The Role of Online Booking Systems (<em>wang shang gua hao</em>) in Transforming Patient Experience and China's Healthcare Reform

Abstract

Introduction China has a long-standing problem for patients to queue and book appointments with doctors (gua hao) in real life, especially with those medical experts (zhuan jia hao). The demands for expert doctors in 3AAA hospitals are extremely high, leading to a hidden market for scalpers to trade doctors’ appointment notes. To tackle this problem, China introduced a series of regulations in the year of 2009 as a means of healthcare reform, and required these 3AAA hospitals to adopt the Online Booking Systems (wang shang gua hao; abbreviated as OBS below) gradually – in which patients can book with doctors in advance by their personal identity information and doctors can easily access his/her clinical record before the appointment [1]. This is quite similar to GP online services offered by NHS (i.e. www.chooseandbook.nhs.uk); but it can be both managed by public institutions such as Beijing Health Bureau (www.bjguahao.gov.cn) and private funds (http://www.guahao.com/). This paper aims to examine how these online booking systems can transform patient experience. Methods This study interviews five groups of middle-aged people (with 3 – 5 people each group) in Beijing, mainly focusing on their experience of booking appointments with doctors as well as those of their relatives/friends [2]. A set of semi-structured questions are asked to identify the extent to which the OBS have changed patients’ behaviors/perceptions, as well as to examine what factors have constrained their adoption of OBS [3]. Meanwhile, this study will assess the impact of technological change in relation to various socio-economic factors [4]. Throughout this process, participants will be asked to identify problems needing to be the most urgently tackled, regarding China’s healthcare reform. Lastly, their views towards electronic medical records are investigated in relation to the privacy issue. Results and Discussion In overall, participants interviewed by this study have shown positive attitudes towards the Online Booking Systems (OBS), mainly due to its accessible feature – i.e. People can take the initiative in terms of scheduling their own appointments (Besides this, many of them also use the telephone platform “114” as an alternative to make appointments). But it is clear that numbers of appointments allocated to OBS are limited [5]. Moreover, some criticize these technological advancements as a “temporary medical relief that only treat the symptom”, given the fact that 1) the supply of medical resources – still unevenly distributed both at the national and regional level – cannot meet the demand of patients and 2) the scarcity of expert doctors exacerbate patients’ willingness to strive for the perceived “best” medical service – despite few complained about the quality of these experts. On this basis, factors such as “illness seriousness”, “emergency extent” (mainly means those needing operations) etc. could pressure patients or their relatives to buy expert doctors’ appointment notes from scalpers for higher prices. Regarding the electronic medical records, most participants interviewed in this group have shown some extent of agreement on sharing them with their doctors as well as for further medical research; while they strongly opposed letting third parties to use them for commercial purposes (e.g. recommending medicine). References and Notes Li, Q.; Li, W. Large Hospital Registration System Design and Implementation. Programmable Controller & Factory Automation 2011, 9, 51-55. The middle-aged group always needs to take care of elderly people and children, thus having extensive experience in terms of making appointments with doctors. Bryman, A. Social Research Methods, 4th ed.; Oxford University Press: Oxford, 2012. Kierkegaard, K. Governance Structures Impact on eHealth, Health Policy and Technology 2015, 4, 39-46. Liu, B.; Jiang, X.; Cao, D.; Wang, L.; Wang, H. A Comparative Study of Different Booking Methods in Hospitals of China, Modern Hospital Management 2007, 5, 5-7.