Is 'Internet + Health Management' a False Proposition? Insights from a Pioneer's Journey and Business Prospectus

Life and Death—The Most Painful Realization

I used to be an oncologist at the 301 Hospital. Upon graduation, I was assigned to the Department of Oncology. Ten years ago, nearly all the cancer patients we encountered were in advanced stages. Consequently, working in oncology did not give me a strong sense of curing diseases and saving lives; instead, I served more as a psychological counselor, providing comfort to patients, knowing that each one would eventually pass away.

In fact, advanced-stage cancer is incurable; under current medical technological standards, the only effective approach is early detection, early diagnosis, and early treatment.

Later, when I studied abroad in Germany and observed the country’s health checkup system—where a series of health management approaches, including medical examinations, are covered by insurance—I began to reflect on the underlying issues within China’s health checkup industry.

"My family can be described as a three-generation medical lineage, yet even so, the concepts of health check-ups and health management remain poorly understood, let alone among the general public."

I was once a physician at the 301 Hospital’s Oncology Department, yet during that period I never underwent any health checkups. After establishing my own health screening center, we primarily conducted examinations for chronic diseases, with incomplete cancer screening protocols. Consequently, in 2005, while visiting South Korea to study their health examination processes, I was unexpectedly diagnosed with early-stage gastric cancer.

Had it not been for this trip and the health checkup industry, I believe I would no longer be alive. At that time, I was diagnosed with indurated cell carcinoma, a highly malignant cancer that typically carries a clinical survival period of only three to six months.

For me, the health checkup gave me a second life.

My father, however, was not so fortunate. As a healthcare professional involved in hospital and pharmaceutical management, he suffered from physical discomfort for twenty years but never paid it much mind, attributing it merely to the aging process. Symptoms such as urinary urgency and frequency were never properly evaluated; even when examinations were conducted, physicians tended to dismiss them as typical manifestations of benign prostatic hyperplasia in the elderly. It was only later, during a check-up at my medical examination center, that he was diagnosed with advanced-stage prostate cancer.

"Because it was late stage, there was nothing that could be done. I accompanied him for about a year, and my father passed away within the timeframe we had anticipated. This event had a profound impact on me."

Having personally stared death in the face and endured the helplessness of losing my closest loved ones, I have come to deeply appreciate the immense value and significance of medical check-ups. For cancer, regular screenings enable early detection, offering the possibility of cure and long-term survival.

Therefore, after returning to China in late 2001, I co-founded a health screening center with my husband. Our vision was to leverage this approach to enable more people to detect and diagnose diseases at the earliest possible stage, thereby facilitating timely treatment and cure.

Truth vs. Falsehood: The Grand Proposition of Health Management

In the health checkup industry, my background as a physician has been immensely beneficial, given the close interconnection between health screenings, physicians, medical services, and medicine; thus, my professional expertise has provided substantial support. However, I believe that what has helped me most in entrepreneurship is my academic journey.

In our era, studying abroad demanded exceptionally high comprehensive qualities. We had to handle every task independently—from defining research topics and writing dissertations to managing the entire laboratory process, integrating diverse resources, and defending our theses. In fact, the first three to five years of my entrepreneurial journey were extremely arduous, reminding me of the solitary hardships I endured as a student. The difference, however, is that I now have a team by my side. When a group of people follows your lead, the challenges you face are even less daunting than those encountered by master’s or doctoral students. Therefore, I believe that the experience of pursuing my education has been even more beneficial to my entrepreneurial endeavors.

The most significant issue identified during health examinations is the large number of patients with chronic diseases. These patients require extensive follow-up, guidance, and the implementation of targeted interventions, with a subset also having specific healthcare service needs.

In essence, health management is the fundamental approach and means to address chronic diseases. Therefore, to integrate the upstream and downstream segments of the industrial chain from physical examinations to medical services, a service platform for health management is indispensable.

Over the past decade or so, everyone has been exploring health management. Some people consider it a pseudoproblem; I believe this stems from a stark reality—no one in China has made money from health management.

Health management is challenging due to its high costs and poor patient compliance. Moreover, the national healthcare system is predominantly treatment-oriented, leaving hospitals with insufficient capacity to engage in health management. Meanwhile, socialized institutions struggle to promote these services because of the high costs, substantial investment required, and low customer adherence. Nevertheless, health management remains the most effective approach for addressing chronic diseases; it is not a pseudo-concept.

Offline institutions that solely provide physical examinations have experienced rapid growth and achieved profitability; however, if you engage in health management, the profit model becomes challenging, making it difficult to scale and expand.

Fast and Slow — Leveraging Internet Development

In the current era of the internet, big data, cloud computing, and smart terminal devices have provided solutions to the issue of adherence in health management. Whether adopting a private physician model, a family doctor model, or a community-based model, it is essential to leverage big data and customer insights to deliver precise health management.

