Opinions of the General Office of the State Council on Promoting the Development of "Internet plus Health Care"

· Document Number：No. 26 [2018] of the General Office of the State Council

· Area of Law： Internet Plus Health and Sanitation

· Level of Authority： Regulatory Documents of the State Council

· Date issued：04-25-2018

· Effective Date：04-25-2018

· Status： Effective

· Issuing Authority： General Office of the State Council

Opinions of the General Office of the State Council on Promoting the Development of "Internet plus Health Care"
(No. 26 [2018] of the General Office of the State Council)
The people's governments of all provinces, autonomous regions, and municipalities directly under the Central Government; all ministries and commissions of the State Council; and all institutions directly under the State Council:
For the purposes of thoroughly implementing Xi Jinping Thought on Socialism with Chinese Characteristics in a New Era and the spirit of the 19th CPC National Congress, boosting the implementation of the Healthy China Strategy, raising the level of modern health care management, optimizing resource allocation, innovating service models, improving service efficiency, reducing service costs, and satisfying the ever-growing needs of the people for health care, according to the Outline of the Plan for "Healthy China 2030" and the Guiding Opinions of the State Council on Actively Advancing the "Internet plus" Action ( No. 40 [2015], State Council), with the approval of the State Council, the following opinions on furthering the development of "Internet plus health care are hereby offered.
I. Refining the "Internet plus health care" service system
1. Developing "Internet plus" health care services.
(1) Medical institutions shall be encouraged to apply the Internet and other information technologies to expand the space and content of health care services and build an online and offline integrated health care model covering the whole process of health care.
The development of Internet hospitals depending on health care institutions shall be allowed. Heath care institutions may use Internet hospital as their secondary name and, based on physical hospitals, use Internet technology to provide safe and appropriate health care services, allowing online subsequent visits for some common diseases and chronic diseases. After acquiring documents on the medical records of patients, physicians shall be allowed to write prescriptions online for some common diseases and chronic diseases.
Health care institutions and qualified third-party institutions shall be supported in setting up Internet information platforms to provide telemedicine, health consultation, and health management services so as to promote the effective communication among hospitals, medical personnel, and patients. (The National Health Commission and the National Development and Reform Commission shall be responsible. The authority first mentioned shall take the lead and the same shall apply hereinafter)
(2) Health care consortia shall actively use Internet technology to expedite the realization of the connection of medical resources from bottom to top, the interconnection and sharing of information, and efficient business synergy, facilitate services such as appointments for diagnosis and treatment, two-way referrals, and telemedicine, advance "primary check-up and higher-level diagnosis," and promote the development of an orderly hierarchical diagnosis and treatment pattern.
The higher-level health care institutions under health care consortia shall be encouraged to use artificial intelligence and other technical means to provide remote consultation, remote electrocardiograph diagnosis, remote imaging diagnosis, and other services oriented to the primary level and promote the real-time access to, mutual recognition, and sharing of examination and diagnostic analysis results among the health care institutions under health care consortia. Telemedicine services shall be promoted in covering all the medical consortia and county-level hospitals across the country and gradually extending to community health care service institutions, township health care centers and village clinics so as to enhance the capabilities and efficiency of primary health care services. (The National Health Commission, the National Development and Reform Commission, the Ministry of Finance, and the State Administration of Traditional Chinese Medicine shall be responsible)
2. Innovating "Internet plus" public health services.
(1) The online access to and well-regulated use of the electronic health records of residents shall be boosted. Hypertension and diabetes, among others, shall be brought into focus in strengthening the online service and management with respect to the chronic diseases in the elderly. With children under the National Immunization Program as priority service targets, existing preventive vaccination information platforms shall be consolidated to optimize preventive vaccination services. The use of wearable devices to obtain vital signs data shall be encouraged, and pregnant women shall be provided with health monitoring and management services. The information management, follow-up assessment, and classification intervention of patients with severe mental disorders shall be intensified. (The National Health Commission shall be responsible)
(2) Health care institutions shall be encouraged to cooperate with Internet enterprises, strengthen the consolidation of regional health care information resources, and explore the application of big data technology analysis methods such as crowd flow and climate change to predict the epidemic trends in diseases, strengthen the intelligent monitoring of infectious diseases and other diseases, and enhance the capabilities to prevent and control major diseases and tackle outbreaks of public health events. (The National Health Commission shall be responsible)
3. Optimizing "Internet plus" contracting in family doctor services.
(1) The building and application of intelligent information platforms for contracting in family doctor services shall be accelerated, the technical support of higher-level hospitals for primary level shall be strengthened, an online evaluation, assessment and incentive mechanism shall be explored, the capacity of services of the family doctor team shall be enhanced, the quality and efficiency of contracting in services shall be heightened, and the trust of the people in family doctors shall be augmented. (The National Health Commission, the National Development and Reform Commission, the Ministry of Finance, and the State Administration of Traditional Chinese Medicine shall be responsible)
