Goodbye, Mr. Tumor: Opportunities for Internet Healthcare in Specialized Disease Areas
VCBeat Think Tank No.10
Time: August 19, 2015 (Wednesday)
Location: Hangzhou Qingchuang Iteration Innovation Space
Speaker: Xu Yi, CEO of Yijiayi
Xu Yi's Key Insights
I. The “Four Don’ts” of Entrepreneurship
II. The Allure and Challenges of Niche Oncology Markets
III. Heavy-Mode Approaches to Tackle Major Issues
IV. How Disease-Specific Apps Can Build Competitive Advantages
V. A Little Bit Is Needed"Sentiment"
Xu Yi, who has long served as Sales Director at multinational pharmaceutical companies such as Roche, has driven the launch and market promotion of several blockbuster oncology products and targeted therapies in China.
In 2014, he left his executive position at a multinational corporation to launch a startup, introducing “YiJiaYi,” China’s first true patient–physician communication platform dedicated exclusively to oncology, and successfully secured Series A financing. YiJiaYi covers the entire continuum of cancer care, from pre-diagnosis to post-treatment, and is committed to advancing patient–physician information exchange and resource matching in the field of oncology.
Xu Yi's Key Insights
1. The "Four Don'ts" of Entrepreneurship:Xu Yi embarked on his entrepreneurial journey after identifying critical pain points in oncology care. He believes his model can create a win-win scenario for physicians, patients, and the government. His “Four Don’ts” principle for startups dictates: do not proceed if there is no distinctive advantage; do not proceed if the barrier to entry is too low; do not proceed if it does not address an essential need; and do not proceed if it merely seeks attention without substantive value.
2、The Allure and Challenges of Oncology Market Segmentation:The oncology market represents the most ideal niche segment, characterized by numerous pain points, strong demand, limited competitive products, substantial market size with clear growth trends, high barriers to entry, and high average transaction value. However, it is also a challenging segment to serve due to its high level of specialization, the unique characteristics of its target users, the extremely busy schedules of oncologists, the need to mitigate legal and regulatory risks in product functionality, and uncertainties surrounding profitability models.
There are three major pain points in oncology care: 1. Cancer patients tend to seek treatment at large hospitals, making the process of finding a doctor difficult and unguided; meanwhile, physicians often see patients who are not appropriate for their specialties, leading to inefficient use of medical resources. 2. Treatment is frequently ongoing when cancer patients are discharged, and they wish to maintain contact with their doctors; however, physicians are willing but unable to meet this demand due to limited capacity. 3. Although there is an abundance of cancer-related resources, patients struggle to find the right ones, while these resources fail to reach the appropriate users.
3. Heavy-Mode Response to Heavy Issues:“Yi Jia Yi” provides patients with the opportunity to pre-consult with oncology specialists, enabling them to select their provider before seeking care. Physicians can also accept patients aligned with their expertise, thereby enhancing efficiency and realizing professional value. The “Yi Jia Yi” model emphasizes a physician invitation system, user acquisition through offline channels, intensive backend involvement, and a specialized team.
4. How Disease-Specific Apps Can Build Competitive Advantages:Design products based on a deep understanding of the needs of both doctors and patients; adopt a physician-centric promotion model; introduce interactive features to enhance user stickiness; develop a profitability model grounded in profound industry insights; and build a professional, experienced core management team.
5. A Touch of “Sentiment””：I used to disdain talking about “passion,” considering it somewhat pretentious. However, after all this time, I have come to believe that passion is essential. Only when pursuing an endeavor brings not just financial reward but also the joy and sense of accomplishment from helping others can it truly be called a career!
I. The “Four Don’ts” of Entrepreneurship
Compared to the aspiring entrepreneurs here, I have merely taken one step ahead. My hope is to be a pioneer, not a martyr. I understand that many of you with an interest in internet healthcare will be attending, so I would like to share my entrepreneurial journey and personal reflections. Rather than focusing primarily on my company, I will center my talk on my insights, using my company as a case study. Today’s theme is “Heavy Models for Heavy Problems: Opportunities for Internet Healthcare in Specialized Disease Areas.”
Why I Started My Business
I’d like to ask everyone here: please raise your hand if you’ve recently watched the film “Go Away, Mr. Tumor,” and keep it raised if you shed tears while watching it (not many hands go up). Well, I did tear up when I watched that movie. Although I have been working with oncologists and cancer patients for many years, and have encountered countless individuals like Xiong Dun and Dr. Liang, I know how incredibly difficult their journey is, and I hope to do something to help them.
