From Enterprise Management to Internet Hospital Leadership: Management and Operations Are Drivers, but Medical Capability and Safety Are Fundamental
With the advancement of healthcare reform, the number of internet hospitals on the market continues to grow. Their primary development models fall into three categories: government-led, hospital-led, and enterprise-led.
Among them, enterprise-led internet hospitals provide services to patients through collaborations with one or more offline physical hospitals, such as 39 Internet Hospital, DXY Yinchuan Internet Hospital, and Kangkang Chronic Disease Internet Hospital.
Almond Internet Hospital adopts a fully self-built model, rather than relying entirely on offline physical hospitals for liability and risk management. At its core, Almond enables physicians to engage in multi-site practice at the internet hospital, establishing a unique management framework and operational system.
These entrepreneurs lead the development and management of internet hospitals, with some still in the planning stages and others already operational. How do these entrepreneurs manage and operate internet hospitals? What are their distinguishing characteristics? And how effective is their management?
To this end, VCBeat interviewed the directors of four internet hospitals, including Li Tiantian of DXY Yinchuan Internet Hospital, Martin of Xingren Internet Hospital, Pang Chenglin, General Manager and Executive Director of 39 Internet Hospital, and Zeng Mingfa, founder of Kangkang Chronic Disease Internet Hospital, aiming to address questions surrounding internet hospital management.
Martin, President of Xingren Internet Hospital
The leadership team of Xingren Internet Hospital comprises the President and Vice Presidents. The President is Martin, Founder and CEO of Xingren Doctor. The Vice President is Ms. Xu Lin, Co-founder and COO of Xingren Doctor, who previously managed multiple star products at Tencent, each serving hundreds of millions of users.
Martin has over 19 years of experience in the healthcare sector, spanning clinical practice, hospital management, and healthcare informatics. As a professional specializing in healthcare and technology, he possesses extensive experience in operating China’s largest mobile health platform, Xingren Doctor (which boasts 420,000 real-name verified physicians).
In addition, Martin served as General Manager of Business Development for Siemens Healthineers’ Information Technology Solutions in China (a business unit with global annual revenues exceeding €1 billion), Asia-Pacific Solutions and Clinical Director at iSoft Group (CSC Medical Systems), and Deputy General Manager at United Family Healthcare (China’s first Sino-US joint venture hospital). He previously worked as a clinician in Australian public hospitals and as a medical officer (Lieutenant) in the Royal Australian Navy. He participated in United Nations peacekeeping missions and provided wartime medical logistics support during counter-terrorism operations at the Sydney Olympics.
“An internet hospital not only requires physician management but also the management and operation of a professional practice platform. Previously, I managed United Family Healthcare, the first Sino-American joint venture hospital in China, and founded the Xingren Doctor multi-site practice platform, which also included the construction and operation of offline physical clinics (the Doctor WeWork Multi-Site Practice Studios). Therefore, with my experience in managing both physical hospitals and multi-site practices, overseeing the Xingren Internet Hospital presents little difficulty,” Martin told VCBeat.
“Moreover, I don’t perceive a shift from entrepreneur to hospital president; rather, it has been a natural transition through three stages: from managing a hospital to managing a company, and then seamlessly managing both simultaneously. I excel in both traditional hospital management and internet hospital management extended through the Xingren Platform, which is also inherent in the company’s DNA.”
Three years ago, the Xingren Doctor app was launched with the positioning of being a career development partner for China’s outstanding physicians. Embedded in Xingren’s DNA is a core commitment to helping doctors manage their own practices, a philosophy that stands in stark contrast to the prevailing mindset and experience of most healthcare system administrators, who view physicians merely as employees.
Meanwhile, Xingren has established a streamlined channel for physicians to practice at multiple locations, making multi-site practice more convenient and helping doctors operate and manage their patient bases. The Xingren Internet Hospital serves as another channel for multi-site practice, seamlessly integrating physician-patient communication and patient management platforms through the Xingren Doctor APP.
On this platform, remote consultation services are also provided to patients, integrating offline testing and examination institutions, offering online prescriptions, post-consultation follow-ups, and online prescription renewals. By intelligently connecting medical resources across various regions and collaborating with more payers, the platform helps patients resolve their health issues more efficiently and intelligently, building an internet hospital that establishes a complete, closed-loop ecosystem for the entire diagnosis and treatment process.
