Using AI to shape China’s modern family doctor services

China is implementing a national family doctor system. A new model, shaped by technology, could help patients access personalised care.

In 19th-century Europe, family doctors were typically viewed as traditional and old-fashioned, yet they were always accessible and enjoyed the confidence of their patients¹. They were devoted and worked tirelessly in their community, becoming friends and counsellors to patients².

Two centuries later, a new generation of family doctors, assisted by AI, is emerging in China. Just like their predecessors in Europe, these doctors aim to build strong relationships with their patients. But, by using advanced technologies to enhance medical services, they are revolutionising the way healthcare is provided.

In a family doctor system (FDS), GPs establish a close relationship with their patients, offering comprehensive services and helping them obtain long-term coordinated healthcare. However, given China’s massive population size, delivering personalised medical care to patients in a timely manner can be a challenge.

Many Chinese patients typically start their healthcare journey with hospital visits and specialists, rather than a family doctor. As a result, hospitals in 

China are frequently overwhelmed³.

To address this challenge, China’s central government made FDS an official national strategy in 2011 amid ambitious healthcare reforms. In 2016, it piloted a family doctor contract service in 200 cities⁴. Despite these efforts, significant barriers to implementation remain, including a shortage of GPs, long waits for appointments, distrust in primary care quality, difficulties associated with changing a GP upon relocation, and the unavailability of patients' medical records.

As China’s healthcare system continues to evolve, the family doctor system (FDS) is emerging as a vital part of its national medical and health system reform.⁵⁶⁷ Advancements in AI are proving critical to reducing strain on hospitals and ensuring timely and comprehensive medical care.

A push towards family physicians 

China's largest insurer, Ping An, launched its family doctor service (PAFD) in 2022. It aims to become the first point of contact for customers with health concerns and boost its insurance business.

These family doctors are World Organization of Family Doctors (Wonca)-accredited GPs employed by Ping An Health, a healthcare division of Ping An Group. PAFD is staffed around the clock to offer health advice, prescribe medications for non-specialist conditions, and facilitate referrals for advanced medical care. The entire process is assisted by artificial intelligence.

“Since 2014, we have invested Rmb 10bn ($1.39bn) annually in technology R&D,” says Michael Guo, the co-chief executive officer at Ping An Group, who believes in integrating cutting-edge technologies and personalised medical services to create benefits for end users.

The membership-based programme is available 24/7, with online doctors providing one-on-one personalised medical diagnosis and treatment. Members can upload their physical exam results to the PAFD platform. The AI system swiftly analyses the data, identifies health risks, and creates personalised health plans for timely intervention.

The PAFD platform can monitor the health of chronic disease patients using smart devices such as wearables, issuing real-time alerts as needed. It also features a 21-day lifestyle programme to assist members in managing their diet, exercise, sleep and other behaviours and habits essential to wellbeing.

PAFD offers pre-hospitalisation consultations, doctor and hospital referrals, appointment assistance, nursing care, personalised recovery guides and post-discharge follow-ups for individuals with specific medical conditions.

Following the launch of PAFD, nearly 13mn members have registered and benefited from its services. Ping An attributes the programme’s effectiveness to two elements: leading medical technology and an extensive online-to-offline healthcare network.

Working with more than 3,000 in-house scientists, the group has also developed five medical databases for diseases, prescription treatment, medical products, medical resources and personal health. Through machine learning, Ping An converts this trove of medical data into useful information for disease prediction and management.

With a network of 50,000 doctors remotely providing health management services, the group also operates seven hospitals, 17 health management centres and 10 children’s rehabilitation centres, collaborating with more than 36,000 hospitals, nearly 233,000 pharmacies, and over 104,000 healthcare management institutions across China.

Healthcare has made a significant contribution to Ping An’s financial businesses. The conglomerate reports more than 63 per cent of its 236mn retail customers used services from its health and senior care ecosystem as of June 30, 2024, while nearly 16mn life insurance customers used Ping An’s health management services. Healthcare has also spurred customer acquisition, with 28.6 per cent of the Group’s new retail customers acquired from its health and senior care ecosystem in the first half of 2024. Customers entitled to health and senior care services contributed more than 68 per cent of new business value to life and health insurance in the first half of 2024.

“China has one of the largest and fastest-growing ageing populations in the world,” said Michael Guo. “We're dedicated to assisting our customers in living healthier with timely, more efficient, and affordable family doctor services.”

Each period in global history has had some kind of family doctor⁸. As China faces an ageing population, related healthcare issues, and the exponential associated growing costs⁹, it is imperative to reimagine the role of family doctors in a modern context.

References

1. Loudon, I. (1984). THE CONCEPT OF THE FAMILY DOCTOR. Bulletin of the History of Medicine, 58(3), 347–362. http://www.jstor.org/stable/44441751
2. Life, B. (2022, June 4). A short history of general practice: The coming of family practice. https://bjgplife.com/a-short-history-of-general-practice-the-coming-of-family-practice/
3. https://www.chinadaily.com.cn/china/2014-05/19/content_17518763.htm & https://www.ft.com/partnercontent/ping-an-insurance/empowering-chinas-health-providers.html
4. 于士航. (n.d.). 卫生计生委关于印发推进家庭医生签约服务指导意见的通知_部门政务_中国政府网.https://english.www.gov.cn/news/top_news/2016/06/06/content_281475365910494.htm 
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7792058/
6. https://www.researchgate.net/publication/23266935_Family_medicine_in_China
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7032899/
8. https://link.springer.com/chapter/10.1007/978-1-4757-3999-2_2
9. https://www.prb.org/resources/chinas-concern-over-population-aging-and-health/