2016 in Mobile Healthcare: Change Is Coming

"As a practitioner in the mobile health industry, looking back at 2015, I still have significant regrets."

Over the past year, the mobile health sector—and indeed the broader internet healthcare industry—has witnessed some positive developments. However, in the face of the deep-seated issue of doctor-patient conflict, many of these efforts have been superficial at best; to put it more diplomatically, any achievements made have amounted to only marginal improvements.

The frequent outbreaks of doctor-patient conflicts, along with the recent “exorbitantly priced scalper appointments” incident, have drawn greater public attention to China’s doctor-patient issues. In my view, one of the root causes of these medical challenges lies in the imbalance between supply and demand, while another stems from restrictions on independent practice imposed by the healthcare system. These two underlying issues are mutually causal.

Regarding the latter, extensive discussion is clearly not feasible at present; therefore, we will focus on the first issue. From the perspective of supply and demand, there is insufficient supply-side resources, uneven resource allocation, and low resource utilization efficiency, while demand continues to grow. At a macro level, to alleviate this problem, several potential approaches can be broadly identified as follows:

First, enhance supply capacity by increasing the number of healthcare professionals and boosting medical investment. However, given the current situation, it is unrealistic to significantly increase the number of healthcare workers in the short term. The medical field has its unique characteristics; practitioners must meet specific standards to be licensed. Moreover, training qualified professionals is a lengthy process that cannot be rushed.

On the contrary, due to poor practice environments, frequent risks, and inadequate financial incentives, qualified medical professionals continue to leave the field at a rapid pace, undoubtedly exacerbating the current situation. The “multi-site practice” model anticipated by Chinese physicians remains only in its pilot phase, while the long-awaited “independent private practice” is still nowhere in sight.

In the past year or two, numerous startups have emerged to provide services and products tailored to physicians. As capital investment heated up, some mobile health app teams, drawing on O2O models, began aggressively “capturing” physician users at any cost, leading to a situation where there were too many medical apps and not enough doctors to go around. For these healthcare teams, the critical question they must now address is what to do next after acquiring physician users.

Second, improve the efficiency of medical resources. In the short term, enhancing the processes and efficiency of the existing hospital system also requires considerable patience.

Currently, we are only seeing some medical institutions begin to leverage the power of the internet for marginal improvements in service processes. For instance, appointment registration can now be done via WeChat or certain medical apps, representing a degree of incremental enhancement. However, there is still no visible potential for improving the overall patient experience throughout the healthcare journey, and inefficiency remains prevalent.

Is it possible to improve physicians’ efficiency? There is indeed some potential. After all, medicine is a field that requires continuous learning. If practitioners can leverage new media channels and technological tools to enable the medical community to learn rapidly, access the latest medical knowledge in real time, and acquire new treatment modalities, this will undoubtedly have a positive impact on the industry. However, this remains a gradual process.

Third, optimize patients’ demand for medical services. However, a key premise is that a decline in healthcare demand is unlikely in China; in the face of an increasingly severe aging population, demand for medical services will continue to rise.

The current situation raises the question of whether medical demand for common diseases and certain chronic conditions can be diverted to secondary hospitals, rather than having all patients flock to tertiary Grade A hospitals. Cognitive biases among patients regarding healthcare have led to a severe imbalance in the allocation of medical resources, creating a vicious cycle. Tertiary Grade A hospitals are unable to provide sufficient service resources to all visiting patients, resulting in low patient satisfaction.

Is it possible to guide the growing demands of the patient population, thereby alleviating pressure on the healthcare system? The government is actively promoting a tiered diagnosis and treatment policy; however, this issue can only be mitigated if the general public possesses a basic scientific understanding of medicine and health, eliminating unnecessary misconceptions. Cultivating public awareness requires long-term investment. Fortunately, channels such as WeChat Official Accounts now enable more effective information dissemination, reducing the cost of user education.

I believe the aforementioned aspects constitute the “rigid” challenges currently facing the healthcare industry. Developing mobile health or internet-based healthcare solutions while bypassing these critical links holds little significance.

In the past few years, we have witnessed numerous startup teams making attempts in various directions, ranging from cultivating patient-centric communities at the outset to leveraging new technologies and products to facilitate doctor-patient matchmaking. By 2015, a growing number of startups had come to realize the importance of securing “physicians” as a core resource.

But what can be done after acquiring physician users? Will patients continue to flock to the platform once physicians are on board? We do not see this possibility.

