Editor's note: People's Daily recently announced the launch of the "People's War 'Epidemic'" content science and technology theme contest to promote the deep integration of content science and technology with the real economy and society. Focusing on the competition, the People's Network Venture Capital Channel launched a series of reports on new opportunities for the development of new technology industries in the "People's War", to explore the stories refined in the fight against epidemic prevention and control, and explore the prospects of industrial development.
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"You can't go out during the epidemic. It's very convenient and fast to buy medicine through the Internet."
Open the drug purchase app, upload the prescription photos, and the doctor confirmed the diagnosis by telephone... Liang Daban successfully purchased the prescription drugs for skin diseases, and two days later, the drugs were delivered to the express cabinet at home. "At the initial diagnosis in the hospital, the doctor told me to take medicine for two months continuously, but the prescription medicine can only be given for one course of treatment first, and my medicine just finished after the Spring Festival holiday." The sudden epidemic situation made Liang Daban afraid to go to the hospital. Through the introduction of his friends, he tried to buy prescription medicine online.
During the special period, there were not a few people like Liang Daban who tried to use Internet medical services. According to the statistics released by Analysys Qianfan, during the Spring Festival in 2020, the peak number of independent APP daily activities in the field of online Internet consultation reached 6.712 million, and the peak number of active pharmaceutical e-commerce reached 1.4821 million. The epidemic has catalyzed the introduction of relevant policies such as online medical insurance, and accelerated the popularization of Internet medical care.
The policy is favorable, and medical insurance reimbursement can also be made for online medical treatment
On March 2, 2020, the National Health Insurance Bureau and the National Health Commission issued the Guiding Opinions on Promoting the "Internet+" Medical Insurance Service during the Prevention and Control of COVID-19, which clearly defined that Internet medical institutions can issue electronic prescriptions for the insured online, and dispense drugs flexibly offline in a variety of ways, so that the insured can enjoy medical insurance payment.
On March 5, "Internet medicine" was included in the central medical insurance document for the first time. The Opinions on Deepening the Reform of the Medical Security System issued by the Central Committee of the Communist Party of China and the State Council pointed out that qualified medical institutions should be included in the management scope of medical insurance agreements to support the development of new service models such as "Internet+Medical". According to the above policy requirements, the expenses incurred by the insured in the process of Internet diagnosis and treatment and drug purchase can be settled online through medical insurance.
During the epidemic, Wuhan, Hubei, was the first city to bear the brunt. In order to ensure the drug demand of patients with chronic diseases, the municipal medical insurance bureau introduced Internet hospitals and helped to launch medical insurance online. Micro medical Internet General Hospital is the first Internet hospital in Wuhan to access online medical insurance. After the information of insured personnel is verified, online consultation, drug purchase and medical insurance reimbursement will be automatically carried out for medical insurance settlement.
With the successive introduction of the "Internet+medical insurance" policy, the vitality of Internet medical care has been further stimulated, and patients' medical care concepts are constantly changing. Hu Jinglin, director of the National Medical Security Bureau, published an article in the sixth issue of Qiushi magazine published in 2020, saying that for the needs of outpatient patients with severe and chronic diseases, Wuhan included more than 1300 "Internet+" medical service fees paid by medical insurance every day, and more than 1100 prescriptions were transferred to designated retail pharmacies.
Zhong Yi, the founder of pharmacy online shopping mall, said frankly that the promotion of relevant policies is a major benefit for hospitals, doctors, patients, drug production and pharmaceutical e-commerce. Policies such as Internet medical access to medical insurance are necessary for the full implementation of "Internet+medical". "The elderly in China, some patients with chronic diseases and severe diseases have a high frequency of medical drugs, and all need medical insurance to relieve the pressure of medical treatment. In addition, online medical insurance can use big data and blockchain technology to ensure the quality of drugs through traceability, and eliminate insurance fraud."
With the support of policies and traffic, Internet medical has embarked on the road of expansion. Following Hubei, the electronic medical insurance voucher has been piloted in some cities in Hebei, Jilin, Heilongjiang, Shanghai, Fujian, Shandong, Guangdong and other provinces (cities). On March 25, Dingdang Express was the first to launch the "medical insurance to home" service in Shenzhen. Through the medical mall on the WeChat public account, citizens can select drugs in the medical insurance drug zone and then settle through medical insurance.
"I used to buy drugs online only when it was inconvenient for me to go to the hospital." Zhang Miao, who works in Shenzhen, said that now online drug purchases can also be reimbursed through medical insurance, and in the future, I would prefer to use a more convenient and fast online drug purchase platform.
