I won the IDG venture pitch competition in 2018. Subsequently, I was invited to participate in a road show organized by the ChinaSF and GlobalSF, a non-profit organization based in the city of San Francisco, CA. The event lasted for a week (March 17-22) during which we met with over two hundred leaders of Chinese hospitals and government officials. We visited three different cities; I learned about the latest policy and opportunities in the care management market using Artificial Intelligence in China.
1. A Comparison of the China and US healthcare market
a) Insurance payment and reimbursement systems are different.
医保（yi bao) is the primary health insurance in China; every citizen enjoys its basic medical coverage. The US. Medicare system is accessible to only patients who are sixty-five years and above while 医保accommodates everybody in China. Basically, the hospitals are allocated a major quota annually; the patients undergo comprehensive and lengthy annual wellness checks to meet the requirements for insurance coverage. There is no plausible way to reduce the duration of medical checks or accrued costs. Many hospitals currently contend with an excess number of patients who have daily appointments, which is an indication that the main focus should be access to Medicare.
b) The Interoperability of EMR system is different
In China, the EMR systems are disconnected; each hospital/clinic has an independent EMR system were patient’s records are discretely stored with no external access. The interoperability of the system is at a zero level. However, it can be affirmed that the Chinese organizations act by instructions from the government. The EMR data will be promptly presented to the government if such a request is made.
Hospitals have different capacities to perform Medical Data Analytics
In the hospital, the EMR system serves as a means to collect data, there is no formal reporting, and the data analytics department in hospitals keeps a record of the patient population for the government. This information is also available to medical researchers.
c) Care Management targets are different
In China，CCM (Chronic Care Management) is at its budding stage, due to the payment model, the first group of patients targeted by the CCM in China is the rich and famous 人群， while in the US, Medicaid, and Medicare cover the costs of CCM for the poor and elderly patient population.
In Summary, there are differences between the healthcare systems in China and the US. Many of the issues encountered in the US do not exist in China. Most importantly, there is no provision for reimbursement regarding the CCM or Annual Wellness checks; instead, the costs are covered by the insurance system.
2. Healthcare Opportunities in China
a) Care Management for the top tier population (高端人群)
In China, the number of rich and high-level government officials who demand more convenient access to better care is rising. These groups of people are willing to pay expensive membership fees in view of accessing a care management program that provides;
1) A comprehensive medical record,
2) Access to medical experts and foreign physicians,
3) Access to local specialty doctors (专家挂号服务)
4) Access to gene therapy （基因注射）
5) Prescription of supplements （高级康复产品）
6) Prediction and disease prevention （智能健康）
7) Travel assistance to seek medical treatment overseas etc.
b) Care Management for seniors (智能养老)
In the next five years, China is expected to invest billions of dollars in modernizing its Senior Care System. It is common knowledge that this is an area many organizations are desperate to invest. Currently, major investments in senior Care Systems is focused on acquiring real estate and provide better staff services. From this perspective, system implantation is almost regarded as secondary, while integrating systems to promote health care in the area of Senior Care is important.
c) Integrated hospitals system and healthcare (大健康 + 网络医疗)
The major hospitals in Beijing, Shanghai, and Guangzhou are exploring significant initiatives such as Massive healthcare projects. There are two areas of focus:
1) Building an online hospital system to promote the coordination of healthcare services generally. A major part of these efforts is experimental and targeted at only evaluating the situation. The people involved do not have a definite plan to accomplish these goals. Seminars and conferences are organized frequently; during these programs, active conversations are held. However, there are seeming lapses in implementation.
2) Developing accurate care coordination procedures by connecting community hospitals and resources社区医院
3) Using existing medical data to develop disease diagnosis and prevention: 大数据疾病诊断和预防。 This area is more clinical and big data-centric. Current focuses are developing solutions using big data to diagnosis specific diseases such as Diabetes, Cancer, etc. Big companies such as Alibaba are already partnering with different hospitals to commence on projects for lung cancer diagnosis.
In part II of this memorandum, I am going to explain how Lucidact plan to partner with local governments to take advantage of some of the above opportunities.