August 19, 2022

madmenburger

Health for a better future

Improving family medicine in China and battling COVID-19 with smart systems

Dr Wu Hao has devoted his career to improving community health and integrating technology, data systems and efficient management to serve a growing population

In the 11 years that Dr Wu Hao has headed the Fangzhuang Community Health Service Centre in the Fengtai district of Beijing, its outpatient volume has soared from fewer than 110 000 to 440 000 today.

The centre, which has just 25 general practitioners and a team of nurses, has transformed the way community health is practiced in the capital region, especially in the management of chronic diseases like hypertension and diabetes.

“My country has a large population, wide expanses of land, and uneven development. So how can we make people gain access to high-quality services quickly and conveniently? I believe it is about using technology to help us achieve that goal. This
would be helpful in reaching people in remote areas and in achieving scientific advancement and equality,” said Dr Wu, who wears many hats besides being the director of the centre.

Managing more patients, better, through smart use of technology

He pioneered an intelligent family physician-optimized collaborative concept (IFOCM), an integrated human-centred and information technology-based service for family physicians. His was the first community health service institution to be set up in Beijing.

It is built around a collaborative patient-centred, family doctor model of primary care. The “smart” system integrates elements like electronic patient health records, feedback from wearable devices that measure vital information like blood
pressure and the use of mobile apps and text messaging, and links up other relevant institutions for referrals.

This enables doctors to remotely assess and monitor patients, rank patient conditions, flag priority patients and send reminders and relevant information. This way, they provide 24-hour customised care, and refer patients to affiliated hospitals for specialist
care when needed, while also giving patients the resources to participate in managing their own health.

An “intelligent” approach to fighting community spread of COVID-19

In 2020, Dr Wu recognised technology’s potential role in the fight against the COVID-19 pandemic in China. He therefore advocated for its use among the hundreds of policy proposals he raised in the midst of leading community infection prevention
and control — from calling for the linkage of the infectious disease reporting system to the electronic patient record system to better monitor and intercept outbreaks, to urging health workers to use WeChat to communicate with those in isolation.


Dr Wu Hao supervises community-level epidemic prevention and control in Wuhan (Feb 2020). Credit: Fangzhuang Community Health Service Centre, Fengtai district, Beijing

His base, the Fangzhuang Community Health Service Centre, established epidemic prevention and control teams and used the IFOCM system to investigate and triage fever patients and suspected COVID-19 cases, while continuing with health consultations and
follow-up and monitoring at home, among other functions geared towards minimising the spread of the virus.

Everyone returning to the area was included in the system, and those from hotspots or displaying COVID-19 symptoms were closely monitored.

The centre opened a 24-service hotline and WeChat official account, so patients could consult their family doctors for free, which, apart from ensuring that other medical needs did not fall by the wayside, served to provide accurate information and reassurance.

But all the technology and reform in the world can only do so much. In recent years, as patient numbers continue to surge, Dr Wu worries over the shortage of skilled general practitioners, and has long championed implementation of policies and incentives
to encourage more people to be trained as GPs.

General practitioners needed: how to attract, train and retain doctors dedicated to community health

One of the first few doctors on the ground in Wuhan in early February 2020, as the then-unnamed virus tore through the city, he has since witnessed how the pandemic exposes and aggravates shortages in community healthcare.

An example: local community health centres did not have fever clinics in part because of a lack of qualified personnel, pushing those with high temperatures, including some suspected COVID-19 positive patients, to seek treatment in major hospitals. This
drove up cross-infections at these hospitals, which were overwhelmed with such patients.

For his part, as a professor in the Department of General Medicine of Capital Medical University in Beijing, Dr Wu has been committed to training doctors to enlarge the pool of family physicians — he and his team train nearly 5000 family physicians
a year.

He is also dedicated to improving the basic medical and health service system in poor areas in China, ensuring equal access to primary health care nationwide, and promoting better health at the community level.

Dr Wu Han speaking during an event to promote COVID-19 vaccination in Beijing 2021.Dr Wu Hao promoting COVID-19 vaccination in an event organized by People’s Daily in Beijing (March 2021). Credit: Fangzhuang Community Health Service Centre, Fengtai district, Beijing

“As for my work in the future, I am hoping to build a pool of talented general practitioners who will play a leading and exemplary role in guiding their teams to continue the development and application of IT standards and technology for smart home
medicine. This way, we’ll combine prevention and control of infectious diseases and chronic disorders with improved health literacy of the population,” he said.

WHO’s support

According to the WHO China Office, strengthening primary health care is an essential part of WHO China’s support to the government as it builds an integrated, people-centred health service. In China, primary health care is provided by general practitioners,
public health nurses and community pharmacists. By 2019, 90% of households in China can access the nearest PHC site within 15 minutes, and the number of general practitioners (GP) per 1000 population increased from 1.38 in 2015 to 2.61 in 2019.

Global recognition for local, grassroot work

Dr Wu Han in personal protective equipment.
Supervising epidemic prevention and control in Shijiazhuang, Hebei (Jan 2021). Credit: Fangzhuang Community Health Service Centre, Fengtai district, Beijing

Dr Wu was fighting the pandemic in Shijiazhuang, the capital of Hebei Province in China’s north when he learnt from the National Health Commission that he had won the 2021 Sasakawa Health Prize. Surprised and “very, very honoured and proud”,
he hopes this global recognition will boost the profile of and interest in community level health care.

In recent years, the IFOCM programme has improved outcomes and health prospects in many hypertension patients at the centre, through “increased efficiency, evidence-based practice, close collaborations and greater physician-patient interactions”.

The results prompted the government to facilitate the rollout of the system in other community health service centres in the Beijing region.

“What I am most proud of is that, over the past decade, is that I have been doing a very important thing: working on and promoting smart medicine to help health staff at the grassroots improve their quality and efficiency of work. One thing in ten
years,” he reflected, when asked about his proudest achievement.

“This award is an endorsement of my work by internationally. It is also a great incentive for workers and medical personnel working in primary health care. As we all know, it is very difficult to win this award at the grassroots level. This also
confirms a Chinese saying: the cream of the crop may come from all walks of life. This will inspire more good people to work at the grassroots level, promoting health care and improving equity and equality in health care,” he said.

“This award is both an honour and an urge, because after all, this international award is an honour to the entire institution where I work, and it will put us in the spotlight. This award belongs to everyone at my institution, as I am just a part
of the team. It will also further motivate us to work harder,” he concluded.