Healthcare Asia (November 2023)

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www.healthcareasiamagazine.com The magazine for healthcare administrators and policy makers Display to 30 November 2023 | DISRUPTING CANCER CARE BARRIERS AC HEALTH INVESTED IN BUILDING A MULTI-DISCIPLINARY CANCER CARE HOSPITAL 3 WAYS AI WILL STAND OUT IN HEALTHCARE DELIVERY IN 2023 MAJOR HEALTHCARE SHIFTS IN SEA TECH STARTUPS EASE HEALTHCARE COST BURDENS WITH AI SUSTAINABLE HEALTHCARE, ETHICAL AI TAKE CENTRE STAGE AT THE HCA SUMMIT AND HCA FORUM 2023
ISSUE NO. 19 Healthcare Asia
Paolo Borromeo CEO, AC Health
Simplifying Presbyopia Correction1-9 The First-of-its-kind presbyopia-correcting IOL with wavefront-shaping technology and a clinically proven monofocal visual disturbances profile 1-4 References: 1. AcrySof® IQ Vivity® Extended Vision IOL Directions for Use. 2. Alcon Data on File, US Patent 9968440 B2, May 15, 2018. 3. Alcon Data on File, TDOC-0055575. 09 Apr 2019. 4. Alcon Data on File. TDOC-0055576. 23-Jul-2019. 5. Alcon Data on File, TDOC-0056718. 18-Jun-2019. 6. Ligabue E, et al. ACRYSOF IQ VIVITY: Natural vision at a range of distances provided by a novel optical technology. Cataract & Refractive Surgery Today. April 2020 // 7. Alcon Data on file. A02062-REP-043696, Optical Evaluations of Alcon Vivity®, Symfony*, Zeiss* AT LARA* AT LISA IOLs. Feb 2020. 8. Lawless M. Insight news. “An IOL to change the cataract surgery paradigm?” available at “https://www.insightnews.com.au/an-iol-to-change-the-cataract-surgeryparadigm/”. Accessed Date 17.07.2020. 9. Ike K. Ahmed, et al. The Vivity Extended Depth of Focus IOL: Our Clinical Experience. Cataract & Refractive Surgery Today. February 2021// Please refer to product direction for use for complete list of indications, contraindications and warnings. © 2021 Alcon Inc. 8/21 ASIA-VIV-2100019 AcrySof IQ Vivity® IOL

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In Indonesia, Mayapada Healthcare Group stands at the forefront of digital transformation, adopting artificial intelligence (AI) and hospital information systems. Their concerted efforts are directed towards achieving the implementation of electronic medical records, indicative of a forwardlooking approach to healthcare management.

In Singapore, known for its technological prowess, a more cautious stance is observed regarding AI in myopia screening. Dr. Foo Li Lian of the Singapore National Eye Centre highlights the importance of rigorous performance evaluations and research.

In Malaysia, talent retention remains a pressing issue in the face of a globalised workforce. UM Specialist Centre responds by creating an environment that encourages medical professionals to collaborate within their teaching hospital.

Meanwhile, the Philippines turns its focus to cancer care, with the Asian Hospital and Medical Center dedicating a two-floor facility to the cause and Ayala Corporation Health establishing the Healthway Cancer Care Hospital.

Together, these stories reflect the steadfast commitment to excellence and the improvement of healthcare standards in SEA.

Read on and enjoy!

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2 HEALTHCARE ASIA RETAIL SINGAPOREASIABUSINESS REVIEW | MARCH 2018 CONTENTS For the latest business news visit the website www.healthcareasiamagazine.com FIRST COUNTRY REPORT HEALTHCARE TECH CEO INTERVIEW ANALYSIS 20 FEATURE PROFILE MAYAPADA HOSPITAL EMPLOYS AI TO ADVANCE INDONESIA’S HEALTHCARE INFRASTRUCTURE EVENT 28 Sustainable healthcare takes centre stage at HCA Summit 30 Patient-centricity is the future of Thailand’s healthcare 31 Digital innovation headlines HCA Forum 2023 in Jakarta 32 Ethical AI and more highlighted at HCA Forum Kuala Lumpur CEO INTERVIEW AHMC PUTS UP DEDICATED CANCER TREATMENT FACILITY 26 04 Financial catastrophe: Underfunding slows down Asia’s cancer care 05 Evolving AI in APAC healthcare spark data governance 06 APAC’s telehealth woes: privacy and contacts 14 Thai hospitals bolster IVF to attract Chinese tourists 16 Healthier SG lowers hospitals’ load and cuts spending 10 Startups alleviate developing nations’ healthcare costs 11 This new app simplifies subsidised vaccinations for Singapore’s seniors 22 UMSC leads the way in privatised healthcare 24 Nuffield opens flagship clinic at iconic Orchard Rd 18 3 ways AI will stand out in healthcare delivery in 2023 VOX POP 08 Major healthcare shifts in Southeast Asia 12 CEO INTERVIEW AC HEALTH EASES FINANCIAL BURDEN FOR FILIPINO PATIENTS Published bi-annually by Charlton Media Group SG: 101 Cecil St., #17-09 Tong Eng Building, Singapore HK: 299 QRC, 287-299 Queen’s Road Central, Sheung Wan, Hong Kong ME: FDRK4467,Compass Building,Al Shohada Road, AL Hamra Industrial Zone-FZ, Ras Al Khaimah, UAE

Financial catastrophe: Underfunding slows down Asia’s cancer care

Underfunded healthcare systems and the absence of universal health coverage, particularly in India, Indonesia, the Philippines, and Vietnam, leave over half of all cancer patients in Southeast Asian countries vulnerable to financial woes due to high out-of-pocket medical expenses.

Thomas Hofmarcher of the Swedish Institute for Health Economics said the annual number of new cancer cases increased from 4.9 million in 2002 to 9.5 million in 2020, and this is expected to worsen due to an unprecedented rate of population ageing.

Although high-income countries with higher proportions of older populations, such as Japan or the Republic of Korea, face much higher cancer numbers than middleincome countries, this pattern is reversed in survival rates, he said. In the wealthier countries of Asia and the Pacific region, such as Australia, Japan, and the Republic

of Korea, around 56 to 65 in every 100 new patients survive cancer, whereas in the developing part of the region only around 28 to 40 in every 100 new patients survive.

“In Asia, early detection is hampered by low awareness of the early signs of cancer amongst the general population and the absence of or low participation in screening programs, such as for breast cancer,” Hofmarcher said.

In addition, cancer patients in lower-income Asian countries incur full out-of-pocket costs for some generic medicines, which are readily available in higher-income nations, because several of the most basic cancer medicines listed on the World Health Organization’s Model List of Essential Medicines are not listed on their national formularies. Hofmarcher blamed this on underfunded healthcare

systems and the absence of universal health coverage, especially in India, Indonesia, the Philippines, and Vietnam.

“As many as half of all cancer patients and their households in Southeast Asian countries face financial catastrophe from high out-of-pocket medical bills and related expenditures in their first year after cancer diagnosis,” he said.

To address these problems, Hofmarcher recommended a “value-based and evidencebased” inclusion of new medicines in national formularies, the use of potential savings by governments in the region to stimulate competition amongst pharmaceutical producers, and stricter price control of originator medicines after patent expiry to create budget headroom for governments.

“These savings could be re-channelled to fund and list innovative medicines, offering a more sustainable financing model whilst improving patient outcomes,” he said.

Cancer care

GlobalData stated some recent developments of cancer treatment including the growth of surgical energy instruments after the World Cancer Day events, which seeks to raise awareness of cancer and urge early detection and treatment.

The surgical energy instruments market went up by 5% between 2015 and 2021 and is projected to continue to grow at a similar rate until the end of the decade, GlobalData said.

Brian Hicks, senior analyst at GlobalData, said there are many different types of surgical energy instruments on the market but the most frequently used ones are “monopolar and bipolar instruments.”

Dr. Satyajeet Salunkhe, medical devices analyst at GlobalData, said “due to the probability of the presence of residual cancer cells, medical practitioners typically recommend chemotherapy or radiation therapy to avoid cancer recurrence.”

“MRD tests will ensure giving chemotherapy or radiation therapy only in patients showing early signs of cancer progression avoiding unnecessary exposure to toxic anti-cancer therapies in patients which lack evidence of cancer progression,” added Salunkhe, in his recent comments on vitro diagnostics to help cancer patients in Japan. Cancer is still one of the leading causes of mortality in the Asia-Pacific region. Half of patients treated with conventional anti-cancer treatments show resistance to cancer medicines and develop serious side effects.

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Cancer patients in lower-income Asian countries incur full out-of-pocket costs for some generic medicines, which are readily available in higher-income nations
In Asia, early detection is hampered by low awareness of the early signs of cancer amongst the general population
HEALTHCARE FINANCING

Evolving AI in APAC healthcare spark data governance

Rapid digital advancements are reshaping the Asia Pacific healthcare industry, with the majority of healthcare organisations expected to adopt data governance frameworks by 2026. They aim to uphold ethical practices whilst using artificial intelligence (AI) to transform predictive, preventive, and personalised care.

Calvin Lau, research director and head of the public sector in IDC Asia/Pacific, said the digital transformations of the healthcare delivery systems in the region are expected to speed up, but rising inflationary costs could hamper additional healthcare investments.

This compels healthcare providers to rethink and reallocate healthcare budgets more prudently, he said.

“The [COVID-19] pandemic has also exposed the inability of some public health frameworks to provide care adequately to certain sections of society. The pandemic-induced drive to greater healthcare equity, making healthcare more accessible to more people, will be the future healthcare trend in Asia Pacific”, said Lau.

In the process of aligning with the care needs, healthcare organisations are expected to prioritise more on establishing ‘care anywhere’ programs, leveraging clinical data, exploring seamless connectivity, and automating

APAC SEEN AS A SIGNIFICANT PLAYER IN THE IOMT MARKET BY 2030

Asia Pacific’s internet of medical things (IoMT) market is projected to expand at a 20% compound annual growth rate by 2030 on skyrocketing demand for remote healthcare solutions, according to a report by market intelligence firm SkyQuest.

“Asia Pacific has emerged as a significant force in the IoMT market and is expected to continue its dominance by 2030,” SkyQuest said in a statement, noting that the anticipated growth will be driven by “increasing investments in the sector, rising demand for advanced medical devices and government initiatives to promote digital health.”

IoMT is a collection of smart medical devices and applications connected within a network through the internet. This allows healthcare providers to monitor patients

in real-time, improve accuracy of diagnosis, streamline workflows, track inventory and even automate processes, amongst other things. Globally, the IoMT market is expected to register a 28.9% compound annual growth rate between 2023 and 2030. IoMT solutions and devices could result in $300b worth of savings for the world’s entire healthcare industry according to the study’s estimates.

Majority of healthcare executives are choosing investments in digital health tech. Robust demand for wearable medical devices for remote patient monitoring as well as advancements in sensor technologies have been the major growth drivers for the sector worldwide. SkyQuest expects this trend to continue throughout the decade as virtual consultations and issuance of electronic prescriptions gain popularity.

care processes, along with strong anchoring on trust, compliance and explainability, the report said.

