Mindray's Internet Healthcare Journey: From Disease-Centric Insights to Wearable Devices

VCBeat VB Think Tank Session 4

Time: Afternoon, Thursday, April 16, 2015
Location: IC Coffee
Speaker: Xu Chao, Mindray Bio-Medical

I. Transformation of Medical Device Companies
II. The Essence of Internet Healthcare
III. Target Populations for Internet-Based Healthcare Services
IV. Demands of Patients with Chronic Diseases
V. What Internet Healthcare Can Do
VI. Quality Internet Healthcare Services
VII. The Role and Demands of Physicians in Internet-Based Healthcare
VIII. On the Disruption, Integration, and Laissez-Faire Theories of Internet Healthcare
IX. Differences Between Internet Healthcare and Other Mobile Internet Services
X. Questions and Answers

Guest Profile
Xu Chao
As a former cardiologist, 50-year-old Xu Chao jokingly refers to himself as the oldest entrepreneur in the internet healthcare startup sector. He stated that he, a member of the post-1960s generation, will lead a team primarily composed of individuals born in the 1980s to serve patients from his own generation. His team will embark on an exploratory journey into internet healthcare for Mindray Bio-Medical, a company listed on the New York Stock Exchange. At this salon event, he unveiled Mindray Bio-Medical’s strategic layout in internet healthcare for the first time.

Hello everyone:

As everyone knows, Mindray is a company that started with hardware. We have been in operation for 24 years. The manufacturing and sales of hardware present new challenges to us under the new economic situation. Therefore, we have some new thoughts. Today, I would like to exchange ideas with you and seek your guidance and suggestions.

I got up at 5:00 a.m. this morning. My flight from Shenzhen to Beijing departed without a minute’s delay, leaving me with an hour to stroll along Zhongguancun Entrepreneurship Street before the salon began. There, I could feel the entrepreneurial fervor—the relaxed atmosphere, the flow of people, capital, and information all swirling together. This reminded me of what I used to see while walking around the Harvard University campus. I believe many of you have been there as well: passing by a roadside café, you might spot two people in conversation. You have no idea what achievements they have already attained, nor can you predict what successes they will achieve in the future. Likewise, I believe the future of each person here is equally unpredictable. I would like to take this opportunity to wish you all great success and fruitful outcomes in your new ventures and fields.

I. Transformation of Medical Device Companies
Let me start by introducing myself. I specialized in cardiac electrophysiology and worked as a cardiologist at several hospitals, with my last position being at Shanghai Ruijin Hospital. After leaving the hospital in 1996, I joined multinational medical device companies, where I held roles in sales, marketing, and liaison offices for foreign representatives. I also co-founded a company with friends and spent three years working with dental equipment. More than a decade has passed since then. Two and a half years ago, I returned from abroad and joined Mindray.

At Mindray, my first role was Clinical Marketing Director, responsible for global expert relations and academic exchanges in the fields of critical care, emergency medicine, and anesthesiology. To date, I have assumed three responsibilities. Currently, I am honored to be appointed as the head of preparations for Mindray’s mobile internet healthcare business.

Let me briefly introduce Mindray, and then I invite you to assess whether our thinking on entering the internet sector is logical. Mindray is a homegrown Chinese brand, founded in Shenzhen in 1991. To date, it is the largest company in China’s medical device industry. In 2014, its global revenue reached US$1.3 billion, with approximately 9,000 employees worldwide, and 55% of its revenue came from markets outside China. Listed on the New York Stock Exchange (NYSE) in 2006, Mindray remains the only Chinese medical device manufacturer listed on the NYSE.

We have four core business segments. The Patient Monitoring & Life Support Systems division, where I am based, is the largest business unit. Its main products include patient monitoring, respiratory care, anesthesia, defibrillation, and ECG solutions. Ultrasound, medical imaging, CT, and MRI fall under the Ultrasound Business Unit. In vitro diagnostics involves a wide range of biochemical products, while the surgical segment covers products such as surgical lights, operating tables, ceiling pendants, orthopedics, and endoscopes. We have been strategically positioning ourselves in the internet healthcare sector for three years, primarily focusing on hardware manufacturing. However, it is regrettable that we have lacked clarity on target customers, sales strategies, and distribution channels for our hardware products over the past two to three years. Recently, we have been conducting continuous research and now aim to rethink our approach from a new perspective.

