Internet healthcare, challenges and opportunities after the decline of capital heat

Image source @ Visual China

Wen | Yuan Guobao

Ma Yun once predicted that the next Alibaba will be born in the field of Internet medical treatment. Alleviate the "difficult to seek medical treatment" and "expensive medical treatment" people's livelihood pain points, rich application scenarios, and then plug in the wings of the Internet, Internet medical care does have a lot of imagination space, coupled with the sudden outbreak of the new crown epidemic, it has brought unprecedented benefits to Internet medical treatment, for a time Internet giants have entered the Internet medical track, hot in the sky, financing is highly intensive. But the good times were not long, the hottest track ushered in the "strongest supervision", once the most favored "prince", before he had time to find a way out, because several "edicts" fell out of favor, and the former followers gradually dispersed, staged a plot of "prince" becoming "frog".

Is Internet medical treatment really "not fragrant"? What are the challenges and opportunities after the capital heat is reduced?

The giant with its own buff becomes a "medicine god"

As everyone knows, I accidentally became a "medicine god"

Internet medical treatment is "selling drugs"? Of course not!

Internet medical care is to rely on the Internet comprehensive online and offline advantages to complement each other, to achieve the further integration and development of health resources and industry, alleviate the problem of unequal medical resources and medical information, for the health and well-being of the people, for the establishment and improvement of China's basic medical and health system and the implementation of the healthy China strategy has an important role. There is no doubt that the future development direction of Internet medical treatment is to solve the problem of "difficult to see a doctor and expensive to see a doctor" in the mainland, and enterprises cannot realize their value by selling drugs alone. With one wing, you can't fly high. Of course, the giants with buffs know this, but the development of online consultation, health management and other sectors is not something that can be achieved overnight.

The emergence of the epidemic has promoted the rapid outbreak of the domestic Internet medical industry. According to the statistics of the Planning and Information Department of the National Health Commission, during the epidemic prevention and control period, the number of Internet diagnosis and treatment in hospitals under the national health commission increased by 17 times compared with the same period in 2019, and the number of Internet diagnosis and treatment consultations on some third-party platforms increased by more than 20 times. However, in China, after the rapid development of the industry, what follows is definitely the "strongest supervision", "strong supervision" has brought a clear development direction to the Internet medical industry, and has also opened a new round of survival of the fittest. In the context of standardized development, "selling drugs" is indeed an important source of revenue to support Internet medical enterprises. After all, from the essence of business, the profitability of enterprises is one of the necessary elements for whether it can go long.e.

But in the future development, the industry giants will gradually confirm to people that I am not just a "medicine god".

For the three giants of the industry, it is only a matter of time before I get rid of my "medicine god".

The "strongest regulation" is both a pain and an opportunity, and policies and industries often develop interactively.

In 2018, the General Office of the State Council promulgated the Opinions on Promoting the Development of "Internet + Medical Health", Internet hospitals obtained "birth permits"; the National Health and Family Planning Commission issued three management measures and management norms, and Internet medical care has a "talisman". The rapid development of Internet medical care in the past few years has benefited from the support of policies.

In 2020, the emergence of the epidemic has spawned a large number of online medical needs, which has promoted the explosive growth of the domestic Internet medical industry. However, with the normalization of the epidemic and the recovery of offline medical capabilities of physical hospitals, the public's attention to Internet hospitals will gradually become the seriousness of online diagnosis and treatment in 2021; in terms of policies, the state has further strengthened the supervision and intensity of Internet medical treatment, and Internet medical care has ushered in the "strongest supervision". On October 26, 2021, the National Health Commission issued the "Detailed Rules for the Supervision of Internet Diagnosis and Treatment (Draft for Comment)" for public comments, which blocked loopholes such as Internet medical imposters, excessive diagnosis and treatment, and payment of doctors' kickbacks.

The arrival of the strongest regulation, the sudden change of the jianghu, the most direct reaction to this phenomenon is manifested in the capital market. Even Internet hospital giants such as Ali Health and JD Health, which have strong background support, the average decline in stock prices will reach 70% in 2021. Has the Internet medical industry, which has experienced great winds and waves, come to an end? It is still that sentence, benchmarking regulatory conditions, big waves, survival of the fittest. Strong supervision is stable development, and supervision is both a pain and an opportunity.