The healthcare delivery system in the Asia Pacific is making the transition towards patient-centricity strongly facilitated by the evolution of the digital front door, healthtech ecosystem, and enhanced focus on data, redefining care further into care anywhere, predictive care, and personalised care, said Manoj Vallikkat, senior research manager of healthcare insights in IDC Asia/Pacific.

“Whilst there is focus on the use cases that leverage on emerging technologies, moving forward, the industry will witness increased involvement of LOB (Line of Business) heads along with IT leaders, as part of the ecosystem, in evolving patient-centric care models”, said Vallikkat.

AI in APAC healthcare

A Philips study showed that APAC’s healthcare leaders are at the forefront of adopting AI and predictive analytics. APAC markets are also investing in AI and predictive analytics within the next three years. Caroline Clarke, CEO and EVP of Philips ASEAN Pacific, said it opens opportunities for leaders in healthcare such as in quality, cost, and speed of care but challenges linger.

“The value of data and technology is only strong as the human experience it supports, so the digital transformation approach must be centred around people,” Clarke said.

HEALTHCARE ASIA 5 FIRST
The value of data and tech is only as strong as the human experience it supports
It’s vital that our approach is centered around people
Calvin Lau Manoj Vallikkat Caroline Clarke HEALTH TECH

AI GAINS GROUND IN HEALTHCARE IN APAC

As AI integration starts to reshape healthcare, chatbots, and virtual assistants offer promising benefits such as providing seamless preventive care, symptom identification, and patient engagement.

GlobalData said the platform will increase from US$1.5b in 2019 to US$4.3b in 2024. The data analytics firm cited healthcare companies implementing technologies in healthcare systems such as Genomic Vision, which rolled out FiberSmart. This tech enables visualisation and analysis of long DNA fibres at high resolution.

GlobalData medical analyst Kamilla Kan said the accuracy and efficiency of diagnoses will be improved through AI.

Generative AI

AI chatbot ChatGPT has been hogging the headlines across every industry and even the healthcare sector may find potential uses for it, GlobalData reported.

Tina Deng, principal medical devices analyst at GlobalData, said ChatGPT can be used to assist physicians with bureaucratic tasks such as writing patient letters so doctors can spend more time talking to patients.

The chatbots also have the potential to increase accuracy and effectiveness on “processes for preventive care, symptom identification, and postrecovery care,” said Deng.

AI integration into chatbots and virtual assistants can motivate and interact with patients.

AI can review a patient’s symptoms and then recommend diagnostic advice and different options like virtual check-ins or face-to-face visits with a healthcare professional, GlobalData reported.

These processes can reduce the workload for hospital staff, increase the efficiency of patient flow, and cut healthcare costs. Chatbots can also respond to patient’s questions about medical products and share brand news with customers.

APAC’s telehealth woes: privacy and contacts

TELEHEALTH

Telehealth may be increasing but privacy concerns are still one of the challenges when using such a healthcare platform. A Gilead Sciences study showed that data privacy and the lack of inperson contacts have emerged as key barriers to the adoption of telehealth in APAC markets.

Nearly half of the people living with HIV (PLHIV) in the Asia and Pacific region said data privacy issues are one of their obstacles in using telehealth services.

Specifically, 43% of PLHIV and 35% of individuals at risk (IARs) are concerned about cybersecurity risks when using telehealth.

The second barrier to using telehealth is the lack of in-person contact, with nearly half of IARs, or 47% saying they feel discomfort about this.

Caroline Choi, senior director of medical affairs Asia 5 lead, Gilead Sciences, commented that telehealth may remain high in the post-2020 era but there should still be equity of access.

Choi added, “Not only do HCPs and Community-Based Organizations need to implement innovative forms of care, such as providing e-prescriptions,

but healthcare systems must also adapt to the needs of patients when modernising HIV services.

Convenience, flexibility, and improved access to additional HIV information were the top three reasons why they used telehealth.

The study was based on replies from 1,531 respondents, which are composed of 787 PLHIV and 744 IARs, across nine markets in the Asia Pacific. The survey responses were received from June to September 2022.

Telemedicine use remains high Telemedicine apps, a key catalyst for digital healthcare adoption in Asia that saw a surge in usage during the COVID-19 pandemic, have retained high usage levels throughout 2022, reported Bain researchers. The average monthly active app users reached 257 in 2022, which was even higher than 213 in 2021, based on data from Bain.

Digital native companies took up 80% of monthly active app users in 2022, whilst the remaining 20% were served by provider-owned apps. But the provider-owned apps have expanded their share of users from 7% in 2020.

“Digital-native companies continue to lead the telemedicine market in Asia, though provider-owned apps have recently started gaining share. Traditional healthcare providers have the advantage of offering digital and inperson services to an existing, trusting patient base,” Alex Boulton and Vikram Kapur, partners at Bain, said.

But telemedicine adoption may have significantly more headroom in some countries. Usage in Malaysia, Thailand, and the Philippines, whilst fast-growing, considerably lags usage in Singapore, India, and Indonesia, the report noted.

In mature healthcare markets, such as the United States and Europe, service providers have scaled up digital health services in the existing business-to-business ecosystem.

In emerging Asian markets, where private health insurance coverage remains low, and private provider groups are fragmented, digital natives play a more meaningful role, the report noted. Hence, both providers and digital natives can offer a wide range of end-to-end services across digital and in-person care.

6 HEALTHCARE ASIA FIRST
Healthcare systems must adapt to the needs of patients when modernising HIV services
Digital-native companies lead the telemedicine market in Asia
Caroline Choi Alex Boulton Vikram Kapur
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Major healthcare shifts in Southeast Asia

Southeast Asia is a highly heterogeneous region with wide variation in healthcare markets. However, across the board, we see four important trends that will have a major impact in 2023.

First, digital health will continue to be a major focus for all healthcare players. COVID-19 has greatly accelerated digital adoption in the delivery of health services. Video consultation, chat interactions between doctors and patients, remote monitoring, online access to health results, and AI chatbots for triaging, are now widely available and are becoming baked into consumer expectations. Healthcare players, including medical groups, hospitals, and diagnostic chains all now recognise digital patient engagement as core to their business.

Success will require going to market with a differentiated and focused value proposition, delivered through a high-quality digital product, and with a clear linkage to revenue.

Second, we see ongoing efforts in multiple markets to build the primary care sector to try and make healthcare services more costeffective and accessible. Governments increasingly recognise that effective primary care is crucial for the health system to function in an efficient manner. The pandemic has also increased public awareness of the importance of primary care providers as the first line in the healthcare system. For instance, Singapore recently announced a Healthier SG plan under which residents will be encouraged to enrol with primary care practices for better continuity of care and to improve prevention efforts. In Indonesia, the Health Minister has spoken of primary care as being one of six key pillars for Indonesia’s healthcare reform.

Homecare and financial challenges

Third, we also expect to see growing use of home care or home services. The pandemic has shown that a considerable proportion of healthcare services can be effectively delivered at home. This can be as simple as the home provision of phlebotomy for lab tests, or as complex as the provision of comprehensive home care for end-of-life patients. Patient preference and technological advances, supported by investor interest, will drive continued expansion of this space. Finally, we expect that healthcare financing will become increasingly tight. The deteriorating economic outlook means that governments and private citizens will face increasing difficulty in financing health expenditures. At the same time, healthcare costs are expected to continue to increase. Given this, there will be increasing pressure to revise financing frameworks to put them on a more sustainable basis, ensure that payments are effective at driving healthcare value and improve operational efficiency and effectiveness. For instance, PhilHealth, in the Philippines, is in transition to the diagnosis-related group (DRG)-based reimbursement which will better reflect case complexity, improve their ability to monitor the quality of care, and improve PhilHealth’s financial sustainability.

Southeast Asian healthcare has become an exciting incubator for innovation as long-term secular forces were catalysed through the pandemic. Whilst admittedly a diverse collection of markets, most are burdened by rising demand from ageing and more affluent populations that overwhelm a constrained supply of medical professionals and infrastructure.

Pre-pandemic, it should be noted, private and public stakeholders are already making positive steps towards embracing structural reform and technology as essential solutions to the region’s healthcare access challenges. For example, both Indonesia and the Philippines underwent significant universal healthcare coverage reform in the five years preceding the pandemic, and the leading regional telehealth providers were founded in 2015 and 2016.

The pandemic was a crucible for stakeholders in the Southeast Asian healthcare markets. Notoriously traditional and slow-moving provider systems experienced extreme stress and were forced to ‘rethink’ the way care was and should be provided. After almost three years of fire-fighting and bootstrap innovation, we should hope and expect 2023 to be a year of proactive innovation.

Opportunities for innovation

Rising consumerism in healthcare. Consumers are willing to prioritise and spend more on their healthcare. 50% of surveyed consumers in the region indicated a willingness to increase out-of-pocket spending over the next few years. Consumers desire more information about their healthcare and options and are more eager to spend on prevention and wellness. A realignment of stakeholder trust. The notion of hospitals as de facto healthcare providers is slowly fading away. The industry is rapidly moving toward delivery models that are more convenient for consumers and less expensive to deliver, and care is moving outside hospital walls. Technology is helping healthcare organisations deliver high-touch services without the time or expense of physical interactions.

Increased desire for simplicity and convenience. More than 90% of surveyed consumers in Southeast Asia wanted a simpler system of care—a single touchpoint to manage all their healthcare needs. That need is being fulfilled differently across the Southeast Asia region. Digitally native companies are racing into markets like Indonesia, where primary care is limited, emboldened by the fact that one-third of survey respondents prefer that the ‘single touchpoint’ be virtual (an app or a hotline). Digital healthcare isn’t replacing established systems; rather, it’s enabling more connected, hybrid experiences. Integrated offline-to-online models have the potential to deliver better patient experiences whilst optimising cost and efficiencies for care providers. Telehealth adoption increased dramatically through the pandemic and recent data on active users from the region’s top digital health apps supports the assertion that telehealth is here to stay.

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Startups alleviate developing nations’ healthcare costs

Countries like Indonesia and the Philippines are still grappling with a shortage of healthcare staff, resulting in underserved patients. Because of this, healthcare firms are increasingly turning to digitalisation as a solution. However, lower-income countries often face investment prioritisation challenges due to forecasts, such as INSEAD’s study projecting a significant 75% increase in health expenditures across Southeast Asia, which poses a challenge for their investment decisions.

Healthcare startups with operations in South Korea, Singapore, and other markets in the Asia Pacific have stepped up to help hospitals and patients save costs through their innovations. They developed applications that can be accessed by patients through their smartphones and partnered with governments or non-profit organisations (NGOs).

Easy access to diagnoses

AIHealth.SG detects and evaluates one’s risk of non-communicable

diseases (NCDs) using AI to assess blood pressure, body mass index, and other data inputs all with just a tap of a smartphone. This allows patients to monitor their vital signs directly.

“Our AI, which is very unique to us, runs on smartphones, and these smartphones are low-resource phones, dating back to 2016 upwards. That means it’s accessible by the majority of the population in a lot of these low- and middle-income countries,” said Shaun Rossiter, CEO and founder of AIHealth.SG.

Despite being an advanced technology, AIHealth.SG said deploying their software to patients costs nothing with the help of a country’s government.