In Martin’s view, the launch of internet hospitals by Almond Health effectively extends physicians’ practices into the online realm. It is not merely about providing online consultations alongside offline clinical care; rather, internet hospitals enable a seamless extension that facilitates integrated online-offline diagnosis and treatment for patients. Therefore, the core of managing and operating an internet hospital lies in the management and operation of physicians. In regions such as the United States, Singapore, and Hong Kong, the management of physicians’ multi-site practice is already highly mature. For instance, Parkway and Gleneagles Hospitals in Singapore have established well-developed management models and standards for overseeing physicians’ multi-site practice. In China, driven and accelerated by a series of policies under the new healthcare reform, the access criteria and management frameworks for physicians’ multi-site practice within internet hospitals are also poised to mature rapidly.
Xingren Internet Hospital serves as the indispensable central nervous system within Xingren’s “New Healthcare” ecosystem. It is an essential component in building an efficient and intelligent new healthcare system, acting as a critical hub for connecting core medical resources, delivering efficient and intelligent medical services, and generating a health big data-driven medical cloud infrastructure. The Xingren Medical Cloud comprises several interconnected yet distinct modules—including Electronic Medical Record Cloud, Diagnostic Cloud, Prescription Cloud, Laboratory Testing Cloud, Medical Imaging Cloud, and Genomic Cloud—that function both independently and in synergy. Only through genuine cloud integration can New Healthcare enable doctors and medical institutions to provide truly cross-regional, cross-institutional, and cross-physician intelligent medical services to the public, thereby realizing the national goal of “shared medical resources.”
Especially for patients in regions with underdeveloped medical resources, Xingren Internet Hospital truly enables them to share high-quality medical resources across China. Meanwhile, Xingren leverages its internet hospital as a hub to connect with premium healthcare service providers, jointly building a more intelligent big data center for healthcare and wellness, delivering smart medical services, and ultimately benefiting the entire population and humanity as a whole.
Pang Chenglin, Executive Dean of 39 Internet Hospital
39 Internet Hospital also has two deans: an Executive Dean and a Dean. Mr. Pang Chenglin serves as the Executive Dean and General Manager, while Professor Huo Yong, a renowned cardiovascular expert both in China and abroad, serves as the Dean.
Pang Chenglin graduated from Beijing Medical University (now Peking University Health Science Center) with a bachelor’s degree in Clinical Medicine. He served as a resident physician in the Department of Cardiology at Peking University First Hospital for three years, where he was honored as one of the “Top Ten Outstanding Resident Physicians” at the hospital. From 2006 to 2008, he completed training in the Peking University International MBA Program, and in 2015–2016, he graduated from the China Venture Capital Workshop (Advanced Level, Phase 7).
Meanwhile, he is a senior executive at Longmaster Information & Technology Co., Ltd., a seasoned professional in pharmaceutical marketing and management, and an external mentor for the MBA program at the University of International Business and Economics. He spearheaded the formulation of strategic objectives for the secondary diagnosis of complex and critical cases at 39 Internet Hospital, as well as the establishment of its hospital platform and operational team. Previously, he served as Marketing Director and member of the management team heading the Specialty Care Marketing Department at Bayer, and as Senior Marketing Director at Pfizer. With over 20 years of experience in pharmaceutical marketing and management, his career includes 18 years in the marketing departments of Bayer and Pfizer, approximately three years in sales at Shanghai Roche, and three years of formal residency training in cardiology. He is a veteran pharmaceutical marketing expert who advanced from the roles of medical representative and assistant product manager.
From Pang Chenglin’s perspective, 39 Internet Hospital is, first and foremost, an enterprise. It must adhere to the principles of entrepreneurship and corporate management, with key focus areas including talent acquisition, financial management, product development and R&D, strategic goal-setting and execution, as well as business model establishment and replication. At the same time, it is an internet hospital backed by a physical hospital and licensed by the government as a medical institution. Therefore, its operations must align with the fundamental principles and nature of healthcare—namely, to effectively address patients’ needs and leverage the expertise of medical specialists.
Internet hospitals are merely one form of internet-based healthcare. Pang Chenglin stated, “The essence of internet-based healthcare remains medical care; it must adhere to the oath that health is intertwined with the entrustment of life, and uphold the principle of ‘to comfort always, to help often, and to cure sometimes.’ Through this model, high-quality, standardized, and safe medical services can be efficiently connected and extended to a broader range of healthcare institutions and patients, thereby truly achieving the decentralization of premium medical resources.”
Consequently, Pang Chenglin frequently alternates between the roles of General Manager and Executive Dean. Much like the integration of online and offline services is essential for internet healthcare to closely approximate the on-site clinical experience, these two roles mutually reinforce each other. Therefore, in managing 39 Internet Hospital, Pang Chenglin primarily adopts a two-pronged approach: one focusing on internal corporate operational management systems, and the other on hospital administrative regulations.