But what is certain is that the "fall out of favor" of Internet medical treatment is by no means "strong supervision", it may not have explored a set of profit models, and capital has begun to lose patience.

"Thinking" and "Doing" of Internet Medical Treatment

The arrival of "the strictest supervision" has made the Internet medical industry that has "grown barbarically" for many years feel painful, and under the pain, it has also made enterprises in the industry begin to wake up and look for the "original intention" of Internet medical treatment, of course, this is also the original intention of "strong supervision". The 2021 "Opinion Draft" was introduced, on the one hand, so that "medicine to medical treatment, medicine to medicine, technology to technology", on the other hand, but also let the Internet medical return to the essence of "medical services", once again remind enterprises, the core logic of the Internet medical business, or to what problems to solve, what kind of value to create.

By 2021, industry companies have actually handed over some of their own answer sheets, whether listed or not listed, experienced two decades of ups and downs, so that the market has a deeper understanding of the industry, and made its judgment and choice. So in 2022, what thinking and transformation does Internet medical care need?

1. Return to the essence and original intention

The most important problem in China's medical and health field is that high-quality medical resources do not match the needs of patients, that is, the problem of "difficult to see a doctor, expensive to see a doctor", and the biggest advantage of Internet medical care is to use the network as the carrier and digital technology as a means to supplement offline face-to-face interaction through data interaction, so as to solve the problem of time and space restrictions, alleviate the problem of "difficult to see a doctor, expensive to see a doctor", and let people enjoy equal, inclusive and convenient medical treatment through the Internet.

For a long time, China's medical resources have been unbalanced, and high-quality resources are extremely scarce, which has become a stumbling block for Chinese people to move towards the era of common prosperity. Internet medical care returns to the original intention of medical services, relying on digital transformation, it can alleviate some problems. With the deepening of users' trust in Internet medical care and the further establishment of related policy systems, Internet medical care will once again flourish. It also means that the deep integration of online and offline medical resources has become the trend of the times, and the platform with medical advantages, brand advantages, technical advantages and traffic advantages will undoubtedly become the leader.

In terms of policy, the "Detailed Rules on the Supervision of Internet Diagnosis and Treatment (Draft for Comments)" stipulates that Internet diagnosis and treatment "shall not be the first diagnosis, only follow-up consultation" This provision takes into account the non-contact shortcomings of Internet diagnosis and treatment, and from the perspective of safety, it has a certain necessity, which clarifies the positioning of Internet diagnosis and treatment, and strengthens the development direction of "health management" in the industry. However, this provision is more difficult to implement in practice, the elderly, as the main users of Internet diagnosis and treatment, are not good at using Internet services and equipment, but when conducting online follow-up consultation, they also need to upload a large amount of information (outpatient cases, inpatient cases, diagnostic certificates...). To determine whether it is a follow-up consultation, this is much beyond their scope, and some hospitals can not provide materials to prove whether it is the first diagnosis, the definition of the first diagnosis is not clear, adding a lot of complicated and cumbersome procedures.

Based on actual operation, it is also necessary to further clarify the logic between online and offline, and it is not advisable to apply one size fits all to the first diagnosis online, so as to truly play the convenient role of Internet medical treatment, otherwise it will increase the cost of people's time and procedures, contrary to the original intention.

Times give opportunities, but they also grant missions. Internet medical care is to improve the well-being of the people as the goal, related to the people's livelihood, enterprise development and policy formulation as long as the original intention, firm faith, I believe that it will be exchanged for the return of the market and the happiness of the people.

2. Promote the sinking of high-quality medical resources

Where is the real main battlefield of Internet medical treatment? Undoubtedly, it is the rural areas that are most scarce in medical resources. The more remote and backward the area, the more scarce the medical resources, the lack of talents and equipment, and the great demand for follow-up consultation. There are also many left-behind children and the elderly, and the middle-aged group that goes out to drift and has a real and urgent need for remote health monitoring. Hundreds of millions of people in rural areas are the real capillary level of just need.