II. The Essence of Internet Healthcare
Today, the title of my speech is “How Internet Healthcare Can More Effectively Serve More Patients,” with “effectively” referring to both efficiency and effectiveness. I would like to quote a physician named Trudeau, a 19th-century American tuberculosis specialist. He was a student at Columbia University College of Physicians and Surgeons when he contracted tuberculosis. At that time, there were no specific drugs for tuberculosis, making it essentially a terminal illness. Each day, he would go to the lakeside to breathe fresh air and relax, and eventually he experienced spontaneous recovery. He returned to his studies, but unexpectedly developed a fever again upon returning to New York, with a recurrence of symptoms, prompting him to rest once more. After many such cycles, he ultimately earned his degree and became a tuberculosis specialist. He was the first physician to isolate Mycobacterium tuberculosis, the pioneer who conceived the idea of the first tuberculosis sanatorium, and the founder of what has been referred to as “Tuberculosis University.” Before his death, he left a famous aphorism about medical practice: “To cure sometimes, to relieve often, to comfort always.” This quote was later engraved on his tombstone as his epitaph.

I believe everyone here has heard these three statements: Medicine has many limitations; doctors cannot cure all diseases, and complete cures are not common. For patients with advanced-stage cancer, we lack effective methods to achieve a radical cure; instead, we alleviate their pain and improve their quality of life through palliative care, which constitutes assistance. “Always to comfort” means that physicians should demonstrate humanistic care and concern for their patients. Cure, help, and comfort represent the true essence of medical practice. If we regard these three keywords as the core tenets of medicine, and then examine internet-based healthcare in this light, what is its essential nature? Can it fulfill these three objectives?

We believe that the essence of internet healthcare is, fundamentally, healthcare—just as e-commerce is commerce, maglev trains are trains rather than aircraft, and new energy vehicles are defined by having four wheels and operating on highways. We hold that, regardless of the delivery channel, what is provided to patients should be treatment, assistance, and care. Internet healthcare leverages mobile internet technologies to overcome the temporal and spatial limitations inherent in traditional healthcare.

Another characteristic of internet healthcare involves issues of efficiency and traceability. Thirdly, internet healthcare cannot alter the authority, professionalism, and diagnostic-therapeutic role that physicians hold over patients. No matter how you educate your patients, you cannot enable them to reach a level where they can self-diagnose and self-treat. To cite an extreme example, even when we physicians fall ill, we do not treat ourselves but instead seek assistance from other doctors; this underscores the issue of professionalism. Internet healthcare should not merely consist of remote communication; it must also provide face-to-face interaction, support, and reassurance. In the context of internet healthcare, “face-to-face” translates to offline services.

III. Target Populations for Internet-Based Healthcare Services
Based on the health status of the general population, which can be categorized into four groups, which patients are best served by internet healthcare? Let us first consider acute and critical cases. Among the audience here are physicians and hospital administrators. Patients within our hospitals are either acute or critical cases, and the equipment manufactured by Mindray is also limited to this scope, referred to as in-hospital services. Another segment comprises patients who have previously visited the emergency department, been hospitalized, and subsequently discharged. In theory, their post-discharge care should be managed by community healthcare providers. However, can community healthcare effectively manage these patients? Community physicians are general practitioners and lack the expertise to manage highly specialized chronic conditions. For example, a patient with coronary heart disease who has undergone stent implantation (three stents) requires ongoing medication. Community hospitals often do not stock these specific medications, and their physicians may lack the knowledge to properly manage dosing regimens. Consequently, such chronic disease patients do not receive adequate care and treatment after leaving large hospitals, leading to recurrent episodes, repeated hospitalizations, and emergency visits. This results in a poor quality of life and substantial healthcare costs.