Ji Jiankang: A Health Management Service Platform Integrating Big Data and Medical Services

We currently leverage online health management to track, intervene, and engage with clients. This approach addresses challenges related to geographical distance, patient choice, and doctor-patient communication. Therefore, our future development strategy focuses on integrating big data from internet platforms with health management to deliver a variety of platform-based or offline medical services tailored to clients.

A closed-loop model integrating community-based, corporate, and real estate-affiliated medical clinics with internet platforms constitutes a genuine entry-point solution for addressing chronic disease management. Such platforms can also serve as an entry point for tiered diagnosis and treatment, facilitating the integration of backend medical services from various tiers of healthcare institutions.

Although governments at all levels are channeling various resources toward chronic disease management, the ultimate responsibility for such management lies with physicians. Given the limited availability of medical personnel, our approach is to leverage our influence to drive societal change and, by capitalizing on our accumulated data and robust technological platform, enable patients to independently upload their hospital records.

To break through the periphery of public hospitals, we must connect with China’s private medical institutions (currently numbering 40,000), help them transition to internet-based operations, and digitize their management data. By creating an online-to-offline closed loop within the private healthcare system, we can drive public hospitals to reform. Currently, we have partnered with 300 institutions across China.

Ciming Aoya: A Personalized Health Management Hospital

The private physician service model was developed by us to create a service system tailored for high-net-worth individuals, taking into account China’s market environment and the demands for health management. In fact, the entire scope of our services closely resembles that of family physicians abroad; however, our system is more comprehensive than their overseas counterparts.

Each private physician is supported by a health consultant, an assistant, and a secretary, forming a four-person team that delivers comprehensive, customized private medical services to members. This service model is relatively expensive and therefore difficult to replicate, as it heavily relies on the physicians, the operational system, and the backend support infrastructure.

Since launching our first facility in 2012, we have achieved profitability, maintained a highly stable client base, and attained very high customer satisfaction. However, due to the substantial capital investment required and the extensive service chain involved, we have not yet replicated this model with a second facility. For this high-end brand’s business model, we will continue to expand gradually, starting from first-tier cities and slowly moving downward.

Furthermore, some believe that the development of smart mobile terminal devices will impact the health checkup industry, particularly in three to five years. However, given that over 90% of current marketized health checkup clients are group clients, with payments made by employers as part of employee benefits, this business model continues to develop commercially. Moreover, demand is growing increasingly robust. Therefore, there are currently no signs indicating any adverse impact on traditional health checkup institutions.

Q&A Highlights

How receptive are customers to the sale of health checkup packages through online marketplaces? What has been your experience?

Han Xiaohong:Currently, online sales account for a relatively small proportion of our total revenue. As a traditional company, we are gradually advancing our digital transformation. We anticipate a significant increase in online sales this year. However, prices on our e-commerce platform may be higher than offline channels, as our online business primarily targets consumer (B2C) customers, whereas our offline operations focus on business-to-business (B2B) clients. Our pricing strategy adjusts seasonally; during off-peak periods, we offer more favorable discounts to B2C customers. For instance, from January to March, when corporate demand is lower, it becomes more cost-effective for individual consumers to make purchases.

What New Collaboration Models Exist Between Physician Groups and Health Checkup Companies?

Han Xiaohong:Within the health checkup industry, iKang is at the forefront of collaboration between physician groups and health checkup companies, having already launched such initiatives, whereas Meinian Onehealth and Ciming have not yet truly commenced. Currently, there are two models for physician groups: one comprises freelance physicians, and the other consists of physicians within the public healthcare system. Regardless of whether they are freelance or part of the public system, these groups require socialized medical service platforms, clients, and teams. Health checkup companies serve as particularly advantageous partnership platforms for physician groups. Therefore, I believe that various types of physician groups can establish their service outlets and leverage multi-site practice qualifications within health checkup centers to provide follow-up medical services for the centers’ clients.

Following Ciming’s acquisition by Meinian, has your ideal target been brought closer or has a gap emerged? In what direction will Ciming focus its development going forward?

Han Xiaohong:Regarding the collaboration with Meinian, it has actually brought me closer to my goals and ideals. Deep down, what I am most passionate about is advancing the development of preventive medicine in China and raising public awareness of health. Going public was also a step toward this objective; in my view, an initial public offering (IPO) is merely a financing tool—a means of securing capital at the lowest possible cost to enable rapid corporate growth. However, after five years of repeated deliberations and eventual stagnation of our IPO plans, I began seeking alternative opportunities. With the synergistic development achieved through our partnership with Meinian, I feel that I am now closer than ever to achieving my goal.

Since the merger of Ciming and Meinian, our entire team has become significantly stronger. This has also allowed me to dedicate more efforts to promoting value-added services across the industry, such as addressing “Internet Plus” initiatives and advancing high-end medical care within health management. Looking ahead, my primary focus will shift toward chronic disease management and the development of big data-driven healthcare service platforms.