“If this was funded by a government, in terms of getting it out to the general population, then they simply need to download the app, or, integrate within the Ministry of Health app that they have, or private hospital group,” Rossiter explained further.

“One challenge to adoption by the patients who are afraid that maybe

AI could take their identity or do this or do that, when in fact, that’s not what it’s designed to do. User experience was also a challenge as was using low-resource smartphones in non-connected environments,” said Rossiter. But after the COVID-19 pandemic, Rossiter said it would be easier to address this hesitation barrier because patients know that technology will help them understand risks in their health.

AIHealth.SG is a startup based in Singapore that started operations in April 2022 to provide a library of health risk assessment tools using AI technology available to new and existing private and public health, telemedicine, insurance, pharmaceutical, and corporate entities either as software as a service (SaaS) or white label offering.

Reduced MRI scan time Being inside a Magnetic Resonance Imaging (MRI) is difficult for patients, especially the sick and elderly, for its long scan times, noise, and crucial requirements.

Patients are mandated to stay inside and be as very motionless as possible. Some even suffer from claustrophobia. MRI software service provider and startup, AIRS Medical’s, Jaeyeon Yoon said his co-founders’ mother was facing the same issue which led them to run their healthcare startup that seeks to minimise scan time.

With AIRS Medical’s deep learning technology called SwiftMR, it reduces by up to 50% the MRI scans that usually take 20 to 90 minutes. The reason behind longer scan times is to create a high-quality image and if there is a lower scan time, it will compromise the quality. What AIRS Medical’s software does is to improve the lowquality image that was generated from the accelerated scan.

“If the MRI scan time is reduced to half, they can only spend half time inside the MRI scanner, and also their waiting time will be reduced to take an MRI exam,” said Yoon, who is AIRS Medical’s business development head. Yoon added that using SwiftMR will reduce costs as healthcare providers do not need to replace their old scanners.

To read the full story, go to https:// healthcareasiamagazine.com/

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AIHealth.SG detects and evaluates one’s risk of NCDs and patients can monitor their vital signs directly from their smartphones (Photo from AIHealth.SG website)
Our unique AI runs on low-resource smartphones dating
to
HEALTHCARE TECH: AI
Healthcare providers use software that runs on smartphones for diagnosis.
back
2016
Shaun Rossiter
ASIA PACIFIC
Jaeyeon Yoon

This new app simplifies subsidised vaccinations for Singapore’s seniors

The health appointment system enables the elderly to book appointments using a QR code scan.

In July 2022, Singapore faced a grim reminder of the dangers of pneumonia when a fouryear-old girl died from COVID-19 whilst also battling the respiratory disease, which is responsible for one-fifth of all deaths in the country. Despite the availability of life-saving pneumococcal and flu vaccines, less than 10% of Singaporeans above the age of 65 have taken both doses, prompting the government to seek innovative solutions.

As a response to this, software development firm Open Government Products (OGP) has stepped up to tackle this challenge by releasing a health appointment system (HAS) that made the program more accessible to the elderly.

“When it came to… accessibility, we found that it was quite difficult to get a vaccine. So that’s why we want to address this area,” said Dr. Nicola Lew, Medical Officer, Future Systems Office and Infocomm, Technology & Data Group, Ministry of Health.

To launch the pilot program of the HAS, OGP, with the help of the Singapore government, will reach out to more than 600,000 senior

citizens in the country. Through the appointment system, they can now receive their Community Health Assist Scheme (CHAS)-funded pneumococcal vaccines under the National Adult Immunisation Schedule (NAIS).

How the app works

Through a simple scan of a QR code, eligible adults aged 65 and above can access the app and book their vaccination appointment.

“They or their loved ones can scan a QR code and be directed to our website where they would be able to easily search for CHAS GP clinics available near them,” said Lew.

Clinics were invited to enrol in the HAS during its public launch on 14 August 2022. Lew said the app allows clinics to fully manage the availability of appointment slots with minimal administration required.

If the pilot launch is successful, Lew said they will roll out the appointment system from 150 clinics to 300. “But we do hope that if the pilot does prove to be successful, we would like to expand it to include other vaccination types,” she added.

[The app] assists the GPs in assuring us that there is a stream of patients coming in

Preparations

One of the clinics that signed up for the pilot launch was DoctorAnywhere clinic headed by Dr. Raymond Ong.

The new appointment system allows them to notify applicants that there are still vaccine stocks at the inoculation site, Ong explained.

“[The app] assists the GPs in assuring us that there is a stream of patients coming in. [It compels them to be mindful that they] should stock more vaccines, prepare, and cater time for these patients as well,” he added.

Ong said they are also able to gauge the volume of demand through the appointment system. “I think that’s something that most clinics will be able to handle as well, especially now that we have a system sort of keeping, informing us of demand,” he said.

DoctorAnywhere offers National Adult Immunisation such as influenza, pneumococcal conjugate, pneumococcal polysaccharide, tetanus, reduced diphtheria, acellular pertussis, human papillomavirus, Hepatitis B, measles, mumps and rubella, and varicella.

HEALTHCARE ASIA 11 HEALTHCARE TECH: OGP
Through a simple scan of a QR code, eligible seniors can access the app and book their vaccination appointment
SINGAPORE
Dr. Raymond Ong Dr. Nicola Lew

AC Health eases financial burden for Filipino patients

US$55m invested in building a multidisciplinary cancer care hospital.

Although cancer is amongst the top causes of death in the Philippines, its treatment remains unaffordable for many, with an estimated minimum cost of P1m in the first year of diagnosis. Ayala Corporation (AC) Health plans to address this by building its cancer specialty centre in the country, the Healthway Cancer Care Hospital.

AC Health CEO Paolo Borromeo told Healthcare Asia that they invested US$55m (P3b) to build the centre offering a complete range of cancer services, from screening, diagnosis, treatment, to post-cancer care.

“Being able to create cancer screening programmes more broadly in our clinics, our other hospitals, and our digital platform, would allow us to screen properly and refer patients as needed to our cancer hospital,” said Borromeo.

Jimmy Ysmael, CEO of AC Health’s overall hospitals and clinics group, Healthway Medical Network, will lead the Healthway Cancer Care Hospital. Other top officials are Nona Ong, chief operating officer of Healthway Cancer Hospital, Dr. Manuel Francisco “Ramy” Roxas, medical director, and Dr. Conrado “Gary” Lorenzo, medical advisory council chairman.

Borromeo said there will be a soft launch in July 2023 whilst the cancer hospital’s full launch is scheduled in September.

Expensive equipment vs affordable cancer care

The 100-bed cancer specialty hospital in Taguig City, Metro Manila, Philippines will offer a range of equipment for radiation oncology to surgery, chemotherapy, and palliative care. The hospital plans to install 18 chemotherapy infusion units, two linear accelerators (LINACs), and diagnostic and imaging machines.

Cutting-edge equipment at the hospital was puchased with the help of key partners Varian and Siemens Healthineers’ subsidiary, Varian – Cancer Treatment Services International, which is an established name in cancer diagnostics and treatment.

AC Health joined hands with Varian-CTSI in 2020 to develop and operate the Healthway Cancer Care Hospital and provide oncology services.

When asked if it is truly feasible to bring down treatment costs whilst investing in the latest technologies and innovations, Borromeo emphasised that they will leverage the AC Health ecosystem and partnerships with other providers to deliver the best value for patients.

“Improving patient outcomes will always be at the centre of everything we do in our cancer hospital, so we are constantly finding ways to expand options for cancer treatment. For instance, we are providing alternative and affordable options for chemotherapy and [cancer] medication by leveraging

our pharmaceutical business and bringing in biosimilars and generic equivalents, which could significantly cut the cost of chemotherapy,” said Borromeo.

Cancer treatment outlook

Cancer is the third leading cause of death in the country, according to Philippine Statistics Authority. On top of this, six out of 10 Filipinos die without consulting their physicians, a JCO Global Oncology journal showed.

But with developments such as the implementation of the National Integrated Cancer Control Act, signed in 2019, AC Health believes more awareness and action in addressing gaps in cancer treatment can be created.

“More broadly, we hope that initiatives like ours and other investments in [oncology] will lead to better screening, lead to better treatment, and hopefully, help mitigate the effects of cancer on the Philippines and our society,” said Borromeo.

To cite a recent investment in oncology, the Marcos administration has approved the public-private partnership project for the Philippine General Hospital to establish a cancer centre. News reports said the project’s P6b funding will provide for 300 beds.

On the Philippine healthcare outlook, Borromeo said he sees more opportunities to decrease out-of-pocket spending and resolve geographical disparities that make access to healthcare services difficult.

As chairman of the Private Sector Advisory Council (PSAC) Healthcare Team to the President, Borromeo said he sees developments in the national and local government’s goal to improve healthcare for all Filipinos.

12 HEALTHCARE ASIA CEO INTERVIEW
Improving patient outcomes will always be at the centre of everything we do
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We hope that initiatives like ours and other investments will lead to better screening, better treatment (Photo: Paolo Borromeo, CEO, AC Health)
PHILIPPINES
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Thai hospitals bolster IVF to attract Chinese tourists

They are also offering hotel stays and visa and wellness packages as part of their medical tourism strategy.

Even if China is not the dominant patron of medical tourism in Thailand, analysts expect that hospitals in the Land of Smiles will be smirking and grinning over positive margins as Chinese tourists’ demand for in vitro fertilisation (IVF) markets heightens. The reason? The end of China’s one-child policy is taking a toll on its birth rate.

Waritthorn Kaewmuang, equity research analyst at UOB Kay Hian Securities Thailand, said some of the youth in China might not want to have kids possibly due to low income may contribute to higher dependence on IVF treatments abroad.

China’s population had fallen for the first time in six decades. In 2022, according to government data, there were about 6.77 births per 1,000 people in China, down from 7.52 births in 2021. Kaewmuang said Thailand’s IVF treatment is also attractive to Chinese tourists due to its above-average success rate of 48%.

More doctors [and] better equipment allows Thailand to develop further in various subspecialty area

Another factor why Thailand is attractive for IVF treatment is because it is over 50% cheaper compared to costs in China, Shin Thant Aung, Director at YCP Solidiance Thailand, said. He added that this could be an advantage as IVF is normally not covered by healthcare insurance.

“For example, China’s IVF treatment is around US$10,000. But in Thailand, you’re gonna get it at US$3,000,” said Aung.

China’s policy for IVF treatments is also strict when it comes to gender, which is why some medical tourists go to Thailand to get their fertility treatments, Aung noted. In a news article, it was mentioned that Beijing banned access to IVF for single or unmarried women.

Proximity is also another factor why Thailand is attractive. Thailand is nearer to China compared to other countries that offer IVF treatment. The distance between China and Thailand is 1,391 miles if you travel by plane compared to the distance

between the mainland and Turkey, one of the most preferred nations for IVF treatment, at 3,706 miles.

“Between China and Thailand, it is closer compared to Turkey. If you compare the distance, the flight costs, and also the average operation cost, which is around half compared to most of the countries. This is one of the reasons that China seems to benefit,” Kaewmuang said in a recent Healthcare Asia interview.

In 2022, the top source markets in Thailand were Malaysia, India, and Singapore. The Thailand government said it is expecting to receive 30 million tourists this year from its initial projection of 28 million tourists. About seven million to eight million of them are likely to come from China.

