Yixuntong Establishes Over 4,000 Online 'Micro-Clinics' Through Grassroots Family Doctor Support System

In the landscape of China’s new healthcare reform policies—represented by tiered triage, family doctor systems, and integrated medical and elderly care—and within the Healthy China 2030 planning framework, primary care occupies a pivotal position. However, primary care remains the weakest link in China’s healthcare system. This weakness is manifested not only by a lack of equipment and infrastructure but, more critically, by a shortage of qualified primary care professionals, particularly general practitioners.

Mr. Cai Junfang, founder of Yixuntong, and his team have long been committed to grassroots development. After nearly eight years of effort, through continuous practice, trial and error, and communication with various stakeholders, they have developed a model that uses the “Micro-Clinic” as the operational unit, leveraging a “Family Doctor” assistance system to facilitate electronic contract signing and deliver post-signing services.New Model, primarily targeting the management, prevention, and control of chronic diseases at the primary care level, we have initially established commercialized products aligned with the realities of China’s primary healthcare system.

VCBeat (WeChat ID: vcbeat) interviewed Cai Junfang. Below, we share his experiences and insights on launching internet healthcare ventures at the grassroots level.

Yixuntong was established in 2010, a time when tensions between doctors and patients were prominent in society. The government sought to leverage information technology to advance healthcare reform and alleviate these tensions. To this end, Yixuntong entered into a cooperative agreement with the government. Under government leadership, it participated in health informatization initiatives through SMS services and became one of Henan Province’s five major medical informatization centers—specifically, the Doctor-Patient Communication Center. This marked the earliest prototype of the Yixuntong platform.

As an officially approved project of the Henan Provincial Health and Family Planning Commission, Yixuntong has achieved rapid development with government support. Within just one year, it attracted 160,000 registered medical professionals, nearly 500,000 blog posts published by doctors, and provided instant responses to consultation inquiries.

Yixuntong initially focused on enhancing doctor-patient communication and interaction primarily through lightweight consultations and articles published by physicians. Despite possessing substantial physician resources in Henan Province, how to better leverage these resources and establish a viable business model became key considerations for Yixuntong following its initial growth phase.

The Yixuntong team has always maintained that, regardless of how healthcare reform unfolds, physicians remain the most critical factor. Therefore, Yixuntong’s sole strategic direction is to establish a closed-loop healthcare ecosystem by effectively organizing and leveraging its extensive network of physician resources, thereby delivering a broader range of services on its platform rather than limiting itself to lightweight online consultations.

To achieve a closed-loop medical care system, in 2014, Yixuntong innovatively introduced the concept of the “Micro-Clinic,” transplanting the internal ecosystem of hospitals onto the Yixuntong platform. Modeled after the team-building methods for physician groups within hospitals, the Micro-Clinic establishes the roles of Director and Members. The Director can organize physicians of senior, intermediate, and junior levels according to operational needs, assigning tasks and allocating patients. Additionally, as needed, the Director can assemble cross-regional and cross-specialty physicians into a multidisciplinary, multi-regional service team. Leveraging the platform, the Micro-Clinic Director can also generate revenue and distribute profits in accordance with the service workflows and management standards established by the Yixuntong platform.

Based on the micro-clinic model, Yixuntong secured Series A funding from a professional venture capital fund in 2014. For Yixuntong, this investment provided not only financial support but also invaluable guidance from experts with extensive management experience, as well as access to their industry resources in the healthcare sector, all of which have been crucial to the company’s growth.

With capital support, Yixuntong rapidly integrated a batch of offline resources in Henan Province, including hospitals and pharmaceutical companies. It achieved a closed-loop service system on its WeClinic platform, covering electronic prescriptions, medical examinations, two-way referrals, remote consultations, and surgical coordination. Furthermore, it enabled business collaboration, information sharing, and hierarchical referrals among various WeClinics.

The micro-clinic model has stimulated physicians’ enthusiasm, with the transaction volume of electronic prescriptions, referral forms, and test orders within micro-clinics gradually increasing. In the first half of 2016, after Yixuntong completed the closed loop of medical services, it reactivated a portion of its existing physician base, establishing approximately 4,000 micro-clinics and engaging more than 10,000 active physicians.

As the new round of healthcare reform, represented by the family doctor contract service model, deepens, the Yixuntong platform has demonstrated strong vitality through its operational advantages and integration of abundant online medical resources. Building on the micro-clinic team service model, Yixuntong rapidly developed a targeted Family Doctor Assistance System. Under government leadership, the system supports the implementation of family doctor contracting and follow-up services.

Family doctors primarily serve patients with chronic diseases. How can enterprises participate in this field, effectively prevent and control chronic diseases, and generate revenue at the same time? When addressing these issues, Cai Junfang first discussed the core of healthcare reform and the impact of chronic diseases on the national economy.

We know that the earliest disease spectra consisted primarily of infectious and communicable diseases; therefore, the development of the entire healthcare system was predominantly hospital-centric and treatment-oriented. This constitutes the current system, around which the industry chain has been structured—developing various therapeutic products, pharmaceuticals, surgical instruments, and other supplies—that reach hospitals through supply chains.