My interest in internet healthcare began in 2013, when the trend had not yet taken off in China. I primarily studied American apps, recognizing that certain models could be adapted and leveraged with my own resources to benefit both physicians and patients. This prospect left me eager to act. The model I envisioned was a win-win scenario: it would benefit doctors, patients, and even the government, while allowing our team to realize their aspirations. As I approached 40, I felt that I would regret it if I did not give it a try.
The “Four Don’ts” of Entrepreneurship
I believe many aspiring professionals are eager to enter the competitive arena of internet healthcare. If you intend to establish your own niche in this landscape, you must first understand how it operates. The market is already bustling with activity. As everyone knows, the three major tech giants—BAT (Baidu, Alibaba, and Tencent)—are already formidable players, having recruited top-tier talent with exceptional expertise. There are also cross-industry entrants such as Xiaomi and Ping An. Beyond these, numerous other prominent figures have made their mark across various sectors. Already, several large-scale projects with valuations exceeding $1 billion, or even higher, have emerged.
From the U.S. classification perspective, my understanding is that internet healthcare encompasses physician tools, consultation platforms, wearable devices, and chronic disease management—the last of which includes a vast array of offerings. I recall that, according to a report by VCBeat, there were already 89 diabetes-related products alone by the end of last year. The sector also spans seven major categories, including pharmaceutical e-commerce, medical alliance platforms, and new media. Where should we begin? Should we start with physicians, partner directly with hospitals, develop wearable devices, or target end-users directly? These are all questions we need to consider as we identify an entry point. Regardless of where one chooses to start, allow me to share my insights:
First, entrepreneurship still requires focus; we will concentrate solely on this one endeavor.If you try to do everything now, when you approach investors for funding, they will inevitably ask, “What if the major players already in this space decide to enter? Can you outcompete them?” Therefore, I believe that attempting to do everything is equivalent to doing nothing, as it is exceedingly difficult to surpass the behemoths already dominating the market.
Second, the activities undertaken should have barriers to entry, meaning they are not something anyone can do at will.I once attended an event where the guy sitting next to me had developed a diabetes management platform. He told me that he was a patient himself and, after living with the disease for three years, he created this platform, which now boasts 700,000 users and collaborates with several blood glucose meter manufacturers. Therefore, I find it unsurprising that there are 89 diabetes-related products on the market. Although the market is large, the barriers to entry are low. Everyone should consider what the competitive landscape would look like if they were to enter this space now.
Third, it is essential to identify genuine needs and focus on rigid demand.A friend of mine, Liu Qian—not the magician, but a critic—recently wrote an article pointing out that many mobile health projects address needs that are not well-founded. Many of these needs are taken for granted. It is reminiscent of the fervor for learning from Lei Feng in the past, when some teams would help elderly women cross the street, while other projects were essentially helping them back. There have been quite a few such articles recently; I have written on this topic as well. This issue warrants serious attention.
4. You must consider the business model.You may not generate revenue temporarily, but we must always clarify how we can achieve profitability if everything goes according to plan. If a venture cannot make money even under ideal conditions, I, for one, would not pursue it, as the risks are too high.
Therefore, I propose a principle called the “Four Don’ts”: don’t engage in activities lacking distinctiveness; don’t undertake tasks that anyone can perform; don’t pursue non-essential needs; and don’t chase mere attention. In summary, my philosophy is: “Only do what you are good at.”
II. The Allure and Challenges of Niche Markets in Oncology
The Two Sides of the Oncology Niche Market
From this perspective, oncology can be considered an ideal niche market. Why is that?
First, there are numerous pain points; if we call this a rigid demand, I believe no one would dispute it. We will discuss the pain points in more detail later.
Second, there are few competing products. Why is this the case? Because the professional barriers in this field are relatively high; early-stage startup teams with weak professional backgrounds are unable to operate effectively, while highly qualified professionals are often hesitant to venture into entrepreneurship. To my knowledge, only three or four projects in this sector have publicly announced securing investments exceeding RMB 10 million. Some focus solely on patient communities, while others primarily engage in patient education. In a true sense, Yi Jiayi appears to be the only provider currently offering comprehensive information services covering the entire journey of oncology care, from pre-diagnosis to post-diagnosis.