Big data management requires standardized data sources based on a standardized minimum dataset. Currently, there are no such standards in China; the collected data is essentially garbage and has not been effectively utilized.

Han Xiaohong:I believe many of our friends have physical examination reports. If these reports could be aggregated to conduct population-level analyses, predict future disease trends, and perform big data mining, they would certainly not be waste but rather hold significant value. Perhaps undertaking such work requires substantial human, material, and financial resources, considerable effort, and must be driven as a top-priority initiative by senior leadership. Nevertheless, we are gradually making progress. I am confident that this data represents a gold mine, not trash. Currently, Ciming and Meinian together possess a stock of 30 million records.

How does your institution manage individuals in the pre-disease sub-health state, such as those with obesity, hyperlipidemia, or who smoke?

Han Xiaohong:Regarding health management for individuals with obesity and hyperlipidemia, let me provide an example. We collaborated with Sinopec to launch an online internet-based health management service. Targeting thousands of employees across Sinopec’s operations in 27 countries, we implemented a straightforward intervention focused on exercise management. Over a period of more than three months, we established a net-growth-oriented competitive framework among exercise teams, which intensified mutual competition within the teams while also enhancing employee cohesion and solidarity. Through three months of interactive engagement and competitions, follow-up comparisons of pre- and post-intervention health checkup data revealed remarkable improvements in employees’ lipid profiles and obesity metrics.

With a growing number of health checkup companies and increasingly fierce competition, how can Ciming enhance its competitive advantages?

Han Xiaohong:Intensifying competition is a very real challenge, one we anticipated when founding the company. Currently, the most significant competitive pressure in the overall market environment comes from state-owned enterprises rather than private ones. Our competitors are not so much from the open market as they are from public hospitals, which account for 90% of the market share.

 Q: How do you view the intersection between health checkups and insurance?

Han Xiaohong:Chronic disease management must be integrated with insurance. However, at the current stage, insurers lack the incentive to do so, as our existing accounting mechanisms and actuarial systems show that insurance companies are incurring losses in the chronic disease sector. Nevertheless, if products can be optimized, the chronic disease management process effectively controlled, and supported by favorable policies, insurance will ultimately serve as the fundamental solution for financing chronic disease care.

Question: You mentioned that your development strategy follows the "rural areas encircling cities" approach. Which tier of private hospitals is Ciming willing to collaborate with—Tier 2 or Tier 3? In our Tier-3 cities, public awareness of health management is relatively low; how can we promote it?

Han Xiaohong:We are committed to leading and driving all private medical institutions forward. In the internet era, regardless of whether they are located in first-, second-, or third-tier cities, we plan to select one or two such institutions in each city to convert our online resources into offline services. Currently, we have partnered with 300 institutions across China.

Regarding health management in Tier-3 cities, I believe China is currently following the path of health management. We have been conducting physical examinations for over a decade, and such examinations represent the first step in health management. Therefore, to understand health management, one should start with physical examinations. Tier-3 cities are gradually establishing physical examination institutions, which I consider the initial step in health management education. Progress will be gradual; over the next few years, these cities will inevitably reach that stage.

Q: Patients focus on diseases and treatments. How can we encourage them to pay for health management services?

Han Xiaohong:To encourage clients to pay for health management services, we need professional physicians who proactively track client progress and implement targeted interventions.

Our experience is based on leveraging customer data to gain a comprehensive understanding of their conditions, enabling our physicians to proactively and actively follow up with them. Once customers receive high-quality service, they naturally become more willing to pay and try new offerings; however, throughout this process, customers often remain in a passive role.

Q: Have the data of Ciming and Meinian been integrated? What is the current status?

Han Xiaohong:The data from Ciming and Meinian are still in their respective cleaning phases, as our data structures differ. Our shared vision and common goal is to extract value from this data to provide customers with additional services. While the objective is sound and the direction clear, we face significant obstacles and challenges.

 Q: Many companies are currently promoting so-called "high-end" products. How do you, Mr. Han, define the term "high-end"?

Han Xiaohong:"In fact, I initially struggled to accept the term 'high-end.' Later, I realized that it was the only word that could clearly convey to our clients what we do. In my view, there is no such thing as 'high' or 'low' in medical services; they are determined by an individual's actual needs and health status."

When we first launched Ciming Health Checkup, we provided services for the general public, with an average transaction value of around a few hundred yuan. To this day, our pricing remains at this level, focusing primarily on screening for chronic diseases and early-stage cancers among the general population. However, when it came to offering health management services, we had to use the term “premium” to distinguish health management from standard health checkups.

 Question: Hello! Can we send professionals to your location for training?

Han Xiaohong:Our platform is open, and the entire Ciming organization welcomes friends from all over China to come and learn. We receive visitors almost every day from various countries around the world and different regions across China, including those from public institutions, private enterprises, and social organizations.