Research on the Problems and Countermeasures of the Application of

“Internet+” in County Hospitals

Jiyuan Zhang

1,† a

, Yukong Wu

2,† b

and Yao Xiao

∗

Department of Police Management,Sichuan Police College, Luzhou 646000, Sichuan, China

The People's Hospital of Jianyang City, Chengdu 641400, Sichuan, China

†

These authors contributed equally to this work

Keywords: “Internet+”, Internet Hospital, County Hospital, COVID-19.

Abstract: The construction of Internet hospitals is an important form of practice of “Internet+” medical treatment, which

is conducive to achieving the equalization of high-quality public medical services, thereby promoting the

construction of a healthy China. This article takes the construction of an Internet hospital in Jianyang People's

Hospital of Sichuan Province as an example, conducts an empirical analysis of the practice of “Internet+”

medical treatment in grassroots hospitals, introduces in detail the main functions and processes of Internet

hospitals, and summarizes the problems in the construction process.

1 INTRODUCTION

People's livelihood has always been the focus of our

party and country, especially health care. So how to

get through the “last mile” of serving the people's

health needs, and solve the problems of “three long

and one short” for people to see a doctor, that is the

problem of long queue time for registration, long

waiting time for payment, long waiting time for

taking medicine and short time for seeing a doctor

(Yan 2011). And It is the unremitting pursuit of our

health workers to let ordinary people enjoy high-

efficiency and high-quality equal medical care. At

present, China is rapidly promoting the development

strategy of healthy China. Today, with the rapid

development of information technology and public

health emergencies, such as COVID-19, exposing

many problems of modern medical care, it has

become an inevitable trend to comprehensively

promote the construction of Internet hospitals.

Therefore, based on the practice of building an

Internet hospital in a county-level public hospital in

the western region, this article attempts to sort out and

analyze the current challenges and problems of using

"Internet +" technology in primary hospitals, and

https://orcid.org/0000-0002-5748-4822

https://orcid.org/0000-0002-4272-5945

propose some paths for scientifically advancing the

construction of Internet hospitals.

2 RESEARCH METHODS

Since 2013, the CPC Central Committee and the State

Council have attached great importance to the

development of “Internet+” medical care, especially

after the COVID-19 outbreak, The CPC Central

Committee and the State Council have intensively

issued a series of policy documents related to the field

of Internet medical care, and provincial and

municipal levels have successively issued specific

implementation opinions, guidelines and other

normative documents, which have pointed out the

direction for the construction and development of

Internet hospitals. “Internet+” Medical is a new

application of Internet in medical industry, supported

by physical hospitals. It uses the Internet as the carrier

to provide various forms of health care services such

as health education, disease risk assessment, remote

treatment and rehabilitation through certain technical

means. On one hand, through video consultation, the

Internet Hospital can effectively improve patients'

medical experience, and the waiting time for patients

https://orcid.org/0000-0002-7186-8777

Zhang, J., Wu, Y. and Xiao, Y.

Research on the Problems and Countermeasures of the Application of Internet+ in County Hospitals.

DOI: 10.5220/0011155900003444

In Proceedings of the 2nd Conference on Artiﬁcial Intelligence and Healthcare (CAIH 2021), pages 5-10

ISBN: 978-989-758-594-4

to register and pay fees can be greatly saved. On the

other hand, It can effectively improve the coverage of

medical services, including pre-treatment, in-

treatment and post-treatment medical services.

Meanwhile, it helps the sinking of high-quality

medical resources, and Internet hospitals, in

conjunction with medical associations and

community medical institutions, promote a wide

range of remote cooperation among medical

institutions, form a two-way referral mechanism and

promote graded diagnosis and treatment.

County hospitals are direct windows for more

ordinary people. The effective implementation of

“internet+” in county hospitals will undoubtedly

benefit more ordinary people, Especially rural

grassroots people. Well, how effective is the

construction of county Internet hospitals at present?