Internet-based healthcare can overcome barriers of time and space. We believe that home-based management of chronic diseases is the service model best suited to our capabilities, as this is where the target patient population resides from the perspective of the provider-patient relationship. For individuals in a sub-health state—such as those who are overweight, have smoking habits, or experience minor symptoms despite having normal physiological indicators—lifestyle modifications are required. Mobile health solutions are less suitable for this group; instead, they would benefit more from preventive care and health education provided by community health centers.

We believe that the key determinant of quality and success in chronic disease management is communication between physicians and patients. Medical devices are not the primary factor; wearable devices merely provide objective data as an important tool. We hold that physicians will only trust information derived from professional-grade wearable devices, and such devices can fulfill their role only after this information has been trusted and interpreted by physicians.

Mindray has never intended to manufacture smart bands, as this is not our core competency. Our requirements for wearable devices are: compact size, lightweight, low power consumption, comfort during wear, long standby time, ease of operation, automatic analysis, and data reviewability. We are developing promising products that should be launched soon. As a medical device manufacturer, we boast a robust training and service network. We will establish physical experience centers and dedicated departments to handle complaints related to operational difficulties and quality issues.

IV. Demands of Patients with Chronic Diseases
So, as patients with chronic diseases, what are their expectations and demands for internet healthcare? What kind of services do they hope internet healthcare can provide for them?

Our understanding is as follows:

First, as I am in Beijing, I certainly hope that hypertension specialists from Peking Union Medical College Hospital and Peking University will first help me determine whether my hypertension is primary or secondary. Once the diagnosis is established and a medication regimen is prescribed, I will be very satisfied. This constitutes the first step.

Step 2: During home recovery or in the course of daily work, patients may seek follow-up consultations and recommendations from specialists who are familiar with their medical conditions, particularly those with chronic diseases accompanied by serious comorbidities, such as stroke patients with hypertension.

Third, if an echocardiogram performed at Peking University Hospital reveals thickening of the left ventricular wall and enlargement of the left atrium, I would prefer that the same sonographer responsible for operating the ultrasound equipment at that hospital conduct all my subsequent examinations. This ensures that my longitudinal data remain comparable over time, thereby enhancing their clinical value.

Finally, I hope to receive timely advice and follow-up consultations when my condition changes. With the arrival of spring and autumn, my blood pressure has suddenly spiked, and I am unsure how to adjust my medication dosage.

"As a patient with a chronic disease, if I use internet medical services and have wearable devices on my body, with someone providing support behind the scenes, I hope for this kind of doctor-patient service model."

V. What Internet Healthcare Can Do

So, how can internet-based healthcare meet the service demands of patients with chronic diseases?

First and foremost, professional consultation and interaction are essential. Cardiologists should treat cardiac patients, and gastroenterologists should treat gastrointestinal patients. It is unprofessional to accept all patient inquiries and management requests indiscriminately, regardless of specialty.

Second, whether on the platform or offline, this doctor-patient relationship should be a long-term relationship of mutual trust. It is crucial to establish such trust between doctors and patients. Offline interactions provide the optimal setting for building this mutual trust.

Third, we believe that the electrocardiogram (ECG) and blood pressure data provided by professional-grade wearable devices are credible for physicians. This is akin to bringing a miniature Coronary Care Unit (CCU) into one’s home. Historically, the concepts of hospitals and hotels did not exist; hotels emerged because travelers needed overnight accommodation and services were available to meet this need, while hospitals developed because physicians required continuous observation of patients’ conditions. There is no rule mandating that patients must be hospitalized when they fall ill; the setting for medical care can vary. The critical issue is how to deliver these services directly to the vast patient population, which is both our consideration and what internet-based healthcare can achieve.

Our view is that public hospitals are behemoths and highly specialized institutions. We have no intention of disrupting them or expecting all patients to flock to us—that is simply impossible. The internet healthcare model we are attempting serves merely as a supplement to the existing system. What do we mean by “supplement”? Currently, the situation is such that a person is considered a patient only from the moment they enter a public hospital until they leave its doors. Once they exit, they are no longer regarded as patients, even though their condition persists and they are left without ongoing care. We aim to help public hospitals manage the aspects they lack the capacity to address. For instance, after a patient with coronary heart disease receives three stents and is discharged, physicians have no knowledge of the patient’s subsequent condition. When the patient returns for a follow-up visit, there is a gap—a blank period—in their medical history. Our goal is to provide management and continuity of care during this interim period.

