the surveys on attitudes toward eHealth programs were typically collected from medical professionals or based on small convenience samples ( 7 , 8 ). Data are missing on the readiness of eHealth adoption in the general Chinese population.…”

“…The literature from developed countries such as the U.S. suggested that access to mobile tools is not equivalent to using mobile tools for health purposes; and despite ubiquitous access to Internet, a persistent digital divide persists ( 9 ). Within such a complex context of high enthusiasm of Chinese government to promote Internet hospitals and limited global evidence of eHealth program sustainability from middle- and low-countries ( 1 , 5 ), understanding eHealth behaviors of the Chinese population is an essential first step to formulate evidence-based eHealth policies. The current study aimed to fill up this literature gap by presenting a profile of eHealth behaviors in the general Chinese population with two research questions: (1) what's the prevalence of eHealth behaviors in China, and (2) what are the factors associated with adoption of eHealth behaviors?…”

Development and evaluation of an eHealth self-management intervention for chronic kidney disease patients in China: protocol for a mixed-method hybrid type 2 trial

“…There is significant support and momentum for the implementation of eHealth based selfmanagement interventions in China. China had 731 million internet users (penetration rate 53%) and 1.3 billion mobile phone users (penetration rate of 90%) in 2016, and this number is still growing [23][24][25][26]. Furthermore, policymakers and care experts in China have recently launched the national health strategy 'Healthy China 2030'.…”

Hospital-Owned Apps in Taiwan: Nationwide Survey

“…In China, Internet hospitals provide innovative health care directly through Internet technologies such as websites and mobile apps. In a study of the 43 established Internet hospitals, 18 (42%) of the hospitals provide access to outpatient health care via mobile app [ 13 ]. Related studies have focused on the contributions from the use of mHealth apps to specific disease outcomes [ 14 - 16 ].…”