Personal Growth

Disruptive DNA: Groundswell for mobile health

September 2016

Founder Jennifer Xu shares her secrets on bringing a successful mHealth (mobile health) app to the Chinese market.

Harvard MBA holder Jennifer Xu is on a mission to revolutionise the way that China does healthcare. “We are empowering doctors and empowering patients," Xu says.

To that end, her company, Green Apple Health (Kang Kang Hui), offers a mobile "mHealth" app based on a “doctor-patient acquaintance model", which lets patients use their smartphone to follow-up on initial appointments and gain more insight from signed-up Kang Kang Hui physicians.

Here's how the app works: after the first face-to-face consultation with a regular doctor, an enrolled Kang Kang Hui patient can pick a Green Apple Health doctor for remote added input, in the form of a phone call, any time, anywhere. Rinse and repeat. Big on convenience, Xu's platform removes the need to wait in a crowded state hospital that reflects China's seriously overloaded health system.

2014 OECD figures confirm that China's health system lags behind many others. With just 1.6 physicians per 1000 population in 2012, China has around half the number of doctors per capita than the OECD average of 3.2 physicians per 1000, and far fewer nurses - with 1.8 nurses per 1000 population in China in 2012, compared to an OECD average of 8.8 nurses.


Xu's app, launched in her native Shanghai three years back when China's venture capital market was “super-hot", has already attracted more than a million patients. Over 100,000 registered doctors are also on board, according to Xu. She has since completed second-round “series B funding", raising US$10 million from two regional players, DT Capital and GSR Ventures.

The spark for her creation was another queue-busting, Uber-style app, Didi Dache, which Xu used in Beijing. Although new and basic, Didi Dache, which debuted in June 2012, removed the tedium of queuing for taxis and so began gathering viral momentum.

Wowed by how powerful digital technology could be, Xu, who has worked for Bain, Groupon and Eli Lilly, realised that China's health sector was also ripe for disruption. She dreamed up a dial-a-doctor app, reflecting both her own healthcare background and her belief that the medical market holds great potential.

“...I always faced the world with curiosity, constantly trying to change, to experiment, to create, even to undermine everything"

India incentive

Xu's desire to dramatically improve patient care in China was heightened by a 2011 medical tour of India. She was genuinely surprised to find that India's health care system proved much more advanced than she thought: 70 per cent of its hospitals are private and provide top-tier facilities and corresponding quality service.

As a result, India's reputation for health excellence was such that it had become a magnet for global medical tourism, with one analyst, KPMG health consultant Dr Mark Britnell, even praising the country's potential to be “the cradle of the world's healthcare needs."

Closing the gap

Xu's product is disruptive in several ways. The main one that has had angels queuing up, Xu says, is its relationship-building power: its capacity to foster a direct, lasting connection between patient and doctor.

Theoretically, a doctor who channels Green Apple Health can offer much better service - behave like an American family physician offering undivided attention.

In particular, patients with common or recurring medical conditions may gain from connecting with a listed Green Apple Health doctor. Doing so has the added advantage of removing the need to queue in hospital for three-plus hours at a time.

Xu has already spotted an opportunity to extend the app to provide online pharmacy services, with the aid of the American provider Cardinal Health.

The partnership with Cardinal Health means that, again, instead of queuing in hospital, a patient seeking a “refill" can quickly and efficiently place an order via the internet. Once a doctor has sent approval, the prescribed drugs can then be mailed directly to their home.  While it’s handy for patients, doctors benefit too.

Power to the doctor

According to Xu, her app results in better earnings for signed-up doctors, who typically charge about 100 renminbi or US $15 per 10-minute session. The fee means good earnings for doctors who join her service. In comparison, State doctors are poorly paid, with juniors making just US$400 a month.

A knock-on benefit for doctors is increased independence - even the chance to launch a private practice. Xu cites one super-active professional user who has gained over 1,000 Green Apple platform patients and founded his own practice, which he owns totally.

Xu is on a mission to revolutionise the way China does healthcare

Market Opportunity

Despite Xu’s success, the field of mobile health apps has its share of ups and downs. For example, Google Health personal medical record app was taken off life support in 2012, after a four-year run during which it failed to scale.

Yet mobile health apps are widely acknowledged as one of the fastest growing sectors in the app market.