By referring to a large number of normative

documents and related academic research and based

on the empirical investigation of the People's

Hospital of Jianyang city, this document explores

some targeted countermeasures and suggestions for

county Internet hospitals.

3 PRACTICE AND

EXPLORATION IN PRIMARY

HOSPITALS

The People's Hospital of Jianyang city was founded

in 1939 and has a history of 82 years. The hospital

covers an area of 33,900 square meters, with a

building area of 147,000 square meters, total assets of

1.4 billion yuan and 1,600 registered beds. It is the

first county-level hospital of the National Health and

Health Commission to meet the recommendation

standard of comprehensive service ability of county-

level hospitals. Last year, there were 1.313 million

outpatient and emergency visits, 65,000 hospital

discharges and 23,000 operating tables.

According to the national, provincial and

municipal policies of “Internet+” medical care and

related requirements, Since 2015, the People's

Hospital of Jianyang city gradually carry out and

promote the construction of related projects.

3.1 Internet + Remote

At the end of 2015, the construction of remote system

began. At present, remote consultation, remote

imaging, remote ECG and remote desktop

consultation systems have been built. The platform

covers 29 medical institutions within its jurisdiction

and has established telemedicine cooperation

relations with 4 units, including People's Hospital of

Peking University, Beijing 301 Hospital, West China

Hospital of Sichuan University and People's Hospital

of Sichuan Province, also covers 29 grass-roots

medical institutions, and has established the “N+1+n”

regional remote hub platform model. A total

investment of more than 5.7 million yuan (including

3.7 million self-raised funds and 2 million

government special funds) was invested.

By the end of August 2021, the People's Hospital

of jianyang city had participated in video lecture

training and case discussion for a total of 431 times,

completed 2244 desktop consultations in primary

hospitals of medical association, and reported

161,222 DR diagnoses (exposure times), 9,184 CT

diagnoses, 939 MRI diagnoses, 35,871 ordinary ECG

diagnoses and 2,821 ambulatory ECG diagnoses.

Through the “Internet+” Remote project, it is not

only beneficial to the common people in medical

association units, but also a powerful starting point to

promote the implementation of medical reform policy

and graded diagnosis and treatment at the grassroots

level.

3.2 Internet + Medical Care

In April, 2016, through cooperation with related

enterprises, the People's Hospital of Jianyang city

started the construction of “Internet+” Medical Care

project, focusing on solving the queuing problem of

patients' register and payment, and at the same time

realizing the functions of booking, report self-

printing and inquiry, etc.

At present, the hospital area has achieved the

whole hospital coverage of wireless wifi. Patients can

make online appointment registration through

WeChat official account or hospital website. Many

self-service systems machines were installed in the

hospital. Through self-service systems machines,

patients can register, pay fees, print inspection reports

and so on. Among them, the outpatient appointment

function can be accurate to 30 minutes, which greatly

reduces the waiting time of patients in hospital and

effectively optimizes the hospital medical order.

Considering the site limitation of centralized

settlement, the hospital carefully integrated the

system, realized the settlement by floors, and diverted

the settlement patients. Patients can complete

outpatient payment, admission and settlement at the

floors of the emergency building and the nurse station

in the inpatient department. At present, 40% of

patients choose to register and pay through WeChat

and self-service machines, by this way, all patients'

CAIH 2021 - Conference on Artiﬁcial Intelligence and Healthcare

examination reports are pushed and self-printed. And

through the automatic medicine taking system of

outpatient pharmacy, the waiting time for patients to

take medicine is shortened from 2 hours to 3 minutes.

Through the construction of “Internet+” Medical

project, the queuing problem of patients seeking

medical treatment has been greatly improved, and the

experience of patients seeking medical treatment has

been improved.

3.3 Internet Hospital Construction

In May, 2021, the Internet Hospital of the People's

Hospital of Jianyang city went online, and based on

the “Internet+” technology, an online and offline

integrated health service model was built, which

realized the intelligent mobility of the in-hospital

diagnosis and treatment process (as the Figure 1

shows).