The unique nature of healthcare dictates that delivering medical services via mobile networks is largely impractical, as it faces significant constraints from both regulatory restrictions and specific operational scenarios.

We should honestly acknowledge that mobile internet is not a panacea and does not work well for the healthcare industry.

The new problems arising from these attempts are the high costs of subsidizing both physicians and patients. After acquiring physician users, can their efficiency be fully leveraged? It cannot be considered efficient to simply have physicians sit in front of computers and answer hundreds of online inquiries every day. If the answer is no, then such efforts undoubtedly make matters worse. Furthermore, this model appears too lightweight regardless of perspective, with overly singular scenarios. While it would be overly arbitrary to claim it has no value at all, it amounts to, at best, a peripheral service, much like appointment registration.

What Are the Possibilities for Mobile Health and Internet-Based Healthcare in the Coming Years? In My View, One Likely Scenario Is the Emergence of a Large Number of New Types of Diagnostic and Treatment Institutions Leveraging the Internet and Information Technology.

These novel diagnosis and treatment institutions have the potential to reconstruct the entire healthcare process. Even their clinic management systems are independently developed, with a patient-centric approach. They are committed to providing more effective treatments, better clinical environments, more efficient visits, and higher patient satisfaction. Clinics of this model are currently the scarcest resource; once they achieve scale, they will exert a catalyst effect, bolstering confidence among more practitioners and offering an opportunity to transform people’s long-standing perceptions of healthcare.

Some practitioners may disagree with my view, as brick-and-mortar clinics are asset-heavy and seem inconsistent with typical internet business models, while also demanding substantial cost investment. This is a reasonable concern; the industry tends to prioritize immediate results, with few willing to pursue strategies that are “inefficient in the short term but highly efficient in the long run.”

Standardize clinic construction, optimize the patient journey, and effectively integrate with online services. In the short term, this is inevitably an inefficient endeavor; however, once standards are established, rapid replication and scaling become possible, ultimately achieving relative efficiency. Without such deliberate and foundational efforts, no substantive change will occur. Rather than making superficial adjustments, it is better to take action early.

Once the model is validated, a significant influx of capital will inevitably enter this sector, particularly from health insurance institutions. While they may not be directly involved in healthcare delivery, the integration and optimization of resources are undoubtedly imperative.

Additionally, smart hardware in the healthcare sector was once highly popular but has recently cooled off somewhat. I believe that if suitable scenarios can be identified, smart hardware will make significant contributions. For instance, within clinics, it is possible to effectively leverage new medical hardware to assist in patient tracking and continuously monitor their status, although successful cases remain limited at present.

Regarding some of the more popular concepts in the industry, such as “precision medicine,” “medical big data,” and “physician groups,” I believe they remain merely conceptual at present. It is understandable that industry professionals are enthusiastic about them, but the general public need not pay excessive attention to these notions. In the long run, they may prove important; however, they are not our most urgent priority at the moment. Perhaps it is precisely the proliferation of flashy yet insubstantial concepts that has contributed to a certain degree of restlessness within the industry.

On a more optimistic note, policy restrictions are dwindling. Many regions, such as Hangzhou (where I am based), have actively piloted multi-site practice for physicians and introduced additional policies to encourage private investment in healthcare. For entrepreneurs in the medical industry, spring is just around the corner.

We also aspire to introduce a portion of physician resources into the market. For instance, by designating a certain proportion of physicians (as it is unrealistic to include all) and allowing them to practice independently, we can entrust the market-oriented segment to market forces. This would liberate physicians from the public system, enhance their initiative, and boost productivity. We believe this will undoubtedly bring about remarkable changes to the current predicaments in healthcare.

In 2016, internet healthcare is expected to become even more vibrant. It is believed that innovative forms of medical services will emerge in the public sphere, such as chronic disease management approaches integrating healthcare with the internet, and effective use cases for smart hardware in the medical field, with some successful examples likely to appear.

Faced with the complexities of the healthcare industry and the intricate issues between doctors and patients, everyone is dissatisfied. Everyone has an answer, and it seems that everyone has a solution. Yet, few are willing to take action; too many remain mere bystanders—a situation that is somewhat ironic.

We look forward to more participants diving into the quagmire of healthcare, focusing on solving problems rather than becoming obsessed with concepts.

Let’s come together to make a difference. We should look forward to 2016 with hope.

Fortunately, change is on the horizon.

Source: Southern Weekly | Author: Feng Dahui, CTO of DXY