Focus: AI ambulances and robot doctors: China seeks digital salve to ease hospital strain

Ping An Healthcare and Technology Co

28/06/2018 14:05

By Adam Jourdan
    HANGZHOU, China/SHANGHAI, June 28 (Reuters) - In the eastern
Chinese city of Hangzhou, an ambulance speeds through traffic on
a wave of green lights, helped along by an artificial
intelligence (AI) system and big data.
    The system, which involves sending information to a
centralised computer linked to the city's transport networks, is
part of a trial by Alibaba Group Holding Ltd  BABA.N . The
Chinese tech giant is hoping to use its cloud and data systems
to tackle issues hobbling China's healthcare system like snarled
city traffic, long patient queues and a lack of doctors.
    Alibaba's push into healthcare reflects a wider trend in
China, where technology firms are racing to shake up a creaking
state-run health sector and take a slice of spending that
McKinsey & Co estimates will hit $1 trillion by 2020.
    Tencent-backed  0700.HK  WeDoctor, which offers online
consultations and doctor appointments, raised $500 million in
May at a valuation of $5.5 billion. Ping An Good Doctor
 1833.HK , a similar platform backed by Ping An Insurance
 2318.HK   601318.SS , raised $1.1 billion in an IPO this year.
    "The opportunity is growing very fast," said Min Wanli, the
Hangzhou-based chief machine intelligence scientist at Alibaba's
cloud division.
    Alibaba is working with a hospital in Shanghai using data to
predict patient demand and allocate doctors. In Zhejiang
province, the company is working on AI-assisted diagnosis tools
to help analyse medical images such as CT scans and MRIs.
    "You need to go through very specialized training in order
to read these images, but we know that experts are a very scarce
resource," said Min.
    Chinese hospitals are increasingly using technology to
bridge the gap between urban centres and remote parts of the
country where doctors are in short supply. Using
document-sharing systems and livestreaming video, specialists
can direct more junior medical staff on-site doing patient
diagnoses.
    DXY, one of China's biggest online networks of doctors,
offers consultations on the WeChat social media platform for
patients with chronic diseases such as diabetes, with a team of
nurses and doctors providing medical advice.
    China is pressing to reduce healthcare costs that are
soaring as the population ages, putting huge strains on the
state insurance system.
    At the same time, Beijing has been promising better access
to healthcare and improved grass-roots care - despite a lack of
family doctors - which has brought technology into the spotlight
as a way of maximizing stretched resources.
    "Educating doctors is going to take too long," said Rogier
Janssens, Beijing-based general manager of Germany's Merck
KGaA's  MRCG.DE  biopharma business in China. He added that
smartphones could help deliver primary care faster and cheaper.
    "There are hundreds of millions of people who still go
without care for relatively simple diseases."
    China's healthcare system has long grappled with a shortage
of doctors, exacerbated by low wages and a dearth of local
clinics and general practitioners. That means patients often
crowd into large, specialist hospitals for even minor ailments.
    Beijing has been trying to fix the problem, setting targets
to increase the number of family doctors across the country.
    However, the government has been slow to embrace technology
within the healthcare system, held back by the challenge of
digitalising a sprawling, fragmented hospital system still
dominated by public hospitals and state-run firms.
    
    ONLINE DRUG SALES
    The policy winds may be starting to change. Beijing has
enacted legislation over the last two years that has included
strong support for internet-based basic healthcare services.
    Premier Li Keqiang said this year that healthcare tech 
could "help alleviate the problem of inaccessible and expensive
public health services that have long been a big concern".
    Now, Beijing may be about approve the sale of some
prescription drugs online, creating a major opportunity for
local and global firms, according to companies in the sector.
    Janssens of Merck KGaA said the company had "good
indications" that policymakers were addressing the issue of
pharmaceutical e-commerce "as we speak".
    Li Tiantian, the founder and chairman of DXY, said the
health ministry had met with healthcare companies like his own
and planned to soon release a policy on "internet hospitals",
which would open up some online sales.
    "I think the new policy will be released very soon,
potentially in July," he said.
    The policy would allow approved hospitals to consult,
prescribe and sell drugs to chronic disease patients online.
However, regulatory concerns over safety and pushback from
state-run distributors sank a similar plan several years ago.
    Li added that Ningxia autonomous region, in north-central
China, had already been approving some internet hospital
providers on a test basis.
    Global drugmakers are taking notice. A move to open up
online sales - if approved nationwide - would help shake up a
drug market dominated by state-owned distributors and public
hospitals, where most medicines are still prescribed and sold.
    Merck KGaA, for example, recently announced a tie-up with
Alibaba Health  0241.HK  focused on systems to help track
medicines to avoid counterfeiting, but also on online drug sales
and potential direct-to-patient sales online.
    
    FALSE HOPE?
    In the United States, technology firms like Amazon  AMZN.O ,
Google  GOOGL.O  and Apple  AAPL.O  have made pushes into
healthcare, with mixed results, often finding sprawling medical
markets tougher to crack than entertainment or media.
    Technology firms in China also face major obstacles.
    One is convincing patients to see doctors online or getting
hospitals to spend extra money on high-tech tools that promise
efficiency boosts or improvements for patients. And regulators
still have concerns about drug sales online.
    Doctors and industry insiders also said that technology
alone could not solve the issues facing the sector.
    "Technology is important but is not enough on its own," said
DXY's Li, a former doctor. He said the most immediate benefit
was creating new channels for simple primary care.
    Wang Aihu, a cardiologist at Beijing Chaoyang Hospital, said
medical centres were increasingly using online appointment and
payment systems, and that he conducted internet consultations
for patients in remote regions.
    He added that his hospital may eventually have "AI-powered
medical imaging systems or robot doctors", but these could not
replace medical staff.
    "These promising technologies will help accelerate and
improve diagnoses, but will not replace good doctors, who are
still needed to verify and correct diagnostic results," he said.
    That hasn't stopped one hospital in Beijing doing a "man vs
machine" standoff this month to detect neurological disorders
including brain tumours. A robot developed by the prestigious
Tsinghua University and iFlytek  002230.SZ , a local firm, has
also taken and passed China's medical exam for doctors.
    For most people in China, however, AI ambulances and robot
doctors may need to wait a bit longer.
    Tony Li, 55, a cancer patient in Shanghai, said he had seen
little cutting-edge tech in Chinese hospitals in regular visits
over the past few years.
    "From what I heard, some of the newest technologies can help
doctors identify tumours at earlier stages, and that's great,"
he said. "But the internet has a tendency of exaggerating
things, giving us enormous false hope."
    Alibaba Cloud's Min acknowledged the company was still
working to prove the value of its technology, and that many
hospital administrators were still suspicious of things like
cloud computing.
    But, he said, "In China, once a new technology is proven
useful then everybody is crazy about it."

 (Reporting by Adam Jourdan; Additional reporting by Shanghai
newsroom; Editing by Philip McClellan)
 ((adam.jourdan@thomsonreuters.com; +86 21 6104 1778; Reuters
Messaging: adam.jourdan.thomsonreuters.com@reuters.net))