How Medical-Grade Wearables Are Reshaping Cardiovascular Care in a Trillion-Yuan Market

As the population ages and chronic diseases increasingly affect younger individuals, China has entered a period of high prevalence for chronic conditions. The number of patients with chronic diseases such as cardiovascular disease is rising year by year. Facing a vast patient population numbering in the hundreds of millions, the management of cardiovascular disease is poised to create a rapidly growing market worth hundreds of billions of yuan (including markets for pharmaceuticals, medical wearable devices, etc.).

How to transform the previously extensive patient management model and better manage patients with cardiovascular diseases in today’s era of interconnectivity is undoubtedly a question worth considering.

In light of this, as World Hypertension Day (May 17) and National Vascular Health Day (May 18) approach, VCBeat has partnered with JD Health to release the “2021 Internet Cardiovascular Disease Management Insights,” exploring how the internet can better empower the management of cardiovascular disease patients, achieve data connectivity, and support comprehensive lifecycle management encompassing prevention, treatment, and rehabilitation.

Recently, the main data from the Seventh National Population Census were released. The data show that China’s total population stands at 1.41178 billion, an increase of 72.06 million compared with the 1.33972 billion recorded in the Sixth National Population Census in 2010. Among them, the population aged 60 and above reached 264.02 million, accounting for 18.70% of the total. Compared with 2010, the proportion of the population aged 60 and above rose by 5.44 percentage points. The growth in the population base and the deepening aging of the population will both affect the number of patients with cardiovascular diseases.

The situation we face is not optimistic. In our report, we point out that the current number of prevalent cases of cardiovascular disease has reached 330 million, and the mortality burden from cardiovascular diseases remains severe. According to the China Health Statistics Yearbook 2020, the age-specific and cause-specific mortality rates (per 100,000 population) among urban residents in 2019 showed that diseases of the circulatory system (including heart disease, other hypertensive diseases, cerebrovascular diseases, etc.) accounted for 286.31 per 100,000, far higher than the rate for malignant tumors at 161.56 per 100,000. Among rural residents in 2019, the age-specific and cause-specific mortality rate (per 100,000 population) for diseases of the circulatory system was 330.61 per 100,000, also significantly exceeding the rate for malignant tumors at 160.06 per 100,000.

In this context, the Healthy China Action (2019–2030) mandates that the mortality rate of cardiovascular and cerebrovascular diseases be reduced to 209.7 per 100,000 population or lower by 2022, and to 190.7 per 100,000 population or lower by 2030.

To achieve this goal, it is necessary to actively implement preventive measures for the population at risk of cardiovascular disease (pre-disease stage) and strengthen management for those already diagnosed, thereby controlling the number of new cases and reducing the mortality rate among existing patients due to cardiovascular disease.

The “prevention + management” strategy has been effectively implemented. In response to a proposal on “strengthening the prevention of heart disease,” the National Health Commission stated:

However, cardiovascular disease rehabilitation still faces significant challenges. Taking cardiac rehabilitation for heart disease patients as an example, as we pointed out in our report, “only 13.2 Grade A tertiary hospitals per 100 million people are capable of providing cardiac rehabilitation services,” leaving a large number of patients to undergo rehabilitation outside the hospital setting. Due to the scarcity of medical resources, many hospitals are unable to devote sufficient attention to rehabilitative care, forcing patients with other cardiovascular conditions to also opt for out-of-hospital rehabilitation management.

Healthcare inherently encompasses the entire continuum of care, including pre-diagnosis, during-diagnosis, and post-diagnosis stages. However, due to current constraints, hospitals are often only able to ensure the quality of care during the diagnosis and treatment phase. The National Health Commission has pointed out that the next step is to continue “promoting the integrated development of disease prevention, treatment, rehabilitation, and management, and effectively carrying out cardiovascular disease prevention and control work.” Improving the pre- and post-diagnosis phases requires leveraging the internet as a connector between online and offline services.

In the report, we highlight that patients with cardiovascular diseases currently have needs for medical consultations and medication, device monitoring, and healthcare services. A significant portion of these needs is not adequately met through offline channels. Leveraging its supply chain capabilities and internet-based medical services, JD Health provides users and patients with a range of health and medical services, including online consultations, health advice, home delivery of medications, and disease education.

On the JD Health platform, 41% of users seeking consultations for cardiovascular issues come from fourth-tier cities and below. While this partly reflects the platform’s overall user distribution, it also highlights a strong demand for medical care among patients in areas with limited access to healthcare resources. Digital healthcare providers, such as internet hospitals, are well-positioned to meet this need.

In fact, in 2020, as the COVID-19 pandemic disrupted offline medical visits, the advantages of online consultations were further amplified. On March 23 this year, Mao Qun’an, Director of the Planning Department of the National Health Commission, stated that, according to incomplete statistics, more than 7,700 hospitals at the secondary level and above have established appointment-based diagnosis and treatment systems, and the number of internet hospitals built across China has exceeded 1,100. The number of internet hospitals nearly doubled over the past year. As of December 31, 2020, JD Health’s internet hospital platform had onboarded more than 110,000 physicians, with an average daily volume of online consultations exceeding 100,000 throughout 2020.

Online, internet healthcare can address challenges such as pre-consultation inquiries, post-diagnosis rehabilitation, and patient management.

