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On October 26, the Medical Administration and Administration Bureau of the National Health Commission issued an announcement to solicit opinions on the "Detailed Rules (Draft for Comments)".

The "Regulatory Rules" point out that professional information such as electronic certificates and doctors providing Internet diagnosis and treatment services should be published prominently on the Internet diagnosis and treatment platform to facilitate patient inquiries.

The "Regulatory Rules" require that medical institutions should fully inform patients about the rules, requirements and risks related to Internet diagnosis and treatment, and can only carry out Internet diagnosis and treatment activities after obtaining the patient's informed consent. Medical institutions should conduct real-name authentication of medical personnel carrying out Internet diagnosis and treatment activities to ensure that medical personnel have legal qualifications.

In addition, Internet diagnosis and treatment is subject to a real-name system, and patients are obliged to provide medical institutions with real identity certificates and basic information, and are not allowed to fake others for treatment.

The "Supervision Rules" mention that the electronic medical record information generated by medical institutions during the Internet diagnosis and treatment process should be shared with the electronic medical record system of the physical medical institution that is relied on, and the online and offline quality control will be carried out by the physical medical institution that is relied on. Internet medical record records are managed in accordance with the relevant provisions of outpatient electronic medical records. Graphic dialogues, audio and video materials during the diagnosis and treatment process should be traceable throughout the process, traceable, and data interfaces should be opened to provincial supervision platforms, and the storage time must not be less than 15 years.

Internet diagnosis and treatment supervision

Chapter 1                    

Article 1 In order to standardize Internet diagnosis and treatment activities and strengthen the construction of the Internet diagnosis and treatment supervision system, these rules are formulated in accordance with the laws and regulations and regulations such as the "Basic Medical and Health Promotion Law", "Doctor Law", "Infectious Disease Prevention and Control Law", "Medical Institutions Management Regulations", "Nurse Regulations", "Internet Diagnosis and Treatment Management Measures (Trial)", and "Internet Hospital Management Measures (Trial)".

Article 2 The Internet diagnosis and treatment mentioned in these rules refer to Internet diagnosis and treatment activities carried out by medical institutions in accordance with the "Internet Diagnosis and Treatment Management Measures (Trial)" and "Internet Hospital Management Measures (Trial)".

Article 3 The national health and health authorities and traditional Chinese medicine authorities are responsible for guiding the national Internet diagnosis and treatment supervision work. Local health and health authorities at all levels (including traditional Chinese medicine authorities, the same below) implement local supervision responsibilities.

Chapter 2                                                              

Article 4 Provincial health and health authorities shall establish a provincial Internet medical service supervision platform (hereinafter referred to as the "provincial supervision platform") to realize real-time supervision of medical institutions (hereinafter referred to as the "medical institutions") within their jurisdiction that carry out Internet diagnosis and treatment activities.

Article 5 Medical institutions that carry out Internet diagnosis and treatment activities shall actively connect with the provincial supervision platform where they are located, upload and update the "Medical Institution Practice License" and other related practice information, and actively accept supervision.

Article 6 Medical institutions shall have special departments to manage the medical quality, medical safety, pharmacy services, information technology, etc. of Internet diagnosis and treatment, and establish corresponding management systems, including but not limited to the self-inspection system for medical institutions in accordance with the law, medical quality and safety management systems related to Internet diagnosis and treatment, patient safety adverse event reporting system, medical personnel training and assessment system, patient informed consent system, prescription management system, electronic medical record management system, information system use management system, etc.

Article 7 The Internet hospital as the second name of a physical medical institution shall be verified at the same time as the physical medical institution; the Internet hospital that obtains a "Medical Institution Practice License" by a physical medical institution shall be verified once a year.

Article 8 Medical institutions and electronic certificates and other professional information of doctors providing Internet diagnosis and treatment services shall be published prominently on the Internet diagnosis and treatment platform to facilitate patient inquiries.

Article 9 Medical institutions shall fully inform patients of the rules, requirements and risks related to Internet diagnosis and treatment. Only after obtaining the informed consent of the patient can they carry out Internet diagnosis and treatment activities.

Article 10 Local health and health authorities at all levels shall publish to the public the list of medical institutions approved for Internet diagnosis and treatment in their jurisdiction on provincial supervision platforms, supervise telephone numbers and other supervision methods, set up complaint acceptance channels, and promptly deal with illegal and irregular behaviors.

Article 11 Local health and health authorities at all levels shall establish an evaluation and exit mechanism for medical institutions in accordance with the "Regulations on the Management of Medical Institutions" and its implementation rules.