Inadequate number of specialty healthcare staff

The challenge for Thailand’s IVF treatment market is its inadequate number of physicians compared to Turkey, Kaewmuang said. To compare, a 2020 World Bank report showed that Thailand had over 0.9 physicians for every 1,000 people, whilst in Turkey, the ratio is 1.9 per 1,000 population.

Kasem Prunratanamala, head of CGS-CIMB’s Thailand research, said there is a need to resolve the low supply of sub-specialty doctors, such as professionals in IVF.

“With more doctors [and] better equipment, it allows Thailand to develop further in various subspecialty areas, which in turn would attract more international patients,” advised Prunratanamala when asked how the market can address sub-specialty doctor shortage.

One way of resolving this is to offer competitive or higher pay for doctors performing surgery for subspecialty areas. “[If the pay is lower], it may force new physicians and new doctors to go to [Turkey] instead of [Thailand],” said Kaewmuang.

Prunratanamala said the Bumrungrad International Hospital and Bangkok Dusit Medical Services (BDMS) are amongst the hospitals that will benefit from the reopening and IVF treatment demand from Chinese medical tourists.

When analysed, Aung said these hospitals have a high-profit margin, with Bumrungrad having a 38%

14 HEALTHCARE ASIA
Bumrungrad is one of the hospitals that will benefit from the IVF treatment demand from Chinese medical tourists (Photo from Bumrungrad website)
COUNTRY REPORT: THAILAND
Waritthorn Kaewmuang

profit margin in 2021 whilst BDMS has over 30% gross profit margin. Bumrungrad, one of the most expensive and popular hospitals, accommodates a lot of Chinese patients. Bumrungrad has a fertility centre that has a team of more than 20 specialists and personnel who can provide counseling for couples with infertility concerns. The costs

COUNTRY REPORT: THAILAND

during the economic revival in China. In news reports, the Thailand government said it will start issuing one-year visas for people seeking medical treatment. It approved a measure that proposes to lower visa prices to THB5,000 (US$145) from THB6,000 (US$174). Asked if there will be a competitive advantage by offering discounts, Prunratanamala said Chinese tourists are “not price sensitive” for IVF treatments, as long as the success rate is high.

“If you get a lot of discounts, but the treatment fails. You’ve lost your money,” Prunratanamala said.

of fertility screening packages depend on their treatment but range from US$280 (THB9,600) up to US$496 (THB17,000).

Attracting Chinese tourists

The first strategy to attract Chinese tourists, Prunratanamala said, is implementing visa packages and offering hotel services, especially

Another strategy is by leveraging its wellness segment. It can attract more tourists to visit the market, said Kaewmuang.

In 2017, the Thailand National Statistics Office said the number of tourists that visited the market for healthcare and wellness was around 3.3 million. The next strategy to drive up the medical tourist market is a hospital collaboration with Ping An Health Insurance in China, Kaewmuang said.

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Shin Thant Aung Kasem Prunratanamala Thailand will start issuing one-year visas for people seeking medical treatment

Healthier SG lowers hospitals’ load and cuts spending

Healthcare reform in Singapore empowers general practitioners and family doctors to provide preventive care in communities.

With the establishment of ambulatory care centres, some of Singapore’s big hospitals resolved their overwhelmed capacity. This same strategy is applied with The Ministry of Health’s Healthier SG, which seeks to place higher focus on preventive care with an ecosystem-based approach that engaged general practitioners and community care centres, offloading the burden from tertiary care hospitals.

“The main idea behind Healthier SG is to shift the emphasis of the healthcare system from treatment to prevention. In the long run, this will produce better health outcomes for the population at a lower cost. For this to happen, the locus of activity needs to shift from hospitals to community care providers, particularly GPs,” Dr. Alan Ong, principal at Boston Consulting Group (BCG), told Healthcare Asia

Patients can go to a family doctor first, and build that relationship and trust with them

Under the health reform, there are four goals: i) deploying family doctors for preventive care, developing health plans for lifestyle adjustments; ii) regular health screening and vaccinations, activating community partners to lead healthier lifestyles; iii) launching national enrolment exercise for residents to commit to seeing one family doctor and a health plan; and iv) setting up IT and manpower plans as well as financing measures to operate Healthier SG.

Naithy Cyriac, a Partner at YCP Solidiance, said the health reform also helps create a more seamless patient journey. For example, patients will first go to family doctors for preliminary health assessment; and for further consultation, they may be transfered to other tertiary hospitals.

She noted that since some community care centres might not have the most sophisticated

medical equipment, a bigger hospital will act on the treatment that will need advanced technology. “Instead of patients directly going to bigger hospitals, they can go to a family doctor, first, and build that relationship and trust with them,” said Cyriac, in an interview with Healthcare Asia

Another way that health reform can help big hospitals is to promote the role of primary care through smaller clinics that large private hospital networks have now been focusing on. Cyriac cited Raffles Medical Group, IHH Healthcare, and Fullerton Health as some of the well-known healthcare groups investing in primary care facilities.

“The large private hospital groups are actively engaging their customer base by sharing insights on their website and allowing residents to register interest/enrol for the Healthier SG initiative easily,” said YCP Solidiance’s Cyriac.

The implementation of Healthier SG relies on the national enrolment programme, which will be in phases starting in the second half of 2023. The Ministry of Health will encourage residents aged 60 years and above to enroll with a family doctor in mid2023, followed by those in the 40-59 age group in the next two years.

Lower healthcare spending

A major goal of Healthier SG is to reduce long-term growth in healthcare expenditures. Preventive care is often substantially cheaper than treatment, whilst also resulting in better health outcomes for the population. Evidence for this comes from systems such as Kaiser Permanente which have a strong emphasis on prevention woven throughout all aspects of their interactions with patients, said BCG’s Ong. However, it is also important to recognise that cost savings will take time to materialise.

Ong said the initial phases of Healthier SG will boost recommended health screening and to increase uptake of regular follow-up and management of chronic diseases.

“This will have a short-term impact of increasing strain on the health care system as more people are found with medical conditions, and more people come forward for the management of their chronic conditions,” Ong said.

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The main idea behind HealthierSG is to shift the emphasis of the healthcare system from treatment to prevention (Photo from HealthierSG.gov.sg)
COUNTRY REPORT: SINGAPORE

“However, in the long run, earlier detection and intervention will result in a lower burden of disease. It is therefore important to plan with an understanding that Healthier SG will take time to show the desired outcomes of lower cost and better quality of life,” Ong explained.

YCP Solidiance’s Cyriac said Healthier SG’s goal of lowering cost is a long-term effect, given the reform’s phased approach.

The idea is that the reform seeks to address vulnerability to chronic disease by enabling patients to have regular annual consultations with their family doctor for early diagnosis and treatment of potential symptoms linked to chronic diseases, Cyriac said.

Doing this would reduce the number of patients diagnosed with chronic illnesses in the long run, resulting in fewer patients in need of long-term care on a five- to ten-year timeline, she said.

One way of lowering the cost of healthcare under Healthier SG is also implementing more affordable drugs. This is where the pharmacist’s cooperation with GPs and family doctors will come in.

“Since more people register with GPs, it will be easier to deliver the screening in a community base. For example, through local clinics, people can receive recommended diabetes screenings to identify patients’ health conditions. With the increased screening coverage, patients could be identified at an early stage,” Chia Hsuan Lin, an analyst at GlobalData, told Healthcare Asia.

“It will be essential for GPs and pharmacies to provide medical consultations and personal advice,” added Lin. Spending on early-stage

COUNTRY REPORT: SINGAPORE

residents. Additionally, residents will no longer need to co-pay part of their bills (usually 15%) when opting for MediSave for chronic care management,” she said. Expenses for yearly check-ins for family doctors will also be subsidised by the government and family doctors will receive an annual service fee, tiered based on health risk profile, scope of needed care, and progress made in preventive care or chronic disease management for the enrolled residents.

treatments or moderate to severe treatments is seen to increase and the government’s goal is to control the overall spending, making it more affordable, said Lin. Lowering healthcare expenses will especially help the elderly, who face severe financial burdens since they are the most vulnerable to illnesses.

Amongst the factors that prompted the new health reform is the growing geriatric population in Singapore. One in four residents is expected to reach 65 years old and above by 2023.

Singapore also saw the prevalence of chronic diseases that include hypertension and hyperlipidaemia, which went up to worryingly high levels, at 32% and 37%, respectively. Notable subsidies, according to Cyriac, include access to fully subsidised recommended screenings (type 2 diabetes, hypertension, breast/cervical/colorectal cancer etc.) and vaccinations (influenza and pneumococcal vaccinations for 65+ years old etc.). “The first onboarding consultation with the family doctor will be free for

“Additionally, to ensure consolidation and sharing of patient health metrics, a one-off grant will also be offered to the primary clinics to encourage digitalisation,” said YCP Solidiance’s Cyriac.

GPs that are part of the primary care network (PCN) will also get funding and administrative support from the Ministry of Health.

“This initiative further incentivises family doctors to join the PCN. In 2018, 340 clinics were part of the PCN and have grown to 670 clinics today compared to about 1,800 clinics in total in Singapore,” said Cyriac.

Eldercare facilities

The Ministry of Health is also studying provisions in the bill as it will also implement clear and stringent safeguards to ensure proper handling of health information. Another obstacle to digital apps is encouraging the elderly population to use them. The expansion of eldercare centres (ECs) may help and Healthier SG is seeking to grow the ECs from 119 currently to 220 by 2025.

To read the full story, go to https:// healthcareasiamagazine.com/

HEALTHCARE ASIA 17
It will be essential for GPs and pharmacies to provide medical consultations and personal advice
Dr. Alan Ong Chia Hsuan Lin One of the healthcare reform’s goals is developing health plans for lifestyle adjustments (Photo from HealthierSG.gov.sg) Staff at elderly care centres will be trained to improve their capabilities in guiding the elderly with digital concerns Naithy Cyriac

3 ways AI will stand out in healthcare delivery in 2023

Generative

When you type your symptoms on Google to search for one’s possible health condition or disease, it’s almost always wrong. In 2023, healthcare players will try to bridge this gap through generative AI. Boston Consulting Group partner, Anurag Agrawal, said using generative AI will be amongst the trends for digital health this year.

The first use of generative AI is to improve patient communication by removing human elements to cut costs and enhance speedy responses to patients, Anurag said.

An example of this is the use of chatbots, which is what US hospitals did in 2020 when patients piled up. To address the overwhelmed capacity, patients were introduced to an AI chatbot where they can simply log their symptoms.

With generative AI, the machine has access to individual personalised medical records and data so that when a patient logs into the system and discloses one’s symptoms, the AI, with the right development, will precisely guide the patient on what to do next. “[The AI may ask] if it

Generative AI can improve patient communication by removing human elements

is a serious condition [and] if you need to come to the hospital. If it’s not required, you can give a phone call to the doctor,” said Agrawal. For Tina Deng, principal medical devices analyst at data analytics firm GlobalData, AI such as ChatGPT may also be used to help physicians in painstaking tasks such as writing patient letters so doctors can focus on talking to patients.