Figure 1: Internet hospital construction function and service platform.

Main online functions include: Patients register

online, make an appointment, and consult and consult

through pictures, texts, voice, etc. Online payment is

completed, and patients can choose a variety of ways

to take medicine. After the payment of the medical

technology project, it will be connected with the

medical technology reservation system in the

hospital, and the patients can choose the time to make

an appointment for inspection by themselves, and the

system will inform the patients of the appointment

and expiration reminder online or by text messages.

Hospitalized patients order food and mail the patient's

medical records. Realize the integration of online and

offline patient medical information (as the Figure 2

shows)

Figure 2: Internet hospital service process.

Through the construction of Internet hospitals,

medical data intercommunication and business

linkage have been realized. Patients can enjoy high-

quality medical resources without going to the

hospital for a long time to register and treatment.

Hospitals can break through the time and space

Research on the Problems and Countermeasures of the Application of Internet+ in County Hospitals

constraints to access the personal health and

medical information of patients, and record the health

information of patients in real time, and effectively

use medical resources to provide Internet-based

medical services for patients, and extend hospital

services from in-hospital to out-of-hospital, from

intervention in single diagnosis to full coverage of

diagnosis and treatment, and constructing the whole-

process diagnosis and treatment management with

patients as the center, and improve the efficiency of

hospital services, expand the connotation of hospital

services, and strengthen the monitoring of treatment

effect and medical quality （Shan 2011）. Through

Internet Hospital treatment, patients can also freely

switch between online and offline modes for

treatment according to their own needs, which greatly

improves patient satisfaction and loyalty. In the

satisfaction survey of public hospitals of National

Health and Health Commission, the average

satisfaction of hospital patients increased from

90.04% in 2018 to 95.32% in 2020.

3.4 Internet + Epidemic Management

Since the outbreak of COVID-19 in 2020, in order to

ensure the effect of epidemic prevention and control,

hospitals need to limit the number of patients and

divert outpatients. Under this situation and demand,

the “Internet+” Epidemic management gives full play

to the advantages of online diagnosis and treatment.

With the help of Internet Hospitals, consultation,

prescription, follow-up, dispensing, inspection and

appointment, and other in-hospital and out-of-

hospital business linkage modes came into being.

Chronic patients and follow-up patients can realize

online dispensing and prescription continuation

through Internet Hospitals, and they can receive

medical services without coming to the hospital,

which greatly alleviates the difficulty of going out

and seeing a doctor during the epidemic. Through the

nucleic acid detection reservation function of the

Internet platform, the public can directly make an

online reservation for the detection time and complete

the payment online, and then go directly to the site for

detection according to the reservation time. By this

way, it can simplify the process comprehensively,

realize sampling in different time periods and at

different peaks, and greatly save public time and

energy. At the same time, materials services such as

medical record mailing and drug delivery at home on

the Internet platform can reduce the stay time of

patients in hospital during the epidemic and avoid

cross infection.

3.5 Internet +Medical Education

The latest health big data shows that the health status

of Chinese people is not optimistic, the aging

population is becoming more and more serious,

diseases are becoming younger, and the public's

demand for basic health science knowledge is

increasing, while many reports from the media

without screening have led the public to be misled by

false health concepts （Wang and Wei 2014）. In this

case, it is necessary for hospitals to enhance the

awareness of medical staff in spreading professional

health science and open up the way for medical staff

to release professional medical knowledge. The

Internet platform provides a channel for medical staff

to publish teaching content. Popular science articles,

videos, pictures and short videos of various

departments and doctors in hospitals can be published

on the platform, so that high-quality and professional

teaching content can accurately reach a large number

of patients. On the one hand, it can help doctors to

manage patients efficiently, and at the same time, it

can provide patients and their families with access to

professional health education information, and

enhance the stickiness and compliance of patients.

