Hulingjia: Revolutionizing Elderly Home-Based Rehabilitation and Care Through an Internet-Enabled Integrated Model

Hulingjia is a home-based rehabilitation and nursing product for the elderly under Yikang Meichen Health Technology (Beijing) Co., Ltd. Its founder, Xu Lishan, told VCBeat that as population aging intensifies, the accompanying elderly care challenges are becoming increasingly severe, thereby giving rise to a vast market in the elderly care industry.

Public data shows that in 2014, China’s population aged 65 and above reached 137.55 million, accounting for 10.1% of the national total. The primary factor is demographic shifts, namely declining birth rates and increased life expectancy. “The average life expectancy for elderly Chinese is 73 years, while their healthy life expectancy is approximately 62 years. This means that, on average, seniors spend 11 years battling illness,” Xu Lishan told VCBeat. Given the severe aging population and the prevalence of chronic diseases, home-based care and geriatric rehabilitation have become issues that every “2+4 family” (a couple supporting both sets of parents) must address.

Xu Lishan stated, “The market for the elderly is the most inelastic market. This is not merely a medical issue, but also a matter of national welfare and people’s livelihood, as well as moral values; it is an issue that every family must address.”

Through its research, Hulingjia has found that over 60% of elderly individuals are not clearly aware that they suffer from serious chronic diseases, leaving their chronic disease management needs unaddressed. Furthermore, latent symptoms associated with illnesses in the elderly are difficult for laypeople to detect, making it challenging for adult children to determine whether their parents are ill. Moreover, even when both the elderly and their children recognize the need for care, this demand often remains inadequately met.

However, China’s rehabilitation and nursing systems remain underdeveloped. Xu Lishan noted that in recent years, substantial resources have been directed toward enhancing both hardware and software within hospitals, while pre-hospital patient triage and post-discharge rehabilitation and nursing services have been neglected. Some entrepreneurs have recognized this gap and are attempting to address the pre-hospital market through internet-based solutions. For instance, Chunyu Doctor seeks to connect physicians with patients via online platforms, enabling doctors to access more clinical cases and providing patients with more professional pre-admission consultations. Meanwhile, the rehabilitation and nursing sectors currently lack high-quality initiatives.

Hulingjia is considering introducing advanced foreign systems for home-based rehabilitation and nursing care for the elderly.

In the United States and Canada, the mature healthcare system is divided into three parts. The first part is pre-hospitalization: when patients notice physical discomfort, they visit private clinics or consult their family doctors to determine the cause, assess whether hospital care is needed, and identify the appropriate medical specialty if referral is necessary. The second part occurs at hospital admission, where patients receive treatment after obtaining professional diagnoses. The third part involves rehabilitation and nursing care following the completion of treatment. “Canada’s home-based rehabilitation and long-term care system for the elderly may be the most suitable model for China’s national conditions,” Xu Lishan told VCBeat.

Reference the Canadian System

After evaluating multiple advanced home-based elderly care systems, Hulingjia ultimately chose to adopt Canada’s model as a reference. Xu Lishan outlined the following reasons for selecting the Canadian system.

First, the macro-level national conditions of the two countries are similar. Both China and Canada define individuals aged 65 and above as elderly. In 2011, the proportion of people aged 65 and above was 9% in China and 16% in Canada. By 2036, the elderly population is projected to reach 25% in China and 30% in Canada. Additionally, the eldercare structures of China and Canada are remarkably similar. In Canada, 92% of elderly individuals age in place at home, while 8% opt for institutional care. Meanwhile, China’s policy also promotes a model where 90% of the elderly receive home-based care, 7% utilize community-based services, and 3% reside in institutional facilities.

Second, Canada has extensive experience in home-based rehabilitation and care for the elderly, supported by favorable policies.

Currently, one in six seniors in Canada receives home-based elderly care. Since 2011, the Canadian government has provided annual funding of CAD 5 billion for home-based elderly care services. This translates to an annual government subsidy of CAD 6,000 (approximately RMB 30,000) per senior recipient.

Ontario is one of the leading provinces in Canada for home-based rehabilitation and care for the elderly. In southwestern Ontario lies Schlegel Villages, a retirement community that serves as a model for integrated industry-academia-research collaboration in elderly care. The village houses research institutes and colleges, where care staff undergo specialized professional training. These caregivers gradually accumulate practical experience, thereby enhancing the quality of care services. Within the community, seniors receive comprehensive assessments—covering their living environment, physical health, and mental well-being—before accessing nursing and rehabilitation services provided by professional care staff.

Canadian public policy promotes healthy aging by offering tailored rehabilitation and care programs based on the health status of older adults, thereby significantly improving their quality of life.