AI can also review a patient’s symptoms and recommend diagnosis and different options like online check-ups or face-to-face visits with healthcare professionals. The second application for generative AI is its ability to study massive amounts of medical data, Agrawal said. “Generative AI will look at the data, they will identify patterns of what is going wrong with the patients. In a hospital with multiple intensive care units, generative AI will help them work together to find out what kinds of protocols need to be developed to better care for patients and improve outcomes,” said Agrawal. The third application is helping with developing drugs under pharmaceutical segments in the life

sciences industry, Agrawal said. When tapping suitable patients for clinical trials, generative AI will do it for them.

“A very important part is identifying receptor candidates where the pharmaceutical product would target generative AI will help us do that very rapidly. You saw the COVID-19 vaccines, the mRNA vaccines coming out in two and a half years. With all kinds of bells and whistles taken care of, that will start happening even faster,” said Agrawal.

According to GlobalData, the AI market will reach $383.3b in 2030, with a 21% compound annual growth rate (CAGR) from 2022 to 2030.

Digital healthcare outlook

When using technology to cut down costs, Agrawal sees more digital trends being developed aside from the use of generative AI. The implementation of virtual reality and digital twin technologies are some of the new trends he sees for this year.

For digital twin, a 2023 BCG study showed that the technology will help in clinical trials to reduce the number of patients in placebo groups and raise study diversity, with the aim of decreasing recruitment costs and fasttracking time to approval.

Since digital twins are virtual representations of the patients, they will also be used by scientists to predict how the live patient can respond to treatment through using deep phenotyping, which compiles health records, genomic data, and other data sources.

In the development of virtual reality, such tool can be used for medical training and patients’ mental health, amongst others.

“There are multiple applications that I see emerging in medical training, which helps one visualise medical anatomy, in ways that one could never have thought of 10 to 15 years before, will be a very important application,” said Agrawal.

“Similarly with patient communication, with virtual reality, one could take patients through their disease in a manner to which they could never have been exposed to before,” he added. Overall, Agrawal views these technologies as helping in the growth of digital health, which has seen a massive uptake due to the pandemic.

18 HEALTHCARE ASIA
One important application of generative AI is in medical training
AI will help find suitable
diagnoses and analyse large medical data.
ANALYSIS: AI
Tina Deng
ASIA PACIFIC
Anurag Agrawal
HEALTHCARE ASIA 19

Mayapada Hospital employs AI to advance Indonesia’s

healthcare infrastructure

It also taps into advanced hospital information systems to improve patient outcomes.

As Indonesia faces the challenge of getting 87% of its hospitals to implement electronic medical records in their services, the Mayapada Healthcare Group seeks to lead the healthcare industry’s digitalisation by investing in artificial intelligence (AI) and advanced hospital information systems (HIS). Apart from this, the hospital is also extending facilities of its Centre of Excellence services such as oncology and has started offering advanced radiotherapy facilities in its largest hospitals.

Healthcare Asia sat down with Navin Sonthalia, chief operating officer of Mayapada Healthcare Group and Chris Khang, president and CEO of GE HealthCare in ASEAN, South Korea, and Australia and New Zealand to discuss how their partnership has helped shape healthcare infrastructure in Indonesia.

What is the current state of digitisation and telehealth at Mayapada Hospitals?

Navin Sonthalia (NS): We are a medium-sized group in Indonesia with five operating hospitals:

Mayapada Hospital Tangerang, Mayapada Hospital South Jakarta, Mayapada Hospital Bogor BMC, Mayapada Hospital Kuningan, and Mayapada Hospital Surabaya. Our sixth hospital has opened in the first quarter of 2023.

Over the last four years, our group has significantly expanded its footprint in Indonesia. The COVID-19 pandemic has boosted our brand recognition as we have performed more than 700,000 PCR tests and treated thousands of patients since June 2020.

The pandemic threw the spotlight on telehealth and telemedicine, which were essential for continuity of care in spite of disruptions such as lockdowns. However, there is more to digitisation than just telehealth and telemedicine. As such, we see a need to adopt more advanced hospital information systems with various plug-and-play features.

How did the advanced HIS improve the hospital’s operations?

NS: Advanced hospital information systems (HIS) leverage various

technologies including the Internet of Things (IoT) to capture high quality and volume of data such as the individual healthcare records of patients. The plug-and-play feature of an advanced HIS enables us to capture data at every step of the patient journey. This allows providers to improve the delivery of precision medicine and care, which enhances patient outcomes and saves more lives.

What are the strengths of Mayapada in serving patients and improving staff well-being?

NS: COVID-19 has revolutionised the way we evaluate, diagnose, and treat patients. With that said, we established a centre of excellence for different therapeutic areas such as oncology and cardiology.

We continue to expand these across all our hospitals and provide end-to-end care from diagnostics to treatment and even posttreatment care. With the rollout of this strategy, we continue to see increased demand for healthcare services even in the post-COVID phase. This could be due to a higher

20 HEALTHCARE ASIA
FEATURE PROFILE
Mayapada opened its sixth hospital in the first quarter of 2023 Our focus in the next three to five years is on AI and diagnostics INDONESIA

GE HealthCare has a clear vision and strategy to support the Indonesian government

level of health awareness amongst the public and a backlog of elective surgeries from the last two years.

Tell us more about the oncology specialist treatment areas. How does the centre of excellence work?

NS: At our centre of excellence, we are constantly bringing in new facilities for oncology treatment. We currently house our advanced radiotherapy facilities at two of our largest hospitals in the Mayapada Hospitals group - Jakarta Selatan and Tangerang hospitals.

What should we expect from Mayapada Hospitals in the next three to five years?

NS: Our focus in the next three to five years is on artificial intelligence and diagnostics. GE HealthCare is one of the AI service providers that best meet our needs. GE holds a large volume of data on their database and can provide rich AI insights.

We are also looking to bring in state-of-the-art equipment for clinicians and patients and an advanced hospital information system is required to make this a reality.

What is the trend of digitisation in Indonesia and how is it keeping up with the trends?

Chris Khang (CK): Indonesia is adopting a holistic approach as its healthcare system undergoes digital transformation. Part of this approach includes a government-driven initiative where the Ministry of Health will focus on six pillars for healthcare transformation. These pillars aim to address a variety of issues including

healthcare access, primary care, and treatment for various therapeutic areas such as neurology, cardiology, and oncology. At GE HealthCare, we have a clear vision and strategy to support the Indonesian government in addressing its priority areas across the six pillars which include primary care, health system resilience, health financing, secondary care, health talent, and health technology.

The centrepiece of this vision and strategy is to empower individuals to lead healthy lives through proactive and personalised care in the form of precision health. Precision health uses medical treatment informed by data to improve treatment outcomes for patients. Digital and AI technology is key for precision health, and these elements play an important role in driving Indonesia’s healthcare transformation. The use of digital and AI technology can broaden access to rural areas and remote areas, and enable accurate diagnosis and treatment, particularly in the neurology and cardiology space.

We expanded our collaboration with the government to support them in their nationwide digital imaging initiatives. The technology key to this project is our Edison Digital Health Platform - a GE HealthCare developed platform that combines and connects artificial intelligence to other smart devices. I believe this technology will help Indonesia achieve its next phase of transformation, particularly in the context of AI and digital transformation.

Is Indonesia lagging or advancing in digital healthcare within the Southeast Asian region?

CK: Indonesia is definitely on its way to realising digital transformation in its healthcare system.

A combination of factors including the COVID-19 pandemic, support from the private sector such as Mayapada Group, and publicprivate partnership have leapfrogged Indonesia’s healthcare transformation. We are seeing a lot of interest to further improve the healthcare infrastructure in Indonesia. The country is focused on providing better care for therapeutic areas such as cardiovascular, neurology, and oncology and is building treatment centres across the country. Whilst the COVID-19 pandemic is a painful experience for many, it was an opportunity for Indonesia to work in close partnership with private stakeholders such as Mayapada Group to transform its healthcare system digitally.

Disclaimer: This written article has been edited for length and clarity.

HEALTHCARE ASIA 21
FEATURE PROFILE
GE Healthcare empowers individuals to lead healthy lives through proactive and personalised care in the form of precision health
Digital and AI technology [are] key for precision health
Navin Sonthalia Chris Kang

UMSC leads the way in privatised healthcare

The Malaysian hospital has a 99% retention rate for both staff and doctors.

The healthcare industry is rapidly evolving, with the privatisation of hospitals offering increased potential for revenue and benefits for all involved. UM Specialist Centre, led by CEO Norzaiton Senusi, is a case in point; the Malaysian hospital has seen its revenue reach RM250m (US$55m) in 2022, with the average specialist earning up to RM1m (US$221,788) annually. This range would still depend on the performance and services of the specialists.

The hospital also offers sponsorships for the talents to further their post basic as well as sponsoring the high school-leavers to further studies in diploma of nursing. The sponsored students will remain employed with UMSC for a designated term. A scholarship for the diploma can cost up to RM40,000 (around US$8,000) for each recipient.

“It is not 100% but we are about 95% to 99% in terms of our retention strategy, not only for the staff but also for the doctors,” Norzaiton told Healthcare Asia.

The private healthcare hospital has more than 270 consultants who practise in multi-disciplinary specialties. It also employed more than 500 expert professional staff members composed of nurses, radiographer, pharmacist, medical laboratory technician, and non-clinical talents.

Robotics surgery department

Aside from staff retention, UMSC seeks to ensure that its facilities are up to date. This is why it is currently venturing into more cutting-edge technology in a new hospital building.

This new building will feature treatments such as robotic surgery and high-intensity focused ultrasound (HIFU), which are medical processes that use ultrasound waves to treat conditions. “We plan to go to even something big for example, like robotic surgery, the HIFU for the oncology patients, proton beam therapy and to treat the uterine fibroids,” said Norzaiton. “In summary, we will continuously make improvements to innovate, automate the process, which we can do now and whenever there will be another process with a higher and more aggressive innovation that we will do,” she added. The robotic surgery will also improve minimally invasive surgical approach as well as reduce manpower needed for surgery. Yale Medicine defines minimally invasive surgical approach as a “type of surgery that involves smaller incisions and shorter recovery time.” Before there was a lot of blood loss when performing surgery and it also required several nurses. Now with the help of robots, it will reduce wounds and there will be an improvement in wound management. UMSC is not the first medical centre to adopt robotic medical surgery in Malaysia. To be at par with other established private hospitals, the needs to provide advance treatments facilities and services are crucial. UMSC could be the second hospital

in Malaysia to start HIFU treatment in the country. On the HIFU treatment, Norzaiton said it focuses more on women’s treatments, specifically fertility treatments. HIFU treatment mitigates fertility impact and the risk of complications women may face in typical treatments. Asked about the target date of the new hospital, Norzaiton said the specifications of the project are in the pipeline but they are eyeing to start construction next year. They also project completion by 2026 or 2027, when it will also start the full implementation.

A Bain & Company 2023 research also showed that investments in surgical robotics surged over the past decade as there is a promising improved precision and visualisation for surgeons and better experience and outcomes for patients. The robotics surgery market has a US$3 to US$3.5 billion global market, up from around US$800 million in 2015.

