"Big health’ and the future of medicine in China

The so-called Fourth Industrial Revolution is in full swing, bringing with it both disruption and opportunity. Most importantly, it brings potential to reshape the world as we know it, better equipping services to deal with the new challenges they face in the 21st century.

In healthcare specifically, digital transformation is impacting broadly and deeply, disrupting business models, services, regulations, and skills supply and demand.

The Chinese healthcare vacuum

According to the 2017 Future Health Index from Philips, China has the lowest density of skilled health professionals among the 19 countries surveyed (31.5 per 10,000 population), while simultaneously maintaining the highest risk of impoverishing expenditure for surgical care.

The system has been tested to its limits over recent decades, not helped by a lack of focus on disease prevention and early diagnosis and a dearth of skilled healthcare professionals. This has led to overcrowding in the country’s most sophisticated hospitals, poor access and, thanks to a disease-curing rather than disease-prevention approach, frequent late diagnosis.

Reforming a healthcare system that’s no longer fit for purpose is a high priority, and the Chinese government’s objective is both straightforward and ambitious: improve both access and affordability for its 1.3 billion citizens.

The Chinese government’s overarching idea is to move from “disease-centered” care to “big health”, aiming to deliver a full suite of health services that cover the entire care continuum, with an emphasis on health management and chronic disease management. This is reflected in the Future Health Index findings, which indicate that the Chinese people and healthcare professionals alike recognize the importance of prevention in healthcare.

Nearly two-thirds (62%) of the Chinese general population believe that healthcare professionals should focus the majority of their time and resources overall on preventive care; seven in 10 (69%) of healthcare professionals agree.

Overburdened infrastructure

One of the main areas of reform addresses decentralization of the country’s multi-tiered healthcare system, in order to streamline the way in which resources are organized. Separating and directing minor ailments and serious illnesses appropriately into three tiers is critical in reducing waiting times, better utilizing resources available across all of China’s medical institutions and addressing the issue of overcrowding in tertiary hospitals. Most significantly, all hospitals, regardless of size, will need to share resources, expertise and information to ensure cost savings and efficiencies are realized.

The pressures on an overburdened infrastructure have encouraged, if not forced, the Chinese government to embrace the role of technology in relieving the burden on an over-stretched healthcare system. Central to this is encouraging the application of big data to enable precise diagnosis and personalized healthcare. With nearly a fifth of the world’s population in China, there’s plenty of data out there, but little is collected or organized in a way that can be analyzed. This has made the Chinese government focus on accelerating the roll-out of the disease-based standard clinical data repository across a range of therapy areas. By 2020, three digital national databases will be established, incorporating health information, health profiles and medical records.

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The use of smart devices and wearables that continuously collect health and contextual data, allowing patient monitoring anywhere, is also encouraged. The scope of such devices is significant, potentially leading to fewer readmissions, more rapid emergency responses, and more immediate care to avoid deterioration or adverse events, such as stroke or falls.

With an imbalance between the allocation of medical resources and utilization between different tiers of hospitals, there are increased calls for a more integrated healthcare network. The impact? Both large and small hospitals will need to share resources and expertise to save money. Building up cloud-based regional imaging centers to support low-tiered hospitals to ensure right-first-time diagnosis, and connecting different levels of hospitals to enable data-sharing, remote consulting and two-way referral are just some of the ways in which digital technology will play a crucial role.

Embracing connected care

The Future Health Index indicates that a large majority (92%) of Chinese healthcare professionals believe it is important that the healthcare system in China is integrated. And fortunately, the government has little to do to convince the general public about the benefits of health-related technology: they’re already open to its applications and, in many cases, already using connected-care technology to track their own health. For example, the Future Health Index noted that about two-thirds (67%) of the general population surveyed say they have used connected-care technology to track health indicator(s) in the past 12 months. What’s more, of these users, the majority (84%) say they have shared information from connected-care technology with a healthcare professional in the past 12 months.

This willingness to engage with connected-care technology will have an important role to play in creating more and better access to healthcare solutions across the whole continuum of health – from prevention to diagnosis, treatment to post-acute care.

A digital shift

With around $7.5 trillion spent globally each year on health, there is significant potential for digital transformation in the sector – both in terms of creating efficiencies, but also harnessing new opportunities to improve patient outcomes. From advances in connected home- and virtual care, to data-driven solutions that allow patient health to be monitored more effectively in real time, digital solutions are instrumental in accelerating the shift to value-based healthcare.

There are particularly significant gains to be made in prevention and home care. The move from primarily “inpatient” to “outpatient” settings will not only broaden geographic and demographic access, but will also signal a significant shift in the current healthcare model, freeing up resources.

While there is no denying certain existing structural and cultural barriers that need to be overcome globally – from reimbursement models and financial incentives to regulation, or even some basic concerns around trust – the Chinese government has shown significant commitment to embracing this shift. And, as pockets of activity are already proving, wider adoption of smart, connected technologies will continue to boost affordability and access.