Online medical consultation has grown from a niche convenience into one of the fastest-moving corners of digital health, expanding at an average rate of 150 percent every five years and accelerating further during the COVID-19 pandemic, when remote advice aligned with social distancing measures and reduced cross-infection risks. Yet according to a new perspective article published in Frontiers in Digital Health, the legal machinery governing these services has not kept pace with the technology behind them. The analysis, authored by Qi Chen of Beijing Union University, argues that the sector now operates inside a web of regulatory gaps, leaving two questions dangerously unresolved: what kind of service an online consultation actually is, and who bears responsibility when something goes wrong.
The distinction matters more than it might first appear. Chinese regulations define internet diagnosis and treatment narrowly, as follow-up consultations for common and chronic diseases, along with “Internet+” family doctor contract services, delivered by a medical institution using its own registered practitioners. The National Health Commission has clarified that diagnosis and treatment occurs when a practitioner reaches a diagnostic conclusion about a disease and proposes a treatment plan, such as prescribing medication or directing hospital admission. Services that involve no definitive diagnosis or treatment fall into a separate category of advisory services. Traditional consultation platforms, which connect users with practitioners but are not themselves medical institutions, have generally been classified on the advisory side of that line, and platforms such as Chunyu Doctor state explicitly in their user agreements that their recommendations rely solely on user descriptions and do not constitute a basis for diagnosis or treatment.
Courts have largely endorsed that framing. In disputes over online consultations, both the Beijing Chaoyang Primary People’s Court and the Beijing Second Intermediate People’s Court have classified the interactions as advisory rather than medical care. But the picture is not static. In one case heard by the Beijing Third Intermediate People’s Court, a patient used the Chunyu Doctor platform for post-operative follow-up communication on the recommendation of the surgeon who had performed his operation. While generally accepting that consultation services are advisory, the court held that the communication in question constituted medical diagnosis and treatment. That judgment signals that a blanket label of “advice” is no longer sufficient, and that the nature of a consultation must be assessed according to its specific circumstances.
To ground the analysis, Chen searched the Wolters Kluwer China Law & Reference database for cases involving online medical consultation and internet healthcare under two causes of action: disputes over the right to life, bodily integrity, and health, and disputes over medical malpractice liability. The search covered cases decided from July 17, 2018 onward and returned 20 cases, 13 of which originated in Beijing. After excluding decisions that merely mentioned the keywords, five cases remained, all from the capital. Beijing therefore serves as the analytical context for the study, a choice the author justifies by the city’s concentration of medical resources and its position at the forefront of digital health development, where legal challenges tend to arise earlier and in more complex forms than in rural regions.
The scale of Beijing’s online health infrastructure explains why. The city is headquarters to nationally recognized platforms including JD Health, WeDoctor, Haodf, also known as Good Doctor Online, and Chunyu Doctor. During the pandemic, Beijing assembled an Online Medical Consultation Platform for COVID-19 bringing together more than 1,000 doctors and five hospitals. By July 2025, the city supported 102 internet hospitals and 307 medical institutions providing online diagnosis and treatment services, alongside a municipal-level unified platform enrolling 54 hospitals and nearly 9,000 doctors. Those facilities handled 1.12 million online consultations in the first six months of 2025, a 45 percent increase relative to the same period in 2024.
Regulation has followed, but imperfectly. At the national level, the primary instruments are the Measures for the Administration of Internet Diagnosis and Treatment, the Measures for the Administration of Internet Hospitals, both effective July 17, 2018, and the Detailed Rules for the Supervision of Internet Diagnosis and Treatment, effective February 8, 2022. These rules require service providers to be medical institutions, limit internet services to follow-up consultations, and designate medical institutions as the liable entities. Beijing has layered on local policies, including the Beijing Special Plan for Medical and Health Facilities 2020 to 2035, which outlines a “1 + N + 1” framework of one supervisory platform, multiple service sub-platforms, and one unified public service platform. The municipal health commission has mandated that all medical institutions delivering internet-based services connect to the Beijing Internet Diagnosis and Treatment Supervision Platform. The problem, Chen argues, is that these frameworks were designed for internet diagnosis and treatment rather than consultation specifically, and their liability provisions target medical institutions rather than platforms.