In 2014, 66 million Chinese used mobile health services, and by the end of last year, the number had more than tripled to 138 million, according to the market research firm iiMedia

What's more, according to the research firm MarketsandMarkets, the mHealth solutions market will grow exponentially and be worth US$59.15 billion by 2020. That is roughly the GDP of Luxembourg.

Fighting talk

The question remains though of whether Green Apple Health can avoid being crushed by a heavyweight presence in the health-at-your-fingertips space. One outward threat, China's answer to Google, Baidu, offers an alternative app called Baidu Doctor, which serves as an appointment booking platform.

But Baidu's app looks unlikely to upset the applecart because Xu's has fundamentally different DNA – it is all about building rapport after the first check-up and further down the track. So Xu is unfazed by Baidu.

In fact, she positions herself as comfortable with Baidu and its BAT bedfellows – the e-commerce giant Alibaba and the investment holding colossus Tencent.

“Many startup companies in China are worried that BAT would become fierce competitors. We see it as an opportunity to help us educate the market, and we welcome any potential strategic cooperations with them in the future," she says.

Driving force

Her mission or vision stems from the realisation she had at Harvard that she needed a purpose or cause. If you lack the vision to create value and build a great company, you will quit, she says, claiming that copycats that mimic Green Apple Health's branding and buttons fizzle out.

“They can try to imitate and develop a similar system, but they can never replicate my purpose and intent," she says, critical of general industry shallowness: the tendency for there to be 6,000 wannabe Groupons fixated on profit, instead of long-term value, which is her watchword.

Xu has always been a “wantrapreneur" with a hunger to make things happen. Her ambitious, can-do attitude owes a strong debt to her unfettered upbringing.

“Growing up in Shanghai, I was very lucky that my parents were open-minded, and I was raised in a relatively liberal environment.

“Being brought up 'free-range' meant that there was a certain impetuosity within me - and I always faced the world with curiosity, constantly trying to change, to experiment, to create, even to undermine everything," she says.

Focus on the long view, not a quick buck, she says

Healthy credentials

Despite that subversive streak, Xu has a solid CV characterised by corporate experience and education that fits her field.

Between 2001 and 2005, Xu attended the public research college Shanghai Jiao Tong University, doing a dual-degree in science - including pharmacy - and business administration. Fresh out of college, from 2005–2006, she served as a management consultant for the global advisory Bain & Company.

Next came her 2009-2011 Harvard Business School stint, spurred by an urge “to learn more about myself and think through what I want to do with my one precious and wild life", she says, echoing a question penned by the poet Mary Oliver, which HBS puts to its students.

As part of her HBS master's degree in business administration, Xu studied entrepreneurship and healthcare venture capital. Plus, the course taught her the value of drive and inspired her to seek a purpose or cause.

Before founding her start-up which supplied that, she racked up relevant experience at three different firms. From April until August 2011, she was Entrepreneur in Residence for the e-commerce marketplace Groupon in southern China. During that formative phase, Groupon expanded aggressively, showing how exponential growth is done: build from scratch, test demand, launch and gauge feedback.

Meantime, from May 2010 until 2012, Xu ran the leadership development program at the biotech giant Eli Lilly and Company, before transitioning to another strategic role, at the cardio-care company Abbott Vascular, where she stayed until 2014.

Now, Groupon-style, every decision that her firm makes is based on user feedback diagnosis. In fact, Xu, who comes across as a bit of a data geek, regularly gets her chief technology officer to interview medical sources about how they use her app.

Beyond question

The data-driven entrepreneur is unperturbed by the prospect that her app could nurture a two-tier system of questionable equity.

One reason that the US health system outdoes China's is its market-driven bent, which means mature insurance policies and a profusion of private practices. So opening the market to competition is sound, according to Xu, who argues that patients will happily pay for superior service.

Clearly, her platform offers practical, humanitarian heft, enhanced by her appealing persona and friendly branding.

The funding she has won, the size of her client base and the rosy outlook for the mHealth space suggest that her app boasts more than just traction.

It looks set to keep gaining momentum - even if, as the meticulous Xu states, the venture capital market is a tad less hot than when she launched. As they say, health is wealth.


Writer: David Wilson

Photographer: Sourced