It also sees AI-assisted to fully autonomous robots, advancements in technology, and hardware that will upgrade operating rooms. A 2022 GlobalData report also showed that whilst medical robotics hold promise, high spending slows down its adoption.

“Medical robotics is a fast-growing field, with the surgical robotics segment leading the market. Whilst COVID-19 caused the cancellation of an estimated 15% to 30% of elective surgeries from April 2020, there will still be 3.7 million robotic surgical procedures in 2022,” read

22 HEALTHCARE ASIA CEO INTERVIEW
We plan to go to even something big, for example, robotic surgery
We will continuously make improvements to innovate, automate the process (Photo: Norzaiton Senusi, CEO, UM Specialist Centre) MALAYSIA

the report. High costs of medical robots and additional training to be equipped in using the technology will often be required, which also hinders speedy adoption.

Malaysia’s healthcare spend

A YCP Solidiance 2022 study showed that Malaysia’s total healthcare expenditure has more than tripled from US$7.4b (RM33b) in 2010 to US$16b (RM72b) in 2022.

This data is expected to continue to rise between 8% to 9% year-on-year until 2025, which will make the market’s healthcare industry an utmost priority for both the public and private sectors. Its government even considered the healthcare segment as a National Key Economic Area, with the adoption of technology-based services earmarked as a priority for both investment and research. The recovery of the global tourism industry has also increased the urgency with which Malaysia must prioritise its healthcare growth, as the market seeks to make medical tourism a key pillar of its post-pandemic growth plan.

Data from YCP Solidiance’s professionals in Malaysia also stressed the potential of several high-growth industries such as aged care, vaccine development, and telehealth. These solutions use digital transformation to reach consumers and innovate effective solutions.

Also, in Malaysia’s healthcare segment, telemedicine or telehealth services are growing in the country, similar to its Asian counterparts. An example of this is an Alibaba investment that would permit telehealth services to tap technology including cloud computing that would create more efficient systems and allow telehealth providers to serve more patients.

“Investors, both local and foreign, can take advantage of this opportunity to introduce innovative, tech-driven solutions that answer the ever-changing demands of the Malaysian market,” read the study.

Malaysia’s internet economy contributed 21.12% of the US$174b that the Association of Southeast Asian Nations-6 (Malaysia, the Philippines, Vietnam, Singapore, Indonesia, and Thailand) produced in 2021, with numbers seen to increase as the Southeast Asian region leverages its digital transformation.

“Shifting consumer behaviours and needs in the wake of the global COVID-19 pandemic have made it necessary for business industries to adapt rapidly through collaboration with both public and private sector players to keep up with the ever-changing landscape,” read the report.

High healthcare cost to slow down surgical robotic adoption

Surgical robotics market growth was driven by the robotics surgeries gaining ground in the hospital operating room in the past five years, said data analytics firm, GlobalData. But with uncertain market conditions, the surgical robotics market is more vulnerable compared to other healthcare segments.

Even so, GlobalData sees a rising market for robotic surgical systems and accessories, which is set to reach US$30.7b globally by 2030, posting a compound annual growth rate (CAGR) of 10% from 2022 to 2030.

Tina Deng, a principal medical devices analyst at GlobalData, said an average price of a surgical robotic system in 2022 was about US$1m plus an additional yearly service fee.

“The high cost can limit the ability of hospitals and ambulatory surgical centres to invest in new surgical robotics technology,” said Deng.

Depending on the lifespan of capital equipment, surgical centres may not replace capital equipment or purchase additional units in a given year. Hospitals that have robotic systems prefer to have more robot-assisted procedures to recoup their investment in the new equipment.

GlobalData also warned that consumers could delay or cancel non-essential procedures and services, which will lead to a slight reduction in surgical robotics demand but only in the short term.

AI for eyecare

Another evolving cutting-edge technology in the industry is AI, which is also becoming a game changer for eye care.

“A recent GlobalData poll shows that 49% of respondents believe AI will significantly disrupt their industry, and 25% of respondents believe that disruption has already begun,” Alexandra Murdoch, medical analyst at GlobalData, said.

GlobalData forecasts that the total AI market will be worth US$383.3b in 2030, up from US$81.3 billion in 2022, having grown at a CAGR of 21.4%.

Overall, Boston Consulting Group (BCG) sees a rise in new technologies and competition between ecosystems providing hybrid healthcare.

“So, winning will mean not having just a great product market fit, but also making wise choices about who you partner with and the ecosystem that you are building so that you can then compete with another ecosystem,” said Anurag Agrawal, partner and associate director at BCG.

In 2023, BCG predicts new technologies such as virtual reality, digital twins, and generative AI emerging in digital health solutions.

HEALTHCARE ASIA 23 CEO INTERVIEW
Investors can take advantage of this opportunity to introduce tech-driven solutions
UMSC seeks to ensure that its facilities are up to date (Photo courtesy of UMSC) A medineering surgical robot (Photo by Marco Verch) Tina Deng Alexandra Murdoch

Nuffield opens flagship clinic at iconic Orchard Rd

The dental clinic features recovery rooms, a lab, an expert team, and, soon, an academy.

After spending 13 years of his medical practice in England, Dr. Samintharaj Kumar got fixated on the wellness and healthy lifestyle promoted by the Nuffield gym, part of the largest British healthcare charity. And with that name, Kumar opened his Nuffield Dental Group business in Singapore in 2014 with absolutely zero connection to Nuffield Health.

Now, after implanting over 10 dental clinics in Singapore, the Nuffield Dental Group CEO and founder was faced with a simple yet daunting task – finding a location for the dental group’s flagship clinic.

“We wanted Nuffield Dental Jewel to be the flagship clinic for Nuffield Dental. So it was important that the location was central enough that our patients could funnel into a centre of excellence for complex treatments,” Kumar told Healthcare Asia

In 2020, it struck Kumar to install Nuffield Dental Jewel at Wheelock Place, Orchard Road, dubbed as one of the ultimate shopping streets in Southeast Asia. The location allows them to cater to tourists and locals since Orchard Road attracts seven million visitors annually, according to the Singapore Tourism Board.

“It was very difficult to find a location at that point in time to be very honest, but we were very lucky to get the space where we are at the moment. It spans two units at Wheelock Place,” said Kumar. “It enjoys a very good sort of reach to local customers and also international visitors because of the hotels and the shopping that’s along with it.”

High-end dentistry requires upscaling

Having the flagship clinic also meant upscaling their resources. And that meant installing six dental chairs at Nuffield Dental Jewel from the usual three or four chairs that deliver intravenous sedation procedures safely in their other clinics. In choosing Wheelock Place, Kumar wanted to ensure that the space can house a 3,600-square-foot dental laboratory.

Aside from dental surgeries and high technology, he said their clinic has a dedicated team of dental technicians to develop prostheses or dental crowns, which are fixed prosthetic devices that replace missing teeth.

“It is difficult or virtually impossible to do high-end dentistry without immediate close laboratory support from our technicians,” Kumar explained.

It depends on the dental expert’s examination, but full mouth rehabilitation will likely include tooth whitening, composite bonding, orthodontic teeth straightening, and dental implants, amongst others.

That is why the flagship clinic features recovery rooms for patients who had multiple procedures to restore teeth and bite at optimal conditions. “These are hospital-style

[Orchard Road] enjoys a good reach to local customers and international visitors

rooms where patients can lie down for prolonged periods of time, even up to a day. Here, their vitals such as blood pressure, pulse rate, and oxygen saturation levels can be monitored on an hourly basis,” Kumar said.

Dental academy

But building clinics is not the only important task for Kumar’s dental group, it is also honing the skills of their staff. To add more teeth to the training of dental nurses, Nuffield Dental Group has its own academy.

The academy, which was accredited by SkillsFuture Singapore, offers high-quality courses to dental surgeons, who will increase the quality of oral care in Singapore.

It offers courses on wisdom teeth removal, oral surgery, implant dentistry, ceramic implants, platelet-rich fibrin, and learning cutting-edge technology like how to use the T-scan.

Kumar said the training was first offered to their in-house employees. Over 10 dental nurses were trained in the academy. But now, they are opening the academy even to dental nurses from other clinics who do not have much training. More than training them in the use of dental chairs and dental sterilisation rooms, nurses get upskilled in the dental environment for three days after finishing the course. All courses at the academy will help ensure uniformity and a high level of precision in dental processes, especially the AllOn-4 procedure. This academy’s location is being eyed at the

24 HEALTHCARE ASIA CEO INTERVIEW
SINGAPORE
Building clinics is not the only important task for Nuffield Dental, it is also honing the skills of its staff (Photo: Dr. Samintharaj Kumar, CEO, Nuffield Dental Group)

Nuffield Dental Jewel, where courses for experienced dental clinicians for Singapore and other countries are organised.

In a previous speech, Minister for Education Ong Ye Kung said medicine and dentistry training is pricey, about four to five times expensive. For example, at the National University of Singapore, fees are about $29,000 annually as of 2019.

He then advocated for allowing students with the potential to overcome financial challenges.

Ong revealed the support received from national public initiatives including the School Dental Program. The government also collaborated to carry out dental screening for our three- to four-year-old children in about 800 preschools this year. “Government funding of education plus means-tested bursaries provide a strong base. Your support enables the Faculty [of Dentistry] to exercise judgment and flexibility and give additional help to those who deserve and need it. For the neediest cases, all the fees will be waived, and the student may even get some monthly allowance to get by with our full support,” Ong said.

Testing implants

In October 2022, Nuffield also worked with manufacturing firm, Osteopore, on tapping a dental implant technology, which is a way to replace missing teeth.

“Dental implants replace missing teeth permanently and are a good alternative to dentures or dental bridges. As they are built to closely replicate your natural tooth, they feel comfortable as compared to other teeth replacement techniques,” read the statement on Nuffield’s website.

The technology, called Osteomesh, is described as a “semi-flexible bioresorbable mesh with a bone-like microarchitecture.” It facilitates the immediate implant placement technique, even in compromised extraction sites, which allows possibilities of more complex implant surgery.

Osteomesh has benefits such as protection of the graft material, maintenance of jaw architecture for both hard and soft tissue, regeneration of the patient’s bone, and immediate implant placement. The bone remodeling takes place before complete degradation at 18 months to over two years. It is also user-friendly since it is semiflexible, easy to handle, and provided in a range of sizes

that can be trimmed with scissors. The technology can also be customised to specific patient anatomical needs as required to achieve optimal outcomes. To test this technology, Kumar revealed that they had to work into multiple meetings and outlines.

“We are talking about small defects in the mouth for dental reconstruction, especially with and without implants. Now, to create that view, they will take videos, and we would try and create cartoons or illustrations as to how the products are going to be used,” said Kumar.

In a snapshot of GlobalData’s 2023 report, dental implants and abutments procedure in APAC was 4,182,596 in 2022.

Bite scan tech

One of the technologies of the dental firm is bite analysis scan technology, which is called the T scan. Whilst gum disease and decay are common dental issues, Kumar said the technology helps them analyse teeth deficiencies of people with bite issues. “The T scan force sensor is fantastic in terms of giving me the information I need to improve the quality of life of my patients who have a biting problem,” said Kumar.

“The T scan allows dentists to accurately assess how a patient’s upper and lower jaws come together when biting and the amount of force applied,” he added.

