Shangyi Medical's 'ShuKang' APP: Market-Driven Design Logic for Patient Follow-Up Solutions – VB Salon Chengdu Series Featuring Zhao Linglan

Guest Introduction: Zhao Linglan, Marketing Director at Chengdu Shangyi
Shangyi’s flagship product, the “Shukang” app, is a “full-process patient management tool.” Since 2014, it has focused on and engaged in internet healthcare. The team includes former employees of domestic and international medical device companies such as Johnson & Johnson (USA), with many years of experience in medical device sales and marketing.



On His Wedding Day, This Doctor Spent 10 Minutes Reviewing Imaging Scans for a Patient

I will begin with this scene, which was reported by Tencent News in March. The groom, a physician, had previously performed a gastrointestinal tumor resection on a patient. When the patient came for a one-month postoperative follow-up visit, it coincided with the doctor’s wedding day. He asked his wedding convoy to wait for ten minutes so he could review the patient’s imaging studies before rushing off to his wedding. Cases like this that make the news represent only a small fraction; there are numerous such examples across China. This highlights the significant information asymmetry between physicians and patients.

Why Shukang? Because physicians require follow-up.

To develop a post-operative patient management or follow-up app, we must first understand why physicians conduct follow-ups.
In most cases, there are two main reasons for physicians to conduct follow-up visits,First, as we all know, physicians are required to write articles and conduct scientific research., these efforts require data support; only through follow-up can data on patients' subsequent recovery be obtained. He needs such data, hence the follow-up;Then comes the patient's out-of-hospital management., in this regard, some physicians themselves are highly motivated by the desire for optimal patient recovery, and thus need to assess patients’ physical condition through follow-up visits; these two factors together make follow-up inevitable.

Given the necessity of follow-up, how do physicians conduct these follow-ups? The most common method is making individual phone calls. Typically, a single physician makes anywhere from one or two hundred to several hundred or even over a thousand follow-up calls per year. If senior physicians wish to assess patients’ recovery status outside the hospital, they often delegate the task of making follow-up calls to junior physicians or assistants, who then document the follow-up details in a corresponding logbook.

Telephone follow-ups are generally suitable for patients who live far from the hospital or are unable to return for reexamination due to health conditions or other reasons. The process of telephone follow-up is often something doctors dread. First, calls may go unanswered; even when connected, effective communication with the patient may not be possible. In some severe cases, patients pass away shortly after being discharged post-surgery, and calling them only invites verbal abuse. Moreover, physicians are required to conduct such follow-ups on a monthly basis, sometimes completing several each day, making this task particularly burdensome and distressing for them.

The second aspect is the outpatient follow-up form, where doctors or assistants inquire about patients’ conditions and record them on the form. These data constitute the follow-up information required by physicians. However, conducting follow-ups in an outpatient setting—characterized by high patient volume and busy schedules for medical staff—is cumbersome, and neither doctors nor assistants are inclined to perform this task. Through our analysis, we identified follow-up care as a significant pain point for physicians. Moreover, such follow-ups often yield limited practical benefits for patients. This rationale underpins the development of Shukang.

What Problems Does Shukang Solve? Follow-up Reminders, Understanding Medical Conditions, Viewing Reports, and Doctor-Patient Communication.

So, what problems can Shukang actually solve? It mainly addresses four aspects:
Part I: Postoperative Follow-up Reminders for PatientsAfter surgery, physicians often require patients to return for follow-up visits at specified times. However, as time passes, patients may pay insufficient attention to or even forget these appointments, potentially leading to significant patient attrition. To address this, Shukang has integrated advanced international models and launched a reminder service based on disease-specific follow-up pathways. If physicians have important instructions for their patients, they can also use the platform to send reminders.
Part 2: Understanding the Patient's Physical ConditionPhysicians today often encounter a common scenario: after being discharged, patients frequently contact them via phone or online to report various discomforts and inquire about their condition. Addressing these concerns is a strong need for patients and also aligns with physicians’ interests, as doctors are genuinely concerned about their patients’ post-treatment recovery. Shukang has transformed postoperative monitoring items for each disease into structured questionnaires, enabling a more convenient and scientifically rigorous approach to fulfilling these needs. Patients can complete the process simply by filling out the questionnaires, making it highly user-friendly.
Part III: Uploading Patient Examination ReportsPatients are unable to interpret medical examination reports; only physicians can. Shukang provides a systematic approach to comprehensively collect and record users’ examination reports, enabling easy access when physicians need to review them. Whether patients visit a hospital or an outpatient clinic in the future, they can provide their previous examination reports to physicians for reference.
Part 4: Doctor-Patient Communication, through this platform, doctors can view patients' physical conditions, various reports, and rehabilitation questionnaires, thereby facilitating more seamless and convenient communication between doctors and patients.

