The troika of reach, efficiency, and payment drives the transformation of the digital medical industry
With the gradual improvement of the underlying digital technologies such as artificial intelligence, 3D printing, and robotics, and the role of national policies, the impact of the epidemic, and market changes, medical health The industry shows trends and opportunities in digitalization. At the same time, more and more medical industry boundaries originally divided by medicines, equipment, IVD, medical services, and medical information are disappearing, and behind this cross-border integration is the power of digitalization.
Yang Ruirong, partner of Yuanyi Capital, believes that 2020 is the first year of digital reconstruction of traditional medical care. In this era of great changes in the industry, precise access, efficiency improvement, and payment completion are “the biggest starting point that can change the overall infrastructure construction of China’s medical and health care.”
Based on this background, on November 27, Yuanyi Capital held the “Reconstructing the Medical and Health Boundary-2020 Vision Digital Health Summit Forum” in Shanghai, sharing the digital collaboration of the medical and health industry from many aspects , Interpret the new trends and new opportunities of the digital healthcare industry in the next decade.
From doctor-centered to patient-centered
In the past, the reforms of the medical and health industry were centered on doctors’ medical reform and medical insurance. Today’s digital technology allows medical resources to reach patients directly, making all patient-centric business models possible. At the same time, under the influence of policies such as mass procurement, the profit margins of pharmaceutical companies and medical device manufacturers cannot continue to support the sales system of tiers of distributors, and companies that precisely meet the needs of customers have also urged patient-centric Digital transformation.
In 2020, the number of Internet medical users in China has reached 620 million, close to 70% of mobile Internet users. In the past few years, the government has successively introduced more than 30 policies to support the development of Internet medical care, the latest such as reimbursement of prescription drugs by medical insurance after online consultation. The epidemic has also spurred the digitization of public hospitals. Before the epidemic, only more than 70 public hospitals had Internet medical platforms. This number had increased to more than 1,000 by the time of statistics after the epidemic.
This series of changes makes the medical technology of the top three hospitals and doctors resources can sink to the grassroots, rural areas , The community, and help doctors improveThe efficiency is based on receiving more patients from all over the world, solving the problems of uneven medical resources and confined medical service scenarios in hospitals. Among them, ophthalmology digitization, dental 3D printing, and remote imaging diagnosis are all good application cases.
However, this digital transformation is still relatively preliminary. The large sample survey conducted by Boston Consulting Group and Tencent two months ago also showed that digital medical care is currently mainly infiltrating remote consultations and other aspects, and it is relatively lacking in disease management. Chen Baiping, managing director of Boston Consulting Group, also believes that “the future of disease management will be a particularly important breakthrough in digital healthcare.”
In the field of disease management, the main difficulty lies in the management of chronic diseases. For patients with chronic diseases, the degree of integration of medical services is low, and patients often have to use two or more different platforms to meet all their needs. Therefore, integrating medical service resources and providing patients with integrated, full-process solutions will be an important breakthrough.
Secondly, the professionalism and effectiveness of therapies using artificial intelligence and other digital technologies and data support need to be further verified. In this regard, Gu Chengming, head of Sanofi’s China Medical Department, said: In the 2015 Real World Evidence (RWE) pilot, clinical decision support CDSS has covered more than 100,000 patients in 16 cities receiving SOC (standardized treatment), disease management good results. We have also seen that the State Food and Drug Administration has recently issued “Technical Guidelines for Clinical Evaluation of Medical Devices Using Real World Data (Trial)” and other announcements. Future clinical research is expected to be carried out under the drive and guidance of real-world data and real-world evidence based on this, so as to provide scientific evidence for regulatory decision-making while reducing current clinical research expenditures for data-controlled studies.
Finally, most of the current chronic disease management models lack continuous incentives for patients, and it is difficult to manage discharge from the hospital. In the past medical and health industry model centered on doctors, medical services were often limited to point-to-point communication in the clinic. After leaving the clinic, the compliance and continuity of chronic disease management at home for patients were not guaranteed, which greatly affected the disease. The therapeutic effect. In this regard, Zhang Wei, the founder of Yongliu Technology, mentioned the example of an insurance company’s Discovery Vitality health management project. The project includes two links: users accumulate points by doing activities that are beneficial to health, and users use points to get more disease insurance. Discounts. This continuous incentive is conducive to expanding service scenarios in a patient-centric medical service model.
Liu Guanghui, the attending physician at Tongji Hospital, also mentioned the example of the American health management platform BlueStar. By emphasizing the three-dimensional interaction of communities, families, and hospitals, and focusing on patient self-management, digital technology can help realize the transition from doctor treatment to health management . Similar projects in China include Lilly Youxing etc.
The transformation from a medical insurance-centered to a multi-level medical insurance system
In terms of the current status of payers in the Chinese medical market, total non-government health expenditures in 2019 amounted to 4.7 trillion yuan, of which 1.85 trillion yuan was personal expenditure and 2.09 trillion yuan was basic medical insurance expenditure. As the aging trend of China’s population structure becomes more obvious, the social security balance rate has also dropped rapidly from 18% in 2013 to 4% in 2019.
Judging from the recent policy situation, the government is also starting to solve the problem of insufficient medical insurance funds by building a multi-level medical security system and increasing efforts to develop health insurance. In the face of the increasingly severe challenges of aging and the hidden opportunities in it, digitization can help transform the medical payer.
First of all, in the past, the commercial insurance industry did not provide insurance for patients. In recent years, it has gradually begun to insure non-healthy individuals. Behind this change is AI smart risk control, customer service, digitization of pricing for the sick population, etc.Insurtech The promotion. Taking AI intelligent risk control as an example, the current approach is to provide a person with customized insurance services and health management services by identifying the risks of a person. There are many companies that are trying in this field, but they have not yet ran out of a leading company with development potential. huge.
Secondly, digital technology has made the online sales of health insurance a new force in the insurance industry. In 2019, the premium income of the entire health insurance market exceeded 700 billion yuan, and more than 660 billion yuan in the first three quarters of this year, which will soon surpass the entire auto insurance market. Among them, there is no lack of the impact of the epidemic. In the first half of this year, health insurance companies with online sales capabilities have achieved rapid business growth.