With access to medical care heavily disrupted by COVID-19, the adoption of digital health technologies had an unprecedented uptake in Southeast Asia. Notably, ASEAN countries were quick to shift to telehealth as governments adapted existing medical regulations and policies to allow for teleconsultation and promote remote access to medical care during the pandemic.
This rapid digital transformation of the healthcare industry highlighted the potential of digital health services to transform how societies can access and efficiently receive medical care unconstrained by time and geographical location. At the same time, it provided the much-needed momentum for health service providers and digital startup companies to showcase their innovative solutions in the fields of medicine, health, and biotechnology.
Although huge strides have been made in digital health adoption in recent years, there are still fundamental challenges for Southeast Asia to address to foster a thriving digital health ecosystem. Regional countries need to develop digital transformation guidelines specific to the healthcare sector. In addition, governments need to overcome policy implementation issues to fully embrace the digital revolution in healthcare. Patients still prefer an in-person mode of healthcare delivery as there is still a lack of trust in digital services.
To further comprehend these issues, it is crucial to take stock of where Southeast Asia is in its journey towards fully embracing digital health.
The State of Digital Health Readiness in Southeast Asia
A recent report by the World Bank outlined three stages leading towards the maturity of digital health demand and supply: digitalisation, digital-for-health, and digital-in-health. The first stage, “digitalisation”, lays the architectural framework and administrative processes for health information systems, connecting health providers and facilities, and collects standardised medical data. The second stage is “digital-for-health”, where medical data and digital technology become part of daily business processes. Last, the final stage is the full realisation of “digital-in-health”, which envisions the merging of digital technology and health data into a seamless process embedded in mature and transformed health systems.
Based on ongoing research on digital health readiness in ASEAN by the ASEAN-Japan Centre and the Tech for Good Institute, most countries in the region are in the early stages of digitalisation. Roadmaps are currently being developed to integrate health information systems, digitise medical records, and improve digital infrastructure to allow inclusive access. While this is a step in the right direction, there are key fundamental pillars of digital health that need attention from policymakers. Through interviews with thought leaders and health experts in Singapore, Malaysia, Philippines, Lao PDR, and Vietnam, key themes identified to advance the digital health agenda include: a) setting up the digital infrastructure, b) building trust among users and service providers, and c) fostering innovation by promoting the digital health startup ecosystem.
Developing Standards for an Interoperable Digital Health Infrastructure
Among ASEAN countries, the lack of established and integrated digital health data infrastructure remains one of the main challenges. At the most basic level, some countries have started digitising medical records at the national level. Singapore, Malaysia, and Indonesia have made efforts towards a national electronic medical records system, albeit in varying stages of implementation. However, the seamless utilisation of medical data across various platforms remains a challenge among these countries. This has implications for the continuity of care and adds friction to the experience of digital health users.
Experts identified that the lack of data standards and alignment were key stumbling blocks against fully leveraging the potential efficiency gains of electronic medical health records. For example, public and private hospitals may use different platforms to encode medical data, which also come in different data formats, in recording a patient’s medical history. Without clear data standards, harmonising digital systems and improving interoperability remain a daunting task.
Data encoding is another challenge for developing a data ecosystem for the healthcare industry. Some level of digital literacy is needed for healthcare professionals to transition from paper-based records to electronic data. This is especially important for medical care facilities in rural areas where training is needed to ensure healthcare professionals are familiar with digital technologies.
Building Trust Through Data Protection and Governance
On top of improving the interoperability of the data ecosystem in healthcare, promoting trust among users is also crucial to advance the digital health ecosystem in the region. Digital health experts highlight the need for strong regulatory frameworks and mechanisms that balance innovation and data protection. Getting this right is critical as it would promote trust in the ecosystem. Trust is a key element in promoting digital health technologies to users, especially for patients using electronic health solutions for the first time.
Patients must be able to access digital health services with confidence that their data is stored, used, and shared in a responsible manner. Hospitals and medical facilities must also adhere to set standards and guidelines as provided by law to ensure that patient data records are safe and secure.
One key best practice to promote trust while ensuring that appropriate guidelines are in place is through adopting sandbox practices. Digital health sandboxes would allow for new technology solutions to be tested in a controlled environment first before being rolled out to the public. This would also be an opportune time for regulators to ensure that clear data governance, robust cybersecurity guidelines, and data protection policies are in place. Currently, Singapore, Malaysia, and Indonesia have sandbox programmes with respect to digital health technologies.
Promoting Digital Startups to Foster Innovation
Aside from having traditional healthcare industry players such as hospitals and clinics adopt digital technologies, digital health experts point to the importance of startup companies in advancing the digital health ecosystem. Startups play a huge role in developing tech-enabled solutions that can further promote digital health adoption for users and introduce innovative business models.
To foster innovation in the healthcare industry, countries such as Singapore and Malaysia have established dedicated agencies to support digital health startups. For example, Startup SG provides funding, training, and infrastructural support for startups, accelerators, and investors while Malaysian Research Accelerator for Technology and Innovation (MRANTI) is an accelerator that provides research incubation support from ideas to market access and scaling-up.
However, identifying a successful business model and proof of concept with actual market value and demand is just one step in promoting innovation. Governments should also promote market entry for digital startups by enabling a level playing field. Allowing startups to scale and grow is crucial for them to have meaningful impact on the healthcare industry.
The use of technology will be critical in Southeast Asia, not for short-term gains in efficiency, but for the long-term care of its citizens. As World Health Organization (WHO) data shows, the region is slowly transitioning to an ageing population. WHO estimates that 13.7% of Southeast Asians will be 60 years old and above by 2030, a number that is expected to increase to 20.3% by 2050. Leveraging digital health technologies will help to promote access and improve the quality of care as Southeast Asia faces new health challenges brought about by an ageing population.
While digital health adoption has received a significant boost during the pandemic, it is important to highlight the role of ASEAN governments to sustain this momentum moving forward. Embedding digital transformation strategies into the larger national health plans would help guide digital health ecosystem players’ focus on infrastructure, trust, and innovation, all of which would drive the digital health agenda forward.