QPG health is a mobile health app developed by Shanghai Kangkanghui Technology with two versions separately designed for doctor users and public users. Doctors and patients can communicate over health issues on the platform. Now we analyze its business model based on stress test data as of the end of November 2014 and our on-site visit.
Test of doctor-side app
QPG health has listed information about tens of thousands of doctors and hundreds of hospitals in 28 provinces, but our extensive inquiries showed a large majority of doctors who replied patients’ messages are based in Shanghai. That is likely because the company has only carried out business operations in Shanghai and just expanded its presence into Beijing recently.
Now we take a look at doctors with favorable comments by patients. We found that a substantial number of such doctors have actually not activated conversations with patients, and that brought a question about how these favorable comments are generated since they have not sent any text messages to any patient. The app then automatically directs the user to another doctor, but most questions sent to the recommended doctor have not been replied. Apparently, these favorable comments are manually added into the platform and they are not really posted by patients.
During the test, we found that some old or retired doctors are also on the list of recommended doctors, but in fact these doctors do not know how to use the mobile app. That reaffirmed our speculation that the doctor information listed on the app was collected by the company, and only a small number of doctors are actually using the app.
Analysis of effective replies
We managed to collect fewer than 200 doctor replies, and here is a brief summary.
Fewer than 200 out of the 700 doctors on the list replied our questions, and most replies were unsatisfactory and came very late. More than three quarters of doctor replies were posted in the evening and a few hours or even a few days after medical questions were raised. No doctor made reply immediately after a question was asked. Some doctors provided detailed answers to the questions, but a lot more doctors asked patients to find answers at Baidu, the most widely used search engine in China. Some doctors advised patients to go to designated hospitals even before they have a basic understanding about their health conditions. Generally speaking, doctors registered on this platform appear very impatient to patients’ request for help.
We tried to contact dozens of doctors in 34 hospitals with favorable remarks. Only two doctors answered our questions late in the night, three doctors made no reply, while the rest could not be contacted because they have not opened the service to answer patient inquiries.
Two doctors made replies, while no doctor in other regions responded to patient questions.
We managed to find two doctor users of the app in Shanghai after one month of hunt, and we have not found any repeated user even after the prize money was increased to RMB 5,000 (excluding angel users who have personal ties with the app’s development team). However, since December we have begun to discover signs of intensifying marketing campaign and growing user numbers. We believe that was because the developer has secured funding and started to aggressively promote the app. Based on our study and interview with some active doctor users, we learned that they are indeed using the app to answer health questions from patients they never met. In the initial stage there were many questions on the platform, but the number of patients raising questions has since been on the decline. As a result, doctor users are increasingly less active. What we learned from the study and interview was in line with our test results. We can conclude from the interviewees’ stories that patient questions are either not replied or replied too late in the evening. However, if doctors could not reply in a timely manner, most users would have run out of patience and uninstall the app or find alternatives. After all, there are many similar software products on the market, such as Chunyu Doctor, Quick Doctor Answers and Good Doctor. The interviewees believe the above three reasons have led more and more users to abandon the QPG app.
Here is Dr.2’s analysis of download figures and user comments
On the android market, user comments were mostly recorded between August 25 and September 18, 2014. There were relatively more comments at 91 Helper, 360 mobile assistant and myapp, between 6 and 12 pieces every day; and almost all users rated the app a full score with much of the same favorable remarks like “professional”, “practical”, “very good”, “helpful to protect our health”, “very useful” and etc. Such similar remarks have been repeatedly seen at other major app markets.
Let’s take remarks posted on 360 mobile assistant as an example (Table 3).
Based on the analysis of download statistics and remarks, we speculate that the developer of QPG health has fabricated the download figures and favorable comments to make the app seem more popular. Perhaps they noticed that Dr.2 had disclosed data fraud by some companies, this time they made some small changes to the remarks by adding or deleting a few words or punctuation symbols. However, these repeated remarks were too close to each other and were written almost the same time at the major app markets. The tactic could only fool potential investors who are interested in funding the app development. The app was behind 100th place on the app store in terms of download numbers with 293 user ratings, but it was puzzling that many remarks were talking about games (Figure 1).
QPG doctor app has more than 10,000 downloads at the android market, but there were only three remarks at the eight app markets. On the app store, there were 21 ratings and 11 remarks, numbers that make data fabrication allegations less justified.
Two new messages are updated on average every day at the app’s Weibo account, and a lot of these messages cover topics like life information, health & diet tips as well as health jokes. Most of the app’s fans are believed to be fake fans who are paid to follow specific accounts and forward their Weibo messages. There were basically no re-forwarded messages, no praises or remarks by its fans. That is to say, the app only has a few, if any, genuine users who did indeed use it.