VI. Quality Internet-Based Medical Services
If you provide high-quality internet-based medical services, the following outcomes can generally be achieved for patients with chronic diseases: the progression of chronic conditions is slowed. For example, hypertensive patients in their 50s or 60s may remain stroke-free for a decade, maintain good health, and avoid myocardial infarction. Daily symptoms are significantly alleviated, and the frequency of angina episodes decreases, ultimately providing patients with a sense of security. They receive medical care anytime and anywhere; with wearable devices connected to physicians, they can contact their doctors at any time should issues arise. Doctors provide professional guidance, leading to a marked improvement in quality of life. This constitutes a high-standard service. If patients experience such positive outcomes, they are willing to pay for the service—a separate topic in itself.

Objectively speaking, the frequency of emergency department visits by patients has significantly decreased. Whereas they previously required five emergency room visits and five hospital admissions annually, now only one or two visits suffice. This has led to a substantial reduction in pharmaceutical expenditures for both individuals and the state. From this perspective, such outcomes align with the developmental direction of China’s healthcare sector. The average life expectancy of patients with chronic diseases has increased, the number of individuals returning to social activities has risen markedly, and the caregiving burden on family members has been reduced. Furthermore, this trend facilitates the diversion of patient flow from tertiary hospitals, thereby alleviating pressure on their bed capacity.

It is widely acknowledged that outpatient departments are overcrowded, making it difficult for patients to access medical care. At the entrance of Peking Union Medical College Hospital, numerous scalpers are reselling appointment slots, yet many patients still fail to secure consultations. In reality, we recommend that large hospitals categorize their outpatient population. By analyzing outpatient data, we can determine how many patients are returning for prescription refills, how many are first-time visitors, and how many are chronic disease patients seeking follow-up care. Understanding this distribution will help us formulate appropriate next steps. While triage is frequently discussed, effective triage requires concrete measures. Simply mandating that certain patients remain at primary care facilities and prohibiting them from seeking care at Peking Union Medical College Hospital is not acceptable to Chinese patients. If a serious condition is misjudged and treatment is delayed as a result, who can bear the responsibility? Primary care physicians cannot assume such liability. The goal should be to retain those who appropriately belong in primary care while facilitating referral for those who require specialized attention.

We previously observed that nearly one-third of patients admitted to the cardiology ward were hospitalized for heart failure. These patients, classified as NYHA functional class IV, were discharged after their condition improved by two functional classes. However, many were readmitted within a few days, indicating inadequate home care. Neither the patients nor their family members knew how to properly manage the disease, and lifestyle habits remained unchanged—for instance, they continued to consume high-salt diets. This led to frequent readmissions. Therefore, effective chronic disease management can help alleviate the burden on both outpatient and inpatient services.

VII. The Role and Demands of Physicians in Internet Healthcare
We believe that in the doctor-patient relationship, physicians have always held a dominant position—an advantage that has persisted from ancient times to the present. Regarding the role of internet healthcare in chronic disease management, physician engagement determines its success or failure; without their participation, it is bound to fail. So how can we encourage active physician involvement?

Current Drivers of ChangeAs we see it, the current drivers can be broadly categorized as follows. The first is the realization of personal value. For example, at the inaugural Wearable Medical Device Exhibition held yesterday in Shenzhen, I had discussions with several clinical experts. I asked them whether they have patients who maintain good relationships with them and seek their advice outside of regular working hours after procedures such as the implantation of two or three stents or a pacemaker. They confirmed that this is quite common and represents a genuine demand. I then asked if they could transform these friendly relationships into formal service contracts. They responded that this would be inappropriate; given the high level of trust from patients, Chinese doctors find it difficult to engage in such arrangements. Instead, patients typically express their gratitude by bringing local specialty gifts each year. I further questioned whether it would be feasible to gradually cultivate habits of paid services among both doctors and patients starting now. They agreed that this should be possible, suggesting that professional socialized services could eventually replace interpersonal favors. In fact, patients desire such services, which would eliminate unnecessary social pleasantries for both parties. Patients also possess the willingness and financial capacity to pay, yet there is currently no supply of such services in society. I pointed out that this has long been different in the United States, where patients are truly the lifeblood of physicians’ practices. As practicing physicians, and particularly as those aspiring toward independent practice, shouldn’t we reflect on how our personal value can be realized?

