Online consultations primarily target mild patients for preliminary assessment and advice; for severe cases, it is still recommended to seek in-person medical care.
Written by | Ding Ning Edited by | Shen Xiaoshan
21-year-old Zhang Ning had been coughing at home for half a month. When she reached the entrance of the fever clinic, she turned back home due to concerns about cross-infection.Restless, Zhang discovered the “online consultation” link shared in her social media feed.With a try-it-out attitude, she sent her symptoms to the doctor online:“Coughing at night, no fever, no travel history to Wuhan, no contact with pneumonia patients.”Ten minutes later, she received a reply from the doctor suggesting to “observe at home.” Previously, she had never used the “online consultation” feature.Zhang told Southern Metropolis Weekly that every morning she woke up to the increasing number of confirmed cases in the news, doubting her own risk of illness.
Li Xiang, who returned home after studying in Wuhan, also experienced similar anxiety.Li said he had been home for over 10 days and felt slightly feverish, but only had a temperature of 37.3 degrees and no cough.With a thermometer always in hand, he hesitated to talk too much with his family, constantly contemplating whether to go to the hospital, which became his daily routine.It wasn’t until yesterday that an online respiratory doctor advised him to “stay at home, don’t be afraid, just isolate at home with these symptoms,” that he felt a bit relieved.
Image shows a screenshot of the online consultation provided by the respondents.
As the number of confirmed cases of the novel coronavirus pneumonia surged, many people found themselves in a dilemma about whether to go to the hospital or observe at home.“Online consultation” has become a second avenue for many seeking medical care.
Is “online consultation” reliable?What are the current legitimate platforms?How should it be used correctly?
“Online Consultation” Booms
Pop-up message boxes, inquiries about symptoms, responses to patients… On New Year’s Eve, Dr. Zhang Yan, a respiratory physician at Sichuan Provincial People’s Hospital, spent the night with her phone.In recent days, Dr. Zhang has been continuously providing free consultations online, having seen nearly 800 patients by January 27.
After finishing a day of in-person consultations, at 8 PM on the 27th, Dr. Xu Jianqiang, head of the respiratory department at Shenzhen Children’s Hospital, picked up his phone again to respond to patient inquiries online.“The parents asking questions are very anxious and under a lot of psychological pressure; I respond to their questions during my breaks,” said Dr. Xu.
During the novel coronavirus pneumonia outbreak, over ten thousand doctors, like Zhang Yan and Xu Jianqiang, have been providing online consultations.As of 10 AM on January 28, “Ping An Good Doctor” had conducted a total of 948,000 consultations related to the epidemic;by 9 AM on January 29, the “WeDoctor” platform had 12,775 volunteer doctors, providing approximately 620,000 consultations, with a total platform visit count reaching 70 million.At the bottom of the platform interface, it can be seen that almost every minute, doctors from all over the country are “continuously supporting.” According to Caixin, the number of consultations in Hubei province continues to surge on multiple online medical platforms, reaching as high as 3,000 per hour.
Chen Xiangjun, head of the ENT department at Southern Medical University Shenzhen Hospital, stated in an interview, “Due to the tight medical resources in various places, especially in Wuhan, online consultations are a very important auxiliary battlefield in this epidemic.”
Image shows a doctor from “Ping An Good Doctor” conducting an online consultation.
What is “Online Consultation”?
“Online consultation” originates from the background of the internet and is also known as “non-contact medical care,” contrasting with the “contact” between doctors and patients in traditional medical methods.In “online consultation,” both doctors and patients do not need to meet in person, but communicate through text, images, voice, etc., on an internet platform.
Currently, due to the overwhelming number of patients in some areas, medical resources are under pressure. Hospitals such as Wuhan Union Hospital, Wuhan Tongji Hospital, Wuxi Third People’s Hospital, and Sichuan Provincial People’s Hospital have all opened online consultation channels for fever patients regarding the novel coronavirus infection.Platforms like “Ali Health,” “Dingxiang Doctor,” “Ping An Good Doctor,” “Haodf,” “WeDoctor,” and Tencent WeChat also provide related “online consultation” services.
According to the “Internet Diagnosis and Treatment Management Measures” published by the National Health Commission in 2018, medical institutions are not allowed to conduct internet diagnosis and treatment activities for first-time patients.Therefore, most online medical platforms currently only provide light consultations, offering advice rather than diagnoses and prescriptions.
Image shows the “WeDoctor” and “Ping An Good Doctor” APP’s online consultation platform.
How to Use “Online Consultation”?
Before using “online consultation,” one must first have a basic judgment of their condition.
According to a study published in The Lancet on January 24 regarding the first 41 patients, the clinical manifestations of patients with novel coronavirus pneumonia include fever (98%, 40 cases), cough (76%, 31 cases), and fatigue (44%, 18 cases).More than half of the patients also experienced difficulty breathing (55%, 22 cases), but headaches (8%, 3 cases) and diarrhea (3%, 1 case) were rare.
Dr. Zhang Yan stated in an interview with Southern Metropolis Weekly that as long as patients do not have an epidemiological history (i.e., a history of epidemiological contact, which at this stage refers to having traveled to Hubei, especially Wuhan, within two weeks of developing symptoms like cough or fever, or having contact with fever patients from Hubei), fever, cough, or severe symptoms like difficulty breathing, it is advisable to consult online and rest at home while monitoring their temperature.
According to the Xi’an Evening News, an expert from the Infectious Disease Department of Xi’an Jiaotong University Second Affiliated Hospital stated:Winter and spring are high seasons for respiratory diseases, and common symptoms like sneezing and runny nose are not typical symptoms of novel coronavirus pneumonia.If there is no contact history with Wuhan, it is more likely to be a common cold, flu, or bronchitis.Therefore, if experiencing mild discomfort, there is no need to crowd the fever clinic to avoid cross-infection and to reduce the burden on limited medical resources.
