Implementation Opinions of the General Office of the Shanghai Municipal People's Government on Promoting International Medical Innovation and Development in Shanghai

SMPG GO G [2024] No. 32

Attention: all District People's Governments, and all Commissions, Offices and Bureaus (Administrations) of the Municipal People's Government:

To further advance high-level institutional openness of the medical field, promote mutual empowerment of various business forms such as medical care, insurance, and tourism, and accelerate the establishment of an international medical center city, and with the approval of the Municipal People's Government, the opinions on promoting international medical innovation and development in Shanghai are hereby set forth as follows:

I. Optimizing the Service Layout to Develop the International Medical Service Industry

1. Enhancing the international medical service layout. Shanghai will strengthen research on international medical layout planning and optimize the allocation of the international medical service resources. It will seize the opportunities presented by Pudong New Area's pilot comprehensive reform and the experiments by Lin-gang Special Area, Hongqiao International Central Business District, and Oriental Hub International Business Cooperation Zone to implement national strategies so as to accelerate the clustering of international medical services. It will foster competitive private medical institutions to improve their ability to provide international medical services, and regulate the development of the international medical departments of public hospitals. (Responsible units: the Municipal Commission of Health, Pudong New Area People's Government, Lin-gang Special Area Administration, Hongqiao International Central Business District Administration, Bonded District Administrative Bureau of the Pilot Free Trade Zone Administration, and Shanghai Hospital Development Center)

2. Expanding international medical services. Continuous efforts will be made to enhance the international medical service system, including outpatient and emergency services, inpatient care, vaccinations, health check-ups, health management, and traditional Chinese medicine (TCM). The development of telemedicine, online medical services and other forms of services is encouraged. It is necessary to establish specialized outpatient departments and clinics and promote a "generalist + specialist" model that provides personalized care throughout the entire life cycle, catering to diverse and international medical needs. (Responsible units: the Municipal Commission of Health, and the Municipal Disease Control and Prevention Administration)

II. Developing Specialized Strengths to Enhance the Core Competitiveness of the Municipality's International Medical Services

1. Establishing specialized clinical brands. Medical institutions will be supported in developing specialized international medical projects and establishing a service brand for characteristic diseases based on their academic strengths. The application of advanced therapies such as CAR-T cell therapy and particle therapy is encouraged. Clinical use of innovative technologies, drugs, and medical devices will be promoted. International medical service institutions with advanced clinical research experience will be supported to establish research hospitals. (Responsible units: the Municipal Commission of Health, the Municipal Commission of Science and Technology, the Municipal Medical Products Administration, and Shanghai Hospital Development Center)

2. Leveraging the special strengths of traditional Chinese medicine (TCM). The Municipality will develop the "Shanghai-Style TCM" international brand and carry forward the excellent cultural connotations of traditional Chinese medicine, highlighting the dialectical diagnostic principles and holistic approach of TCM. The effectiveness of TCM in treating chronic, geriatric, complex, and rare diseases will be fully explored, and high-quality international clinical TCM centers will be established. It is necessary to expand characteristic TCM services such as acupuncture, moxibustion, massage, cupping, herbal steaming, and traditional exercise therapies, as well as introduce healthy lifestyle concepts. High-level TCM institutions are encouraged to set up overseas TCM medical centers. The development of international TCM service standards will be strengthened through the International Organization for Standardization (ISO) TCM Technical Committee Secretariat. (Responsible unit: the Municipal Commission of Health)

3. Establishing the Municipality’s international medical brands. Shanghai will implement a strategy that integrates the strengths of top private and public hospitals, and attract internationally-renowned foreign-funded medical institutions with advanced technologies and management experience. Shanghai encourages the establishment of mechanisms of international medical joint-consultations, referrals, and technical collaborations through agreements between specialized and general hospitals and between private and public hospitals. Cooperation among international medical institutions will be supported to promote characteristic specialized services. (Responsible units: the Municipal Commission of Health, and Shanghai Hospital Development Center)