Jia Li's mother, who lives in Baoji, Shaanxi Province, needs to take medicine for a long time because of diabetes. In order to reduce the burden, a year ago, Jia Li began to buy medicine in Internet hospitals. After learning that the Internet diagnosis and treatment services of 12 tertiary hospitals in Shaanxi Province will be included in the medical insurance settlement system, Jia Li was very happy
"Internet+medical" needs to get through the "last mile"
The issue of medical insurance reimbursement has always been considered as the "last mile" of the Internet medical revolution. Although the policy trend is conducive to the development of the industry, there are still barriers to be broken in the actual implementation process.
Chen Xiaoyue, a surgeon in charge of a tertiary A hospital in Lanzhou, Gansu Province, said that the involvement of the Internet has accelerated the hierarchical diagnosis and treatment services and improved the efficiency of medical resources. But after the epidemic, many optimistic predictions may not be realized in the short term.
"The online policy was mentioned in the Opinions on Promoting Telemedical Services of Medical Institutions issued in 2014. The implementation and promotion of the online policy vary greatly among provinces and cities, and there is a gap between the service capabilities of online and offline medical institutions. It still takes time for the policies such as Internet medical access to medical insurance to be popularized from the pilot to the whole country, and it also requires good cooperation between government departments, hospitals, pharmaceutical factories and pharmaceutical e-commerce platforms. "
The background data of clove doctors shows that the number of online consultations has decreased significantly compared with the period of the most serious epidemic in China. Li Tiantian, the founder and chairman of DXY, said that the introduction of online medical insurance and other policies is more conducive to the industry, but not to specific enterprises. "The first problem to be solved is the settlement of medical insurance in different places. According to the current policy, patients in Shanghai can only use the online Internet platform of a hospital in Shanghai for reimbursement. This greatly limits the advantage of the Internet as" service without boundaries ". Internet companies are unlikely to build a platform in every region and hospital in the country."
Zhong Yi pointed out that because the medical insurance systems in various provinces and cities are not unified, relevant service enterprises need to connect one by one, which restricts the speed and scale of medical insurance online. "At present, hospitals with online medical insurance qualifications are all non private, and the Internet third-party drug trading platform cannot be the main body for applying for medical insurance settlement, which requires the application of physical pharmacies, and the review cycle is long, which makes online medical insurance impossible to be rapidly popularized nationwide."
Zhong Yi hopes that in the future, the vertical pharmaceutical e-commerce platform will also be included in the main body of medical insurance settlement applications. At present, the pharmacy network is trying to build a cooperation platform with the relevant departments of the local government to prepare for the subsequent launch of medical insurance. He suggested that under the supervision of the government, a national unified platform for the circulation of electronic prescriptions of Internet hospitals and a unified platform for medical insurance settlement should be established. Local medical e-commerce only needs to dock with a third-party platform with medical insurance online reimbursement qualification, so that patients can use medical insurance anytime and anywhere to purchase drugs, which can not only reduce the management cost of the medical insurance department, but also strengthen the risk control of online medicine.
Although the development of "Internet+medical insurance" takes time, Chen Dongdong, vice president of Zhonghai Investment and Investment, reminded that "the introduction of medical insurance online and a series of policies related to medical research and development, circulation and other issues will, to some extent, reconstruct the pattern of the pharmaceutical industry." He believed that enterprises with innovative capabilities will get resource preference and thus truly benefit.
"The online medical insurance will not only bring about changes in payment methods, but also the corresponding payment mechanism, diagnosis and treatment data mining, resource allocation, and other opportunities to further change the existing pattern. In China, this change will take place under the active guidance of the government. Relevant enterprises and institutions should actively comply with the policy, make a reasonable layout in the aspect of marketization, use the optimized model to provide market-oriented supplement for medical insurance, and use technical means to realize the reasonable allocation of resources and the amplification of data value. " Chen Dongdong said.
■ Related reading
People's War "Epidemic" - People's Venture Capital Series Report
（1） Venture Capital Observation: AI empowers new drug research and development, with a long way to go
（2） Venture Capital Observation: After the epidemic "test", intelligent enterprises are expected to enter the "fast lane"
（3） VC observation: blockchain industry is expected to develop after the epidemic "test"
（4） VC observation: content technology in "cloud supervision" promotes new momentum
（5） Venture Capital Observation: The epidemic accelerated the launch of medical insurance, and Internet medicine still faces the "last mile"
(Editor in charge: Yue Shangyuan (intern), Wang Zhen)
