Implementation of Shared Decision-Making Within Internet Hospitals in China Based on Patients’ Needs: Feasibility Study and Content Analysis

Abstract

Background Internet hospitals are developing rapidly in China, and their convenient and efficient medical services are being increasingly recognized by patients. Many hospitals have set up their own internet hospitals to provide web-based medical services. Tianjin Medical University General Hospital has established a multidisciplinary and comprehensive internet hospital to provide diversified medical services according to the needs of patients. A way to further improve web-based medical services is by examining how shared decision-making (SDM) can be carried out in internet hospital diagnosis and treatment services, thereby improving patients’ medical experience. Objective The aim of this study was to analyze the feasibility of implementing doctor-patient SDM in internet hospital diagnosis and treatment services based on patients’ needs in China. Methods In this study, the medical data of 10 representative departments in the internet hospital of Tianjin Medical University General Hospital from January 1 to January 31, 2022, were extracted as a whole; 25,266 cases were selected. After excluding 2056 cases with incomplete information, 23,210 cases were finally included in this study. A chi-square test was performed to analyze the characteristics and medical service needs of internet hospital patients in order to identify the strengths of SDM in internet hospitals. Results The internet hospital patients from 10 clinical departments were significantly different in terms of gender (χ29=3425.6; P<.001), age (χ236=27,375.8; P<.001), mode of payment (χ29=3501.1; P<.001), geographic distribution (χ29=347.2; P<.001), and duration of illness (χ236=2863.3; P<.001). Patient medical needs included drug prescriptions, examination prescriptions, medical record explanations, drug use instructions, prehospitalization preparations, further consultations with doctors (unspecified purpose), treatment plan consultations, initial diagnoses based on symptoms, and follow-up consultations after discharge. The medical needs of the patients in different clinical departments were significantly different (χ272=8465.5; P<.001). Conclusions Our study provides a practical and theoretical basis for the feasibility of doctor-patient SDM in internet hospitals and offers some implementation strategies. We focus on the application of SDM in web-based diagnosis and treatment in internet hospitals rather than on a disease or a disease management software. The medical service needs of different patient groups can be effectively obtained from an internet hospital, which provides the practical conditions for the promotion of doctor-patient SDM. Our findings show that the internet hospital platform expands the scope of SDM and is a new way for the large-scale application of doctor-patient SDM.

The Relationship Between Static Characteristics of Physicians and Patient Consultation Volume in Internet Hospitals: Quantitative Analysis

“…As of June 2023, there have been more than 3000 internet hospitals in China carrying out internet diagnosis and treatment services for more than 25.9 million people, and the scale of internet hospitals has increased by about 1300 compared with the end of 2021 [ 5 ]. Yu et al [ 6 ] confirmed the feasibility of implementing shared decision-making between doctors and patients in the diagnosis and treatment services of internet hospitals by analyzing the characteristics and medical needs of patients at the Tianjin Medical University General Hospital Internet Hospital, providing a new approach to enhancing patients’ medical experience. The organization can rely on the medical institution entity to establish an internet hospital to provide patients with safe and appropriate medical services via the internet [ 7 ].…”

The Application of online medicine in the diagnosis and treatment of pulmonary nodules in thoracic surgery (Preprint)

“…While greatly improving clinical diagnosis and treatment efficiency, they also provide significant satisfaction of patients 6 . At the same time, influenced by various factors, especially the increasing demand for patient diagnosis and treatment of pulmonary nodules, the continuous improvement of online diagnosis and treatment functions and the continuous expansion of service scope have become research focuses 7 . This article reviews the application and research progress of online diagnosis and treatment on the Internet in patients with pulmonary nodules in thoracic surgery.…”