According to World Health Organization estimates, human life expectancy increases by five years every 15 years. Based on this projection, life expectancy is expected to approach 110–120 years by 2050. In developed countries, greater emphasis is placed on healthy life expectancy rather than overall life expectancy alone. For instance, while the average life expectancy in Beijing is 81 years, the healthy life expectancy is only around 59 years, meaning individuals spend approximately 22 years living with chronic diseases. In contrast, in developed nations such as Japan, the gap between healthy life expectancy and overall life expectancy is merely 8 to 10 years.

On one hand, while life expectancy has increased, the period of life spent in poor health has also lengthened. On the other hand, a more significant issue is that our current healthcare system is ill-equipped to adapt to this demographic shift toward an aging population. As China’s population ages, 80% of the country’s 10 million annual deaths are attributable to chronic diseases, with 75% to 80% of healthcare expenditures dedicated to their management. This imposes an unsustainable burden on the nation. Therefore, healthcare reform must shift away from the current hospital-centric and treatment-focused model toward an integrated approach that combines medical and social services, providing unified management and prevention for chronic diseases. Achieving this transformation requires fully leveraging the role of family physicians.

Such a prevention and control system can only be established at the primary care level. The Yixuntong Chronic Disease Management System builds a service network that permeates primary care settings. Primary care physicians form teams through the Yixuntong "Micro-Clinic," achieving integration across county, township, and village levels, establishing a regional medical service system. This system creates chronic disease management records for patients and provides health assessments, treatment evaluations, guidance, and consultations. Under the supervision of specialists, it establishes effective models for patient education and adherence management. When a patient’s condition changes and exceeds the capacity of primary care physicians or requires expert guidance, they can request consultation from other physicians via the Micro-Clinic. If necessary, real-time connectivity and high-definition video conferencing are available to obtain clear and prompt remote medical guidance. If a patient’s condition requires further medical services, primary care physicians can also provide access to green channels, examinations at partner hospitals, expedited referrals, and electronic prescriptions.

Establishing a chronic disease prevention and control system is the government’s responsibility. As a commercial entity participating in this effort, where does Yixuntong’s business model lie? What drives its sustainable development? If the hospital-centric treatment model is disrupted, how can profitability be achieved through this system?

First, Yixuntong is selective in its patient targeting. Currently, it has identified five major categories of chronic diseases as its primary focus: hepatitis, post-operative cancer rehabilitation, chronic obstructive pulmonary disease (COPD), diabetes and its complications, and hypertension and its complications. It is estimated that there are 25 million individuals with hypertension in Henan Province alone. Within this population, Yixuntong further categorizes grassroots chronic disease patients into three groups. The first group comprises individuals with relatively better economic conditions and higher levels of education. These patients, once educated about their condition, are willing to undergo timely examinations and treatment under medical guidance and are prepared to cover the costs out-of-pocket. This group accounts for approximately one-third of the population and represents the primary target audience. The second group consists of impoverished individuals, supported through collaboration with the government. Yixuntong provides the services, while the Henan Poverty Alleviation Foundation and the government jointly bear the costs associated with ensuring effective treatment for this demographic. The third group relies heavily on basic medical insurance and the New Rural Cooperative Medical Scheme (NRCMS) and demonstrates a low willingness to pay out-of-pocket. Yixuntong has temporarily deferred addressing the needs of this segment, currently focusing only on the two aforementioned groups.

As for the business model, Yixuntong’s current approach is to leverage its service network to provide healthcare entities with incremental services—those that should be delivered but are currently lacking—and share in the revenue generated by these entities from such services.

Cai Junfang believes that to achieve effective chronic disease management and a win-win outcome for all parties, it is essential to establish a new primary healthcare service system—one that is open to society and industry. Yixuntong plays precisely such a role.

Online consultation companies often remain tight-lipped about their revenue. However, given Yixuntong’s clear business model, Cai Junfang confidently stated in response to VCBeat’s question: “Within a few months of launching the Micro-Clinic platform, Yixuntong facilitated over RMB 50 million in transactions, all generated from medical services provided by physicians, who have also benefited significantly. Data shows that doctors at the village and township levels achieved a 30%–50% increase in income by delivering medical services through the Micro-Clinic platform.”

Currently, Yixuntong is signing contracts with local governments by leveraging the physical model of Regional Chronic Disease Management Centers. Under the unified leadership of the government, it coordinates various functional departments at the provincial and county levels—including health, civil affairs, human resources and social security, and finance—and mobilizes social resources to establish a regional system for chronic disease prevention and management.

The Regional Chronic Disease Management Center is a permanent institution that legally and organizationally solidifies regional projects. Within the framework of the Regional Chronic Disease Management Center, we will leverage the operational management advantages of “YiXunTong,” fully utilize governmental administrative efficiency, integrate social resources, and establish an organizational model characterized by complementary strengths, clear division of responsibilities, and orderly supervision.

Currently, Yixuntong is seeking a new round of financing, primarily to expand into 18 county-level regions in 2017 and to achieve breakthroughs in artificial intelligence by leveraging its extensive accumulated medical data. This includes completing product designs for intelligent diagnosis and intelligent training, thereby assisting primary-care physicians in improving their professional capabilities.