During product design, we placed significant emphasis on clear categorization and detailed feedback mechanisms. Through Shukang, physicians can systematically collect patient feedback via questionnaire-like formats, thereby consolidating all relevant information. Why adopt this approach? If a physician receives a 200-character WeChat message from a patient, their initial task is often to sort and categorize the content, while also worrying about potential omissions that may necessitate further inquiries. In contrast, our questionnaire-based design yields data with distinct categories, ensuring a systematic and structured format that eliminates concerns about missing information. Additionally, we employ a color-coded system—green, yellow, and red—to alert physicians to the nature and severity of issues. This approach significantly enhances workflow efficiency for clinicians, which is why it garnered strong support from many clinical practitioners from the outset.
For every disease, we have a dedicated medical team assigned to it. Once patients are admitted into the system, they are categorized based on their specific conditions and routed to the appropriate teams for management, whether for information inquiries or other services. Meanwhile, physicians can quickly locate patients within their respective specialties through this mechanism. In cases where patient care involves multiple physicians rather than a single doctor, differing clinical roles may arise. To address this, Shukang offers workgroup services that facilitate more efficient collaboration among medical teams. Additionally, we have incorporated features enabling family members to participate and interact in the patient’s care journey. Upon completion of the overall product, the result appeared truly impressive, leaving us all somewhat excited at the time.

Follow-up apps are notoriously difficult to develop—so tough that you’ll have no friends left.

Internet healthcare and app-based follow-ups sound wonderful in theory, but in practice, we’ve found them to be incredibly challenging—so much so that it’s been a lonely journey. Here, I share a summary of the many issues we’ve encountered over the past year.
First, follow-up requirements vary across different medical specialties., for instance, cardiologists and cardiac surgeons have different needs for follow-up care. If we were to meet the needs of every individual, our workload would be enormous, making it difficult to address everyone’s requirements in product design. Therefore, we have devoted significant effort to resolving this issue in specialty-specific follow-up management.
The second point is that physicians have varying requirements for follow-up care.For instance, a surgeon may perform both intestinal and gastric procedures, each entailing distinct follow-up requirements. We must accommodate the differing needs associated with these two types of surgeries. Furthermore, even among two thoracic surgeons, their specific procedural requirements can vary significantly. Consequently, we face substantial pressure in addressing these complexities.

Third, not every physician has a need for follow-up.According to our investigation, only about 20% of physicians have a strong need for scientific research. Many doctors lack sufficient motivation for research and do not have the time to conduct it. It is quite challenging to identify this top 20% from the large pool of physicians. Calculations show that fewer than 20,000 doctors in Sichuan Province have a need for patient follow-up services, and the total number of target users across China is only around 300,000 to 400,000. This highlights how difficult it is to achieve a significant scale. Furthermore, among these 300,000 to 400,000 physicians, we face another challenge: there are substantial differences across professional ranks, medical specialties, and cities. Their motivation and perspectives on patient follow-up vary significantly, which undoubtedly adds to the difficulty.

Start from one region and persist in providing general practice services.

After extensive exploration and experimentation, we ultimately reached a consensus to persist in developing our general practice solution. Why? Initially, we recognized that most surgical specialties could be addressed. Later, we discovered that once the interconnected logic among departments such as cardiology and gastroenterology was identified, the underlying business logic proved universally applicable, requiring only the insertion of specialty-specific follow-up content. We remain committed to advancing this general practice approach. While some may argue that niche specialty markets are too small, companies have different strategic starting points; we choose to focus on comprehensive coverage. For instance, our tumor follow-up pathways are built upon the NCCN Guidelines as a foundational reference. We review relevant literature, translate it into structured data, collaborate with engineers for integration into our system, and proceed domain by domain. To date, we have covered 10,000 diseases and incorporated over 8,000 surgical and therapeutic procedures, essentially encompassing all surgical operations and a significant portion of internal medicine conditions.Secondly, we aim to deepen our presence in specific regions. As mentioned earlier by representatives from Matrix Partners China, metrics such as traffic, user count, and activity levels behave differently in healthcare. Unlike the TMT (Technology, Media, and Telecom) sector, which relies heavily on traffic and user scale, healthcare demand is relatively fixed. Therefore, we decided to concentrate our efforts regionally, currently focusing primarily on Sichuan Province, along with parts of Shanghai, Guangzhou, and Beijing. Having worked in both domestic and international enterprises, I recognize that product quality is evaluated across multiple dimensions. Another critical aspect is service delivery. Only by providing intensive, high-touch services can we earn physicians’ trust. We have developed an integrated service system combining online and offline activities, thereby establishing competitive barriers and fostering strong partnerships.

