Beyond Offline Complementarity: How Internet Healthcare Is Reshaping the Medical Service System

Internet healthcare has risen since 2013, advancing through continuous exploration and trial-and-error, and has become an important supplementary force in China’s healthcare service system. To this day, even though industry giants such as JD Health and Ali Health have emerged in the market, we still cannot definitively assert that the models and efficacy of internet healthcare have become standardized.

“Similar to the transformative impact of the internet on other industries, internet healthcare can reshape the existing medical service system, transforming and enhancing the delivery methods and service processes of healthcare, thereby delivering greater value to patients.”Professor Cai Jiangnan, Founder and Executive Chairman of the Shanghai Chuangqi Health Development InstituteWe remain unwavering in this conviction. The exemplary performance of internet-based healthcare during the COVID-19 pandemic serves as one piece of evidence supporting this view.

How Is Internet Healthcare Reshaping the Traditional Medical Service System? How Will Core Stakeholders in the Internet Healthcare Ecosystem—Including Healthcare Institutions, Internet Healthcare Platforms, Health-Tech Companies, and Multinational Pharmaceutical Firms—Identify Breakthrough Strategies? VCBeat Seeks Answers Through Interviews with Industry Experts and Corporate Research.

The development of internet-based healthcare can be broadly divided into three stages. During the first stage, which spanned a considerable period in the past, the internet served merely as a supplementary means to bridge disparities in medical resources across regions. For instance, experts from leading hospitals in developed areas provided remote medical consultations and advisory services to hospitals in remote regions via internet platforms.

The second phase began around 2013. As the internet advanced rapidly on its path to “disrupting everything,” the core thesis for startups was to identify which industries remained ripe for internet penetration. The healthcare sector, viewed as a “blue ocean,” consequently came into the spotlight for investors and entrepreneurs. Over the subsequent decade, internet healthcare gradually evolved into a significant supplement and supportive force to offline medical services, offering online appointment scheduling, consultations, follow-up visits, and medication purchasing to address patients’ pain points.

From telemedicine to internet-based healthcare, we can observe two distinct changes:First, the driving force behind the internet healthcare industry has gradually shifted from government-led initiatives to proactive promotion by internet healthcare enterprises. Second, the policy environment, trends, and focus in internet healthcare are slowly transitioning from B2B to B2C, moving from inter-hospital consultations to directly addressing patient needs.

It is also in this process that internet healthcare has gradually formed two main forces: internet healthcare companies that independently establish internet hospitals, and physical hospitals, primarily public hospitals, that are digitalizing their medical services.

Internet healthcare companies possess advantages such as strong technical capabilities, extensive resource pools, and comprehensive patient services, enabling them to drive end-to-end medical service delivery across in-hospital and out-of-hospital settings and facilitate horizontal integration of medical resources. The latter focuses on building regional collaborative diagnosis and treatment platforms to promote vertical flow of medical resources, information interconnectivity and sharing within the public healthcare system, and an integrated online-offline medical service model.

Both models exhibit distinct advantages yet suffer from respective shortcomings. Internet healthcare enterprises lack data connectivity with public hospitals, access to core medical resources represented by physicians, and face payment constraints related to global budgets and geographic restrictions. Conversely, internet hospitals predominantly operated by public hospitals encounter challenges such as insufficient digital capabilities, limited motivation among senior physicians to conduct online consultations, and mismatches in payment systems coupled with unreasonable reimbursement standards.

Professor Cai Jiangnan summarized the development dilemmas of the internet healthcare industry in its second phase as “Data, Services, and Payment"three keywords, and proposed three major innovative reforms:

First, promote the integrated development of data systems to enhance convenient, intelligent, and patient-centered services, while adhering to the integrated fusion of online and offline channels. Second, in terms of medical services, facilitate the effective utilization of physician resources, improve the efficiency of internet-based diagnosis and treatment, and ensure consistency and continuity in the quality of medical care. Finally, implement payment reforms and improve the price formation mechanism for “Internet+” medical services.

These three initiatives are central to achieving the third stage of internet healthcare, namely “Internet Healthcare Reshaping the Healthcare Delivery System.” Professor Cai Jiangnan envisions that, driven by the transformative power of the internet, the healthcare delivery system will truly become patient-centered, leverage physician resources more effectively, shift away from the traditional reactive and passive service model, completely break down barriers between in-hospital and out-of-hospital care as well as between online and offline services, and thereby better serve patients.