As clinical medicine becomes increasingly specialized, cardiovascular patients often struggle to determine which department to consult when seeking medical advice. Online healthcare services can address this issue. By engaging in pre-consultation with online physicians, patients can gain a comprehensive understanding of their condition and identify the appropriate department for registration. In contrast, under the traditional offline model, patients previously had to inquire across multiple departments, which not only increased their out-of-pocket expenses but also delayed diagnosis and treatment.

In-hospital rehabilitation outcomes are often superior to those achieved in out-of-hospital settings, partly because inpatients receive intensive care from medical professionals. In contrast, out-of-hospital rehabilitation frequently yields suboptimal results due to the lack of intensive supervision and poor patient adherence. Internet-based healthcare enables continuous patient engagement by delivering timely reminders for medication and exercise via mobile apps, and even facilitates better patient management by monitoring abnormal data through medical-grade wearable devices.

However, with the development of internet healthcare, an increasing number of internet healthcare enterprises have recognized that offline service support is essential to fully unlock the value of internet healthcare. Internet healthcare platforms are also continuously collaborating with hospitals in this process, focusing on strengthening diagnostic and treatment services. For instance, when an online physician determines that a follow-up patient needs an in-person visit, the platform provides services for offline registration and face-to-face consultation appointments. In terms of medication management, companies like JD Health leverage their self-operated JD Pharmacy, the JD Health Alliance Pharmacy network, and automated medicine vending machines, along with their O2O service “JD Medicine Express” covering more than 300 cities, to provide users with convenient and efficient pharmaceutical services.

Internet healthcare has thus established an integrated online-offline service model covering pre-consultation, in-consultation diagnosis and treatment, and post-consultation rehabilitation and patient management. Among these, patient management is particularly crucial.

Among patient needs, we highlight that beyond consultations and prescription services, the greatest demand stems from medical device monitoring and treatment. Typically, upon discharge, physicians merely advise cardiovascular disease patients to monitor relevant data in a timely manner and return to the hospital promptly if any abnormalities are detected.

Patient self-management is often conducted outside the hospital. As an increasing number of patients recover in out-of-hospital settings and utilize medical wearable devices for monitoring, the volume of data recorded by these devices is experiencing exponential growth. It is worth noting that although major internet companies are actively exploring the rational utilization of data from medical wearable devices, data generated through out-of-hospital monitoring often fails to be integrated into in-hospital diagnosis and treatment scenarios. Consequently, the value of this data is frequently underutilized. How can its inherent value be better realized? This is a question worthy of consideration for both medical device manufacturers and patients.

JD Health has also partnered with health monitoring brands during this process, extending medical scenarios into daily life, breaking down traditional medical information silos through big data in healthcare, and achieving full-lifecycle health management for users.

In fact, medical wearable products can be defined by their core functions into three modules: the first module primarily handles the acquisition and recording of physiological data, as well as automated analysis and feedback from the device itself; the second module enables the sharing of monitored data and result feedback through connectivity with the Medical Internet of Things (IoMT); and the third module establishes a scientifically effective emergency response system for disease onset in patients.

In the report, we highlighted some of the dilemmas currently faced by patients:

These challenges align precisely with the core functional modules of medical wearable devices. The issue lies in two aspects: on one hand, some patients lack the habit of disease monitoring; on the other hand, even among those who do monitor their conditions, data interoperability—particularly a comprehensive system for emergency response during disease episodes—has not been effectively established. One thing is certain: as users strengthen self-management and increase their use of wearable medical devices, this trend, built upon extensive connectivity, will further incentivize major internet companies to invest in and integrate relevant components, thereby establishing effective systems for consultation and treatment.

Medical wearable devices enable real-time sharing and analysis of user health data. Leveraging monitoring data, AI models on real-time cloud platforms can calculate risks, issue alerts for abnormal findings, and prompt users with health risks to seek timely medical attention, thereby preventing severe complications. Relevant data generated during patient episodes can also be integrated into offline clinical settings via the platform to aid diagnosis. In this way, companies such as JD Health are gradually bridging the gap between monitoring data from medical wearables and physicians.

In the management of chronic diseases, considering factors such as labor costs, the use of digital-intelligent systems to manage real-time patient data will become a future trend. Leveraging technologies such as big data, the Internet of Things (IoT), and artificial intelligence will better support physicians and empower the prevention and management of cardiovascular diseases. In the future, establishing connectivity between physicians and data is expected to further break down information silos between in-hospital and out-of-hospital settings, thereby driving the healthcare industry toward higher quality, greater efficiency, enhanced equity, and improved sustainability.

We also noted in the report that the wearable medical device market will reach a market size of over $6 billion in 2023. But this is just the beginning. As people become more concerned about their own health, the market for wearable medical devices will continue to expand.

By leveraging technology-enabled solutions, such as remote consultations, the potential of medical experts can be maximized, allowing patients to access professional healthcare services from top-tier specialists without leaving their homes. Meanwhile, gradually strengthening primary care capabilities will help alleviate the overcrowding at large hospitals caused by an influx of patients with minor ailments, thereby further promoting the implementation of tiered diagnosis and treatment.

Core health monitoring data will initially support the prevention and rehabilitation of cardiovascular disease patients, gradually evolving to facilitate scientific research analysis through advancements in medical technology. This progression will enable deep medical differentiation among populations with distinct disease characteristics, ultimately achieving precision medicine and beyond.