His focus is on hospital management, encompassing various systems and standards related to medical regulations; policies and norms concerning the quality and safety of medical services; technical management and safety specifications; and future guidelines for remote consultations across various specialties. Through such standardized management, 39 Internet Hospital has achieved improved medical quality, steady growth in patient volume, an increase in partner medical institutions, and greater satisfaction among senior physicians.
In terms of technology, 39 Internet Hospital has continuously optimized its audio and video technologies to build a medical-grade telemedicine platform. This platform supports various services, including remote consultations for complex and critical cases, remote ward rounds, remote expert outpatient clinics, imaging consultations, live broadcasts of consultations with renowned traditional Chinese medicine experts, and expert visits to grassroots healthcare facilities. The platform was applied in the 2016 Guizhou Medical Poverty Alleviation Project jointly conducted by the China Association for Promoting Democracy (CAPD) and the China Democratic League (CDL), earning praise from Yan Junqi, then Chairperson of the Central Committee of the CAPD.
According to Pang Chenglin, since its launch and operational commencement last June, the provision of telemedicine services to primary healthcare institutions has initially established a replicable model that effectively supports these institutions in implementing tiered diagnosis and treatment. Currently, 39 Internet Hospital has contracted nearly 1,000 renowned experts across various specialties, partnered with approximately 200 medical institutions across 24 provinces and municipalities nationwide, covered 35 clinical specialties, and delivered over 6,000 telemedicine consultations, thereby creating a consultation model that closely aligns with the essence of medical care by providing a strong sense of "on-site presence."
Only business models that delve deeply into operational frameworks and closely align with real-world clinical practices are recognized. Currently, many internet healthcare platforms or online hospitals remain significantly “distant” from clinical practice. It is essential to explore ways to continuously bridge the gap between online and offline services, creating a sense of “presence” akin to traditional medical settings. This integration process of healthcare and the internet will only yield true “Internet + Healthcare” and intelligent healthcare when online and offline medical models and behaviors are tightly integrated, overcoming various barriers in healthcare delivery, and achieving automation, big data utilization, and intelligence.
Pang Chenglin has always adhered to the principle that the essence of internet healthcare remains healthcare itself. He focuses on efficiently connecting and amplifying high-quality, standardized, and safe medical services, thereby truly facilitating the downward distribution of premium medical resources. He aspires to mobilize renowned physicians across the country to support primary care institutions, simplifying access to treatment for patients with complex and critical conditions. His vision includes promoting the implementation of tiered diagnosis and treatment, realizing the professional value of physicians, enhancing their clinical capabilities, and building a respected, domestically leading internet hospital.
Li Tiantian, Founder of DXY
On March 19, at the signing ceremony for Yinchuan Internet Hospital, DXY, a company with years of deep expertise in the healthcare sector, announced that its first Yinchuan DXY Internet Hospital and Big Data Center would be established in Yinchuan.
Li Tiantian told VCBeat: The establishment of the Yinchuan DXY Internet Hospital marks another firm step by DXY in responding to the national call and exploring new models of medical services in the internet era. Meanwhile, this is also a significant move for DXY’s layout in the consumer-facing sector, leveraging its core product, Dingxiang Doctor, to officially upgrade from a light-consultation model of online inquiries to providing comprehensive online diagnosis and treatment services for users.
From the perspective of application scenarios for internet hospitals, leveraging the connectivity enabled by internet technologies—such as shared electronic medical records and high-definition remote audio-video communication—directly facilitates online follow-up consultations and remote specialist consultations between doctors and patients. This ensures that individuals, whether in remote mountainous regions or developed urban areas, can access medical services of equivalent quality, thereby significantly enhancing the utilization efficiency of high-quality medical resources and improving service accessibility. Therefore, online diagnosis and treatment constitute the cornerstone of internet hospital operations.
Regarding the operation of online consultations, DXY developed a WeChat-based application in the summer of 2016. After a six-month trial period, it recorded over 10,000 daily consultations. According to data provided by DXY, this online consultation product, built on the WeChat platform, successfully onboarded more than 10,000 attending physicians from Grade IIIA hospitals within its first six months, despite the absence of large-scale promotional efforts. Currently, the platform receives nearly 10,000 paid consultation inquiries per day, with an average price of RMB 16 per inquiry. In the first quarter, the platform’s monthly transaction volume ranged from a low of RMB 4.3 million to a high of RMB 5.5 million.
