Door-to-Door Healthcare

By+Xia+Yuanyuan

AFTER being struck down by brain hemorrhage at the end of 2014， Guo Fengqin saw her life change for the worst.

After intensive treatment at the hospital， the 63-year-old woman regained consciousness， but remained unable to go about on her own. She needed the assistance of her husband or son every time she had to go back to the hospital for her follow-up treatment.

“My husband was getting older and his health was not good. My son was busy with work and daily care was a big problem for me. I felt like I was a burden for my family，” said Guo.

Fortunately， things started getting better for Guo in 2016， and her health gradually improved. She owes much of this positive turnaround to Yang Hui， a student at Peking Union Medical College Hospital and a registered nurse on Yihu365.com， the first online platform in China to provide in-home nursing services.

“With a platform like Yihu365， where nurses visit our home to provide services， I am spared from the troubles of going to the hospital whenever I need an infusion therapy or a change in medication prescription. Nurses who work in nearby hospitals can come and see me after work， which has really been conven- ient， cost-saving and carefree，” Guo told ChinAfrica.

Visiting nurse

Guo is not alone. According to the Office of the National Working Committee on Aging， the number of elderly people above 60 years old in China reached over 220 million in 2015， with 40 million of them being disabled or semi-disabled. Having injections at home is a service demanded by plenty of elderly patients in China who have difficulties getting about. Nevertheless， public and community hospitals often dont provide such service due to insufficient workforce and the high costs involved.

In response， the Yihu365 mobile application was released on December 22， 2015， which is a mobile Internet service platform dedicated to medical care， with at-home injections provided by visiting nurses as its main service.

“It normally takes 10 minutes for a professional nurse to process urinary catheterization for an elder. But community hospitals usually dont provide visiting nurse services， so the patients family has to call an emergency ambulance and send the patient to an hospital， and then bring the patient back once the urinary catheterization is done，” said Wei Guilei， cofounder of Yihu365.

At the moment， Yihu365 provides professional medical services such as injection， infusion， blood collection， urinary catheterization and nasal feeding， with prices ranging from 100 yuan to 200 yuan （$15 to $30） per home visit， which is somewhat higher than hospital fees and may pose an additional burden on target patients.

With this in mind， the Beijing Municipal Health and Family Planning Department issued a notice in 2016. The notice said the expenses of in-home medical services could be reimbursed if they conform to medical insurance regulations. This could largely ease the burden of patients who are in need of such services.

Currently， the services are available in places like Beijing， Shanghai， Guangzhou， Jiangsu and Zhejiang， and other provinces and cities will follow soon.

Multiple benefits

Yihu365 also brings new opportunities to nurses， especially those who have free time and want to make extra money.

“Nurses usually have more free time after work than doctors， so door-to-door services help increase our income，” said Yang. “Yihu365 sends orders to the nurses who are closest to the patients， so I usually provide services to users who are near my hospital， and it takes little time traveling.”

Instead of having patients crowding hospitals， nurses can provide professional medical services to patients during their leisure time， which is both time and energy efficient. In addition， the services involved do not require medical inquiry or laboratory test， and can easily be done at home.

The platform adopts a strict vetting system. Most nurses work at national top-level hospitals in China and have three years or more of clinical nursing experience， while nurses from community-based institutions are required to have more than five years of experience. As of now， more than 20，000 certified nurses have registered with the platform.

To prevent risks of medical negligence， Yihu365 launched the Angels Eyes project on December 9， 2016， and the company provides free-of-charge insurances to patients and nurses. “This project can better protect the interests of both patients and nurses，” said Yang.

As of October 2016， the number of registered users on Yihu365 had reached 15 million， and the monthly transaction volume exceeded $46 million.

But Yihu365 is only the tip of a booming industry. In 2015， the mobile medical care industry was worth$679 million， with a 54.24-percent year-on-year growth； the total number of users reached 130 million， an increase of more than 66 million compared to 2014. The mobile medical care industry size is expected to reach $1.5 billion by the end of 2017， according to Qianzhan.com， a consultation organization focusing on emerging industries.

Upgraded services

Latest census data show that the number of senior citizens in China is expected to reach 300 million by 2025. Against this backdrop， China is facing an acute lack of doctors and nurses. Currently， there are 3.28 million licensed nurses in China. Nearly 3 million additional nurses are needed， according to Wei.

As the elders health conditions gradually decline， so do their self-care capabilities. In China， governments at various levels， both central and local， have started paying great attention to healthcare for elders， and have explored creative modes of providing medical and healthcare services to this segment of the population.

In view of the growing needs， as the first officially recognized company allowed to experiment with online-to-offline medical and healthcare services， Yihu365 is now looking to extend its coverage beyond in-home on-demand services. The company recently established the Beijing Home-Based Services for Elders Platform， which aims at providing overall nursing services， so that all elderly citizens may enjoy the achievements of technological development.

Family doctors can now sign contracts with Yihu365， which is an important breakthrough that will improve the use efficiency of medical resources by enabling first diagnosis at the grassroots level， two-way referral system， and separated treatment for patients with acute or chronic diseases.

In the future， Yihu365 services will include homevisits by doctors， thus opening up the next step in door-to-door medical services. “It is undoubtedly good for Yihu365， and visiting nurses are the first step toward visiting family doctors，” said Wei.