Another aspect is aligning with the development of mobile internet. Many physicians recognize this as a major trend that will offer significant support in the future; however, they are currently uncertain about how to get started and effectively integrate with internet-based healthcare services.

The current obstacles are time and energy. This primarily refers to large hospitals, particularly Grade 3A hospitals, where physicians are extremely busy balancing clinical care, teaching, and scientific research. Additionally, they are deeply concerned about legal disputes and financial compensation liabilities. They worry, “If a patient sues me, who will protect me?” Addressing these concerns requires supporting legal frameworks and insurance mechanisms.

From a physician’s perspective, what kind of patients do doctors prefer? Doctors favor consultations involving conditions within their area of expertise. Although I am a cardiologist, please do not ask me questions such as, “I had a ventricular septal defect and underwent repair surgery three years ago; I am now three months pregnant—can I continue the pregnancy?” Such questions are difficult for an internist to answer, as they lie at the intersection of two specialties. Physicians prefer patients whose conditions are familiar to them and whom they have previously treated. Additionally, it is advantageous for both physicians and patients to reside in the same geographic area, facilitating follow-up visits.

VIII. On the Disruption, Integration, and Laissez-Faire Theories of Internet Healthcare
In my view, the “Disruption Theory” and the “Laissez-Faire Theory” represent two extreme perspectives. Proponents of the Disruption Theory argue that IT is omnipotent; they believe their approaches can render individual physicians’ clinical experience irrelevant by encoding expert consensus entirely into computer systems. Under this model, patient data would be input to generate automated diagnoses and prescriptions. Most advocates of this theory come from mobile internet or IT backgrounds. While they possess strong confidence and such a vision may eventually be realized, it is certainly not imminent—it is highly unlikely to occur within the next decade or even several decades.To illustrate this point, consider another example: when Western medicine was first introduced to China, one might have expected it to completely supplant Traditional Chinese Medicine (TCM). Yet TCM has not been eliminated. For instance, in cases of intestinal infection, Western medicine can identify the specific pathogen under a microscope—a seemingly scientific approach—and treat it effectively with antibiotics. In contrast, TCM practitioners often achieve successful outcomes in treating bacterial enteritis using herbal remedies with heat-clearing and detoxifying properties, even though the underlying mechanisms remain poorly understood. Logically, TCM should have been eradicated over a century ago. However, what has actually happened? Western medicine has failed to displace TCM, and it still has not done so to date. This historical reality indirectly demonstrates that the Disruption Theory is overly extreme.

The Theory of Inaction. Most senior clinical experts who adhere to this view believe that remote consultations are too risky. Without having seen the patient in person, conducting only a rudimentary inquiry, and failing to discuss family history with other parties, how can one dare to offer advice lightly? It is unreliable; only when you sit before me for blood pressure measurement and cardiac auscultation can a definitive assessment be made. However, I consider this view somewhat conservative. Modern IT technology can assist physicians in accomplishing within two or three seconds what they would be unable to complete in an entire day. A simple example is 24-hour electrocardiographic monitoring: without computational assistance, it is extremely difficult for humans to review hundreds of thousands of heartbeats and identify numerous abnormalities. The so-called Theory of Integration reflects a growing trend toward convergence: the integration of mobile technology with traditional healthcare, the integration of public-sector and private-sector entities, the integration of online and offline services, and the integration of hardware with services. We ourselves advocate for this philosophy of integration.