In addition, on the Internet platform, medical staff

can realize academic exchanges and communication

through video conferences, live broadcasts and other

modes, which can promote cooperation between

regional high-quality hospitals and grass-roots

hospitals, realize medical education assistance and

help homogenize medical services.

4 PROBLEMS AND

COUNTERMEASURES IN

PRACTICE IN PRIMARY

HOSPITALS

4.1 Compared with the Growing

Health Needs of the People, the

Service Scope of County Internet

Hospitals Needs to Be Further

Broadened

In 2018, the Opinions on Promoting the Development

of “Internet+” Medical Health issued by the State

Council clearly pointed out that improving the service

system of “Internet+” Medical Health includes seven

aspects, which Including developing “Internet+”

medical service, innovating “Internet+” public health

service, optimizing “Internet+” family doctor

CAIH 2021 - Conference on Artiﬁcial Intelligence and Healthcare

contract service, improving “Internet+” drug supply

guarantee service, promoting “Internet+” medical

insurance settlement service, strengthening

“Internet+” medical education and popular science

service, and promoting “Internet+” artificial

intelligence application service.

For county hospitals, limited by various resources

and conditions, most county Internet hospitals are still

in the exploratory stage, and the service items are

relatively limited, their service scope can be further

expanded according to the actual needs of local

people, such as “Internet+” Nursing, “Internet+”

Chronic Disease, “Internet+” Return Visit,

“Internet+” Mission, “Internet+” Family Doctor,

“Internet+” Maternity, “Internet+” Insurance (medical

insurance, commercial insurance) and other extension

services.

4.2 Internet Hospitals at the

Grass-roots Level Should Give

Consideration to All Clients and

Promote the Work Step by Step

Most patients of county hospitals are from rural areas.

Among the older medical group, due to low

acceptance of smart phone operation and Internet

hospitals, it is difficult to promote Internet hospitals

for this group. Therefore, while for county hospitals,

considering the full implementation of Internet

hospitals and the detailed design of various

procedures, we should take into account the learning

and adaptation process of most of the elderly farmers,

we should implement some simple and operational

online medical service processes, and at the same

time increase the services of outpatient medical

guides or volunteers, so as to help the elderly farmers

to answer questions and gradually recommend

Internet Hospital.

At the same time, grass-roots hospitals should

also set up a special propaganda team to increase the

publicity to medical association units and the general

public, so as to benefit medical association units and

more grass-roots people, especially those in remote

areas. Internally, there should be a special person to

answer questions at each outpatient floor, also to

promote outpatient face-to-face and to help some

elderly people use mobile phones to operate.

4.3 Higher-level Policy Support and

Related Supervision and Restraint

Laws and Regulations Need to Be

Further Promulgated

At present, the country has issued Internet charging

standards one after another, but the policies related to

Internet medical insurance have not yet been issued,

and the online medical insurance payment and

reimbursement docking technology has not yet been

opened, which has a great impact on the

implementation of Internet hospitals, and cause great

inconvenience for patients with chronic diseases.

Such as the standardization of hospital medical

records. Compared with outpatient medical records of

physical hospitals, Internet hospital medical records

have not yet issued official standards. At present, the

regulations on medical records management in

medical institutions and the basic norms of electronic

medical records (for trial implementation) are still

followed, but this standard is formulated for physical

hospitals, and its content focuses on inpatient medical

records and medical records management. However,

compared with online Internet hospitals, its

applicability needs to be verified.

At the same time, on the one hand, Internet

hospitals are required to strengthen network

information security management and pay attention

to the protection of patients' personal information,

however, at present, at the level of national

legislation, there are some problems in regulating the

management system of Internet hospitals and

strengthening Internet supervision, such as the access

of Internet hospitals and online consultation

(Li

2017). In order to promote the construction of

Internet hospitals in an orderly manner and protect

the interests of hospitals and patients, relevant

normative laws and regulations are essential.

