Shangyi Zhilian: Empowering Primary Healthcare through a Digital Platform Focused on China's Third-Tier Medical Market

In 2016, Zhai Chunjiu embarked on his first entrepreneurial venture in the “Third-Terminal + Internet” project.

The Third Terminal refers to all retail channels that directly sell pharmaceuticals and health products to consumers, excluding hospital pharmacies and retail drugstores. The Third Terminal encompasses vast rural areas and urban residential communities, including individual clinics in communities and rural regions. The medication usage characteristics of the Third Terminal market differ from those of the First and Second Terminals. Sales primarily consist of general medicines, common drugs, and medications for chronic diseases.

Doctors are the primary retail entities in the third-tier terminal. Due to the unique nature of their profession and the healthcare system, they serve not only as physicians dedicated to saving lives but also as individual business operators.

Due to a lack of medical knowledge, many patients fail to understand or accept treatment plans, leading to medication non-adherence. The phenomenon of avoiding medical care due to fear or denial is also prevalent in primary healthcare markets. Many patients are uninformed about chronic diseases and may not even realize they are ill. As these “patients” do not seek medical attention, grassroots individual clinics see few visitors, making it challenging for clinics primarily focused on chronic disease management to survive.

“Medical services and commercial value can coexist, which is also in line with the laws of market value. Over a decade of product sales and promotion, we have accumulated extensive industry experience. In response to clients’ personalized needs, we are capable of proposing innovative solutions tailored to their specific requirements,” said Zhai Chunjiu. “The goal of Shangyi Zhilian is to help primary-care physicians build profitable clinics.”

Recognizing the development challenges facing primary healthcare and the true incidence of chronic diseases in rural areas, she began to focus intently on grassroots clinics and rural medical services. Since 2010, she and her partners have been working diligently in this field for a decade.

In 2017, Zhai Chunjiu spearheaded the establishment of the “Urban-Rural Chronic Disease Prevention and Control” project under the Rural Doctors Branch of the Chinese Medical Doctor Association, serving as the Executive Director of its Executive Office. In this capacity, he oversaw the advancement of urban-rural chronic disease prevention and control initiatives and implemented precision-based strategies for chronic disease management. The project aims to effectively control chronic diseases, bring health and safety closer to the public, and contribute to alleviating the burden of chronic diseases among the general population, particularly rural residents who face significant barriers in accessing medical services.

Subsequently, the project team began to leverage the Internet to promote more scientifically sound and rational clinical diagnosis and treatment protocols at the primary care level through commercial means. After undergoing refinement and detailing, the project was ultimately discontinued; consequently, the team decided to establish a company to operate this internet-based chronic disease prevention and control initiative.

In 2018, Shangyi Zhilian (Guangzhou) Health Technology Co., Ltd. was established, dedicated to providing comprehensive services such as “medical + internet” products and medical education and training to primary care clinics.

“Shangyi” is a homophone for “Shang Yi” (Superior Physician). The Yellow Emperor’s Inner Canon states: “Superior physicians treat disease before it arises; intermediate physicians treat disease on the verge of arising; and inferior physicians treat disease after it has arisen.” This means that the most skilled doctors prevent diseases before they occur, moderately skilled doctors address conditions in their early stages, and ordinary doctors treat established diseases. Shangyi Zhilian aims to connect these “superior physicians” through the internet to benefit the public.

Founder Zhai Chunjiu has dedicated twenty years to the pharmaceutical industry, accumulating extensive experience and unique insights in brand building, team management, and channel development (including OTC chains and the tertiary terminal). The Shangyi Zhilian team is primarily composed of industry sales elites, internet technology engineers, and medical service experts, who bring rich sales experience and channel resources. In response to the small-scale and dispersed nature of grassroots medical units, Shangyi Zhilian has built a cohesive 200-member ground promotion team.

To meet the grassroots patients’ demand for “access to quality medications and appropriate medication use,” Shangyi Zhilian has partnered with pharmaceutical companies such as Zhongzhi Pharmaceutical Group and Tianqin Pharmaceuticals. Furthermore, through its strategic partnership with Dongchuang Holdings, it has augmented resources including physician groups, hospitals, medical technologies, pharmaceutical e-commerce platforms, drug distribution qualifications, and pharmaceutical care service capabilities, thereby enabling grassroots physicians to better deliver high-quality resources.

As the nation intensifies its promotion of tiered diagnosis and treatment, primary healthcare institutions in China are ushering in a “springtime.” Building on this momentum, Shangyi Zhilian, in collaboration with its partners, has established a primary care platform integrating “Internet + Primary Healthcare + Online Product Supply.”