IX. Differences Between Internet Healthcare and Other Mobile Internet Services
In our view, the doctor-patient relationship, framed as a buyer-seller dynamic, is the most irrational pairing imaginable, with sellers exerting complete dominance over buyers. If a doctor prescribes a medication, the patient must take it; doctors hold a clearly dominant position. In other words, if I am staying at a hotel today and wish to switch to another, it is easy—I can select one on Ctrip based on my budget and location. However, it is far more difficult to choose a physician suitable for your specific condition online. How would you know which doctor is best suited to treat your illness? Patients lack medical expertise; for instance, if you have a headache, how would you know whether to consult a neurologist or a neurosurgeon? This represents a significant difference between internet healthcare and other internet-based businesses. Simply providing information to users through an internet-centric mindset cannot resolve the issue of medical professionalism.

We have just discussed free services, massive user bases, and how value-added services constitute the primary revenue stream. The current question is: How many genuine users does internet healthcare actually have in the market? Is this user volume sufficient to attract pharmaceutical companies and insurance providers present here to pay for these services? I believe that a completely free model is likely unsustainable; however, a tiered structure can be implemented, offering basic services for free while establishing robust pricing standards and content for premium tiers.

Another point is that mutual trust between doctors and patients is a prerequisite for payment. In fact, patients are not unwilling to pay; rather, they are willing to pay for outcomes. If we can deliver the aforementioned results, I believe a portion of patients will be willing to pay. Furthermore, the process of disease diagnosis and treatment requires a highly serious and scientifically rigorous platform. Therefore, we will prevent the trend of turning internet healthcare into entertainment. We have no interest in ranking or evaluating which doctor is the most popular online, as this is irrelevant to our mission.

Let me provide a brief summary. The two key terms from today’s discussion are “healthcare” and “patients,” which, when modified, become “internet healthcare” and “chronic disease patients.” Internet healthcare is most suitable for the long-term management of chronic diseases, and this is an area Mindray aims to pursue. Physicians hold a position of absolute dominance and authority relative to patients; we deeply respect physicians and uphold their authoritative role. Compared with traditional medical models, internet healthcare represents a gradual evolution and advancement; at present, it is characterized by integration rather than disruption. In closing, what we have shared today reflects our “worldview” regarding internet healthcare. We did not address “methodology” today, as I believe that everyone here, being seasoned industry professionals, can already infer our intended approach after hearing this presentation.

Thank you all very much; your corrections and feedback are greatly appreciated!

X. Questions and Answers
Question: Hello, Mr. Xu. Thank you for your insightful presentation. As a professional medical device company, how do you personally view the entry of professional-grade equipment into home settings? From the perspective of internet healthcare, which types of devices, or which devices monitoring specific indicators, do you consider most important and worthy of development? Additionally, given the current R&D pace, how do you expect to sustain product output over the next one to two years, or two to three years?

Xu Chao: The first question concerns vital signs—specifically, which indicators should be monitored. There are many types of chronic diseases, and when considering device manufacturing and indicator selection, we approach it from the perspective of the disease itself. Mindray excels in patient monitors, where we have developed specialized expertise in parameters such as blood pressure, electrocardiogram (ECG), body temperature, and respiration, supported by our own patents and algorithms. In our early stages, we adopted a reverse approach: we identified patients based on the parameters we were already proficient in monitoring. After focusing on two or three conditions, we expanded our scope. We then worked backward from specific diseases to design wearable devices. For instance, I am aware of Professor Chen’s collaboration with Apple on Parkinson’s disease research, as well as a foreign company using sensors for gait analysis—all of these initiatives are driven by disease-specific needs. I strongly encourage engineers working on wearable devices within our team to engage more frequently with clinical experts, listen to their experiences, understand the challenges they currently face, and develop solutions accordingly. If we can create such solutions, particularly those involving parameters never previously observed worldwide, it represents 100% invention and complete innovation. Therefore, our first step was guided by our existing strengths, moving from parameters to diseases; the second step involves designing devices based on disease needs. The devices we develop in the future may not yet exist anywhere in the world, reflecting our commitment to innovation.

Question: What types of diseases do you expect to target?

