Nicolas Zhu,Partner and The head of Lifesciences Sector Group,was interviewed by a leading lifesciences publication GBI in September. He talked about telemedicine in China, which is becoming a hot topic on the market. Below is the abstract of the article.
As a means to delivering health services rather than a specific technology, telemedicine lacks a universal definition, and so is necessarily shaped by territorial regulatory parameters. The NHFPC’s “Opinions on facilitating telemedicine services in medical institutions”, released in August 2014, update the previous telemedicine circular issued back in 1999 to reflect the latest industry developments, for the first time setting out a clear definition of the scope of telemedicine, and in this respect representing a landmark document (see Table 1). The document also orders regional health authorities to make fiscal space and regulatory preparations for telemedicine services to be included within local health reform and hospital construction programs.
Table 1: NHFPC telemedicine parameters, August 2014 guidelines (key clauses):
Telemedicine services are defined as:
- One medical institution (the “inviter”) requests another (the “invitee”) to use electronic communications and network technologies to provide technical support for patients’ diagnosis and treatment
- A medical institution provides medical services directly to patients who are offsite
Within this framework, the scope of telemedicine services is as follows, and as specified by provincial HFPCs:
- Tele-imaging (ultrasound, radiology, ECG, EMG, EEG, etc.)
- Remote monitoring of patients
- Interactive services – tele-consultations, tele-outpatients, tele-case discussions
The definition retains the 1999 notification’s emphasis on physician-to-physician communications between one institution requesting diagnosis advice from another. Patient-to-physician telemedicine contact had not previously been a legal possibility, but the NHFPC’s new definition of telemedicine as an activity has.
Physicians tied to hospitals, foreigners welcomed
Although providing for a relatively broad range of telemedicine services, the focus of the regulations is narrowed to the diagnostic sharp end of the telemedicine equation.
Nicolas Zhu, head of life sciences at CMS, notes: “The scope of ‘telemedicine’ as defined is quite conservative and narrow – and strictly in connection with diagnosis. The circular provides clearly that telemedicine can only be conducted by medical institutes and not by any other parties such as medical service or online consultation companies”. Despite recent steps towards freeing up physicians for multi-site practice, for now, “The regulation is very clear: doctors can only provide services through the medical institute where they work, or on a web platform connected to that institute, and cannot act as an individual to provide diagnosis services on a public website or mobile app”.
In keeping with the recent welcome shown to foreign investment into the hospitals sector, the guidance opens the door to cross-border telemedicine service provision. Exactly how this will be worked out in practise has been left vague – foreign-run medical institutes are still not legally permitted to provide medical diagnosis-related services on Chinese soil, and recent permission for wholly foreign-owned hospitals remains at the pilot scheme stage in designated cities/regions. How provinces implement the NHFPC’s guidelines will be key, while further national directives can be expected once the government has had time to view the direction of industry development.
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