Third, the market is sufficiently large, and the growth trend is clear. Although this is not a positive development, it is an undeniable fact. There are over three million new cancer cases annually in China. I estimate the prevalent patient population to be approximately 15 million, which translates to nearly 50–60 million family members. Additionally, the number of individuals concerned about their health or fearing they may have developed the disease likely reaches at least 200 million. Thus, the market size is substantial. While this represents a niche segment, it offers considerable room for growth and expansion.
Fourth, this field has high barriers to entry. Success requires a certain level of professional expertise, industry connections, a capable team, and resources, as previously mentioned.
Finally, its average transaction value is relatively high; oncology patients and their families are not particularly price-sensitive. The key lies in the quality of services you can provide.
From another perspective, this is also the most challenging field.Why is this said?
First, it requires a high degree of professionalism, along with knowledge, experience, and network resources. Therefore, as I just mentioned, this is not something that just anyone can do.
Second, the target user base has unique characteristics, as many cancer patients are elderly. This presents a challenge in terms of their ability to operate the product. Consequently, our operational strategies cannot mirror those used for mass-market consumer products; instead, we must tailor our operations to specific demographics and channels.
Third, oncologists are the busiest physicians; they never lack patients, nor do they lack money. What they lack most is time. Yet what you are asking of them is precisely their time—asking them to spend time engaging with your platform. This is no easy task, is it?
Fourth, attention must be paid to legal and policy risks in the functional design of products. For instance, if a feature is added to allow appointment scheduling, can fees be charged? The answer is no; charging fees would constitute ticket scalping. Even with an internet-based facade, it remains ticket scalping. We must fully consider these legal risks when designing functions and business models. In addition, there are policy-related risks; changes in policies regarding multi-site practice, telemedicine, and other areas directly impact business models and product functional design.
Fifth, how to get users to pay is a question. Although cancer patients are relatively less sensitive to money, getting them to willingly pay, and determining how they should pay, is not easy.
Another critical issue is how we can simultaneously meet the needs of both doctors and patients. Currently, many projects cater to physicians but fail to engage users; conversely, those designed for patients often struggle to attract physician participation. Therefore, addressing the dual demands of both parties has become a significant challenge. In the following section, I will share how YiJiaYi’s model attempts to resolve this issue.
Three Major Pain Points in Oncology Care
What is Yijiayi? It is the first, and to date likely the only, mobile doctor-patient platform in China dedicated exclusively to oncology, covering the entire continuum of care from pre-diagnosis to post-treatment. In a nutshell, we facilitate doctor-patient communication and resource matching; our concept is somewhat akin to Didi Chuxing, Baidu Zhidao, and Zhenai.com.
The fundamental issue in the doctor-patient relationship is the information asymmetry between the public and medical professionals, which is the root cause of the majority of pain points and difficulties in accessing healthcare. Before consultation, it is widely believed that the primary challenge in oncology care is the difficulty in finding and securing an appointment with a physician. However, in my view, the greatest challenge lies not in finding a doctor, but in finding the right one. Consider this: cancer is a highly complex disease. For the same condition, different medical specialties are required at different stages, and even within the same department, physicians have distinct areas of expertise. Take lung cancer as an example. Patients with early-stage lung cancer should seek thoracic surgeons for potential surgical intervention. Those with intermediate to advanced stages may need medical oncologists or radiation therapy specialists. In later stages, patients might require integrated traditional Chinese and Western medicine or palliative care. Even among thoracic surgeons, all of whom may hold titles such as Chief Physician or Professor, some specialize in lung cancer, others in esophageal cancer, and still others in mediastinal tumors. Such nuances are not always reflected in their professional profiles, so how can patients know? Therefore, in my opinion, beyond the difficulty of finding a doctor, a significant pain point in oncology care is the challenge of finding the appropriate specialist.
As previously mentioned, many oncologists do not lack patients. Do they have unmet needs? Yes, they do. In reality, suitable patients often fail to connect with the right physicians; instead, those who seek consultations are frequently inappropriate matches, leading to inefficient use of medical resources. Therefore, if you can help physicians screen for their desired patient profiles and effectively match doctors with patients, your assistance will be welcomed. Many teams fail to grasp this point and attempt to purchase access to these physicians’ resources, yet the patients they refer are not what the physicians actually need. This leaves the physicians frustrated, and over time, they become unwilling to collaborate.
