Tianjin Digital Health Community: A Chinese Model for Value-Based Healthcare

The health security of hundreds of millions of Chinese citizens is undergoing profound changes. On November 18, the National Health Commission held its sixth special press conference this year on “Promoting the Sanming Healthcare Reform Experience” in Lishui City, Zhejiang Province. Immediately following this, on November 19, the National Health Commission organized a training session on promoting the Sanming healthcare reform experience in Sanming City, Fujian Province, sending a strong signal of new healthcare reforms... Upgrading “Medical Consortia” into “Health Consortia” has become the focal point for the next stage of deepening reforms in the Sanming healthcare model.

As the birthplace of the “Healthy Community” model, Tianjin’s Digital Healthy Community merits attention for its innovative approach and practical outcomes. Through over four years of exploration and practice—spanning institutional and mechanistic innovation, technological advancement, and model innovation—Tianjin has successfully established an integrated healthcare delivery system that is “health-centered” and operates on a pay-for-performance basis. This initiative has emerged as a new paradigm in healthcare reform, driving quality improvement and efficiency gains across medical care, health insurance, and pharmaceutical supply (“the three medical sectors”) while implementing value-based healthcare.

“Now, I can pick up my medications at the community health center simply by facial recognition, and the range of available drugs is quite comprehensive. Health managers regularly contact us to arrange screening examinations, monitor my various health indicators, and provide guidance on diet, exercise, and other precautions. If any issues arise, I can consult with them directly online, which is extremely convenient,” said Ms. Yu.

After noticing abnormalities in her health indicators, Zhou Xin, a health manager at the Xianshuigu Town Health Center in Jinnan District, Tianjin, proactively contacted Ms. Yu and advised her to undergo free screening at the community health center as soon as possible. Ms. Yu was highly satisfied with such attentive service.

Figure | The Health Community Model Deploys Health Managers in Primary Hospitals to Comprehensively Advance the Integration of Prevention and Treatment

Ms. Yu’s experience is not an isolated case but a common phenomenon at the Xianshuigu Town Health Center in Jinnan District, Tianjin. In the transition from “managing medical care” to “managing health,” health managers have become a key component of the digital health community model.

“Our responsibility is to provide personalized health management for the general public,” introduced Zhou Xin. “First, we need to assess the health status of our service recipients, determine whether they are chronic disease patients, and establish individual health records. Then, family doctors will assign tasks based on the specific conditions, and we are also required to proactively contact patients on a regular basis to provide health guidance.”

Health manager Zhou Xin alone serves over 2,000 residents with chronic conditions similar to Ms. Yu. Providing personalized services through continuous health monitoring requires substantial effort, and AI is emerging as a “super engine” for enhancing efficiency.

Zhou Xin cited an example, noting that AI has provided significant assistance in data analysis and tiered patient management. “The system issues alerts based on patient tags. For patients tagged ‘red,’ we conduct follow-up visits every 15 days, whereas for those tagged ‘green,’ follow-ups are required only once every three months, substantially improving our work efficiency,” she said.

The continuous improvement in individual efficiency has become a microcosm of the transformation of digital health communities. Zhang Jun, President of WeDoctor Holdings, introduced that WeDoctor’s pioneering “Health Community” model has been successfully implemented and operated in Tianjin, paving a win-win path that leverages AI to enhance the efficiency of the “three medical sectors” (medical care, health insurance, and pharmaceuticals), thereby achieving both public benefit from healthcare reform and commercial innovation.

It is understood that the Digital Health Community model was first proposed by WeDoctor in 2019. Leveraging leading digitalization and AI technologies, the Tianjin Municipal Government partnered with WeDoctor in 2020 to launch the “Tianjin Digital Health Community” special healthcare reform initiative. Under the guidance of the Tianjin Municipal Health Commission and the Healthcare Security Administration, Tianjin WeDoctor Digital Intelligence Hospital took the lead in coordinating 266 community health service centers and over 2,000 stations and clinics across the city to jointly establish the Tianjin Primary Care Digital Health Community. After several years of development and operation, the innovative model of the Health Community has upgraded from version 1.0 to 2.0, achieving remarkable results.

Driven by innovations in both mechanisms and technology, Tianjin’s Digital Healthcare Community has undergone continuous iteration and upgrading. In its early stages, the Healthcare Community established a working mechanism characterized by unified management, standardized services, shared benefits, and joint responsibilities through comprehensive reforms. Empowered by technological innovation, it comprehensively enhanced primary basic medical service capabilities via the “Four Clouds” platforms: Cloud Management, Cloud Services, Cloud Pharmacy, and Cloud Diagnostics. Meanwhile, using diabetes as an entry point, it explored capitated global payment models to promote outcome-oriented healthcare reform. By establishing 238 chronic disease management centers, it strengthened primary healthcare management capabilities, thereby achieving the “Two Increases and One Decrease” goal: improved population health indicators, enhanced primary medical service capabilities, and a reduced growth rate of medical insurance expenditures.

