Due to the long chain characteristics of medical services, the Internet can only cover several links, which leads to the small scale of its developable market. Since the rise of digital medicine in the United States, although its own growth is rapid, it is mainly concentrated in the coordination within and between medical institutions. The number of companies completely separated from offline medical institutions and commercialized is relatively limited.
Although the valuation of the primary market is still high, after listing, its scale is far lower than expected in terms of the company’s revenue and market value. Moreover, in terms of growth rate, most companies have slowed down significantly in the case of low base of revenue scale, and have to rely more on external mergers and acquisitions, but this has pushed up their own liabilities and put pressure on long-term development in the case of continuous losses.
The main reason why internet medical service is difficult to scale is not only the challenges faced by traditional medical services, including the difficulty in creating medical needs, the strength of service providers due to the complexity of medical technology itself, and the difficulty of human nature to accept continuous management; It is also that medical service is a very long chain service model. More offline medical institutions are launched, which is difficult to be fully copied online.
Therefore, although the Internet is good at promoting the completion of short chain services online, both daily entertainment, catering and taxi are instant, and the transaction can be completed at one time; However, the Internet can only seek to serve several links above the whole chain in the medical field, which makes it difficult to become an all-round platform and can only become an auxiliary tool for offline services.
Different from other consumption, the whole chain of medical services is long and highly subject to the service provider. From the beginning of consultation to inspection, follow-up and dispensing and possible further treatment, only outpatient service needs multiple steps. In case of hospitalization, there are more service processes and links from admission to discharge. In all these links, the main services of the Internet are out of the hospital, from outpatient diversion to online consultation, prescription outflow to pharmacies or direct distribution through the Internet, and then to rehabilitation care and follow-up after discharge. Among them, the consultation and hospitalization in medical institutions are the core, and the Internet can only maintain and improve the services based on it.
Therefore, if we want to break through the restriction of the long chain, we must build an online system that can replace the offline system. However, online consultation is subject to many factors, and more focus on the acquisition of drugs for minor and chronic diseases. Due to the lack of examination, doctors can not provide a good medical experience under the premise of facing many uncertainties. Patients also have a skeptical attitude towards online consultation, and will only use it actively when they need to buy prescription drugs. According to the speech of doctor on demand at a meeting in 2015, doctors who do not prescribe drugs to patients in strict accordance with medical norms often get bad comments in remote consultation. This also shows that even in the United States, remote consultation has developed in the direction of the so-called “prescription clinic”.
When it is impossible to bypass the core interrogation elements such as examination, even if the Internet breaks into the interrogation link, it can only play a role in the prescription link in the outpatient field, and can not cover the whole process. In other service links, pre hospital disease management and post hospital acute post hospital service are the advantages of the Internet. After the introduction of value healthcare in the United States, this part of services has achieved rapid growth and spawned a number of internet medical companies.
However, there is another problem with this part of services. The compensation amount of medical insurance in the fields of disease management and rehabilitation nursing is not high, and the enthusiasm of patients’ participation is not high. Medical institutions and third-party Internet services need to provide collaborative services for patients, which leads to limited overall revenue and will not expand quickly.
Therefore, although medical service is a large industry, its own long chain service links lead to the division of the Internet into independent plates in the areas where it can be developed. Because the consultation can not be completely moved to the line, the Internet can not integrate medical services, so it can not grasp the main development scale of the industry, and can only be gradually expanded in several disconnected fields.
The fragmentation of the medical service chain means that every link of the medical service is broken without effective connection. The treatment of patients also focuses on treating headache and foot pain, and lacks the thinking of overall service. On the surface, there are many reasons for the fragmentation of the medical service chain, such as the competition between hospitals, the competition between doctors, the inability of doctors to practice freely and the multi head of medical administration in China. However, in fact, the fragmentation of the service chain is due to the fact that the payer has never been able to effectively check and balance the medical system, so it is unable to straighten out the service chain, which eventually leads to the complete dispersion and fragmentation of the whole medical service chain.
Whether online or offline services, each service subject has its own interest demands. For a long time, service providers have promoted the most profitable part of the current medical system to develop on a large scale, and those who can’t make money are gradually weakened. For example, doctors’ income mainly comes from products. The diagnosis of the disease is increasingly dependent on instrument examination, and the treatment plan is also mainly dependent on drugs and surgery. They are less and less interested in services other than products, such as follow-up and disease management, because they can not obtain the same benefits from these services. This slowly distorts the whole medical service, making the fracture of the service chain more and more obvious.
Under the strong payer system, any new medical service is to make up for the deficiency of the medical service chain, so as to better provide complete services for patients and finally achieve the goal of cost control. For example, digital medicine in the United States is to make up for the lack of services outside the outpatient service and provide more pre-treatment and post-treatment services to help patients better improve their health level. These services are not originally lacking, but originally offline, but online services help to improve efficiency and reduce costs.