Most high-quality medical resources are concentrated in urban areas and tend to be much scarcer in remoter locations. When COVID-19 hit China, the traditional healthcare infrastructure in Henan couldn’t meet the needs of people cut off from tier-1 medical services. However, telemedicine proved invaluable in closing the gap.
By Xu Shenglan and Li Qiwei
Huawei is a standing member of the China Telemedicine Committee and has built up a broad array of related solutions and mature applications, including an HD video conference system that forms the foundation of the telemedicine system.
Back in 2011, Huawei teamed up with China Mobile Henan to develop the top-level design for building a telemedicine platform and a joint innovation center for healthcare big data for the First Affiliated Hospital of Zhengzhou University (FAHZU), putting in place the ICT infrastructure for a telemedicine system and creating the blueprint for its adoption in Henan Province.
The NTCC is a collaborative medical service platform that mainly serves as an inter-hospital data switching platform and includes a video conferencing system. It offers multiple capabilities spanning communication, emergency command, remote consultation, imaging data transmission for remote diagnosis, and remote training. It also includes a remote ECG diagnosis and monitoring center, as well as a remote clinic and precision medicine center.
The NTCC has set a benchmark for telemedicine in China. It carries out 80 to 160 integrated consultations per day, including imaging, medical record analysis, and department-level consultations. Each year the center conducts 40,000 remote integrated consultations; diagnoses 500,000 cases for specialist units, which includes remote pathology, ECG, and imaging; hosts 300 training sessions for more than 400,000 medical personnel; and streams more than 1,000 demo surgeries.
Home consultations with the experts
Telemedicine allows patients in remote mountainous and rural areas to enjoy medical services from provincial-level hospitals in the comfort of their own homes. It also enables doctors at county and township hospitals to improve the standard of the care they provide through consultations with provincial and municipal hospitals.
For patients in Xinyang in south Henan, the telemedicine system saves them the financial and physical strain of having to make a 10-hour round trip to the capital, Zhengzhou.
In April 2019, doctors from three hospitals gave an online joint consultation to a pregnant woman in the NTCC consultation room using Huawei's Telepresence System. They were able to check her medical history and previous examination results on devices remotely, and established that the mother needed to be transferred to another hospital for specific care to avoid subsequent complications.
Thanks to the system, 90 percent of diagnoses and treatment can remain at county-level healthcare facilities, with only critical cases referred to better-equipped provincial hospitals. The system has helped form a national graded diagnosis and treatment system.
The Silk Road of health
In 2018, NTCC started to provide daily cross-border telemedicine services and telemedicine training for Belt and Road nations as part of a seven-level healthcare service system, spanning international, national, provincial, city, county, township, and village levels. Plans are in motion to establish NTCC as a comprehensive service platform at the national and even global level. In the future, it will offer a system comprising one private network, one platform, and one data center system that provides global services and integrates with Belt and Road countries.
In 2018, more than 50 medical staff from over 10 countries participated in telemedicine training on the NTCC. In August 2019, more than 30 doctors, technicians, and nurses from Morocco took part in a two-week telemedicine training course on the NTTC system. Trainee Aadloune Hafida said that she hoped to learn about real-world cases of telemedicine in Chinese hospitals during the training course and apply that knowledge to her own job.
Remote consultations help prevent and control COVID-19
In 2020, Henan faced a tough task in the prevention and control of the coronavirus outbreak. Henan is not only next to the epicenter Hubei, it’s also a major and densely populated transport artery.
Huawei worked around the clock to build a remote consultation system for isolation wards in 147 hospitals designated for treating COVID-19, located in 108 counties across 18 prefectures and cities across Henan. The system was able to unify dispatch, perform remote consultations, share programs, and guide treatments.
During the pandemic, telemedicine was tremendously helpful to patients and medical staff. Its ability to overcome the limits of time, space, and location allowed lower-tier hospitals to access high-quality healthcare resources, alleviate the workload of diagnosis and treatment in designated hospitals, and reduce the risk of infected people spreading the virus by travelling.
According to Zhang Qingxian, a professor and chief physician at FAHZU's Department of Respiratory and Critical Care, experienced specialists across Henan can use the remote consultation system to read patients' X-rays and clinical records and give consultations, helping primary-level physicians on isolation wards.
Three major benefits
First, the system could identify COVID-19 patients whose conditions were worsening, so they could be transferred if required. In one case, specialists were able to identify that a patient's condition was getting worse after remotely examining three separate chest CT scans on February 2, 4, and 6. They proposed transferring the patient from a county hospital to a municipal hospital, so that the appropriate treatment could be delivered.
Second, remote consultations helped doctors identify clinically suspected cases. In one example, they suspected a patient without symptoms had coronavirus from their routine blood lymphocyte counts and chest CT images. The patient had completed two negative nucleic acid tests, but the specialists believed that the changes observed in the images and bloodwork were consistent with COVID-19. They recommended a third nucleic acid test which came back positive, confirming the diagnosis.
Third, remote consultations enabled doctors to identify patients with conditions similar to but not COVID-19 and find the exact cause. For example, one patient had returned two negative results after coming in contact with an infected patient and presenting similar symptoms. A team of physicians conducted remote consultations with primary-level doctors to study changes in his chest CT scans, finally determining that the patient had tuberculosis.
The Health Commission of Henan Province has also used this remote system to guide treatment in the province. On February 10, 2020, the commission held discussions on COVID-19 with more than 30 experts from 11 hospitals. Across the province, over 170 hospitals designated for treating COVID-19 took part through a simultaneous live broadcast. The experts shared their experiences and discussed treatment methods, treatment medication, how to care for patients with the disease, and they answered questions about issues that hospitals faced during early treatment.
By conducting video training via a telemedicine platform, staff in hospitals at all levels can learn about coronavirus treatment without travelling, removing the need for groups of people to gather in training centers, and thus controlling virus transmission.
As of March 20, 2020, Henan specialist healthcare teams had carried out remote consultations on more than 2,000 COVID-19 cases from designated hospitals in the region, and conducted remote rounds of isolation wards across the province using the telemedicine system. They also held expert discussions about coronavirus via the system, using IT to make specialist resources available to lower-tier hospitals and improving the capability of primary-level healthcare facilities to respond to the pandemic. In addition, provincial telemedicine centers arranged for personnel to watch video training meeting on treating COVID-19.
About TECH4ALL: TECH4ALL is Huawei's long-term, digital inclusion initiative. Learn more about TECH4ALL: https://www.huawei.com/minisite/tech4all/en/
