DXY Founder Li Tiantian on China's New Internet Healthcare Regulations: Committed to Primary Care with Minimal Business Impact
On September 14, 2018, the National Health Commission issued three documents: “Administrative Measures for Internet-based Diagnosis and Treatment (Trial),” “Administrative Measures for Internet Hospitals (Trial),” and “Specification for the Management of Telemedicine Services (Trial).”
With this, the long-anticipated new policies on internet healthcare have finally been finalized. The announcement immediately sparked intense discussion within the industry. For existing internet healthcare companies, adjusting and refining their current business models within the regulatory red lines set by the new policies has become a Damocles’ sword hanging over every entrepreneur’s head.
“Highly innovative and forward-looking, it requires pioneering efforts and pilot trials, but a ‘one-size-fits-all’ approach must be avoided.” On that day, Li Tiantian, founder and chairman of the internet healthcare company DXY, expressed this view in an interview with CCTV’s “News 1+1.”
Li Tiantian stated that the new policy has played a role in clarifying definitions, standardizing services, and mitigating risks for the entire internet healthcare industry. As an industry practitioner, he expressed his appreciation for the release of such clear and specific guidance.
As early as April 28, 2018, the General Office of the State Council issued the “Guiding Opinions on Promoting the Development of ‘Internet + Healthcare’,” followed by more detailed industry implementation guidelines released by the National Health Commission. It is understood that, prior to the introduction of these new policies, the National Health Commission invited several entrepreneurs, including those from DXY.cn, to participate in multiple closed-door discussions to ensure policy transparency and practicality. The suggestions and recommendations put forward by DXY.cn and other enterprises were adopted by the National Health Commission and ultimately incorporated into the final document.
Li Tiantian believes that the new policy is highly innovative and forward-looking; therefore, a “one-size-fits-all” approach should be avoided during implementation. Instead, pilot explorations should be conducted in environments where conditions are favorable and regulatory oversight is robust.
When it comes to specific provisions, such as the regulation in the document that “prohibits initial online consultations,” Li Tiantian, a clinician with a background in neurology, highly acknowledges the regulatory authorities’ original intention of ensuring the quality of medical services and safeguarding patients’ lives. However, he also put forward his own views on the prohibition of initial online consultations.
“Indeed, some diseases can be clearly diagnosed and treated through simple consultations or image recognition. Therefore, pilot programs should be launched for specific conditions where regulatory frameworks are in place, rather than imposing outright bans that stifle pathways to breakthrough innovations in certain fields.”
“In fact, the United States has been conducting initial consultations online for many years, and currently, about 50 states across the country support ‘online initial consultations.’” Li Tiantian added, “Of course, safety is a necessary prerequisite for all medical practices.”
In 2017, DXY applied for an internet hospital license in Yinchuan and obtained the relevant qualifications and permits. Currently, approximately 50,000 physicians across China are registered with the Yinchuan Health and Family Planning Commission and the big data regulatory platform through multi-site practice arrangements, providing services to users via the Yinchuan DXY Internet Hospital.
Furthermore, as early as 2015, DXY began investing heavily in establishing offline general practice clinics, becoming a pioneer among internet healthcare companies in transitioning to “offline services.” It is reported that DXY has currently established two wholly-owned DXY Clinics each in Hangzhou and Fuzhou, demonstrating strong growth momentum and enjoying an excellent public reputation.
Therefore, regarding the new policy’s requirement that “internet hospitals must be affiliated with offline physical medical institutions,” Li Tiantian candidly acknowledged that “the new regulations on internet healthcare will not significantly impact DXY’s existing business.” In addition, DXY has established a deep collaborative partnership with a local Grade A tertiary hospital in Yinchuan, leveraging this institution to provide online diagnosis and treatment services, thereby establishing a “double safeguard” to ensure compliance with the new regulatory requirements.
Meanwhile, Dingxiang Clinic has been positioned as a general practice facility since its inception, offering departments including internal medicine, surgery, gynecology, pediatrics, and general practice. This structure also aligns with the new policy requirements, such as the mandate that “the clinical department setup of an internet hospital must be consistent with that of the physical medical institution it relies on.”
During the interview, Li Tiantian repeatedly emphasized that DXY is committed to providing primary medical and health services—both online and offline—focusing on the diagnosis and treatment of common, chronic, and frequently occurring diseases, as well as serving a large population with healthcare needs.
“Currently, many public hospitals offer services that are primarily oriented toward specialty development. They focus on more narrowly defined specialty diseases, and even the diagnosis and treatment of relatively rare and complex conditions. In contrast, private healthcare providers such as DXY place greater emphasis on basic medical services, including community health care, public health, and preventive health education. This differentiates them from the specialty-focused positioning of public hospitals, enabling them to serve as complementary allies working alongside public hospitals to jointly advance the realization of the Healthy China 2030 strategy.”
When discussing DXY’s understanding of internet healthcare, Li Tiantian believes that internet healthcare can provide comprehensive, holistic, and continuous services, including online medical education, consultation and diagnosis, online courses, and chronic disease management via smart wearable devices.
Li Tiantian has his own theory—the “ICE” model—which the media has interpreted as “breaking the ice with ICE”: using DXY’s “ICE” to break the hard ice of China’s healthcare system.
“I” stands for “information,” referring to DXY Doctor, the health science popularization media matrix under DXY. In 2017 alone, DXY Doctor’s platforms accumulated a total of 3.17 billion reads, meeting users’ desire to “take a look.”
C stands for Communication, representing interaction. Specifically, the DXY Doctor app provides medical consultation services to users through online diagnosis and treatment, addressing their need to “ask questions.”
E stands for Engagement, representing deeper levels of interaction. For instance, at Dingxiang Clinic, users can return to offline settings for face-to-face consultations and diagnoses with physicians when their concerns remain unresolved through preliminary online inquiries. Similarly, Dingxiang Mom Academy provides young mothers with long-term access to online expert-led courses and interactive sessions through digital learning platforms.
In the field of chronic disease management, DXY, Tencent, and Eli Lilly have formed a tripartite partnership to provide blood glucose management services to over 100,000 patients with diabetes through an industry-first paid model, resulting in significant improvements in glycemic control.
Li Tiantian is optimistic about the development of internet healthcare following the introduction of new policies. He stated that internet healthcare has never played the role of a disruptor; with the acceleration of technological innovation, there remains significant room for improvement and refinement in its innovative service models.
He hopes that the new policy on internet healthcare will also “protect innovation and offer the industry greater inclusiveness and openness” during its implementation.