Comparing this technology to the manual process, Kumar described that before, dentists had to use paper to identify the problematic spots of the tooth.

This technology replaces “conventional mouth impressions, which are uncomfortable, less exact, and will take multiple appointments.”

A 2022 Ken Research report that there is a rising awareness of dental services such as changes in lifestyle and diet during the 2020 era, including those linked to dental health. With this, Singapore dental services market growth will be driven by the rise in periodontitis and tooth decay.

Solutions include subscription dental services, digital healthcare, and government initiative, said Ken Research.

Under the subscription model, it is quite like Netflix where services may offer an annualised or monthly rate that covers regular cleanings, x-rays, and even fillings or other surgery.

Under digital healthcare, telemedicine, AI, and data adoption may receive support from the government. The government, on the other hand, increased expenditure to further subsidise healthcare.

HEALTHCARE ASIA 25
CEO INTERVIEW
[For students with dire financial need], all the fees will be waived
Nuffield Dental Jewel is the flagship clinic for Nuffield Dental Group (Photo from the Nuffield Dental Jewel website) Photo from the Nuffield Dental Jewel website

AHMC puts up dedicated cancer treatment facility

Asian Hospital and Medical Center invests US$5.5m in high-tech cancer services.

PHILIPPINES

Even the largest of hospitals in the Philippines can be overwhelmed by the increasing demand for cancer treatment capacity. It is in this context that the Asian Hospital and Medical Center (AHMC) in Muntinlupa City, Metro Manila invested US$5.5m (P300m) to develop a facility dedicated to cancer treatment. This two-floor dedicated facility is designed to cater to about 50 cancer patients daily.

Dr. Beaver Tamesis, who took the helm of AHMC as CEO last November, revealed to Healthcare Asia that whilst the dedicated floors will be occupied by over 25 bays for infusions, and a drug preparation facility, some areas will be reserved for patients undergoing transplantations.

“Some rooms would have a lazy boy or chair so that patients can receive their infusion. We should be able to easily accommodate, at a minimum, something like 50 to 60 patients a day,” said Tamesis, passionately describing his vision of the new project.

“[Patients] would be receiving their infusions, and remember, each infusion can take anywhere from 30 minutes to one hour,” the physician and corporate chief added.

Tamesis said some patients, especially the children, can even stay overnight for their medication.

This facility will be highly sterilised and there will also be enough space for staff to prepare the drug treatment for patients, said Tamesis, who used to lead the Pharmaceutical and Healthcare Association of the Philippines.

New equipment

Since the floors are already available, Tamesis said the funds would be used to fit out the floors and buy cuttingedge technology for radiation, chemotherapy, and other necessary equipment for cancer care services.

Currently, the hospital is investing in radiotherapy equipment, particularly the TomoTherapy, which enables the radiation oncologist and the treatment group to precisely hit the tumour with radiation whilst avoiding excessive radiation to the surrounding normal tissue

“We’re finding this is a state-of-the-art [tech] because this is the best way and best prognosis for a patient whose tumours are sensitive to the radiation and under the risk response rate,” said Tamesis.

Even so, his team is still looking out for new equipment and new therapies for cancer treatment.

The AHMC is living up to its name as South Manila’s apex hospital within the Metropolitan Pacific Health (MPH) network of private hospitals in the country. Designated as such, AHMC is an end-referral centre for specialised services.

One of AHMC’s immediate plans is to study how to identify tumours by undergoing blood tests instead of having to “bite” a tissue out of patients.

Tamesis told Healthcare Asia that they are also looking into robotics treatment in the mix of their hospital services. At present, robotic surgeries are available only in some hospitals in the country.

All of these are pipeline projects of AHMC’s Asian Cancer Institute, which has been offering cancer treatments since its establishment eight years ago.

“I have been saying this at the very start that there are a lot of patients who need the help, so we’re making sure that whatever we invest in, is the right investment because it is medically proven to be effective, and cost-effective for the patient, as well,” said the hospital’s CEO.

The ‘pirateable’ workforce

The shortage in the number of doctors is an issue in Asia, especially in the Philippines. World Bank figures in 2020 showed that the country has 0.8 doctors for every 1,000 population. In AHMC, Tamesis identified that radiation therapists and nurses are the most “pirateable” staff in their hospital. Piratable is an urban Filipino slang that means most of these healthcare workers are moving to other countries for higher pay and better lifestyles.

To make up for this, Tamesis said they constantly train their hospital’s new staff, identifying early who could go into these specialty services. One AHMC strategy is to partner with medical schools and universities on providing training to give students a glimpse of hospital work and culture.

26 HEALTHCARE ASIA CEO INTERVIEW
There are a lot of patients who need help, so we’re making sure that whatever we invest in is the right investment
AHMC has invested in cutting-edge technology for radiation, chemotherapy, and other necessary equipment for cancer care services (Photo: Dr. Beaver Tamesis, CEO, AHMC)

“We ensure that we have the right amount of staffing that’s constantly refreshed, trained, and ready to take on these roles that are always in demand. We anticipate the trends internationally but we need to prepare our hospital to make sure that we will not be hampered in our ability to deliver the service patients need and deserve,” he said.

On salaries, the hospital CEO said they have to ensure that nurses and technical staff are compensated properly.

“We’ve always surveyed the landscape making sure that we’re not paying poverty wages, right? We need to pay them right, at the right price for these technical skills,” said Tamesis.

Is the Philippines AI-ready?

The Philippines is also one of the Asian countries adopting AI in healthcare, especially in telehealth services.

For Tamesis, the Philippines does not have a high level of comfort with AI implementation compared to other markets.

“We haven’t reached that level of comfort that says, ‘Yes, we will adopt it wholesale.’ We’re trying to make sure that it delivers the same level of accuracy that we have come to expect from our doctors, in terms of their interpretation of the studies,” he explained.

“There are some areas where [AI] seems to be ahead, particularly abroad, but it still requires the human element to be able to properly put things in context,” he added.

But Tamesis clarified that they are not throwing in the towel for AI as they are also receiving proposals on projects about reading chest X-rays using this new technology.

The Philippine Department of Science and Technology (DOST) released a study on the accuracy of AI-powered reading of chest X-rays in the diagnosis of COVID-19 pneumonia in a tertiary hospital. This tool will be used for the efficient diagnosis of such conditions.

We haven’t reached that level of comfort that says, ‘Yes, we will adopt [AI] wholesale’

Charity partnerships

Recently, the Philippine health department received a P500-m (US$9.2-m) fund that will be allocated for its cancer control programme, which is under the National Integrated Cancer Control Act (NICCA).

This fund will be distributed to 31 hospitals, including AHMC, to invest in the necessary treatment and reduce the financial cost for cancer patients.

Admittedly, Tamesis said their share of the government’s funds is not enough to provide all the services they intend to provide to patients. But they will use that fund to provide support services, laboratories, and supervision patients’ needs, whilst the Department of Health provides the medicine for cancer-stricken children need.

In offering affordable but quality services, what AHMC does is partner with different organisations to help provide, for instance, cervical cancer treatment. Tamesis stressed that some government centres could not accommodate these patients.

He said they also have their charitable arm, the Asian Hospital Charities, which identifies children in need of different services such as cancer surgery. An example is the case of Sophie, whose heart murmur was treated after her family applied for charity services.

The NICCA, a law passed in 2019, has critics exposing its implementation shortfalls. But hospitals like AHMC strive to adhere to its mandate of providing accessible and comprehensive cancer care in a country of low-level income.

AHMC provides a wide range of medical specialties and services, including general medicine, surgery, cardiology, neurology, oncology, and many others. The hospital is dedicated to continuous innovation and improvement, regularly investing in upgrading its facilities and expanding its medical capabilities.

With its patient-centric approach and focus on medical excellence, AHMC has earned the trust of the community it serves. The hospital’s commitment to providing advanced medical care has made it a preferred choice for patients not only in Muntinlupa City but also from other parts of Metro Manila and beyond.

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CEO INTERVIEW
AHMC ensures that doctors, nurses, and technical staff are compensated properly for their technical skills AHMC invested P300m (US$5.5m) to develop a facility dedicated to cancer treatment (Photo from AHMC website)

EVENT: HEALTHCARE ASIA SUMMIT

Sustainable healthcare takes centre stage at HCA Summit

Over the last three years, there have been significant changes in the global healthcare scene, particularly in Asia, compared to the past 20 to 30 years. Now that the industry is moving into a postpandemic era, organisations must continue to learn, adapt, and ensure that they will be able to provide sustainable services to their patients.

In line with this, the Healthcare Asia Summit 2023 in Singapore has brought together professionals from across the Asia Pacific to discuss the future of healthcare. The event was attended by 157 in-person attendees from Asian countries and nearly 100 other participants who joined online through Zoom, Facebook, and LinkedIn.

Alex Boulton, Partner at Bain & Company, started the presentations with a discussion on the healthcare services demand in Asia as patients are experiencing long waiting times and high expenses. Boulton presented findings showing a rising shift

towards consumerism in healthcare, a shake-up in trust, a desire for simplicity and convenience, and a preference for digital engagement and a single touch point for managing overall healthcare needs.

Boulton then talked about opportunities for healthcare ecosystem participants: to simplify the patient journey, create an integrated continuum, provide valuebased care, and empower patients and physicians to drive productivity to close the supply gap. He also noted that the breaking down of silos and the need for collaboration could solve the challenges facing the healthcare industry.

“This is not a sector where you’re thinking intensely about your competitor and how you outcompete. It needs to be thinking about how we sort of come together and solve the challenges,” said Boulton.

Meanwhile, Yong Yih Ming, Chief Executive Officer at Mount Elizabeth Hospital at IHH Healthcare,

gave a provider perspective on evolving patient needs. Yih Ming highlighted the government’s role in ensuring equal access to healthcare through a safety net. Given this, he emphasised the importance of value in healthcare and the development of methodologies to ensure appropriate treatment and consistent practice. He also mentioned the focus on digital initiatives that aim to promote healthy lifestyles, not just treatment.

Dr. Walter Lim, Singapore Managing Director at Fullerton Health, talked about building a sustainable future for medicine, ideally for the next 10 years.

Sustainable healthcare

Firstly, he emphasised the importance of preventive care.

“The crux of it really is prevention is better than cure, which is really the fundamentals of healthcare. And this is what I mean by building from the ground up,” he explained. Secondly, Lim said there is a need to “build for populations” and support vulnerable populations. Lastly, he highlighted the need to build patient journeys by building a strong foundation for health education.

Joining the first panel were Lim Wai Mun, Founder & CEO of Doctor Anywhere; Andrew Wong, Chief Health Officer of Prudential plc; and Serene Cai, Co-Founder of Speedoc. The session, led by Boulton, discusses the future of telemedicine in healthcare and how it has rapidly gained adoption during the pandemic.

The panellists mentioned the importance of understanding how technology is evolving to include remote monitoring, big data collection, and AI. They also agree that telemedicine is becoming an essential tool for healthcare providers to enhance their practice, though it will not replace in-person care completely.

Partha Basumatary, Principal of Boston Consulting Group, talked about climate and sustainability in healthcare in his session. He stressed that environmental, social, and governance (ESG) practices should not be treated as just one initiative but instead as a “strategic advantage.”