Xu Chao: This is completely unpredictable—truly amazing. I came across a report yesterday claiming that a wristband could treat tumors, which was entirely unforeseen. Thus, the allure of internet healthcare lies in its boundless possibilities and sheer innovation.

Question: Thank you, Mr. Xu, for sharing your insights. I would also like to hear your thoughts on chronic disease management, specifically regarding how to achieve profitability in this area. Since delivering such services via mobile devices is relatively new to both patients and physicians, what approach should be taken? Should revenue be generated through platform data, by charging physicians or hospitals, or by charging patients? I would appreciate your brief guidance on this matter.

Xu Chao: This is the core of our business model. While I can discuss it, certain aspects remain uncertain. However, I can outline our intended approach. In the realm of internet healthcare, we adhere to an integrative philosophy, believing that the doctor-patient relationship constitutes the most fundamental foundation of internet healthcare. Simultaneously, we must account for the characteristics of the internet, which necessitates acquiring as large a user base as possible. Therefore, our users are divided into two segments: one segment consists of contracted users who pay for services, while the other comprises users who either utilize our services free of charge or pay a minimal fee. We aim to facilitate conversion between these two groups. From the outset, we have been committed to this direction. We are reluctant to rely on the notion that we will monetize only after five years, once big data capabilities have significantly improved. This remains a conceptual framework; if we can provide high-quality services to patients, those with the financial capacity will be willing to pay.

Question: Hello, Mr. Xu. I would like to ask for your insights. Some traditional blood glucose meter manufacturers are already transitioning toward internet-based models. Could you share your assessment and judgment on the likelihood of their successful transformation? Additionally, while professional medical devices require FDA approval in the United States, what is the current regulatory environment in China? For small-scale monitoring or therapeutic devices and small wearable devices seeking regulatory clearance, what challenges might traditional device manufacturers face in the future when submitting applications in China?

Xu Chao: At the Shenzhen exhibition, you could see that nearly 50 to 60 companies of a certain scale are producing wearable devices. From my perspective, in terms of manufacturing the hardware itself, each of them is likely to succeed, as producing these devices is not particularly difficult. However, the services behind the devices are the key to unlocking their true value; this is my personal view. Mindray’s wearable devices will not be sold separately on the market—in fact, we may not sell them at all as standalone products. Instead, they will be bundled exclusively with our services. This is a principle we are committed to upholding.

Regarding regulatory oversight for the manufacturing of wearable devices, supervision has thus far remained relatively lenient. However, I believe stricter regulations are imminent and will likely align with the current approval processes administered by the China Food and Drug Administration (CFDA), including mandatory clinical trials. Mindray holds certain advantages in this area, given its substantial talent reserves and well-staffed teams.

Question: Hello, Mr. Xu. First of all, it is an honor to hear your presentation here. As we provide services for cardiovascular physicians, my question may be somewhat direct. Your talk was titled “How Mobile Internet Can More Effectively Serve Patients.” If we were to add four Chinese characters to this title to make it read “How Mobile Internet Can Help Physicians More Effectively Serve Patients,” what would be your perspective?

Xu Chao: If we define the issue around the three keywords—internet healthcare, physicians, and patients—I believe that to assist physicians in managing chronic disease patients outside the hospital setting, platform builders should provide them with a highly user-friendly interface. Whether for the patient side, the physician side, or the platform itself, ease of use is paramount. For example, if you are serving cardiologists, you should understand which key indicators they need to monitor when reviewing a patient’s 24-hour data, and present these clearly on the interface immediately. When developing apps, platform construction must align with clinical physicians’ habitual workflows for managing such patients. Secondly, platforms should help physicians identify the patient populations they are willing to serve. While we highly regard physicians’ service to patients as a noble profession and duty, if we approach it from a business perspective, I would emphasize the importance of enabling physicians to conveniently find patients who are well-suited to their services. We must ensure this convenience. I imagine you have given this more thought than I have, given your specialization in this area—specifically, how to facilitate physicians in finding their patients. We have also considered this and would welcome further discussion. I believe both of these directions are quite important.