(2) Online contracting in services shall be encouraged, contracting residents shall be provided with online health consultations, appointments and referrals, follow-up of chronic diseases, health management, extension of prescriptions, and other services, the transformation of family doctor service models shall be advanced, and the people experience with contracting in service shall be improved. (The National Health Commission shall be responsible)
4. Improving the "Internet plus" drug supply guarantee services.
(1) After prescriptions for common diseases and chronic diseases written online are reviewed by pharmacists, heath care institutions and drug distribution enterprises may commission delivery from qualified third-party institutions. The interconnection and real-time sharing of the prescription information of health care institutions and retail drug consumption information shall be explored, and the well-regulated development of online drug sales and medical logistic distribution, among others, shall be furthered. (The National Health Commission, the State Administration of Market Regulation, and the State Drug Administration shall be responsible)
(2) The National Health Information Platform shall be depended on to strengthen the collection of Internet-based multi-source information on short drugs and collaborative application of supply business so as to enhance selection and other capabilities in relation to basic drugs catalogs and encouraged generic drugs catalogs. (The National Health Commission, the Ministry of Industry and Information Technology, the State Administration of Market Regulation, and the State Drug Administration shall be responsible)
5. Forwarding "Internet plus" health insurance settlement services.
(1) The connection and consolidation of health insurance information systems shall be accelerated, the harmonization and sharing of health insurance data and related authorities' data shall be achieved, online payment functions shall be gradually expanded, and "one-stop" settlement shall be advanced, so as to provide more convenient services for the enrollees. (The State Medical Insurance Administration, the Ministry of Human Resources and Social Security, and the National Health Commission shall be responsible)
(2) The scope of networked designated heath care institutions shall continue to be expanded, and direct settlement of out-of-area medical expenses shall be gradually made available at more primary health care institutions. The direct settlement of out-of-province hospitalization expenses for migrant workers, innovators, and startup business owners shall be effectively made. (The State Medical Insurance Administration shall be responsible)
(3) The smart auditing and real-time monitoring of health insurance shall be vigorously promoted, and rules such as clinical pathways, reasonable medication, and payment policies shall be embedded in hospital information systems, so as to strictly regulate health care and expenses. (The State Medical Insurance Administration shall be responsible)
6. Strengthening "Internet plus" medical education and science dissemination services.
(1) The establishment of health care education and training cloud platforms shall be encouraged to provide diverse online medical courses and medical education. A networked, digital, personalized, and life-long medical education and training system shall be developed, and health care professionals shall be encouraged to conduct discussion and exchange in relation to cases of incurable diseases and major diseases so as to improve their professional qualities. (The National Health Commission, the Ministry of Education, and the Ministry of Human Resources and Social Security shall be responsible)
(2) The "Continuing Medical Education plus Appropriate Technology Promotion" Action shall be implemented so as to, with a focus on the demand for poverty alleviation through health, by giving priority to the primary level and poverty-stricken areas, by the means of distance education, promote and disseminate practical and appropriate technologies. (The National Health Commission, the Ministry of Human Resources and Social Security, and the State Administration of Traditional Chinese Medicine shall be responsible)
(3) Online science dissemination platforms shall be established, and the Internet shall be used to provide accurate education of health science knowledge, so as to disseminate a wholesome lifestyle and heighten residents' capability of self-management of health and awareness of health. (The National Health Commission and the China Association for Science and Technology shall be responsible)
7. Forwarding "Internet plus" artificial intelligence application services.
(1)A decision-making support system for clinical diagnosis and treatment based on artificial intelligence shall be researched and developed, and intelligent voice technologies shall be applied in intelligent medical image recognition, pathological classification, and multidisciplinary consultations, and various health care scenarios, so as to improve the efficiency of health care services. The application of the intelligence assistance system for syndrome identification and treatment in traditional Chinese medicine shall be supported to heighten the primary-level ability of traditional Chinese medicine diagnosis and treatment services. Mobile health care based on artificial intelligence technology and smart health care devices shall be demonstrated to achieve the real-time monitoring and assessment of personal health, advance warning of diseases, chronic disease screening, and active intervention. (The National Development and Reform Commission, the Ministry of Science and Technology, the Ministry of Industry and Information Technology, the National Health Commission, and the State Administration of Traditional Chinese Medicine shall be responsible according to the division of labor based on duties)
(2) The consolidation, sharing, and application of clinical and scientific research data shall be strengthened, and the research and development of health care-related artificial intelligence technologies, medical robots, large-scale medical equipment, emergency rescue medical equipment, biological three-dimensional printing technology, and wearable devices, among others, shall be supported. In line with the trend of the innovative development of the Industrial Internet, the level of digital and intelligent manufacturing of health care equipment shall be raised, and industry upgrading shall be boosted. (The National Development and Reform Commission, the Ministry of Industry and Information Technology, the Ministry of Science and Technology, and the National Health Commission shall be responsible according to the division of labor based on duties)
