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A doctor speaking with a patient during an online consultation session at a hospital in Shenyang in China’s northeastern Liaoning province amid the coronavirus outbreak. Photo: AFP via Getty Images

Coronavirus: how free online consultations are easing strain on China’s hospitals and reassuring anxious patients

  • Chinese health-care providers JD Health and China Resources Medical are among the first to offer free online consultations with doctors
  • JD Health’s platform serves tens of thousands of patients an hour and, according to one doctor, paradoxically allows for more personal consultations
Wellness

Every day from his office in Beijing, Dr Liu Yafeng provides online consultations for up to 200 patients from across China.

Since the start of the coronavirus outbreak last month, the specialist in respiratory medicine has been counselling patients worried that they have been infected with the virus.

Liu says one-fifth of the cases he handles are from Hubei province – where the virus originated – and that most of the cases are driven by unwarranted fear.

“Those with real problems – with symptoms worthy of a follow-up check – are rare. [For most], I will go through with them all the coronavirus symptoms listed in the five pages of government-issued guidelines. Then I will tell them that they are definitely not infected. I also advise them to take deep breaths, distract themselves by reading a book, and so on,” Liu says.

He instructs those with real symptoms to see a doctor in person, and to have a computerised tomography (CT) scan for a clinical diagnosis.

“This helps prevent masses of people flocking to hospitals, which stops those with a real need from getting prompt treatment and increases the cross-infection rate at hospitals,” Liu explains.

Dr Liu Yafeng, respiratory medicine specialist with JD Health’s online medical consultation service.

Liu is among 200 full-time doctors employed by JD Health, the health-care subsidiary of e-commerce giant JD.com that was spun off last May. The company launched online consultation services in September charging from a few yuan to several hundred, depending on the stature and popularity of a doctor if a patient has requested a specific one.

Once logged onto the service, patients submit information about their symptoms. Artificial intelligence (AI) systems scan the data to match patients with appropriate doctors.

On January 26, with coronavirus cases in China rising rapidly, JD Health made the service free to those suffering from coronavirus-like symptoms, including cough, fever, fatigue and diarrhoea. As the outbreak worsened, on February 6 it expanded the scope of the free service to cover all medical disciplines including psychology, cardiology, endocrinology and paediatrics.

A doctor speaking with a patient during an online consultation session at a hospital in Shenyang earlier this month. Photo: AFP via Getty Images

A JD Health spokesman says its online consultation platform now has 30,000 physicians, most of them working part-time.

“The average daily consultation volume of the platform has reached 100,000. During peak times, the platform serves tens of thousands of patients an hour. Nearly 60 per cent of all free consultations are handled by respiratory physicians,” the spokesman says.

While the fortunes of many industries such as travel, dining and transport shrivel as China grapples with the ongoing health crisis, online medicine is experiencing a boom. Services are being used by entire city populations, who would otherwise struggle to get to hospitals or clinics because of government lockdowns and public transport suspensions, or who fear cross-infection at hospitals overwhelmed with coronavirus patients.
Before joining JD, I worked at an 800-bed public hospital … The work is like an assembly line, leaving the doctor with no time to give detailed advice to patients. [But] an online consultation can now last for up to half an hour
Dr Liu Yafeng
China’s online health-care market reached 15.5 billion yuan (US$2.2 billion) in 2017 and is estimated to reach 23.5 billion yuan this year, according to German online statistics portal Statista. The coronavirus outbreak is certain to see demand in this sector rise after China’s National Health Commission said on February 8 the country should speed up the development of online consultation services to reduce the pressure on hospitals.

JD Health’s online consultation service is mostly voice- and text-based, as its videoconferencing service is still under development. It is not the only player, nor the first, in this space.

On January 27, state-owned China Resources Medical (CRM) launched a free video-consultation service which has so far benefited more than 1,500 people. CRM owns two public hospitals in Wuhan – Wisco General Hospital and The Second Hospital of Wisco – so most beneficiaries are from the city, seen as the coronavirus’ epicentre, and the wider province of Hubei.

A CRM spokesman says 500 volunteer doctors working on rotation provide the service, which covers 20 medical disciplines including infectious diseases and respiratory medicine.

“Coincidentally, CRM set up a digital medicine team in Wuhan in 2019,” the spokesman says. “Besides the senior management, all the staff on the team are Wuhan locals. The team’s [software] developers who were in quarantine worked non-stop for 30 hours to build the platform.”

After considering privacy and ease of use, the digital medicine team decided to do away with registration.

“Without the need to fill in any identity information, people seeking consultations can find a doctor after simply downloading the phone app,” the spokesman says. “Without the need to type anything, they can go straight to direct video chat with the doctor. Many doctors have their mobiles with them 24/7 as they don’t want to miss any online consultation request.”

A nurse checking on a patient in the isolation ward for coronavirus patients at a hospital in Wuhan. Photo: AP
In 2018, Alibaba, which owns the Post, launched online medical consultation services and 24-hour medicine delivery. It launched the services on its Taobao Marketplace platform for users seeking medical advice or over-the-counter medication, which is delivered within 30 minutes during daytime and an hour during night.

Before the coronavirus outbreak, AliHealth, the Hong Kong-traded health-care flagship of Alibaba that runs the platform, charged for consultations; at the end of January it began offering free consultations for people in Hubei. The platform is handling on average 3,000 consultations every hour, most related to respiratory medicine and the coronavirus.

Fellow tech giants Tencent and Baidu are among others offering free online medical consultations.

Medical workers injecting a patient with medicine at an intensive care ward for coronavirus cases at a branch of Tongji Hospital in Wuhan. Photo: Xinhua

Jeffrey Towson, a former Peking University business professor and host of online video series Jeff’s Asia Tech Class, writes extensively on China’s digital health sector. He told the Post he expects to see an increase in this “low-level triage” through online consultations, with doctors or assistants “talking to patients who are worried or have minor symptoms and telling them if they should come in or not”, though “not necessarily moving the diagnosis and treatment online”.

“Online consultation is most effective for low-level triage and is not as effective for serious medical issues,” Towson added. “You will need physical exams and in-person testing for most significant illnesses. If AI-driven decision-making and remote testing ever take off, then that could change.”

How to stay healthy during coronavirus outbreak, flu season

Meanwhile, JD Health’s Liu says in spite of the lack of physical contact, online medicine paradoxically allows for more personal consultations with patients.

“Before joining JD, I worked at an 800-bed public hospital in Tangshan [a city in China’s Hebei province]. The work is like an assembly line, leaving the doctor with no time to give detailed advice to patients.

“[But] an online consultation can now last for up to half an hour. My patients include those with chronic diseases, elderly or homebound people, or those living in faraway places in Tibet and Gansu. I have more time to tell them how to live a healthier life.”

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