Exploration on the development of public hospital-sponsored telemedicine platform: A case study in China.

Abstract

Background: As a result of recent advancements, Internet hospitals have been a typic kind of telemedicine platform in China. The platforms can now provide a wide range of medical services while breaking through the limitations of time and space with excellent accessibility.

Objective: This study aims to give a comprehensive description on the role extension of a public hospital-sponsored Internet hospital in China from the aspects of the characteristics, patient's benefit and satisfaction, the workload of pharmacists and pharmaceutical care.

Methods: The total number of online prescriptions and detailed information were obtained automatically from the Internet hospital information system from Huashan Hospital Fudan University. Age, sex, associated prescription departments, time of prescription, payment methods, expenditure, drug category and delivery region were included in the analysis. A follow-up questionnaire was distributed as an electronic form that was collected and analyzed through the Internet to evaluate patients' satisfaction and time/economic benefits.

Results: A total of 51,777 patients visited Internet hospital and purchased required drugs from May 2020 to March 2022. The top 5 online prescription departments were dermatology (83.11%), neurology (6.85%), infectious diseases (3.27%), gastroenterology (2.35%) and cardiology (2.03%) departments. During this period, the audit pharmacists reviewed an average of 240 prescriptions per day, and the consultant pharmacists replied to about 42 consultations per day. 77.89% patients living in westsourth China benefited most from the Internet hospitals. They saved longest time (5 days) and the most expenses ($450-600). We observed an average patient satisfaction score higher than 4.5 in majority dimensions, including drug accessibility, effective in communication and confidence in medical staff. During closed-off management period between April to May in 2022, a total of 194,388 drugs were prescribed and delivered to 19,442 patients with the total payments of $1,547,001.2. Compared with those before closed-off management, the proportion of patients visiting dermatology department reduced from 83.11% to 54.87%. There was a significant increase in the number of patients visited general practice medicine department. The pharmacists extended their working hours by 5 h per day. In 2 months close-off management, the audit pharmacists reviewed an average of 320 prescriptions per day, and the consultant pharmacists replied to about 138 consultations per day.

Conclusions: The characteristics of patients in terms of department and disease profiles in the Internet hospital were consistent with those preponderant disciplines in the entity hospital. Patients benefited from the Internet hospital not only in saving times, but also in reducing medical expenses. During the close-off management period, the distribution of departments and disease profiles changed dramatically. These changes indicated that the Internet hospital was no longer just an extension of in-hospital services, but played an important role in fighting the epidemic, changed the mode of patients' medical treatment and hospital diagnosis and treatment at special times.