At the Internet Healthcare Ecosystem Innovation Summit, jointly hosted by Sanofi China and the Chuangqi Health Development Research Institute, core “co-builders” from the internet healthcare ecosystem—including public hospitals, internet platforms, healthcare enterprises, and innovative pharmaceutical companies—shared their firsthand practices in addressing industry bottlenecks from their respective perspectives.

Lin Hui, Director of the Internet and Artificial Intelligence Office at Sir Run Run Shaw Hospital, Zhejiang University School of MedicineIntroduction,Customers, service providers, and healthcare services are the three essential elements for building a robust internet healthcare ecosystem.In response, Sir Run Run Shaw Hospital has adopted a dual approach. On one hand, building upon prior explorations and practices in “Internet+” healthcare, and guided by the goal of establishing a regional tiered diagnosis and treatment service system, the hospital has leveraged its position within the public healthcare system to create a “Medical 4.0” model characterized by “Internet+ Regional Hospital Alliance + Physicians + Health Industry.” On the other hand, by leveraging the internet and integrating next-generation information technologies, the hospital has built a bridge between patients and physicians through health consultations, established corresponding operational and management systems, and shared high-quality medical resources. This has made remote consultations more mobile and enhanced their clinical effectiveness, thereby promoting the development of a new ecosystem for internet-based healthcare.

Physicians are the core resources within the healthcare service system. Internet-based healthcare can, to a certain extent, optimize the temporal and geographic distribution of high-quality physician resources, thereby enhancing their effectiveness.Haodf Online empowers physicians across six dimensions: upgrading medical services, enhancing how patients perceive and engage with doctors, improving outpatient efficiency, optimizing the supply of required medications, advancing peer collaboration models, and increasing income. Meanwhile, Sanofi is among the industry pioneers in exploring the integration and synergy between Clinical Decision Support Systems (CDSS) and internet hospitals, leveraging technological solutions to elevate the diagnostic and treatment capabilities of primary care physicians.

Internet-based medical services can help healthcare institutions provide patient health services both within and outside hospitals, as well as online and offline, enabling more proactive patient care and achieving continuity in medical services.For instance, Haixin Zhihui has built an intelligent platform for managing the entire patient journey, benefiting both cancer patients and clinicians. JD Health, on the other hand, leverages its pharmaceutical and health product supply chain as the core, medical services as the entry point, and digital-intelligence technologies as the driver to provide smart healthcare solutions that optimize and enhance online diagnosis and treatment services.

As key co-builders of the internet healthcare ecosystem, innovative pharmaceutical companies are also continuously contributing their strengths. On one hand, pharmaceutical companies leverage online channels to make innovative therapies accessible to a broader patient population more rapidly; on the other hand, with a focus on full-lifecycle health management, they are promoting the standardization of online treatment and enhancing the public’s experience with digital health services.

As one of the first multinational pharmaceutical companies to enter the Chinese market, Sanofi has made numerous strategic moves based on its deep expertise in the field of chronic diseases.Dr. Gu Chengming, Head of General Medicines Affairs, Sanofi Greater Chinastated that Sanofi places great emphasis on patient management, saying, “We go all out for anything that benefits patients.”

Over the years of its “Internet + Healthcare” strategic deployment, Sanofi has observed that there is still significant room for improvement in internet-based healthcare regarding medical processes, patient experience, and patient trust. “To address these issues, it is essential to first standardize online practices and enhance the quality of care; secondly, it is crucial to integrate all stages of the patient journey—including pre-consultation appointment scheduling, in-consultation treatment, and post-consultation follow-up—thereby improving patient satisfaction and fostering a positive cycle between physicians and patients.”

Specifically, Sanofi is promoting the standardized development of internet healthcare by formulating industry-standard guidelines and collaborating with industry associations and internet healthcare platforms.