III. Deepening Reform and Innovation to Stimulate the Vitality of International Medical Service Providers

1. Pioneering the opening-up reforms of the medical sector. Shanghai will put into practice the planning of the Ministry of Commerce, the National Health Commission and the National Medical Products Administration for expanding the opening up of the medical sector on a pilot basis, so as to actively promote the establishment of pilot wholly foreign-owned hospitals, introduce high-level foreign-invested medical brands, establish a collaborative regulatory mechanism for relevant departments, improve ongoing and ex post supervision measures, and expand the supply of diversified services. Shanghai will seek support from national ministries and commissions to promote international medical service providers to apply, in accordance with provisions, to use urgently needed clinical drugs and medical devices that have been listed overseas. Medical institutions are encouraged to obtain international commercial insurance certification. Explorations will be made to establish localized international medical certification standards and promote the formation of third-party international medical certification bodies. (Responsible units: the Municipal Commission of Health, the Municipal Commission of Commerce, and the Municipal Medical Products Administration)

2. Improving the support policies for international medical development. Shanghai will support international medical service institutions, in accordance with provisions, to open vaccination clinics, and provide health checkups, online medical services, and telemedicine. For private medical institutions that mainly provide international medical services, appropriate support shall be given in accordance with provisions in terms of the configuration of large medical equipment and the planning and setting up of maternal-child healthcare technology services. Shanghai will optimize international medical service pricing, and support international medical service institutions to implement value-based pricing to provide international medical services through agreements with commercial insurance institutions, if they comply with national and municipal laws, rules and regulations on price, taxation management and layout planning. The Municipality will also strengthen policy guidance on pharmaceutical and medical device procurement and optimize the structure of clinical drug use. International medical service institutions may apply for financial support from the municipal business high-quality development special fund (trade in services), and relevant international medical projects may apply for specialized support from the municipal tourism development fund. (Responsible units: the Municipal Commission of Health, the Municipal Disease Control and Prevention Administration, the Municipal Healthcare Security Administration, the Municipal Commission of Commerce, the Municipal Administration of Culture and Tourism, and Shanghai Hospital Development Center)

3. Strengthening the international medical workforce. Shanghai will actively seek support from national ministries and commissions, explore the multi-location practice registration of foreign, Hong Kong, Macao and Taiwan physicians, explore standardized practice of foreign, Hong Kong, Macao and Taiwan occupational therapists, physiotherapists and other medical professionals in international medical service institutions, and carry out pilot projects for standardized practice of foreign nurses. Shanghai will include eligible overseas medical professional qualification certificates in its list of recognized overseas professional qualification certificates, and explore a mechanism for recognizing the equivalent senior professional titles of foreign, Hong Kong, Macao, and Taiwan medical experts who hold certificates on the list. International medical service institutions may, upon application and based on the actual conditions, include international medical departments in the standardized training rotations for resident physicians. International medical doctors, nurses and managers are encouraged to conduct research on international-medical-related clinical medicine, health policy, management science, etc. Qualified doctors in the international medical department of a general hospital are allowed to add a general practice scope to their licenses in accordance with provisions, and general practitioners who have completed standardized training are allowed to practice in the international medical department of a general hospital. Public hospitals providing international medical services may adopt a flexible salary structure such as annual salary, project salary, and negotiated salary to recruit high-end foreign international medical talent in accordance with actual needs. (Responsible units: the Municipal Commission of Health, the Municipal Bureau of Human Resources and Social Security, and Shanghai Hospital Development Center)

IV. Improving Service Experience to Expand Shanghai's International Medical Influence

1. Improving service convenience. Shanghai will optimize measures to facilitate the processing of entry and exit documents for foreign patients, and promote the convenient use of entry and exit documents such as passports for medical treatment. It will promote the development of a foreign language version of this Municipality's appointment registration platform, encourage medical institutions to develop international medical care foreign language versions of web pages or small programs, and improve the appointment mechanism for international medical services. Medical institutions providing international medical services shall comply with the Shanghai local standard "International Medical Service Specifications" (DB31/T 1487-2024) for implementation. The Municipality will improve measures to facilitate payment of international medical service fees, and provide multiple payment methods such as RMB cash, bank cards (including foreign currency), mobile payments, and direct insurance payments. International medical service providers are encouraged to open foreign exchange accounts to facilitate payment of medical expenses by overseas medical insurance and cross-border medical patients. Medical institutions are encouraged to provide multilingual international medical services, provide multilingual medical documentation, and establish and improve the clinical coordination service mechanism for international patients. (Responsible units: the Municipal Commission of Health, the Municipal Bureau of Public Security, State Administration of Foreign Exchange Shanghai Branch, and Shanghai Hospital Development Center)

