Further healthcare system reform calls for desirable pathway design. This paper introduced the logical framework of the new healthcare system reform pathway design and typical practical experience in Hangzhou.Known for " Internet+Smart healthcare" forerunner, Hangzhou has pioneered the reform of public hospitals and the construction of smart handy service for the public.With the aim of fully protecting the health rights and interests of urban and rural residents, comprehensive policy has been taken to deepen the reform of public hospitals; with the comprehensive promotion of contracted services and the primary level sharing of resources as a carrier, we will build a hierarchical medical service system of vertical linkage.We will also innovate and practice the governing philosophy of " Medicine has its limitations but we have the courage to overcome, service is boundaryless and we must pursue excellence".Promotion of party building in the industry also ranks high.Deepening the reform of " one visit for all" in the field of medical and health services as a measure to enhance people′s sense of gain; The " public-private partnership" to encourage the development of the social governance system and legalization in healthcare proves successful at this stage. However, there are still many challenges in the information security maintenance of smart healthcare, the balance of stakeholder interests in public hospitals, the all-round advancement of hierarchical medical service, standardizing and streamlining the reform of " one visit for all".

Based on a sufficient analysis of the theoretical framework of " transformation learning collaboration" ( TLC ) and " people-centered and integrated health care " ( PCIC ) mode, this article introduced the main practices and achievements of " Hangzhou characteristics" countywide medical alliances, centering on TLC mode.Hangzhou takes the countywide medical alliance construction as a pilot, refers to the TLC model, and takes growth-oriented collaboration as the guidance, to promote responsibility sharing, benefit sharing, service integration and management collaboration.Guided by the PCIC model proposed by the World Health Organization, the city has established an integrated service model of hierarchical medical system-prevention-rehabilitation-aging care.The countywide medical alliance system framework features " 5 fields, unified leadership, unified culture, 6 supports, 3 tasks and TLC teams " , which may provide references for the coordinated and integrated development of such alliances.