WeDoctor Advances Internet-Based Tiered Diagnosis System and Files for Hong Kong IPO

10Month24On [date], a forum and discussion on the Internet and tiered diagnosis and treatment were held at the Wormhole Entrepreneurship Home Café in Zhongguancun. Zhu Hengpeng, Director of the Center for Public Policy Research at the Chinese Academy of Social Sciences, and Guahao.comCEOLiao Jieyuan, Professor Wang Jiansheng of the First Affiliated Hospital of Xi’an Jiaotong University, and Tang Zi’ou, founder of Haorensheng Health Industry Group, shared their perspectives on tiered diagnosis and treatment systems and explored potential implementation pathways from different angles. They also highlighted the critical challenges and obstacles that must be addressed in advancing tiered diagnosis and treatment. Below are the key insights and viewpoints from the forum, curated by VCBeat.



Liao Jieyuan: WeDoctor Group Attempts to Crack a Gap in the Glass Wall Between the Internet and Healthcare

Three Development Stages

Liao Jieyuan believes that a thick glass wall still separates the internet from healthcare. While the internet can see healthcare and healthcare can see the internet, it is still too early for the two to join hands. There is no straight line connecting them; WeDoctor hopes to find an opportunity to carve out a crack in the wall through indirect exploration.

Liao Jieyuan, with a background in IT, conceived the idea of leveraging the internet to transform healthcare after witnessing the arduous journey his young nephew endured while seeking medical treatment. “Initially, friends around me advised against entering the healthcare industry. The path has indeed been challenging, but some of our early initiatives are beginning to show promising results.”

In terms of outpatient volume, hospitals in China often handle more than 10,000 outpatient visits per day, which is more than ten to twenty times that of the largest hospitals in the United States. In the United Kingdom, 90% of initial consultations are conducted by general practitioners, and in the United States, over 80% of initial consultations are handled by family physicians. However, China has virtually no general practitioners, with primary care physicians accounting for less than 10% of the total. Meanwhile, physicians in tertiary hospitals account for slightly more than 10% of the nation’s doctors but manage over 40% of the outpatient visits.

In such circumstances, every physician is overworked. The United States has 1.4 physicians per 1,000 people, whereas China has 2.06. This figure does not include the 1.46 million village doctors; if they are included, the ratio rises to 3.15. Therefore, China does not suffer from a shortage of physicians; the core issue lies in the extreme imbalance of medical resources.

The development of WeDoctor Group has undergone three stages. The first stage involved shifting service windows online to optimize the healthcare-seeking process. Initially, queues for registration and payment at tertiary hospitals were moved to mobile platforms. Building on this foundation, further attempts were made to extend additional services to digital channels. For instance, features such as queue numbering for out-of-hospital waiting areas, access to examination reports, one-stop settlement, and post-consultation follow-ups have all been extended to mobile devices.

In fact, more than 80% of hospital counter services can be migrated to mobile devices. The only place where long queues persist is at elevator entrances—a challenge that IT technology is fully capable of addressing. It ultimately depends on whether hospitals have the motivation and determination to change. Over the course of a year, WeDoctor Group can help the public save nearly 20 million working days otherwise spent waiting in line, reducing each individual’s queue time by an average of one to one and a half hours.

During this phase, Liao Jieyuan once made it a routine to wake up at 6:00 a.m. nearly every day and repeatedly approach hospital directors. In 2011, Liao told his colleagues that he planned to onboard 60 hospitals by the end of the year. His team considered this goal too aggressive, yet they ultimately integrated 270 hospitals. Initially, WeDoctor adopted a free strategy for appointment registration services, encouraging hospitals to handle these tasks through their own call centers, with an average cost of RMB 8.7 per successfully booked appointment. Eventually, however, WeDoctor leveraged its call centers to steer users toward its proprietary internet platform, and subsequently directed them from the web platform to its mobile app.

The second stage is team-based healthcare, which aims to achieve a balanced allocation of medical resources by implementing tiered diagnosis and treatment services.

Doctors at tertiary hospitals are so busy that they barely have time to eat or use the restroom, while many physicians at primary care institutions face a shortage of patients. Yet a significant proportion of these primary care doctors possess specialized skills. How can their professional resources be leveraged effectively? This question was the original motivation behind WeDoctor Group’s exploration of tiered diagnosis and treatment.

Tiered diagnosis and treatment involves the “dual decentralization and dual enhancement,” with the key lying in the latter: how to improve the professional competence of primary care physicians, and how to enhance public trust in them. Another challenge is the difficulty in achieving optimal patient–provider matching.