Li Tiantian believes that Yinchuan Dingxiang Internet Hospital is positioned as a medical platform institution, which also requires strict control over medical quality. Managing it according to the methods used for physical medical institutions is not feasible. Since there are no medical devices, imaging examinations, hospital beds, or surgical procedures, the management system typically employed by ordinary Grade 3A hospitals is entirely inapplicable.
Therefore, in the process of design management, “I feel it is more like the management of a general practice clinic.” At the time when DXY Clinic was established, its positioning was as a general practice clinic. During the diagnosis and treatment process, the medication guidelines were designed with reference to extensive clinical experience.
Clinical practice has revealed that patients continue to have needs for physician interaction after leaving our clinic. Approximately three days post-visit, many patients provide feedback with questions. It is essential to provide high-quality service to these patients and assist them in resolving health-related issues encountered in their daily lives.
To address this user need, proprietary remote patient support protocols were developed. These protocols are applied to the management of internet hospitals, helping to standardize medical consultation processes and ensure healthcare quality control.
Taking Dingxiang Doctor as an Example: How to Control Medical Quality?
First, strictly control the quality of physicians and evaluate their capabilities in three steps. Not all physicians are qualified to provide online consultations.
Step 1: Invite doctors to join by invitation. Most doctor-patient communication platforms are eager for all doctors to join, allowing any doctor to register.
“We believe that not all doctors are capable of providing remote consultations or diagnoses. Therefore, we only invite doctors we have vetted to serve patients,” said Li Tiantian.
Step 2: After the invitation, an assessment must be conducted before the physician provides services. By posing simulated questions and evaluating the physician’s responses, we assess the quality of their answers.
Step 3: After passing the examination, close attention will be paid to the process of doctors responding to user inquiries during the provision of medical services.
“For instance, if a patient asks a series of questions and the expert responds, ‘Your issue is quite complex. I hold outpatient clinics on Thursdays; please come to my clinic,’ we remove such experts from our platform.” These experts are not genuinely committed to helping users resolve their health concerns but instead seek to divert traffic to the outpatient departments of their affiliated hospitals, which contradicts Dingxiang Doctor’s original mission of assisting users in solving their medical problems.
To ensure fairness, Li Tiantian also introduced a "peer review" mechanism, inviting physicians in the same specialty to evaluate his responses to users, thereby helping the platform jointly identify and control medical quality.
Therefore, it is unfair to physicians to assess their competence solely based on patient reviews from online consultations. Patient satisfaction is a subjective perception, and users lack professional medical background. A physician’s capability must be evaluated by professionals, who should determine eligibility for participation, assess the quality of responses, and establish criteria for removal.
According to Li Tiantian, Yinchuan Dingxiang Internet Hospital achieves commercialization by focusing on chronic disease management. Meanwhile, it adopts a paid model for consultation services. He is more inclined to build an ecosystem or promote a trustworthy business model.
“As a newcomer to the field of internet hospitals, I am still in the process of continuous trial and exploration. Inevitably, I will encounter various pitfalls and obstacles, but I will also accumulate valuable experience. Through our collective efforts, I hope to see this industry continue to improve, enabling people to enjoy better health and suffer less from disease,” said Li Tiantian.
Dean of Kangkang Chronic Disease Internet Hospital: Zeng Mingfa
Kangkang Chronic Disease Internet Hospital was granted an internet hospital license by the Guiyang Municipal Health and Family Planning Commission, with capabilities for appointment registration, fee collection, and issuing electronic prescriptions. Kangkang established its own chronic disease internet hospital to provide users with secondary consultations for chronic conditions via the internet. Its cloud hospital primarily operates through online physicians and physician assistants, delivering timely medical consultations, advice, and medication adjustments based on blood pressure monitoring data (with physician resources provided by Apricot Forest). After medication adjustments, users can place orders directly through the Kangkang Chronic Disease Internet Hospital, and partner pharmaceutical companies or pharmacies will handle home delivery of the medications.
Kangkang Internet Hospital is positioned as an online hospital specializing in chronic disease management, providing only online diagnosis, treatment, and services related to chronic conditions—primarily represented by hypertension and diabetes—rather than operating as a broad, comprehensive general practice hospital.
When discussing internet hospitals, Zeng Mingfa, founder of Kangkang Chronic Disease Internet Hospital, stated bluntly: “There is considerable debate within the industry. The most significant controversy centers on the reliability of online consultations conducted via digital platforms.”