Jiuyime - Primary Care Platform (Image from the company)

By providing outpatient care management services, smart medical devices, safe and reliable products, and comprehensive operational support, Shangyi Zhilian has established long-term and stable product-and-service relationships with primary care physicians.

For Primary Care Physicians:Shangyi Zhilian has co-developed the "Outpatient Steward" system, which provides services such as online appointment registration, retention of outpatient medical records and medication histories, as well as inventory management and operational statistics.For Grassroots Residents:Shangyi Zhilian has independently developed “Jiuyime,” providing services such as appointment scheduling and registration, medication reminders, access to medical visit records, and self-service medication purchases.

Currently, Shangyi Zhilian has onboarded its first batch of seed users, comprising 50 primary-care physicians. Most of these clients are currently utilizing the drug inventory and supply chain management module, and their feedback is being collected and analyzed. Based on input from these initial users, Shangyi Zhilian has finalized its development prototype, with a planned launch in the second quarter of 2020.

In April 2019, Shangyi Zhilian secured first place in the Biomedical Specialty Competition of the 6th Guangzhou Youth Innovation and Entrepreneurship Contest, known as the “Qingchuang Cup.” Zhai Chunjiu stated, “This award represents societal recognition of Shangyi Zhilian. We will continue our efforts to facilitate the decentralization of high-quality medical resources, enhance the information infrastructure of primary care clinics, provide high-quality, comprehensive, and systematic pharmaceutical products, improve the skills of primary care physicians, and empower grassroots healthcare.”

From the perspective of Shangyi Zhilian, the persistent challenge remains that the limited medical expertise of primary care physicians fails to meet the healthcare needs of the local population. To truly address the issues in primary healthcare, it is essential to enhance the quality of services provided by primary care physicians.

Shangyi Zhilian is deeply committed to grassroots medical channels, dedicated to providing professional and comprehensive academic support to primary care physicians. We also encourage primary care physicians to fully leverage the distinctive advantages of Traditional Chinese Medicine (TCM), with medical technology as the foundation and information platforms as the link, by partnering with tiered hospitals to channel high-quality medical resources down to the grassroots level. This ensures that communities at the grassroots level truly benefit from higher-quality, more efficient, convenient, and affordable medical services.

Given the large population of left-behind elderly individuals in primary care settings and the rising prevalence of chronic diseases, Shangyi Zhilian collaborates with tiered medical institutions, regional medical centers, and renowned veteran practitioners of Traditional Chinese Medicine (TCM) to deliver TCM training programs focused on appropriate technologies in pediatrics, gynecology, geriatrics, and TCM physiotherapy. Within its medical training module, Shangyi Zhilian has launched two flagship academic initiatives: the Study Tour Program at Macau University of Science and Technology, and the Advanced Clinical Training Program in TCM Gynecology for Primary Care Physicians.

In May and August 2019, Shangyi Zhilian held two sessions of the “Clinical Training and Advancement Program in Traditional Chinese Medicine Gynecology for Primary Care Physicians,” with more than 260 primary care physicians participating. The offline course on appropriate technologies for postpartum recovery was offered for nine consecutive sessions, and over 200 academic promotion conferences were conducted either independently by provincial branches or jointly with the headquarters.

Affected by the pandemic, Shangyi Zhilian canceled the training activities originally scheduled for March and instead launched a Cloud Classroom to continuously provide professional training for physicians. To date, eight sessions have been conducted, with cumulative participation exceeding 2,000 attendees.

Since its inception, Shangyi Zhilian has conducted academic conferences on a county-and-district basis. In 2019 alone, it held over 200 sessions, with more than 2,000 physician participants in total.

Currently, Shangyi Zhilian’s existing service tools are still undergoing refinement and improvement. Given that pharmaceuticals are specialized commodities, Shangyi Zhilian’s goal for this year is to complete the integration of upstream pharmaceuticals and laboratory testing equipment. Looking ahead, Shangyi Zhilian will leverage medical technology as its foundation and information platforms as its nexus to partner with tiered hospitals, facilitating the downward flow of high-quality medical resources. This initiative aims to ensure that grassroots populations genuinely benefit from higher-quality, more efficient, convenient, and affordable medical services, positioning “Jiuyime – Grassroots Medical Care Platform” as the preferred choice for primary care patients and achieving synchronization between grassroots healthcare and tiered hospital care.