Follow-up Apps: Balancing the Needs of Doctors and Patients

ShuKang is a tool that requires the participation of both doctors and patients; if either party neglects the details, it may result in critical acclaim but poor market adoption.
For physicians, given the high-frequency nature of its use, it is essential to minimize the learning curve and operational costs. Why? Because they are extremely busy; some physicians work nonstop from 8 a.m. to 8 p.m. If a software solution requires 10 or 20 minutes of training, it becomes impractical for them to adopt. While ensuring medical accuracy inevitably introduces complexity, which can appear even more daunting when consolidated into a compact app, this challenge is not easy to address. Nevertheless, as designers, we must streamline the process as much as possible to reduce the time and effort physicians need to invest in learning and using the tool.
From the patient’s perspective, sufficient attention must also be paid. Why? Doctors use the platform because there are patients, and patients use it because there are doctors. To develop this product effectively, we engaged with numerous physicians, carefully inquiring about what information patients should provide and how to optimize the product for greater convenience and a better user experience for doctors. Based on physicians’ requirements, we initially defined what patients needed to fill in and how they should complete these fields. However, we did not adequately prioritize patients’ own needs at the outset. It was only during actual operation that we realized patients would not necessarily provide the information simply because doctors requested it. For doctors, this is a follow-up tool; but for patients, it is a rehabilitation tool. With this new positioning, the product subsequently operated much more smoothly.

Q&A Highlights
Question 1: From the perspective of follow-up care needs, 90% of patients require rehabilitation. However, from the physicians’ standpoint, fewer than 20% are strongly motivated to use apps for this purpose. How do you view this issue?
Zhao Linglan:Indeed, 80% of physicians lack sufficient time to manage these patients via the app, a reality that is difficult for us to change. Therefore, our immediate priority is to serve the 20% who are highly motivated and willing to participate. Although this 20% figure is currently low, we anticipate it will grow to 30%, 40%, or even 50% as awareness of this concept deepens among medical professionals. By focusing on this group, we aim to establish our service brand and reputation, ensuring that we become the preferred partner for physicians when they decide to adopt such practices in the future. Furthermore, since physicians only follow up with their own patients, we are operating under an “acquaintance-based” doctor-patient model, meaning they do not conduct follow-ups for patients treated by other doctors.

Question 2: Your current product appears to be a backend system for full-course care management, covering pre-hospital, in-hospital, and post-hospital phases. How do you integrate the post-hospital module with hospital systems?
Zhao Linglan:We often hear physicians say that it would be ideal to integrate these cases and facilitate discussions if connectivity could be established; however, implementation poses significant challenges. It requires engaging with each hospital individually for negotiations, and each institution would need two or three engineers on-site for technical deployment, which presents substantial technical difficulties. Even more challenging is negotiating with each hospital’s director to determine how patient data can be utilized in compliance with regulatory requirements. Given these complexities, this initiative has been temporarily set aside.

Question 3: Who is responsible for your follow-up plan? Is it also conducted by physicians? Do physicians have sufficient time to perform these tasks?
Zhao Linglan:Some physicians are actively engaged, with a portion carving out time to do so, while others indeed lack strong motivation. If physicians do not use the app to manage patients, they will delegate follow-up calls to junior doctors. As shown in the image I just displayed, patient information is recorded; our tools help improve their efficiency.