QPG health public version has almost stopped updating with only one or two new articles published a month. QPG health doctor version is still updated every month, but every article is read by dozens of users, and most of them are probably internal staff and their friends.
I waited a long time to publish this article until QPG health has successfully secured funding, so as not to sabotage any fundraising deals in the mobile healthcare sector. I’m not meant to try to kill any financing deal in the sector, because if I want to do so, I would have done long ago. QPG health announced the latest round of fund raising a success even before the settlement process was finally completed. As a result, soon after this article was published, some institutional investors quickly reversed their decision to drop their investment commitment. This incident is also a stark reminder to all people who are trying to start up their own business-exercise discreetness and prudence when dealing with venture capital investors. If you decide to invest in a project, you must accept the consequences if the project fails to deliver as promising returns as you had hoped. Losing credibility is the biggest consequence for a venture capital investor.
So why Dr.2 still believes the app would fail since it has completed fundraising? The answer lies in its business model and the development team leaders’ values.
Firstly, from the macro perspective, the app is supposed to serve like WeChat as a tool of communication between patients and doctors who have met before and become acquainted with each other. However, after it failed to attract enough users in the initial stage, it shifted its business strategy by acting like Momo and encouraging patients to seek help from doctors they have never met before. In fact, though WeChat and Momo have similar user interfaces, they are two messaging products that can never be compatible. If you choose one, you have to drop the other. The shift in business strategy, frankly speaking, is more of a result of investor pressure than an outcome of wrong decisions by the development team leaders. As we know, for most users, a health management tool is only used when they are sick, sometimes once in a week or even several months. However, investors want the app to be downloaded and used by as many people as possible. When the app enables users to seek help from strange doctors, it can apparently attract more users, but what actually happened after that showed that its popularity quickly dwindled, because it cannot catch up with the top three players on the market-Chunyu Doctor, Quick Doctor Answers and Good Doctor. In order to raise money from investors, it has no choice but to fabricate user statistics to make prospective investors believe the app is very popular. After pouring money into the project, investors could only turn a blind eye to the data fraud scandal so that they can continue to fool subsequent investors who might be interested in buying their stakes. Even though they hired an independent research company to study how often doctor users are using the app, the research company would only make phone interviews to collect data that are not accurate and reliable. These investors should hold much of the responsibility for their reckless investment decisions.
Secondly, when we return to the basic philosophy of product design and ask why patients would like to find help at this platform. The simple answer is that doctors are also going to this platform. So why doctors are going to the platform? Because patients are already on the platform. That circular problem might never have an answer that way. Theoretically speaking, anybody can earn money if they build a platform as popular as Taobao. That means, the app developer must try to encourage as many doctors and patients as possible to download and use the app, but that goal is out of its reach in terms of operating capacity and capital resources.
Trusted Doctor, an app that helps doctors get access to patients, is facing much less resistance in building user base because it only has to push more doctors to use the app since patients can find registered doctors with their WeChat accounts. Alibaba Health is offering subsidies to lure patients to use its mobile healthcare services, while Ping An Health is relying on its parent company’s insurance client resources and medical resources to attract both doctor and patient users. It remains to be seen whether these apps can make sustainable success, but there is little doubt that a little-known startup is doomed to fail if it attempts to entice both patients and doctors.
Thirdly, the abrupt launch of viral marketing campaign before a solid base of cornerstone users is established has helped spur an initial surge in user numbers, but user growth has since slowed and stalled. Its rival Trusted Doctor, on the contrary, has made a remarkable initial success after a round of aggressive viral marketing and publicity, although its fate remains murky in the longer term. As two similar apps making the same marketing push in shanghai, they are moving toward different destinations-Trusted Doctor still has time to turn around its fortune, but QPG health has shown signs of failing. QPG’s business practice of offering commissions to registered doctors and additional tips after they persuade patients to get registered is actually against government regulations. Its shortcomings in other areas like operation, technology and marketing team are also evident and there is no need to elaborate. In the first place, a lack of genuine users is its biggest challenge.
Finally, the development team’s leaders, especially their values and business philosophy, should also share part of the blame for the app’s expected failure. When users open the app, they are supposed to be confused by its funny cartooned user interface, because nobody would believe it’s funny to see the doctor. The leaders are said to have MBA credentials, but they apparently have not learned from their MBA courses how to respond to rivals’ business actions, and instead their wrong decisions put the app in a dangerous situation. Moreover, according to several articles mentioning the leaders, they indicated that they started a new business only to get richer and more famous. They always turn deaf ears to dissenting opinions and stubbornly stick to their strategies that are now proven futile.
Conflicts of Interest: The author has no conflicts of interest to declare.
Informed Consent: Informed Consent was not required because data collected and provided could not be tracked back to individuals.
Cite this article as: Tu H. Failed cases of mobile healthcare apps: why QPG health is doomed to fail? mHealth 2015;1:8