II. Improving the support systems for "Internet plus health care"
8. Accelerating the achievement of sharing of health care information.
(1) All regions and all relevant authorities shall coordinate the advancement of the building of a unified, authoritative, and harmonized national health information platform, incrementally achieve the connection with the National Data Sharing and Exchange Platform, intensify the collection of population, public health, health care services, health insurance, drug supply, comprehensive management, and other data, and maintain the efficiency of the channels for data sharing among authorities, regions, and industries, so as to promote the sharing and application of health information of all the people. (The National Development and Reform Commission, the Ministry of Industry and Information Technology, the Ministry of Public Security, the Ministry of Human Resources and Social Security, the National Health Commission, the State Administration of Market Regulation, the State Medical Insurance Administration, and all provincial people's governments shall be responsible)
(2) The construction of basic resources information databases shall be accelerated, and whole population, electronic health archives, electronic medical records, and other databases shall be bettered. The application of information technologies in health care institutions shall be vigorously intensified, and hospitals at and above the second level shall improve the functions of hospital information platforms, consolidate various in-house system resources, and raise the efficiency of hospital management. Hospitals at the third level shall achieve the sharing of in-house health care service information by 2020, and hospitals with good conditions shall achieve the objective as soon as possible. (The National Health Commission shall be responsible)
(3) The hierarchical diagnosis and treatment information system based on the Internet and big data technology shall be bettered, and hospitals of various types at all levels shall be promoted in gradually achieving the sharing and the authorized use among health care institutions at different levels of electronic health records, electronic medical records, diagnostic analysis and examination results. The establishment of information technology-driven hardware and software for primary-level health care institutions in old, ethnic, frontier and impoverished regions shall be supported. (The National Health Commission, the National Development and Reform Commission, and the Ministry of Finance shall be responsible)
9. Refining the "Internet plus health care" standard system.
(1) The unified and standardized National Health Care Data Resource Catalog and standard system shall be improved. The well-regulated management of "Internet plus health care" standards shall be tightened, health care services, data security, individual information protection, information sharing, and other basic standards shall be developed, and harmonized writing rules for the first page of medical records, disease classifications and codes, operative procedures classifications and codes, and medical terminology shall be comprehensive promoted. (The National Health Commission and the State Administration of Market Regulation shall be responsible)
(2) The application of national hospital information technology development standards and specifications shall be accelerated, the promotion and application of the guidelines on the functions of province-coordinated regional platforms and hospital information platforms and data standards shall be enhanced, and data interfaces shall be harmonized, so as to provide support for information exchange and sharing. (The National Health Commission and the State Administration of Market Regulation shall be responsible)
10. Improving the management and public convenience services of hospitals.
(1) With a focus on the increasingly growing demand of the people, information technology shall be applied to optimize service processes, improve service efficiency, and enhance the match between health care service supply and demand. By 2020, hospitals at and above the second level will have generally provided online services such as dayparting appointments for diagnosis and treatment, intelligent guide and triage, queuing patients reminding, diagnostic analysis and examination results inquiry, interim settlement, and mobile payment. Health care institutions with good conditions may provide services such as mobile nursing, online monitoring of vital signs, intelligent medical image identification, and home monitoring. (The National Health Commission and the State Administration of Traditional Chinese Medicine shall be responsible)
(2) Medical laboratory institutions and health care institutions shall be supported in teaming up with Internet enterprises to develop disease prevention, diagnostic analyses, and other health care services. The connection between ambulance-mounted pre-hospital monitoring and care systems and regional or hospital information platforms shall be forwarded, and well-regulated sharing of patient information, remote guidance of acute care, preparation for in-house acute care, and other work shall be effectively conducted, so as to improve the efficacy of acute care. "Intelligent Traditional Chinese Medicine Pharmacy" shall be promoted, and traditional Chinese medicine pills, preparations, and other pharmaceutical services shall be improved. (The National Health Commission, the Ministry of Industry and Information Technology, and the State Administration of Traditional Chinese Medicine shall be responsible)
11. Improving the capability of guaranteeing the infrastructure of heath care institutions.
(1) The guarantees for "Internet plus health care" services shall be enhanced, the building of the health care service system shall be advanced, scientific distribution and reasonable allocation shall be conducted, the Medical Diagnostic Analysis Equipment Guarantee Project for Regional Central Hospitals shall be implemented, and the state shall provide appropriate support for the poverty-stricken areas in the central and western China. The standardization of primary-level health care institutions shall be accelerated, and the capability of guaranteeing basic equipment at the primary level shall be augmented. (The National Health Commission, the National Development and Reform Commission, and the Ministry of Finance shall be responsible)