Within WeDoctor Group’s team-based care model, a key role is that of the Team Assistant. The most critical responsibility of the Team Assistant is triage; they are well acquainted with each member of the team and facilitate specialized internal triage within the team.

Liao Jieyuan discussed this issue with Zhang Xiaolong of WeChat. Zhang Xiaolong suggested that the patient-facing side could be well integrated with WeChat, but the physician-facing side must be developed independently, as WeChat’s infrastructure is fundamentally incapable of supporting it.

Team-based healthcare not only facilitates team collaboration and resource sharing, but also enables leading specialists to mentor and drive the professional growth of primary care physicians, helping them build their personal brands to enhance patient trust.

Regarding the informatics challenges of tiered diagnosis and treatment, Liao Jieyuan stated that any technical issues are a false premise. In Hangzhou, WeDoctor Group embedded the tiered diagnosis and treatment system into physicians’ pre-consultation workstations, completing citywide deployment in just two weeks.

WeDoctor is also endeavoring to establish an internet hospital, marking the third stage of development for WeDoctor Group. In the past, internet healthcare primarily provided information services. By directly delivering clinical consultations, prescriptions, and medical insurance reimbursement through internet hospitals, the true potential of internet healthcare may finally be realized.

As planned, WeDoctor Group will establish 5,000 expert teams by the end of this year and recruit 1 million primary care physicians by the end of next year.

This year's operating revenue is expected to reach RMB 250 million.

Regarding the profit model that has drawn external attention, Liao Jieyuan stated that three years ago, he was unable to answer this question when asked. However, starting from the fourth year, insurance companies proactively approached WeDoctor Group to discuss collaborations, and the path to profitability naturally became clear.

Currently, WeDoctor Group has over 2 million paid health insurance users. Liao Jieyuan stated that the group’s operating revenue is expected to reach RMB 250 million by the end of this year.

Regarding the specific framework for ACOs, Liao Jieyuan told VCBeat that ACOs were initially non-standardized but are now gradually moving toward standardization, a process that requires robust medical support capabilities. The surgical centers being established by WeDoctor Group, through collaborations with healthcare institutions, aim to build high-end medical supply capacity within the ACO system.

Zhu Hengpeng: Tiered Diagnosis and Treatment Is the General Trend

The difficulties and high costs of accessing medical care in China have their own unique characteristics: it is not difficult to seek treatment at community health centers or county-level hospitals, but it is highly challenging to access top-tier (Grade A Tertiary) hospitals such as Peking Union Medical College Hospital. This reflects a core underlying issue: the mismatch between patients and healthcare providers. Specifically, regardless of the severity of their condition, patients invariably prioritize Grade A Tertiary hospitals as their first choice for medical care.

Due to the shortage of sufficient and highly competent general practitioners, patients cannot access quick and convenient triage and guidance services. Instead, they must schedule appointments based solely on physicians’ seniority levels. This results in a mismatch: patients fail to consult the most appropriate specialists, and physicians do not see the patients best suited to their expertise. Consequently, a specialist may end up seeing 200 patients in a single day, only to stand up at 6:30 p.m. with a sigh, remarking, “Of the more than 200 patients I saw today, at most 30 truly required my attention. Sixty percent fell outside my specialty, and although 20 percent were within my field, they did not warrant consultation by a top-tier expert like myself.” This exemplifies the resource waste caused by the absence of a tiered diagnosis and treatment system.

In addition to the shortage of general practitioners, implementing a tiered diagnosis and treatment system also requires addressing the issue of excessively high outpatient fees at tertiary hospitals.

Currently, national statistics indicate that outpatient visits at Grade 3A hospitals still account for 90% of the entire healthcare system, and these hospitals continue to expand rapidly. A number of coal mine owners and real estate developers are also investing heavily in building large hospitals. The majority of hospitalizations in Grade 3A hospitals are driven by outpatient services. In contrast, many surgical procedures in Europe can be performed on an outpatient basis (in day surgery centers), eliminating the need for all patients to remain in Grade 3A hospitals. (Day surgery, which originated in developed countries in Europe and America, refers to the selection of patients with specific indications who undergo hospitalization, surgery, brief postoperative observation, recovery, and discharge within one to two working days, without staying overnight in the hospital.) Outpatient care represents a critical opportunity that should be seized by both tiered diagnosis and treatment systems and social capital.

