The opening of Hong Kong’s first predominantly Chinese medicine-led hospital last December is a milestone for the city’s healthcare system. The Chinese Medicine Hospital of Hong Kong (CMHHK), in addition to providing pure Chinese medicine services, represents the first time patients are able to receive treatment plans led by that system of healing – while also factoring in expertise from Western medical perspectives where appropriate.
By leveraging Hong Kong’s role as an international gateway to China, the hospital’s East-meets-West model sits at the centre of a broader ambition: to develop CMHHK as a Hong Kong model for integrated Chinese-Western medicine (ICWM) that focuses on treatment and clinical outcomes. It also facilitates the integration and proliferation of Chinese medicine across the region and globe, creating a replicable case study echoing the city’s Chinese Medicine Development Blueprint released last December. The blueprint was formulated under the leadership of the commissioner for Chinese Medicine Development Dr Vincent Chung Chi-ho and coordinated by the Health Bureau’s Chinese Medicine Unit. It outlines short-, medium- and long-term actions – comprising five main domains and various strategic goals. The blueprint is the government’s road map for delivering higher-quality, more comprehensive healthcare, at the same time positioning the city as a “bridgehead” in the global expansion of Chinese medicine, in line with China’s overall strategies for its development.
The hospital is translating these priorities into a core pillar of public health: “One of the roles of CMHHK is as a change driver,” says Dr Cheung Wai-lun, project director of the Chinese Medicine Hospital Project Office. “It aspires to develop new knowledge, new practices and new models, and transfer them to healthcare systems. We would like to establish collaborations that work best for patients and improve the healthcare system of Hong Kong.”
For decades, Chinese medicine and Western medicine practices in Hong Kong operated in silos, each with its own institutions, governing bodies, philosophies and clinical logic, posing challenges for both professionals and patients caused by deviations in the fundamental approaches of the two systems. “With years of this isolated practice, there was no platform to communicate, to collaborate or coordinate the practices for individual patients,” Cheung says. “Working together [now at CMHHK] means that in making diagnoses, doing assessments, planning care, delivering treatment and making evaluations, practitioners do so in an integrated manner.
“The professional language used in Western medicine and Chinese medicine has no common path; the two approaches usually create a communication challenge due to the significant philosophical distance between the two disciplines on understanding the human body and how it responds to illness,” Cheung adds. “But for integrated Chinese and Western medicine, we need not resolve this difference. What we should go for are the commonalities: these lie in the outcome of intervention and in how the intervention can improve health – or mitigate side effects.”
The new ICWM approach leverages the strengths and complementary approaches of both practices as it aims to improve health through increased functionality, relief of symptoms and pain, recovery and improved mobility and ability, with treatment delivered through multidisciplinary teams.
One significant challenge is to ensure the safe, simultaneous use of Chinese and Western medicine. CMHHK is creating a database of confirmed outcomes and interactions when a patient uses herbal medicines and conventional drugs in tandem. “In many situations, a patient taking an integrated approach will be taking both. This has to be resolved, and that is why we are leading a research platform to work through the evidence on herb-drug interactions,” Cheung says. “We focus on special disease programmes first, where the profiles of both Western drugs and Chinese herbs are better defined. As we build more programmes, the scope will widen, and we can draw broader conclusions.”
The hospital has identified a number of special disease programmes, chosen through evidence-backed data and clinical research that proves their compatibility with Chinese medicine-based interventions and treatment plans.
It has also developed six specialised Chinese medicine services: internal medicine, external medicine, gynaecology, paediatrics, orthopaedics and traumatology, as well as acupuncture and moxibustion. The hospital currently provides outpatient and day-patient services, and facilities for 24-hour inpatient care will open in December.
On a day-to-day level, ICWM begins by seeking commonalities within the diagnostic traditions of each practice. Professor Bian Zhaoxiang, the hospital’s chief executive, points out that while Chinese medicine practitioners speak about qi, blood, yin and yang – a language system for articulating the Chinese medicine framework – Western medical professionals speak about anatomy and organ function.
“At the start, these are entirely different languages. But in practice, we use the first-level clinical symptom pattern as the common ground. Clinical symptom pattern is equally understood on both sides,” he says. “The explanation for why those symptoms exist differs – that is the second level. But we base our intervention decisions not on the explanation, but on the first-level clinical symptom analysis. And the interventions from both sides are then combined.”
Bian says after working together over time, the multidisciplinary teams come to recognise the complementary strengths of different treatments. For example, a physiotherapist may begin to see a patient improve after acupuncture, while a Chinese medicine practitioner might then appreciate how physiotherapy aids recovery from another angle. “This is the platform CMHHK has built – letting different teams work together on a single clinical platform, gradually opening their assumptions to each other,” he says.
CMHHK also has plans to open a dedicated facility for phase I and phase II clinical trials for the development of proprietary Chinese medicines – the finished form of products available to the public. “CMHHK is already broadening its global network via local, regional and international collaboration. The hospital will establish links with various Chinese mainland and international centres to facilitate convincing multi-centre clinical trials, in turn advancing the evaluation of Chinese medicine to demonstrate the synergetic clinical outcomes of integrative medicine,” Bian says.
Cheung says CMHHK will play an important role in drawing up standardised research protocols to analyse the practice and outcomes of integrating Chinese and Western medicine, with the hope that similar protocols will eventually be adopted internationally.
The hospital aims to lead ICWM by establishing evidence-based clinical protocols and multidisciplinary care – a model aligned with the blueprint and Hong Kong’s first five-year plan, as well as China’s 15th five-year plan to promote the inheritance and innovation of traditional Chinese medicine and its integration with Western medicine. In doing so, it intends to make Hong Kong the global leader for integrated, data-driven Chinese medicine care.
“The key missions of CMHHK are healthcare services, training and education, research, collaboration and creating health values,” Bian says. “We don’t just want to show those values; we also want to understand the scientific values behind the clinical efficacy and the safety monitoring process to develop more sophisticated and more effective healthcare in Hong Kong. And that system can go worldwide.”