Dr. Xu Jianqiang from Shenzhen Children’s Hospital stated in an interview that if a child has a fever for 1-2 days but the temperature is not very high (below 38.5 degrees), they can drink more water at home, maintain a balanced diet, and eat more fruits and vegetables rich in vitamin C.However, if the fever lasts long or is accompanied by high fever or symptoms like headache, fatigue, or mental distress, parents should take the child to the hospital promptly.
After making a basic judgment, where to find legitimate platforms?Currently, in addition to some hospital public accounts that have opened online consultation platforms, there are also some medical platforms that have dedicated sections for “online consultation.”For example, at Tongji Hospital, one can download the “Zhangshang Tongji” APP, register, and find “Online Consultation – Fever Clinic” for online consultation.
On January 25, Tencent WeChat also opened “City Services – Fever Clinic” and “WeChat Search – Online Consultation” to provide online consultation services for patients.As of January 28, more than ten public hospitals, including Wuhan Union Hospital, Mianyang Third People’s Hospital, Shaoguan First People’s Hospital, Guangzhou University of Chinese Medicine Jinsazhou Hospital, Sun Yat-sen University Seventh Affiliated Hospital, and Southern Medical University Third Affiliated Hospital, voluntarily joined the online consultation section.Among them, Wuhan Union Hospital deployed 320 doctors to conduct consultations 24 hours a day, receiving 12,000 patients in one day.Yichang Central People’s Hospital had over 200 doctors join, and within four to five hours of launching online consultations, over 4,000 citizens consulted.
Additionally, searching for “Ask an Expert” on the Alipay interface can also lead to the novel coronavirus pneumonia consultation section.
Image shows the online consultation on the payment interface.
“Due to the special nature of this infectious disease, the internet’s characteristics of being unrestricted by location and time have played a role, and psychological assistance regarding this epidemic can also be conducted on a large scale through the internet,” said Tang Wei, a member of the National Psychological Crisis Intervention Expert Group, chief physician and professor at Wenzhou Medical University Affiliated Kangning Hospital, and director of the Psychological Crisis Intervention Center at Wenzhou Medical University.He stated that since online consultations are limited in terms of communication channels, total information, depth of communication, and accuracy of information, healthcare workers are also navigating through uncharted waters.
“Online consultations can reduce the risk of cross-infection to some extent, but conditions like throat issues, lung auscultation, blood routine tests, and viral nucleic acid screening cannot be completed online,” said Zhang Yan, emphasizing that online consultations primarily target mild patients for preliminary assessment and advice, while severe patients are still advised to seek in-person medical care.
Is “Online Consultation” Regulated?
Do all online consultation doctors have medical licenses?How can the authenticity and reliability of doctors’ information be ensured?WeChat’s relevant person Zhou Yu stated in an interview that all doctors on the WeChat platform are from legitimate public hospital institutions and are licensed physicians of their respective hospitals.“WeDoctor” representatives told Southern Metropolis Weekly that doctors participating in the fight against the novel coronavirus pneumonia can sign up online, submitting their ID, medical license, title certificate, and other documentation.During the certification process, “WeDoctor” conducts a live detection of the applicant’s image, comparing it with the photo on their ID to ensure it is the applicant operating.
However, during interviews, some patients reported that non-respiratory doctors also answered questions related to pneumonia symptoms online.Some platforms initially used AI triage, which responded very quickly, but the fixed responses set by the machine occasionally led to irrelevant answers.
Image shows a brief introduction of the online consultation doctors for the novel coronavirus.
In response, Wuhan Union Hospital stated in an interview that the hospital has quickly formulated screening, treatment, and prevention guidelines for this epidemic, and medical staff have undergone basic training before providing online services.Chen Xiangjun, head of the ENT department at Southern Medical University Shenzhen Hospital, revealed to Southern Metropolis Weekly that doctors participating in “WeDoctor” online consultations have established a WeChat group to discuss uncertain issues among themselves.“Ping An Good Doctor” employs an “AI + human” model, where intelligent triage responds first, then directs patients to doctors based on specific symptom descriptions.
In addition to physical treatment, the “WeDoctor” platform has also opened online psychological assistance.Tang Wei emphasized that the psychological issues that may arise from the novel coronavirus pneumonia should not be overlooked.Currently, patients can be categorized by region (within Hubei, outside Hubei) and health status (not quarantined, family members quarantined while they are not, currently quarantined, and confirmed cases).Symptoms can also vary, including anxiety, panic attacks, somatization disorders, depression, sleep disorders, obsessive-compulsive disorder, and stress disorders.
“Online psychological assistance cannot ascertain the patient’s expressions, actions, body language, and the safety of their environment, making appropriate verbal communication extremely important. How to start and end conversations online poses a significant challenge for healthcare workers. Online psychologists should also have a background in medicine and psychology, as well as practical experience in psychological crisis intervention.Some patients need to be referred to offline hospitals, but we currently cannot contact them. If we could achieve precise online and offline connections, it would be even better,” Tang Wei urged.
Image shows Tang Wei conducting online psychological assistance.
Hubei native Chen Xiangjun is also conducting online consultations in Shenzhen.Seventeen years ago, he fought on the front lines during the SARS outbreak in Shiyan, Hubei.During the interview, he mentioned his classmates who are currently “fighting” at Wuhan Tongji and Union Hospitals, becoming emotional, “The first doctor to sacrifice in Wuhan was from our ENT department. I am ready to charge to the front lines from this second battlefield at any moment.”
(The names Zhang Ning and Li Xiang are pseudonyms.)
Source | Southern Metropolis Weekly
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