Question 4: I would like to ask whether the current patient follow-up process still adds to physicians’ workload. From a design perspective, have you considered ways to reduce their burden? Additionally, while routine follow-ups are typically handled by assistants, your solution requires physicians to perform them personally, thereby increasing their workload. What motivates physicians to undertake this task, and how specifically does your solution alleviate their workload?
Zhao Linglan:First, regarding your mention of physician assistants handling this task, these “assistants” are often junior physicians within the same department. They tend to approach it as a routine assignment rather than engaging with its professional aspects, and they are generally reluctant to perform this work. As for the issue of costs versus benefits, the service we currently provide is tailored to physicians with genuine needs. By leveraging this tool, they can reduce the workload associated with multiple follow-up visits and increase their income, which constitutes the primary motivation for doctors to adopt Shukang. Regarding how this income is generated, we are identifying suitable partner institutions that can provide subsidies to physicians while acquiring the resources they need. We have validated the feasibility of this model. By using this tool, physicians can save time, improve work efficiency, and earn subsidy income, thereby creating a positive feedback loop. Indeed, while everyone shares the same ultimate objective, our points of entry differ. Their approach reflects their own design philosophy and concepts, whereas ours aims to transform the role of physicians. Thus, despite superficial similarities, there remains a fundamental distinction in our underlying approaches. (This part was not entirely clear to me.)

Question 5:For surgical teams, many surgeons focus solely on performing operations, while the attending physicians are responsible for bedside care. Do patients place greater trust in the attending physicians? If these attending physicians do not belong to the top 20% of doctors, how can this situation be addressed or converted?
Zhao Linglan:This 20% does not refer to surgical procedures; rather, the 20% figure I mentioned pertains to the concept of a working group, specifically involving 20% of the medical team. Under normal circumstances, if the team leader is willing to initiate this approach, they will lead junior physicians in jointly delivering care. You noted that patients tend to place greater trust in their attending physicians than in surgeons. Nevertheless, patients will interact with both the chief physician performing the surgery and the attending physician responsible for their bedside care. Based on past experience, as long as patients perceive that they are being managed by the team, they are generally indifferent to which specific individual provides their care, since any physician within the team is qualified to offer medical guidance.

Question 6: This is a low-frequency service with few users and even fewer doctors. I would like to ask what Shukang’s next steps for development are.
Zhao Linglan:For patients, the frequency is not high, but for doctors, it is relatively high. Increasing the frequency of patient interactions places a significant burden on physicians. Therefore, communication methods akin to instant messaging should be avoided as much as possible; instead, using structured scales and questionnaires for feedback is a more scientific approach. Regarding future development, we position ShuKang as a comprehensive, end-to-end patient management tool, initially entering the market through postoperative follow-up. Looking further upstream, we focus on the preoperative phase, starting with patient education. While many large companies are already active in this area, we plan to develop our own capabilities and may also collaborate with other firms. Even earlier in the journey is the physician-finding stage, known as triage or guided consultation, which represents another substantial growth segment. Once we have accumulated a significant user base, we will leverage data-driven insights to accurately direct patients to appropriate physicians through partnerships. This forms our upstream strategy. Downstream, rehabilitation and caregiving services present additional opportunities. We aim to establish collaborations with other companies across all these stages, which constitutes the integrated model we currently seek to build.

Question 7: How can we ensure the quality of data provided by our patients? If the data quality submitted by a patient fails to meet the required standards, it may lead to an increased burden on physicians. In surgery, procedures are often low-frequency events—some patients may undergo a specific operation only once in their lifetime. Therefore, how can we guarantee data quality during the follow-up process?
Zhao Linglan:This is a profound and highly professional question. We have posed this question to many physicians, and currently, there is no single optimal solution; rather, we can only identify relatively effective approaches. Patients provide feedback based on their own conditions. Generally, patients are quite concerned about their health status and therefore tend to take the process seriously. During follow-up visits, patients are typically required to submit test reports, mostly in the form of images. They can transmit the entire imaging files directly to the physician, who then extracts the relevant data. This information is further supplemented through interactive communication between both parties. Rather than abandoning tasks that are difficult for patients to perform, we strive to find a balance: assigning tasks requiring professional medical expertise to physicians, while delegating those that do not require such expertise to patients. Currently, this approach presents no significant issues.

Question 8: Regarding the large datasets you possess, when physicians write academic articles and examine changes in RCT data, how can we ensure the objectivity and authenticity of this data? Currently, if we aim to provide physicians with valuable information, how can we achieve a quality standard comparable to that of research companies or third-party institutions?
Zhao Linglan:This is also an excellent question. First, we provide research support services to physicians. We do not perform data analysis for them; instead, we supply raw data directly and dynamically collected from patients. We offer a web portal through which physicians can export the raw data at any time to conduct their own analyses. If they have specific questions, we provide guidance. While our current approach may not be optimal, it is arguably superior to obtaining data via phone calls.