2. Promoting commercial health insurance. International medical institutions are encouraged to partner with commercial insurance companies for service agreements and establish a stable cooperative relationship. The payment policy for commercial health insurance will be improved, and the proportion of commercial health insurance in international medical payments will be increased. On the basis of the pilot project for online processing of commercial health insurance claims, direct settlement of commercial health insurance will be carried out. Progress will be made in information interconnection between medical institutions and commercial insurance institutions to settle online claims. Commercial insurance institutions in Shanghai are encouraged to develop health insurance products that are connected with featured medical services and medical insurance products for cross-border individuals. (Responsible units: the Municipal Financial Regulatory Bureau, the Municipal Healthcare Security Administration, the Municipal Commission of Health, and Shanghai Hospital Development Center)

3. Developing medical tourism and related services. Travel agencies are encouraged to integrate high-end medical services into tourism packages and improve relevant tourism services. Various intermediary service agencies for international medical treatment will be fostered to provide an international medical service connection platform for overseas health insurance companies, domestic and foreign patients, and medical institutions in this Municipality, and provide one-stop service for medical treatment in Shanghai. Medical institutions are encouraged to cooperate with travel agencies, tourist sites, hotels, intermediary service agencies, etc. (Responsible units: the Municipal Administration of Culture and Tourism, and the Municipal Commission of Health)

4. Strengthening international cooperation and promotion. Shanghai will support long-term and stable cooperative relationships between its medical colleges and institutions on the one hand and renowned international universities, medical institutions, and research institutions on the other, and encourage the establishment of cooperative mechanisms among medical institutions in the fields of discipline development, talent cultivation, and scientific research projects. Medical institutions will be supported in setting up international patient liaison and service centers overseas. Relying on the development of the Belt and Road Initiative, cooperation with countries along the route in medical student training and education will be strengthened. International medical service content will be displayed on the Shanghai International Services Portal.  International medical tourism publicity will be incorporated into the overall plan for Shanghai’s cultural tourism publicity, and travel agencies will be guided to develop international medical tourism routes. International medical service providers will be organized to participate in international tourism exhibitions. (Responsible units: the Municipal Commission of Health, the Municipal Commission of Education, Foreign Affairs Office of the Municipal People's Government, and the Municipal Administration of Culture and Tourism)

V. Enhancing Governance for Sustainable and Regulated International Medical Development

1. Standardizing international medical practice. Medical institutions are encouraged to establish and improve various systems for international medical services, improve the medical quality and safety management system, and build an information system that is compatible with international medical service models and payment methods. Supervision of medical institutions providing international medical services will be strengthened, and acts in violation of laws, rules or regulations will be strictly investigated and penalized. (Responsible units: the Municipal Commission of Health, and Shanghai Hospital Development Center)

2. Enhancing industry self-regulation and coordination. The development of international medical associations and societies is encouraged, and their role will be leveraged in strengthening industry self-regulation, enhancing industry cohesion, and promoting overseas expansion. Explorations will be made to establish the Yangtze River Delta International Medical Alliance so as to transform the advantages of Shanghai's high-level medical openness into the whole region's competitive edge. (Responsible units: the Municipal Commission of Health, and the Municipal Bureau of Civil Affairs)

3. Establishing an international medical statistics and monitoring system. A statistical indicator system for international medical services will be developed, including service volume, patient visits, geographic distribution of patients, specialty consultations, and disease categories. The indicators will be more effectively monitored to guide the design and targeted promotion of international medical products. Medical institutions are urged to enhance third-party evaluations of their international medical services, conduct regular patient satisfaction surveys, and establish a complaint handling mechanism to ensure smooth and timely resolution of the complaints. (Responsible units: the Municipal Commission of Health, and Shanghai Hospital Development Center)

General Office of Shanghai Municipal People's Government

December 30, 2024