He provided an example: During a consultation at an internet hospital, the patient said, “Dr. [Name], I have stomach pain.”
Doctor: What are the symptoms?
Patient: ...
In such cases, how should physicians determine whether the patient is suffering from food poisoning or early-stage gastric cancer?
“Whether it is traditional Chinese medicine or Western medicine, physicians must rely on the four diagnostic methods—inspection, auscultation and olfaction, inquiry, and palpation—and engage in face-to-face communication with patients. Even ancillary tests may be required to identify the underlying cause of the patient’s condition,” said Zeng Mingfa.
Therefore, in the clinical process of internet hospitals, medical diagnosis cannot be conducted without patients' medical histories and diagnostic testing methods. However, management of chronic diseases is feasible. This is because chronic conditions such as hypertension and diabetes represent health issues that lie on the spectrum between disease and health.
In other words, if a patient’s condition is poorly managed after onset, leading to complications or major comorbidities, it may progress to cerebral infarction or myocardial infarction; however, if well controlled, the condition essentially becomes a matter of lifestyle management.
Meanwhile, chronic diseases are relatively easy to diagnose, as indicated by specific biomarkers, without the need for complex diagnostic procedures. The patient population with chronic conditions is substantial; for instance, the prevalence of hypertension among adults aged 18 and above in China exceeds 25%.
The most significant characteristic of the Internet is that its advantages can only be fully realized with a large user base, thereby improving efficiency at minimal management and operational costs.
Therefore, in the management process of Kangkang Chronic Disease Internet Hospital, Zeng Mingfa places greater emphasis on professional corporate management. Consequently, within the closed-loop chronic disease management system, insurance serves as an indispensable financial tool for controlling medical expenses. Kangkang collaborates with insurance companies (with Taikang Online and ZhongAn Insurance providing insurance partnerships) to bundle sphygmomanometers with insurance services for sale, thereby cultivating users’ habits of blood pressure monitoring to acquire more valid data. Only by leveraging extensive personal data can Kangkang provide effective, real-time chronic disease management services to patients.
Another key player in the closed-loop chronic disease management ecosystem is pharmaceutical companies (such as Yiling Pharmaceutical and Dekai Medicine, which provide pharmaceutical distribution services). By leveraging continuous blood pressure monitoring data from Kangkang Blood Pressure, these companies gain data support for new drug development and precision marketing. In particular, Yiling Pharmaceutical, a partner of Kangkang Blood Pressure, is dedicated to the research and development of traditional Chinese medicines for conditions such as coronary heart disease and angina pectoris, and participates in the establishment of Kangkang’s Internet Hospital for Chronic Diseases in the capacity of chronic disease prevention and management.
Kangkang Blood Pressure has established the Kangkang Chronic Disease Internet Hospital, where initial consultations are conducted at the community level, and online medical services are limited to chronic disease management and remote chronic care enrollment. This approach is adopted because chronic diseases are relatively easy to diagnose and affect a broad population. While genuine acute or complex conditions cannot be adequately addressed via the internet, chronic diseases present a viable opportunity for digital healthcare. Once diagnosed, chronic diseases cannot be cured in a hospital setting; instead, they require long-term intervention and comprehensive health management. In response to this need, Kangkang Blood Pressure has developed a management solution combining big data with wearable devices, enabling medical-grade remote monitoring of chronic conditions at home, allowing patients to track changes in their physiological indicators and symptoms anytime, anywhere.
Kangkang Blood Pressure has launched the “Shuangquan Initiative,” aiming to create a hospital without walls. The full name of the “Shuangquan Initiative” is Comprehensive Screening and Whole-Process Management, a methodology for chronic disease prevention and control systems represented by hypertension and diabetes. Inheriting from China’s first chronic disease prevention and control network established at Beijing Shougang by experts such as Wu Yingkai and Liu Lisheng, this initiative effectively reduces the incidence of hypertension-related complications and has gained recognition in global hypertension prevention and control efforts.
Its primary approach involves leveraging primary healthcare institutions as the main platform to effectively integrate internet-based medical services with traditional healthcare. First, Kangkang Blood Pressure establishes medical workstations centered on primary healthcare institutions, serving as service hubs for residents within their jurisdictions. Then, it extends its reach through IoT-enabled devices to facilitate remote management. Kangkang Blood Pressure provides a comprehensive solution that combines wearable ambulatory blood pressure monitors with remote smart blood pressure meters, enabling medical-grade home monitoring. Data can be uploaded and shared in real time, ensuring effective remote home care and addressing the "last mile" challenge in chronic disease management.