In terms of practical implementation, Sanofi partnered with JD Health to launch the “Internet Center of Excellence for Diabetes Diagnosis and Treatment Service Management” (iCOE). Patient-centric, it provides a one-stop solution addressing three key needs: medical consultation, purchase of pharmaceuticals and medical devices, and long-term chronic disease management. By developing and applying online consultation tools, it promotes standardized diagnosis and treatment practices, having served over 60,000 patients to date. In advancing industry standardization, Sanofi and JD Health jointly supported the release in 2022 ofThe First "Expert Guidance Recommendations for Online Diagnosis, Treatment, and Management of Diabetes in Internet Healthcare in China", to promote the improvement of online diagnosis and treatment service quality for chronic diseases via the Internet, better empower physicians, and benefit patients in China.

In 2022, Sanofi and Zhiyun Health launched a deep strategic partnership, with Sanofi becoming a cornerstone investor in Zhiyun Health. Starting from the field of chronic disease management, the collaboration aims to further enhance online diagnosis and treatment services, strengthen early education and management for chronic diseases, improve the patient experience across the entire health management journey, and conduct valuable explorations of the O2O model in internet healthcare.

Meanwhile, Sanofi is also leveraging digital therapeutics research to achieve high-quality and efficient patient disease management.

In 2022, the introduction of administrative measures for internet-based diagnosis and treatment and online drug sales marked the release of regulatory policies for two key sectors: internet healthcare and pharmaceuticals. These policies have made medical quality and safety a central industry theme, charting a clearer path for healthy sector development while creating broader market space for future innovative practices.

Wang Hang, founder and CEO of Haodf.com, believes that the development of internet healthcare has reached a stage where standardized, high-quality growth is inevitable. As public hospitals make internet hospitals a standard offering,Internet hospitals operated by third-party platform enterprises are destined to once again enter “deep waters.” In future development, the two models can complement each other: public hospital internet hospitals focus on improving treatment adherence for complex and severe cases, while third-party platforms lean more toward serving as decision-support tools for medical consultations and providing long-term care services. The two can collaborate by leveraging physicians, the core medical resource.

Dr. Gu Chengming provided a detailed discussion on three entry points that can drive the high-quality development of internet healthcare:

First, continuously introduce high-level hospitals and high-caliber physicians into internet healthcare.，Integrate online and offline channels organically,Enable more patients to access higher-quality online medical diagnosis and treatment services.

Secondly, systematic healthcare is also of great importance.With the application of artificial intelligence, Sanofi is continuously exploring ways to enhance the quality of diagnosis and treatment in primary healthcare institutions and among primary care physicians. To this end, Sanofi is vigorously advancing physician education to ensure that medical training is effectively implemented at the physician level. Meanwhile, leveraging technological solutions, it provides comprehensive disease-management health services covering the entire patient journey—from screening and diagnosis to treatment and post-discharge management, as well as market education—and is exploring the use of Clinical Decision Support Systems (CDSS) to improve the standardization of medical practice among primary care physicians.

Finally, enhance the integrated management of in-hospital and out-of-hospital care, thereby improving the overall level of medical services.Unlike acute conditions that can be resolved with inpatient treatment, numerous chronic diseases require sustained and effective out-of-hospital management, relying on patients’ high-adherence self-management. Leveraging internet-based healthcare platforms, patients can maintain timely and effective communication with physicians. For instance, individuals with diabetes can learn about insulin injection techniques online and consult their doctors in real time through the platform, thereby continuously improving their self-management capabilities.

At the Internet Healthcare Ecosystem Innovation Summit held on December 2, the Internet Healthcare Ecosystem Club was officially launched, bearing the mission of fostering collaborative cooperation within the industry. The “co-builders” aspire to achieve integration and symbiosis, working together to create a high-quality ecosystem for internet healthcare.

 Representatives from the Chuangqi Health Development Research Institute, Sanofi China, Haixin Zhihui, and Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, jointly attended the inauguration ceremony of the Internet Healthcare Ecosystem Club.

Driven by the iterative development of digital technologies such as the internet, big data, and AI, the internet healthcare industry has accelerated its growth. Patient care experiences, physicians’ diagnostic and treatment efficiency, and drug accessibility have all been optimized. As internet healthcare embodies the fundamental attributes of the healthcare sector, it requires a commitment to long-term operations to build a strong reputation among both patients and providers. In an industry prone to frequent disruptions, stakeholders must adhere to “long-termism,” dedicating themselves to sustained efforts while patiently awaiting fruitful outcomes.