The consequences become visible in the platform liability question. Because current regulations designate medical institutions as the primary liable entities, platforms are generally expected only to meet fundamental regulatory obligations: verifying the qualifications of registered practitioners and warning users that the services are advisory and do not constitute diagnosis or treatment. The Chaoyang court, however, has pushed back on that minimalist reading. While online platforms cannot be required to make precise medical judgments on all consulting information, the court observed, they should exercise prudent management, maintain retrievable records for future reference, and refrain from disclaiming all responsibility through standard agreement clauses or brief reminders. The court framed this duty as part of the social responsibility such platforms ought to bear. When and to what extent that responsibility applies, though, remains unresolved, and no uniform standard exists.
New operational models deepen the confusion. Consultation services are now delivered through internet hospitals established independently by physical medical institutions, jointly with third parties, or by enterprises relying on those institutions, and through instant messaging tools via practitioners’ personal accounts or dedicated chat groups. Artificial intelligence adds another layer: many platforms have introduced “AI doctors” that interpret examination results, offer medication guidance, and perform symptom assessment, while users increasingly bypass platforms altogether and seek guidance directly from generative AI systems such as ChatGPT, DeepSeek, and Doubao. AI tools can generate inaccurate information through hallucinations or processing errors, and if a user suffers harm after relying on erroneous output, the grounds, extent, and circumstances under which a platform should be liable remain unestablished.
As a regulatory response, Chen proposes that cities such as Beijing establish a dedicated framework centered on local departmental rules jointly issued by municipal authorities and led by the municipal health commission, with platforms rather than medical institutions as the primary regulated entities. The centerpiece is a four-step test for classifying services. If a service is not provided by a qualified practitioner, as with AI-generated advice, it is advisory. If a qualified practitioner is involved and a medical institution, whether physical or an internet hospital, participates, the service is diagnosis and treatment, a classification the author links to Beijing’s pilot program permitting initial online diagnosis and treatment for specific pediatric conditions. If no medical institution is involved, initial consultations remain advisory, but follow-up consultations that directly relate to a prior offline diagnosis and treatment and occur within a reasonable timeframe should be classified as diagnosis and treatment, reflecting the reality that patients who travel to Beijing for initial treatment often maintain contact with their treating doctors through third-party platforms.
Liability, in turn, should follow the operational model. For traditional platforms and instant messaging tools acting as intermediaries, practitioners bear liability for medical malpractice while platforms incur fault-based liability, covering credential verification, advisory warnings, retrievable records, and assistance to vulnerable users, with instant messaging platforms excused from credential checks. Where medical institutions are involved, with or without AI integration, the institution should bear liability based on organizational fault as the organizer, designer, and provider of services, simplifying the patient’s path to redress while preserving the institution’s right to seek reimbursement from a platform or AI developer. For services provided solely by AI, the author argues that developers should bear product liability, reasoning that multimodal large models meet China’s Product Quality Law definition of a product as something processed, manufactured, commercialized, and circulated, and that strict liability is warranted where healthcare applications directly affect the right to life and health. The study acknowledges its limitations, noting that its Beijing-focused case sample may not capture every legal issue and that AI regulation remains in flux, but its central principle stands: classification and liability should be tailored to how each consultation service actually operates, rather than forced into a single uniform standard.
Subject of Research: Legal challenges and regulatory responses in online medical consultation
Article Title: Legal challenges and regulatory responses in online medical consultation
Article References: Chen, Q. (2026). Legal challenges and regulatory responses in online medical consultation. Frontiers in Digital Health, 8, Article 1957951. https://doi.org/10.3389/fdgth.2026.1957951
Image Credits: AI Generated
DOI: 10.3389/fdgth.2026.1957951
Keywords: online medical consultation, digital health, telemedicine, internet hospitals, platform liability, medical malpractice, artificial intelligence, generative AI, Beijing, regulation, health law, advisory services
News Source: Ophelia Keating. (October 26, 2026). Online Medical Consultation Outpaces the Law, and Beijing Shows Why. Scienmag.