At this stage, the Tianjin Digital Health Consortium has entered Phase 2.0, dedicated to assisting district governments in refining close-knit county-level medical consortia and helping urban medical groups upgrade into regional digital-intelligent health consortia. Centered on the goal of providing residents with full-lifecycle health management, and empowered by AI technology, the Consortium is comprehensively promoting the formation of a tiered diagnosis and treatment system. This is being achieved through measures such as supporting Tianjin’s districts in implementing capitation-based global budget payment reforms for family doctor contracts, and empowering secondary and tertiary hospitals to build capabilities for the “joint management of six diseases.”

“Today, the four major AI agents—AI Physician, AI Pharmacist, AI Health Manager, and AI Intelligent Controller—have comprehensively empowered the domains of ‘medical care, pharmaceuticals, testing, health, and management,’ forming a closed-loop system across all segments of healthcare services,” introduced Zhang Jun.

Relevant statistics show that WeDoctor’s “AI Health Management” application has increased the individual efficiency of health managers by 150%. Furthermore, the intelligent auxiliary diagnosis and treatment and intelligent screening recommendations for complications provided by the “AI Doctor” have improved the quality of primary care treatment plans by 22% and increased the annual primary care screening rate for related tests by 28%. The “AI Pharmacist” has raised the rationality and cost-effectiveness of medication use to over 98%, while “AI Intelligent Control” has boosted medical insurance compliance by 9.6%.

Mr. Zhang revealed that, leveraging the extensive healthcare service scenarios and demands of the Digital Health Community, WeDoctor has established a 2H2C commercialization pathway. By integrating online and offline resources and combining health data analytics, WeDoctor provides users with one-stop, personalized services spanning diagnosis and treatment, chronic disease management, general health management, and commercial health insurance.

At the training session on promoting the experience of Sanming’s healthcare reform, held on November 19, Lei Haichao, Party Secretary and Director of the National Health Commission, emphasized that all provinces should take prefecture-level cities as basic units, implement the spirit of the Third Plenary Session through concrete actions, diligently promote the experience of Sanming’s healthcare reform, and advance reforms in a multi-dimensional and dynamic manner to achieve tangible results.

The achievements of Sanming’s healthcare reform are evident to all. According to public reports, Sanming City will next build upon the development of county-level medical consortia, using health insurance payment mechanisms as a link, to explore the establishment of a “government-led, multi-departmentally coordinated, and socially engaged Integrated Health Community.” This initiative aims to provide the public with integrated health services spanning from prevention to rehabilitation.

In February this year, Shanghai Ruijin Hospital, WeDoctor, and the Sanming Municipal Government joined forces to establish China’s first “Six-Disease Co-Management” Center for full-lifecycle care in Sanming. Leveraging the collaborative model of “Ruijin Medicine + Sanming Demonstration + WeDoctor AI,” the initiative has implemented an innovative “AI-driven Six-Disease Co-Management” approach. This has revolutionized chronic disease prevention and control by shifting from a singular “disease-focused” model to a comprehensive “patient-centered” strategy, thereby more effectively promoting the upgrade of service models from treatment to health management.

It is evident that the Tianjin experience shares similar technical approaches, identical pathways, and consistent goals with the Sanming healthcare reform. A series of explorations and practices have endowed the Digital Health Community model with broader prospects for innovation and development.

Figure | WeDoctor AI Health Community's Chronic Disease Management Center

Tianjin’s Digital Health Community has been recognized for its outstanding achievements, being listed among the “Top Ten New Measures to Advance Healthcare Reform and Serve Public Health” in China for 2020 and 2023, respectively, under the initiatives of “Building the ‘Four Clouds’ Platform to Promote the Development of Grassroots Digital Health Communities” and “Advancing Capitation-Based Global Budget Payment for Family Doctor Contract Services.” In April 2022, the Cyberspace Administration of China, the Ministry of Agriculture and Rural Affairs, the National Development and Reform Commission, the Ministry of Industry and Information Technology, and the National Rural Revitalization Administration jointly issued the Key Points for Digital Village Development Work in 2022, which explicitly proposed “guiding localities to explore the development of grassroots digital health communities.” The experience of Tianjin’s Xiqing District in exploring the construction of integrated digital health communities was included in the Typical Cases of Integrated County-Level Medical Consortia Construction (2023) published by the National Health Commission, and has been promoted nationwide.

Relevant officials stated that the WeDoctor Digital Health Community model has already been implemented in multiple provinces and municipalities, including Tianjin, Shandong, Shanghai, and Jiangxi. As healthcare reform deepens across China, the “Tianjin experience” and the “WeDoctor solution” will play an increasingly significant demonstrative role in the upgrading of nationwide close-knit medical communities and integrated health communities, thereby helping to achieve higher-level universal health coverage.