(2) Priority shall be given to the support for making high-speed broadband networks available at the health care institutions at all levels in urban and rural areas, the pilot program of inclusive telecommunications services shall be conducted in depth, and the extension of fiber-optic broadband networks to rural health care institutions shall be boosted. Telecommunications enterprises shall be prompted to accelerate the pace of evolution and upgrading of broadband networks, deploy high-capacity fiber-optic broadband networks, and provide high-speed network access. The coverage of mobile broadband networks shall be increased, and ambulance-mounted remote diagnosis and treatment shall be supported. (The Ministry of Industry and Information Technology and the National Health Commission shall be responsible according to the division of labor based on duties)
(3) To meet the needs for telemedicine and medical information sharing, among others, telecommunications enterprises shall be encouraged to provide health care institutions with network access services such as Internet leased lines and virtual private networks ("VPNs") and promote the building of telemedicine private networks, so as to ensure the quality of health care-related data transmission services. Heath care institutions shall be supported in electing high-speed and high-reliability network access services. (The Ministry of Industry and Information Technology and the National Health Commission shall be responsible according to the division of labor based on duties)
12. Developing and improving relevant supporting policies in a timely manner.
(1) To adapt to the development of "Internet plus health care," the health insurance cover policy shall be further improved. Qualified Internet diagnostic and treatment services shall be incrementally covered by medical health insurance, and a cost dividing mechanism shall be established, so as to facilitate the nearest health care given to people and promote the effective utilization of quality health care resources. The policies for charges for Internet diagnosis and treatment shall be improved, spending management shall be strengthened, the formation of a reasonable interest dispensation mechanism shall be procured, and the sustainable development of Internet health care services shall be supported. (The State Medical Insurance Administration shall be responsible)
(2) The multi-venue practicing policy for physicians shall be improved, and practicing physicians shall be encouraged to provide "Internet plus health care" services. (The National Health Commission shall be responsible)
III. Tightening industry regulation and safety guarantees
13. Tightening the regulation of health care quality.
(1) Administrative measures to regulate Internet diagnosis and treatment shall be issued to define the bottom line of regulation, improve the access standards for relevant access, minimize access restrictions, tighten interim and ex-post regulation, and ensure the quality and safety of health care services. The building of an online credibility system shall be advanced, the establishment of a health care personnel and health care institutions credible medical digital identities, electronic real-name verification, and data access control information systems using unified signs across the country shall be accelerated, regulatory mechanisms shall be innovated, and regulatory capabilities shall be enhanced. A health care responsibility division mechanism shall be established, and online notice and consent shall be promoted, so as to prevent and resolve health care risks. (The National Health Commission, the Cyberspace Administration of China, the Ministry of Industry and Information Technology, and the Ministry of Public Security shall be responsible)
(2) Third-party institutions such as Internet health care service platforms shall ensure that persons providing services qualify according to the relevant requirements and are liable for the services provided. The data generated in the "Internet plus health care" services shall be retained in the whole process and susceptible to inquiry and traceability so as to meet the needs of industry regulation. (The National Health Commission, the Cyberspace Administration of China, the Ministry of Industry and Information Technology, the Ministry of Public Security, and the State Administration of Market Regulation shall be responsible)
14. Defending data and information security.
(1) Laws and regulations on right recognition, openness, circulation, trading, and property rights protection relating to big data on health care shall be researched and developed. The requirements for information security and health care data confidentiality shall be strictly implemented, an information protection regime for personal privacy shall be established and improved, patient information, user data, and genetic data, among others, shall be stringently managed, and illegally acts of trading and disclosing information shall be punished in accordance with the laws and regulations. (The National Health Commission, the Cyberspace Administration of China, the Ministry of Industry and Information Technology, and the Ministry of Public Security shall be responsible)
(2) The information protection in relation to health care institutions, Internet health care service platforms, smart health care devices, key information infrastructure, and data application services shall be strengthened, and the screening, monitoring, and advance warning of hidden information security risks shall be regularly conducted. Sensitive data such as patient information shall be stored in the territory of China, and if outbound supply is necessary, safety assessment shall be conducted in accordance with relevant regulations. (The National Health Commission, the Cyberspace Administration of China, and the Ministry of Industry and Information Technology shall be responsible)
All regions and all relevant authorities shall issue supporting policies and measures in a timely manner based on the actual circumstances to ensure the implementation of all arrangements. Central and western China, poverty-stricken rural areas, and remote border areas shall, based on local conditions, actively develop "Internet plus health care," introduce quality health care resources, and improve the accessibility of health care services. The National Health Commission shall, in conjunction with the relevant authorities, according to the division of labor based on tasks, strengthen work guidance and supervisory inspection and report to the State Council on important issues in a timely manner.
General Office of the State Council
April 25, 2018