Post-Consultation Challenges. In fact, pain points are more severe for cancer patients after their initial consultation. Patients typically seek care at large tertiary hospitals, which often focus only on a critical segment of cancer treatment. After undergoing surgery or having a chemotherapy regimen established at these major institutions, patients usually return to their hometowns for continued care. Consequently, there is a strong desire among patients to maintain contact with their attending physicians, yet this need often goes unmet. Our survey revealed that two-thirds of discharged patients were unable to obtain their attending physician’s mobile number; among the one-third who did, the likelihood of successfully reaching the doctor by phone was low. This is not to blame the physicians; Chinese doctors are willing but lack the capacity to meet such demands. As a result, when patients encounter issues after leaving the hospital, they cannot receive timely guidance from their attending physicians. They may consult less specialized local doctors and consequently discontinue chemotherapy in favor of traditional Chinese medicine. For patients, failing to complete a standard course of treatment significantly increases the risk of recurrence; for physicians, high patient recurrence rates can adversely affect their professional reputation.
The third pain point is that diseases which are more difficult to treat require more resources, yet matching these resources with patients is often challenging. Many patients search extensively for available resources, while many resources struggle to find suitable patients—both sides are actively seeking each other. With “Yi Jia Yi,” we aim to break down the information barriers between the public and healthcare professionals, thereby alleviating this critical information asymmetry.
III. Addressing Major Challenges with Robust Models
What Can “Yi Jia Yi” Bring?
Specifically, what can be done before the consultation? In short, we provide a platform for patients and their families in need to pre-select and initiate contact with oncology specialists, while also allowing physicians to select their patients. This initial contact and mutual selection occur before the patient formally seeks medical attention. Much like online interactions prior to a blind date, if it becomes evident that there is no compatibility, an in-person meeting can be avoided, thereby saving valuable time. This efficiency is crucial for cancer patients.
Many patients from Zhejiang Province prefer to travel to Shanghai for medical treatment. A typical experience for a patient from Taizhou might go as follows: Upon arriving in Shanghai, they first visit the Shanghai Cancer Center, purchase an appointment number from a scalper, and consult with a specialist, only to be turned away. They then proceed to Ruijin Hospital, where they again buy a scalped appointment to see another specialist, but find that all beds are occupied. Next, they try Zhongshan Hospital, and after visiting several hospitals, they may finally be admitted.In the future, the scenario will look like this: Before leaving home, patients can use the "Yi Jia Yi" platform to have preliminary consultations with three or four Shanghai-based physicians. They can then choose the doctor with whom they feel the most comfortable, who inspires the greatest confidence, and who shows the most interest in their case. The patient can then travel directly to Shanghai to see this selected physician. Wouldn't this significantly improve treatment efficiency and patient experience?
Who used to be the only ones capable of handling this? Acquaintances. But what if those acquaintances lacked sufficient resources or influence? In the past, there was little that could be done. Moving forward, “Yi Jia Yi” will serve as a “trusted acquaintance for the masses” for cancer patients across China. Leveraging professional expertise and resources, combined with mobile internet technology, “Yi Jia Yi” transforms the traditional “acquaintance-based” approach to seeking care for serious illnesses into a highly specialized “Internet + Precision Medicine” model. When patients turn to us, we connect them with tens of thousands of expert physicians—not only helping them find doctors, but ensuring they find the right ones.
We have a feature designed to facilitate communication between doctors and patients after consultations. When patients request phone contact, doctors can invite them to scan a QR code, saying, “Connect with me on the platform; leave messages there, and I will review them when I am available.” This ensures at least one channel for patients to stay in touch with their doctors without causing the disruptions associated with phone calls. Additionally, patients can engage in self-management on the platform by creating electronic health records and maintaining treatment diaries. Entries made by patients are automatically converted into charts on the doctor’s interface. If Xiong Dun had used Yijiayi, Dr. Liang could have monitored her out-of-hospital treatment status in real time through the Yijiayi physician portal.
What is our business model? It is a well-acknowledged fact that establishing a profitable model in mobile health is challenging. While internet platforms typically aim to maximize user acquisition by offering free services or incentives, attempting to monetize these users afterward creates an inherent contradiction. Our solution lies in distinguishing between “users” and “customers.” Doctors and patients are our users, and their access is largely free of charge. As long as they are willing to use the platform, its value will naturally become evident. Who, then, are our customers? They are the providers of medical products and services, such as pharmaceutical companies, genetic testing firms, cancer screening services, and overseas medical service providers.