Drawing on Canada’s home-based rehabilitation and care system, Hulingjia integrates nursing services with healthy aging and chronic disease rehabilitation for older adults. Furthermore, it has established support mechanisms for medical consultations, as well as prevention and emergency response protocols for accidents, tailored to the nursing and rehabilitation needs of the elderly. In addition, Hulingjia incorporates elements of Traditional Chinese Medicine (TCM) nursing, such as health preservation and wellness methods for diabetes and other chronic conditions, to help non-disabled seniors enhance their physiological functions. Meanwhile, Hulingjia has introduced Canadian training curricula, appropriately adapted them, and used them to train its own professional caregiving staff.

Furthermore, Hulingjia also strives to leverage mobile internet and big data processing to make professional elderly care services and specialized staff training more efficient, scientific, and human-centric.

App + Tablet

“We categorize elderly individuals into three groups: Group A consists of healthy seniors, Group B includes those with partial self-care ability, and Group C comprises those who are disabled or suffer from dementia. Each group has its own specific needs, and we provide personalized solutions tailored to each category,” introduced Xu Lishan. He added that for Groups B and C, they offer professional assessment services and develop specialized nursing and rehabilitation plans.

Hulingjia’s product consists of three components. The first is a mobile app used by adult children, the second is a tablet placed at the elderly person’s bedside, and the third is an app used by care providers. “Our platform differs from other internet platforms in that we do not focus on community-building or social networking features. Instead, we facilitate natural connections that are essential within the nursing and rehabilitation processes,” said Feng Yixuan, co-founder of Hulingjia, noting that the three components of the Hulingjia product are designed to work in concert.

First, adult children use the mobile app to make online appointments, during which they complete a brief online assessment and provide their home address and contact information, enabling caregivers to obtain necessary details for in-home services. Subsequently, the assessor notifies the elderly person’s adult children via the app and conducts an in-home assessment. During the assessment, the assessor collects required data using a professional assessment scale (the team’s comprehensive scale integrates 13 well-established scales gathered from around the world, incorporates traditional Chinese diagnostic methods of inspection, auscultation/olfaction, inquiry, and palpation, and follows a standardized assessment process developed in collaboration with the research institute). Based on these data and discussions with the elderly individual, a personalized care and rehabilitation plan is formulated. The finalized plan is then pushed to the adult children through the app; upon their approval, they can proceed with payment to implement the plan.

Upon successful payment, the elderly individual will receive a tablet computer. Subsequently, caregivers will provide ongoing in-home services. Prior to each visit, caregivers will notify both the elderly individual and their adult children of the scheduled service time via the app and communicate relevant details.

Upon arriving at the elderly client’s residence, the caregiver will check in using the client’s tablet to initiate the service. After completing the service, the caregiver will also use the tablet to outline the next phase of care and rehabilitation tasks for the elderly client, which will be carried out by the client’s children or home health aides. Furthermore, the elderly client or their accompanying hired aide will provide an evaluation of the service. The children will be able to view their parents’ ratings of the caregiver, while the caregiver will also submit feedback on their own performance, detailing the level of task completion and overall service conditions.

In early September this year, staff from Hulingjia provided care to an elderly patient. The patient was bedridden and disabled, with a tracheostomy tube in place, gauze dressing on the neck, and a nasogastric tube (a feeding tube inserted through the nose into the stomach to deliver nutrition, typically used for patients who are comatose or unable to eat independently). Prolonged bed rest had also resulted in some skin wounds. Although two caregivers were employed in the household, neither had professional medical training. During dressing changes, the caregivers attempted to sterilize the gauze by steaming it in a pot, a method that fails to achieve sterility. Additionally, while the patient was bedridden, secretions tended to accumulate in the airway. Although a suction machine was available at home, the caregivers did not know how to operate it, causing significant discomfort to the patient due to the inability to clear respiratory secretions.

After arriving at the patient’s home, the caregiver from Hulingjia performed a full-body cleaning for the elderly patient within one hour. Using strictly sterile instruments, the caregiver replaced the gauze around the tracheostomy tube and the nasogastric tube, and cleared accumulated pulmonary sputum, thereby alleviating the patient’s distress.

Xu Lishan said, “Often, the caregivers hired by children for their elderly parents lack professionalism; they want to make their elders comfortable but do not know how. We offer them a choice: professional nursing services that provide peace of mind for families and comfort for the elderly.”

High-quality nursing talent is the core of Hulingjia’s services. All caregivers on the Hulingjia platform are professionally trained nurses; some are students cultivated through collaborations between Hulingjia and nursing colleges, while others are incumbent clinical nurses from major hospitals. Gong Lihua, co-founder of Hulingjia, stated, “We need standardized services and a unified service standard for caregivers to ensure that their care is professional and trustworthy.”

By the end of this year, Hulingjia will expand its services from Beijing to Shanghai. The team is currently seeking financing.