A major cause of the aforementioned problems is the deviation in direction of current policies. The fundamental error lies in mistaking the goal for the means: specifically, treating “separation of prescribing from dispensing” as a reform tool rather than its ultimate objective. For over a decade, policies have focused on lowering drug prices and reducing pharmaceutical expenditures; however, drug prices within medical institutions have ultimately risen instead of falling. Additionally, a factor that cannot be overlooked is the difficulty of achieving “separation of prescribing from dispensing,” which requires coordination among more than ten government departments—a task that is far from easy.

These practical challenges underscore the real-world need for a tiered diagnosis and treatment system, while internet-based healthcare serves as a viable approach and tool. If the online sale of prescription drugs is fully liberalized, online consultations are legalized, and medical insurance or commercial insurance establishes appropriate payment mechanisms, the springtime of internet-based healthcare will truly arrive.

Wang Jiansheng: Leveraging Internet Tools, Doctors Are Already Taking Action

Tiered diagnosis and treatment is not a new concept; it existed in the past as well. However, the content and implications of the previous tiered system differ from those of the current one. Previously, tiered diagnosis and treatment simply meant that patients with serious conditions went to large hospitals, while those with minor ailments visited smaller facilities. Primary healthcare institutions already dedicated 90% of their efforts to public health services, which also served as a key performance indicator for their evaluation. The current tiered diagnosis and treatment system places greater emphasis on integrating medical resources and ensuring orderly patient access to care. Its ultimate goal is to achieve initial consultation at the primary care level, two-way referrals, separate management of acute and chronic conditions, and coordinated collaboration between upper- and lower-level medical institutions.

Tiered diagnosis and treatment primarily involves referrals from primary care institutions to large hospitals, whereas major hospitals are reluctant to refer patients back down the hierarchy. When faced with increased demand, large hospitals have ample capacity to expand their physical infrastructure and even “import” entire medical teams. Currently, however, patient distrust in primary care institutions remains a significant challenge; a survey conducted by Tencent found that 65% of respondents were unwilling to seek medical care at primary-level hospitals. This explains why the “Medical Consortiums” currently being piloted across various regions have yielded limited results.

In layman's terms, tiered diagnosis and treatment aims to match the right patients with the right doctors, and the right doctors with the right patients. If a doctor sees only cold cases every day, they may become an expert in treating colds; however, assigning such a specialist to Peking Union Medical College Hospital would be a misallocation of resources.

In fact, based on Wang Jiansheng’s years of experience working at the grassroots level, primary care physicians have a strong willingness to collaborate with doctors from large hospitals. With internet-based tools such as those provided by WeDoctor Group, cooperation between primary care physicians and specialists at major hospitals has become more convenient.

Although it remains challenging to teach ordinary villagers in rural areas how to use internet tools, village doctors have already actively participated. We currently operate 10 WeChat groups, enabling online connectivity with 1,300 township and village doctors. (Village doctors do not have bank cards; since WeChat requires a linked bank card to create large groups of up to 500 members, the group size limit would otherwise be capped at 100.)

Tang Zi'ou: It Will Take Time for the Kaiser Model to Succeed in China

Kaiser Permanente is the pioneer of Health Maintenance Organizations (HMOs) in the United States. The group’s management model integrates health insurance with healthcare delivery, operating under a physician-led management structure that seamlessly combines health management and clinical care. While overall healthcare costs in the U.S. have surged, Kaiser Permanente has managed to reduce costs by 10%–20% compared to other hospitals. Currently, nearly 30% of Americans have chosen Kaiser Permanente as their healthcare provider.

HMOs have two key characteristics: the first is prepaid care, and the second is the gatekeeper model. Among these, the prepaid system in particular provides an unparalleled advantage, as physicians lack the incentive to provide excessive medical services, with all decisions based solely on treatment efficacy. This has broken the trend of rapidly rising healthcare costs in the United States: healthcare payments are made on a per-capita basis, so if health management is effective, providers can generate profit while meeting patients’ medical service needs.

However, in China, healthcare providers and insurers remain locked in a strategic standoff: hospitals game the insurers, and insurers game the hospitals, ultimately exploiting the information asymmetry that leaves patients at a disadvantage. Kaiser Permanente faces a series of bottlenecks in China, which are fundamentally rooted in ecosystem-level challenges. While we are still optimizing and restructuring resources within individual segments of the industry chain, Kaiser’s model optimizes the entire value chain—a paradigm that is truly a generation ahead.

It is not merely about the industry’s own development, but rather an optimization of the three-party market value chain. Therefore, it requires time—not only for the industry’s organic growth, but also for subtle, gradual changes in the broader environment.