As I mentioned earlier, there are abundant resources related to oncology, and the average transaction value is relatively high. YiJiaYi can generate revenue by matching patients with appropriate resource-based services. Furthermore, if doctors and patients interact on the platform daily, with patients comprehensively uploading their medical histories and treatment journals, a substantial volume of valuable data can be accumulated. There are companies in the United States operating similar business models, whose valuations reached hundreds of millions of US dollars last year. This represents another source of value for us.
Heavyweight Models Address Critical Issues
So, if we look at all internet healthcare companies from the perspectives of “mobile” and “medical,” some are heavily mobile-focused, while others are deeply medical-oriented. Each company can find its own niche in this landscape—wouldn’t you agree? In terms of problem-solving approaches, some adopt asset-heavy models, while others use asset-light models. Using an asset-light model to address minor health issues is one typical approach, exemplified by Chunyu Doctor. If such light-touch solutions prove insufficient and hospital care is needed, patients would then turn to Haodafu Online. In the near future, upon a cancer diagnosis, patients may go directly to Yijiayi—a scenario we hope to see realized.
SoWhere Does the "Heavy" in Heavy-Asset Model Lie?？
First, ordinary telemedicine platforms recruit doctors online, whereas we extend invitations, which requires considerable human and material resources. Although the costs are not excessively high, this is largely due to the substantial support from many individuals.
Second, ordinary consultation platforms operate using internet-based models, whereas we acquire users through offline channels. The advantage of this approach is that users clearly understand why they are coming to us and what benefits they can expect, unlike certain companies that rely on outsourced ground promotion teams to forcibly recruit users.
Third, in terms of the communication format of medical consultations, many general consultation platforms operate on a spontaneous, light-touch model without customer service intervention. In contrast, our customer service and backend teams are heavily involved, with our team even including dedicated attending oncologists. A significant portion of our staff possesses professional medical backgrounds.
Fourth, while routine preliminary consultations can be completed online, oncology cases targeted by Yijiayi cannot be resolved through a 15-minute phone call. The online platform primarily serves as a channel for mutual selection and communication, with the core treatment still requiring in-person medical care.
Finally, the teams differ: teams sourced from general online consultation platforms do not require a strong medical professional background, whereas our team demands a high level of medical expertise. Therefore, our overall business model is relatively asset-heavy.
IV. How Disease-Specific Apps Can Build Competitive Advantages
If everyone is also going to develop a disease-specific app, how can they establish their own competitive advantages?
First, we must leverage our strengths to gain a genuine and in-depth understanding of user needs, rather than making assumptions.
Second, we center our promotion around physicians, prioritizing the acquisition of scarce resources. If these top-tier doctors are willing to join my platform, I am confident that patients will follow.
Third, we introduced interactive features to build stickiness and address the issue of low user frequency. On our platform, physicians can not only manage their patients but also communicate with peers and even refer patients to one another. Meanwhile, users can maintain ongoing contact with physicians at various stages of care. This approach resolves the low-frequency limitation inherent in single-consultation platforms and enhances user engagement.
Fourth, establish a profitable business model based on an in-depth understanding of the industry. I will reiterate this point: for ultimate survival and growth, a viable profit model is essential.
Fifth, the operation of such projects is often complex and requires a strong background in medicine and research. You need to build an experienced and professional core team and enhance team cohesion.
V. A Touch of “Sentiment”
I used to disdain discussions of “sentiment,” considering them overly pretentious. However, after all this time, I have come to believe that such sentiment is essential. Take our company’s customer service team as an example: there is a plaque in their office bearing the four characters “Empathy.” A couple of days ago, I took all my colleagues to watch the film Go Away Mr. Tumor. Afterwards, I told the women on our customer service team that the voices they hear on the other end of the phone every day are Dr. Liang and Xiong Dun. Sometimes, when patients make special requests, our customer service representatives ask me how to handle them. I tell them to treat these patients as if they were their own uncle. Treat your users with the same care and respect you would show your relatives. If they are satisfied, you have done your job well. Both cancer patients and oncologists face significant challenges. Only by serving them with genuine sincerity can we earn their trust and build a strong reputation. This is the only way our business model can succeed. If what you do not only provides financial compensation but also brings you the joy and sense of accomplishment that come from helping others, then it can truly be called a career.
Thank you all for attending my presentation. Thank you!
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