How to alleviate the pressure of large hospitals, make the grass-roots medical institutions "strong", and let the people see the disease, see the disease and look at the disease? It is also what the Internet medical industry needs to consider, Jingdong Health, Ali Health, etc. have long been laid out in rural areas, Jingdong Health actively develops offline scenes, opens the "Jingdong Pharmacy" to the countryside, and relies on platform advantages to divert high-quality medical resources to the weakest rural grassroots.

In November 2020, the General Office of the Ministry of Industry and Information Technology and the General Office of the National Health Commission issued the document "Notice on Further Strengthening the Capacity Building of Telemedicine Networks". The "Notice" proposes that more than 98% of grass-roots medical and health institutions will be connected to the Internet in 2022, which can be seen that "primary medical + Internet" in 2022 is definitely a point of strength.

3. Medical insurance payment that cannot be avoided

In the Internet hospital, one of the most concerned questions is "can I use medical insurance reimbursement"? After all, offline public hospital consultation can be reimbursed by medical insurance, and finally it takes a few dollars to consult, plus there is a more common social psychology in China, doctors are angels in white, it is a public welfare profession of selfless dedication, and people have become accustomed to online free consultation.

Today, online Internet medical care has not yet been connected to a wide range of medical insurance, most of the medical services are patients at their own expense, lack of user payment environment. The current Internet hospitals rely on physical hospitals, and medical insurance only pays for physical hospitals, and it is difficult for Internet medical enterprises to make profits from them. It can be seen that at present, in addition to the relatively clear profit model of selling drugs, the profit model of "medical services" that the state attaches the most importance to is still in the exploratory stage, and the commercialization of Internet medical care is also a problem that must be faced.

In July 2020, the General Office of the State Council recently issued the Implementation Opinions on Further Optimizing the Business Environment and Better Serving Market Entities (hereinafter referred to as the Opinions). The "Opinions" proposes that under the premise of ensuring medical safety and quality, the scope of Internet diagnosis and treatment will be further relaxed, and eligible Internet medical services will be included in the scope of medical insurance reimbursement. On November 2, only four months later, the National Medical Insurance Bureau issued the Guiding Opinions on Actively Promoting the Payment of Medical Insurance for "Internet +" Medical Services. The plan stipulates that the medical examination fees and drug expenses incurred by the insured person due to the Internet + medical services in the co-ordination area due to the follow-up consultation and prescription of the co-ordination area may be paid in accordance with the regulations of the co-ordinating area medical insurance.

Judging from the frequency of the Internet medical reimbursement policy below, the state is also speeding up efforts to promote Internet medical services. Breaking the payment bottleneck of Internet medical care can not rely on unilateral efforts, industry companies are also trying to explore, overcome difficulties, the most promising to solve this problem of the giant, should be Ping An Health. Ping An Health's resources are unique, 2021 practice HMO model, online "commercial insurance service" function, patients in the diagnosis and treatment process, responsibility consultation and medical expenses will be directly settled by the insurance company and the platform, to achieve direct payment of commercial insurance, users do not need to provide information and other cumbersome compensation steps, after the end of medical treatment can be automatically settled claims. And Alibaba Health, with its powerful backer Alipay behind it, is not difficult to break through the payment problem. Not to be outdone, JD.com has joined forces with a number of insurance companies from Fosun to launch a "home medical insurance" managed health insurance service. To promote the development of the Internet medical industry, enterprises need to keep up with national policies, keep pace, breathe together, and walk non-stop on the road of exploration.

In the past 20 years, Internet medical care has risen and fallen, from initial exploration to land grabbing, from capital mania to return to rationality, from policy uncertainty and survival in the cracks to policy encouragement and multi-party recognition. It can be seen that the development of Internet medical care has experienced enterprise motivation and policy motivation, and now after the impact of the epidemic, everyone has experienced an Internet medical application scenario, thus stimulating user motivation. Nowadays, the three forces of policy, enterprise and user are integrated, and the development of Internet medical care that returns to rationality will accelerate in 2022.