Chapter 3 Personnel Supervision

Article 12 Medical institutions shall conduct real-name authentication of medical personnel carrying out Internet diagnosis and treatment activities to ensure that medical personnel have legal qualifications.

Article 13: The doctor must undergo real-name authentication before receiving the treatment to ensure that the doctor is treated. Other personnel, artificial intelligence software, etc. shall not be used to replace the doctor himself. Health and health authorities at all levels shall be responsible for supervising the personnel conducting Internet diagnosis and treatment in the medical institution.

Article 14 Medical institutions shall share the information of medical personnel carrying out Internet diagnosis and treatment activities with provincial supervision platforms, including ID number, photos, relevant qualification information, place of practice, clinical work years and other necessary information. Provincial supervision platforms shall be connected with the electronic registration system of doctors and nurses, and pharmacist information shall be uploaded to the supervision platform and can be queried, and shall be connected with the health supervision information system if conditions permit.

Medical institutions should establish an assessment mechanism for medical personnel carrying out Internet diagnosis and treatment activities, conduct assessments based on legal practice, medical quality, medical safety, medical ethics and style, satisfaction, etc., and establish an entry and exit mechanism.

Article 15 Medical institutions shall conduct regular training for those who carry out Internet diagnosis and treatment activities and engage in related management services. The training content includes health and health-related laws and regulations, medical management related policies, job responsibilities, Internet diagnosis and treatment processes, information platform use and crisis response, etc.

Article 16 If medical personnel conduct Internet diagnosis and treatment activities in other Internet hospitals other than their main practice locations, they shall register or register for practice in accordance with the relevant requirements of the practice of multiple institutions in the Internet hospital.

Chapter 4 Business Supervision

Article 17: The real-name system for Internet diagnosis and treatment is implemented, and patients are obliged to provide medical institutions with real identity certificates and basic information, and are not allowed to fake others for treatment.

Article 18: When visiting a doctor, the patient shall provide medical records with clear diagnosis, such as outpatient medical records, hospitalization medical records, discharge summary, diagnosis certificate, etc. The doctor shall determine whether the follow-up conditions meet the conditions, and collect paper or electronic certificate information that proves that the patient has been diagnosed.

Medical institutions should clarify the conditions for termination of Internet diagnosis and treatment. When the patient's condition changes and the doctor determines that this visit is the first time or there are other situations that are not suitable for Internet diagnosis and treatment, the doctor who receives the doctor shall immediately terminate the Internet diagnosis and treatment activities and guide the patient to a physical medical institution for treatment.

Article 19 The electronic medical record information generated by medical institutions during the Internet diagnosis and treatment process shall be shared with the electronic medical record system of the physical medical institution that is supported, and the physical medical institution that is supported shall carry out integrated online and offline quality control.

Internet medical records are managed in accordance with the relevant provisions of outpatient electronic medical records. Graphic dialogues, audio and video materials during the diagnosis and treatment process should be traceable throughout the process, traceable, and data interfaces should be opened to provincial regulatory platforms, and the storage time must not be less than 15 years.

Article 20                                                             �

Article 21 Medical institutions shall strictly abide by the prescription management regulations such as the "Prescription Management Measures" and other prescription management regulations when carrying out Internet diagnosis and treatment activities, strengthen drug management, prohibit unified prescriptions and supplementary prescriptions. The personal income of medical and health personnel shall not be linked to the income from drugs and medical examinations.

Article 22: If a medical institution conducts drug distribution on its own or entrusts a third party, the relevant agreements and prescription circulation information shall be traceable and the data interface shall be opened to the provincial regulatory platform.

Article 23           The charges and charging standards for medical services for Internet diagnosis and treatment shall be made public online to facilitate patient inquiries.

Article 24 Medical institutions or medical personnel shall not refer patients in violation of regulations, purchase medicines and consumables at designated locations, etc.

Article 25 The provincial health and health authorities shall collect relevant data from medical institutions in accordance with the "minimum availability principle", focus on collecting information on medical institutions' qualifications, medical personnel qualifications, diagnosis and treatment subjects, diagnosis and treatment types, electronic medical records, electronic prescriptions, medication usage, satisfaction evaluation, patient complaints, patient safety adverse events and other information, analyze the overall situation of Internet diagnosis and treatment, and regularly (at least once a month) feedback problems to each medical institution and its registration authority, and clarify the rectification period. After receiving feedback from the provincial health and health authorities, medical institutions shall promptly rectify the rectification situation and upload the rectification situation to the provincial supervision platform and report it to its registration authority at the same time.