4.4 Regional Resource Integration and

Internal Related Management

Systems Need to Be Further

Improved

On one hand, affected by the epidemic situation in

COVID-19 and the medical reform policy, the grass-

roots hospitals are struggling to operate, and there are

not a few operating in debt, and the competition

among grass-roots hospitals is fierce. County Internet

hospitals are operated with insufficient resource

integration, which greatly wastes Internet medical

resources. At the same time, the internal departments

of the hospital should actively communicate with

Research on the Problems and Countermeasures of the Application of Internet+ in County Hospitals

each other, and the health management center should

take the initiative to make full use of the personal

health big data provided by the “Internet+” Medical

platform, carry out health analysis, carry out health

reminders and health education from time to time,

and earnestly implement the concept of “preventing

diseases”.

On the other hand, Internet hospital is a virtual

entity institution, and it is necessary to

comprehensively formulate management systems and

departments similar to physical hospitals, including

but not limited to: medical treatment, quality control,

performance, objectives, salary distribution, etc,

which can further standardize online medical

behavior, ensure medical quality, and effectively

motivate doctors to carry out online medical

activities.

Lastly, while actively promoting Internet

hospitals, we should focus on optimizing the

performance distribution system, changing the

concept of medical staff and fully mobilizing their

enthusiasm. At present, most medical staff still stay

in the traditional way of diagnosis and treatment. In

addition, the daily business work in public tertiary

level A hospitals is relatively heavy, and the

enthusiasm of most medical staff to participate in the

work of Internet hospitals is not high, especially in

such surgical departments as Rehabilitation

Department which give priority to treatment

operations. Therefore, how to change the concept of

medical staff, how to allocate performance pay

reasonably, and how to balance the work of physical

hospitals and Internet hospitals have become urgent

problems for hospital managers.

5 CONCLUSIONS

Under the guidance of Healthy China strategy, the

Internet hospital based on “Internet+” technology has

become a new model of hospital development, which

effectively improves the efficiency and coverage of

medical services. Especially during the outbreak of

new coronavirus pneumonia, Internet hospitals have

played an active role in building integrated smart

hospitals. However, in the process of Internet hospital

construction, it is still necessary to pay attention to

the expansion of service scope, the balance of service

objects, the improvement of security policies and

systems and the balance of regional development.

Also, the problem of effective extraction and

application of relevant data in Internet hospitals, due

to insufficient mining of existing data, excessive

consideration of data transmission in business

processes, and neglect of integrated integration of

overall data information, leads to the original

valuable data into “junk data” (Yang etc. 2021, Zhang

etc. 2018). Most importantly, the positioning of

Internet hospital construction should first be to

improve the quality of medical services, followed by

improving the efficiency of medical services, we

must grasp the relationship between the two, only in

this way can truly be patient-centered.

ACKNOWLEDGEMENT

The project was financially supported by the Sichuan

Innovation Research Center for Public Security and

Social Management (SCZA19C03).

REFERENCES

Li, Q. L. (2017). Discussion and Research on the

Construction of Smart Hospitals in the Internet + Era.

Wireless Internet Technology. 8, 117-118.

Shan, Y. (2011). “Internet+” era of intelligent hospital

construction path to explore. Information research. 2,

90-91.

Wang, H.F. and Wei, X. X. (2014). Public health promotion

is the social responsibility of public hospitals. Modern

Hospital. 4, 149-151.

Yan, H. (2011). Innovation Management Pilot Military

Hospital New Development. Hospital President Forum.

6, 11-15.

Yang, J. Y., Zhou, Y. Q. and Feng Z. C.（2021）. Reflections

on the construction of smart hospitals in China under

the background of public health emergencies. China

Hospital Management. 7, 4-6+13.

Zhang, J. Z., Li, Y. K., Cao, L.Y. and Zhang Y. (2018).

Research on smart hospital construction in China and

abroad. Hospital management in China. 12, 64-66.

CAIH 2021 - Conference on Artiﬁcial Intelligence and Healthcare