Provinces with conditions are encouraged to set rules for determining the rationality of Internet diagnosis and treatment in provincial regulatory platforms, and use emerging technologies such as artificial intelligence and big data to implement analysis and supervision.

Chapter 5 Quality and Safety Supervision

Article 26 Medical institutions shall abide by relevant laws, regulations and regulations on medical quality, patient safety and network security when conducting Internet diagnosis and treatment activities.

Article 27 Medical institutions shall establish a system for reporting patient safety adverse events, designate special departments to be responsible for the collection, analysis and summary of patient safety adverse event reports, and encourage medical personnel to actively report adverse events.

Article 28 Medical institutions shall establish systems such as network security, personal information protection, data use management, etc., and sign agreements with relevant partners to clarify the rights and responsibilities of all parties.

Article 29                                                             �

Article 30                                                             �

Article 31                                                             �

Chapter 6 Supervision Responsibility

Article 32: Internet hospitals that have obtained the "Medical Institution Practice License" and are independently established shall be independently the legal responsibility subject; when the physical medical institution uses the Internet hospital as the second name, the physical medical institution shall be the legal responsibility subject. All parties to the Internet hospital cooperation shall bear corresponding legal responsibilities in accordance with the law and regulations in accordance with the cooperation agreement.

Article 33: If medical institutions and medical personnel violate the "Doctor Law", "Infectious Disease Prevention and Control Law", "Medical Institutions Management Regulations", "Medical Accident Handling Regulations", "Nurse Regulations" and other laws and regulations during the Internet diagnosis and treatment, they shall be handled in accordance with relevant laws and regulations.

Article 34: When a network security incident such as patient personal information and medical data leakage occurs in a medical institution, it shall promptly report to the relevant competent authorities and take effective response measures.

Article 35: If a medical institution encounters medical accidents or causes medical disputes during the Internet diagnosis and treatment activities, it shall handle them in accordance with the relevant laws and regulations such as the "Regulations on Handling Medical Accidents", "Regulations on Prevention and Handling of Medical Disputes" and other relevant laws and regulations. The medical institution registration authority shall perform the corresponding handling responsibilities in accordance with relevant laws and regulations.

Article 36 Medical institutions shall control the quality and safety of Internet diagnosis and treatment activities and set up information feedback channels for patient complaint handling.

Article 37 Provincial health and health authorities shall include Internet diagnosis and treatment in the local medical quality control system, carry out integrated online and offline supervision to ensure medical quality and medical safety.

Chapter 7                  

Article 38 The National Medical Service Data Center connects with provincial regulatory platforms to analyze national Internet diagnosis and treatment related data.

Article 39: Provincial health and health authorities shall formulate implementation measures for these rules.

Article 40       The National Health Commission shall be responsible for interpreting these rules.

Article 41 These rules shall come into effect on the month of 2021.

On October 26, when responding to the proposal of CPPCC member Zhu Shizeng to “realize free medical care for all”, the National Health Insurance Administration responded to the discussion on “India’s implementation of free medical care”.

The National Health Insurance Administration said that India's personal medical expenses account for more than 60% of the total health expenses, and relevant reports on the Internet "do not reflect objective actual situations."

In recent years, there have been rumors on the Internet that although India has a population of 1.3 billion and its per capita GDP is only US$2,100, it has achieved free medical care for all. Since the 2020 COVID-19 pandemic, doubts about "Why can India be, why can't we?" have become increasingly serious.

In July last year, the official WeChat public account of China Medical Insurance under the National Health Insurance Administration published a statement saying that minor illnesses such as colds and fevers can be treated for free in public hospitals in India. However, the treatment level of public hospitals is often average. If you want to diagnose and treat difficult and complicated diseases, you still have to go to private hospitals that need personal payment and are expensive.

However, rumors about "free medical care in India" are spreading more and more widely online, and the rumors overshadow the facts. The National Health Insurance Administration has to come forward to face the scene.

While refuting the rumor of "free medical care in India", the National Health Insurance Administration also explained the basic medical insurance system in my country at this stage.

The National Health Insurance Administration stated that my country has built the world's most extensive basic medical insurance network, covering more than 1.36 billion people, and the insurance rate is stable at more than 95%. However, since the current level of medical insurance financing is not high and the fund support capacity is insufficient, it is still necessary for individuals to bear certain medical and health expenditure responsibilities. The implementation of free medical care is not conducive to the long-term stable and sustainable development of my country's medical insurance system.
Chapter completed!