For his part, Bumrungrad

International Chief Partnerships Officer David Boucher talked about

28 HEALTHCARE ASIA
Healthcare Asia magazine publisher and editor-in-chief Tim Charlton at the HCA Summit 2023
by
and leaders in
healthcare
SINGAPORE
The event was attended
experts
APAC’s
sector.
[Healthcare financing] is a whole village approach
Walter Lim Yong Yih Ming

the medical value of travel in the postCOVID world, caused by significant delays in elective procedures and chronic illness treatments. In addition, telemedicine and remote monitoring are also becoming integrated into medical value travel, making it easier for doctors to follow up with patients from around the world.

Adjunct Assistant Professor Kelvin Tan, Senior Consultant and Head of Service (Adult Reconstruction) of Tan Tock Seng Hospital, reflected on the challenges brought by the pandemic to healthcare in Singapore, such as the bed and manpower crunch, the need for advanced training for nurses and doctors, and the impact on elective surgeries. Patients’ mindsets were likewise changed by the pandemic, as they now have the desire to go home earlier, leading to an increase in ambulatory surgeries.

For Tan, ambulatory surgery is the way forward, but he also looked into alternative solutions such as virtual healthcare services that can encourage patients to recover at home and digital health like wearables and mobile apps, which allow for a less tiring experience for both patients and healthcare providers. Tan also considers a paperless, accessible, and unified platform to store healthcare data as a “dream,” but stresses the need for privacy and cybersecurity.

Sustainable financing and operational excellence

For the second panel, Boucher, Basumatary, and Sunway Healthcare Group Finance Director Chelsea Cheng talked about sustainable healthcare financing in a discussion led by

Pureland Group Partner Chris Hardesty

From a hospital’s perspective, Boucher highlighted the importance of taking a whole-of-society approach and considering the human factor in financing decisions. He stressed that employees must be treated with dignity and respect, whilst other costs can be cut by reducing waste. From a patient perspective, Cheng noted that patients tend to do financial modelling based on best-case scenarios. As such, she believes healthcare financing should be managed with a whole-village

EVENT: HEALTHCARE ASIA SUMMIT

approach. “It’s not just the individuals, not just the government, not just the private sector. That really, it’s a whole village approach,” she said.

Meanwhile, Basumatary admitted that there is no “silver bullet” for innovative financing concepts in healthcare. Still, he identified two main problems: the source of money and the delivery mechanism for affordable healthcare. The first requires systemic changes, whilst the second can be addressed with innovative solutions, such as financing options that allow patients to pay in installments.

Kearney Partner Sanath Kumar Balasubramanyam discussed “Operational excellence to deliver value-based care” for his speaking session. He acknowledged that several challenges need to be addressed from an operational standpoint, then proposed ways to use digital means to move towards efficiency improvements.

InterSystems’ Director for Customer Relations and Sales –Healthcare in Southeast Asia, Stella Ramette, talked about Fast Health Interoperability Resources (FHIR). She stressed the need to break down dialects in all data systems and instead embrace a lingua franca so everyone can do the same thing, whether they are working in a hospital or insurance company, amongst others.

Vejthani Hospital Chief Operating Officer Dr. Tullawat Pacharapha discussed key trends in hospital management that have already been adopted: delivering outcomes that matter to patients, managing

patient experience both in person and digitally, enhancing team collaboration, adopting automation and AI to improve efficiency, and using data and analytics to inform decision making.

For his session, EY Asean Life Sciences and Health Care Leader Abhay Bangi talked about various dimensions of value-based healthcare. Stakeholders in the system have different definitions of value, which makes it challenging to agree on the most critical data points necessary to address value.

Bangi suggested that creating a neutral definition of value, aligning data collection and sources, creating a safe environment for collaboration, investing in the business case and payment model, and upskilling frontline workers are essential steps to implementing value-based healthcare successfully. He also emphasised the importance of the five golden rules, which include considering objectives, tracking outcomes, identifying data sources, evaluating the workforce’s maturity, and analysing payment models.

Value-based healthcare: collaboration and benefits

The third panel discussion featured Dr. Clive Tan, Assistant Chief of Group Integrated Care (Population Health) at National Healthcare Group; Cindy Choe, CEO at Prince Court Medical Centre; Dr. Ethan Lim, Medical Director at Fullerton Health; and Susan Fanning, Health Insurance Industry Expert & Health Actuary.

Read the full event coverage at https://healthcareasiamagazine.com/

HEALTHCARE ASIA 29
Third panel discussion “Value-based Healthcare and its Benefits to Stakeholders in the Ecosystem” Lim Wai Mun Kelvin Tan David Boucher Tullawat Pacharapha Chelsea Cheng

Patient-centricity is the future of Thailand’s healthcare

Industry leaders and experts discussed the latest trends and challenges in the sector in the half-day Healthcare Asia Forum Bangkok

As the healthcare sector in Asia transitions into a new normal, it is being impacted by new trends and drivers. Healthcare organisations have reevaluated their priorities and procedures to conform to the latest methods of offering patient care whilst also encountering innovative developments in the field.

To highlight the key trends and issues shaping the future of healthcare, Healthcare Asia brought together experts and industry leaders in the half-day Healthcare Asia Forum Bangkok, held on 3 April, 2023 at the JW Marriott Bangkok.

Calvin Wijaya, Senior Manager at Bain & Company, started the presentations with a discussion of the organisation’s latest insights on the healthcare industry. Wijaya noted that the pandemic had forced healthcare providers to rethink their care delivery methods. There has been a rise in consumerism in healthcare, a realignment of trust amongst stakeholders, and an increasing desire for simplicity and convenience for consumers, and technology now plays a greater role in helping healthcare companies. Now, patients are looking for a single

Technology and data analytics will continue to be adopted across the care continuum

touchpoint for their care, but it has also become frustrating for them given the multitude of options to choose from. Given this, Wijaya suggested that a winning healthcare model of the future will be patientcentric, personalised, and features connectivity and omnichannel delivery. Wijaya added that with the rise of telehealth, digital technology is now able to make patient care more convenient, efficient, and effective, whilst also improving the patient experience. However, he stressed that there are limitations to the services that can be offered through telehealth, so it is important to work on a connected, omnichannel experience both online and offline.

As the digitally savvy patient base grows, he believes that technology and data analytics will continue to be adopted across the care continuum, and the region can look forward to more cutting-edge services and innovations in the future.

For the second speaking session as well as the Q&A section, Dr. Suebsakul Tonjang, Innovative Sustainability Manager at Bangkok Dusit Medical Services, talked about the challenges facing healthcare

today and best practices to improve sustainability within the sector.

Tonjang admitted that environmental management in a healthcare setup, particularly in a hospital, can be difficult since equipment and other materials in this setting will be used for patient care. However, he posited several ways to reduce energy.

“We can’t decrease the [use] of energy in [an] organisation because it may affect patient care. However, we try to use free energy and renewable energy in our organisation,” he said, pointing out that BDMS has harnessed solar energy in some of its hospitals.

Shin Thant Aung, Director at YCP Solidiance, then discussed Digital Health Transformation and Telemedicine 2.0. He highlighted the growing importance of digital health transformation and telemedicine in Thailand, especially in addressing the health concerns of an ageing population.

He pointed out common challenges faced by traditional healthcare systems in Thailand, which can be managed through digitalisation: insufficient healthcare resources, access to healthcare in remote areas, and the rising costs of healthcare. Aung also emphasised the need to adopt Electronic Health Record (EHR) systems.

Aung added that YCP Solidiance anticipates the following improvements in telemedicine in the future: increased collaboration between public and private entities, increased investment in the healthcare industry, and integration of digital technologies.

Health economics and drug pricing

For his speaking session, Dr. Gunnaphon Anamnart, Chief of Academic Center at Bangkok Hospital Rayong, talked about Health Economics in the Private Sector after COVID-19 Disruption. He dove into how the pandemic affected healthcare economies, how organisations can keep patients engaged, and how to balance business with standard medical care. He highlighted that leaders must be careful when brainstorming ways to resolve problems faced by their organisation. Read the full event coverage at https://healthcareasiamagazine.com/

30 HEALTHCARE ASIA
Panel discussion on the growing importance of digital health and telemedicine in Thailand
THAILAND
EVENT: HEALTHCARE ASIA FORUM BANGKOK
Gunnaphon Anamnart Shin Thant Aung

EVENT: HEALTHCARE ASIA FORUM JAKARTA

is the omnichannel. She suggests an integrated omnichannel delivery across in-person, virtual, and athome care.

Digital innovation is key

Thoroughly impressed during Healthcare Asia’s Jakarta forum was the key role of digital innovation in shaping the future of better health services. Dr. Susan Ananda, CEO of Premier Jatinegara Hospital, underscored that innovation in technology is now part of the best industry practices in the healthcare sector. Employing technology in the service system empowers patients to manage the care they want with utmost convenience.

Digital innovation headlines

HCA Forum 2023 in Jakarta

To highlight the key trends and issues shaping the future of the health sector, Healthcare Asia brought together experts and industry leaders for a forum at the Pullman Thamrin in Jakarta on May 2, 2023. Twelve speakers invited to take the stage at the half-day Healthcare Asia Forum Jakarta shared their insights on various topics, from rising consumerism in the industry, the demand for multidisciplinary care teams, the emergence of digital tools and technology, to revolutionising patient care and services.

Starting off the forum was Arathi Sasidharan, a partner at Bain & Company, whose presentation on “Front Line Perspectives on the Future of Healthcare in APAC” set the tone for the rest of the discussions.

Sasidharan said her organisation has identified four significant findings from the Asia Pacific frontline.

The first finding is the rising consumerism in health that shows 50% of the region’s patients being willing to pay more in exchange for better outcomes and efficiency.

Tech-enabled healthcare facilitates the best results in patient care

Second is a realignment of trust amongst stakeholders, whereas primary and secondary providers and health-tech companies work together to give patients the best services. Third, a desire for simplicity and convenience as patients have been observed to want a single touchpoint to manage care. Finally, the finding that new technologyenabled healthcare norms where the use of digital tools facilitate the best results in patient care.

She also presented a three-step winning model for the healthcare sector in the future, beginning with “focus on patient centricity.” To achieve this, there must be multidisciplinary care teams that include social workers, primary care physicians, nurses, and health coaches, all of whom focus on providing the best health services to the patient. The second is by “staying connected,” which refers to a seamlessly connected experience where patients are enabled by digital tools and supported by increasingly tech-savvy clinicians.

Third in Sasidharan’s winning model

Dr. Ananda cited as an example the digital innovations implemented at Premier Jatinegara Hospital, such as the 24-hour appointment registration, registration via whatsapp chatbot, self check-in which shortens waiting time, making independent payments via kiosks, and using drug delivery services.

Sharing the stage for the first panel session were prime movers in the industry who gave their insights on the theme, “The Digital Future of Healthcare: Revolutionising Patient Care and Enhancing Access to Health Services.”

Chris Hardesty, a partner at Singapore-based private asset manager Pureland Group, moderated the discussion with panelists Alan Ong, a principal at Boston Consulting Group; Dr. Ben Widjaja, president director of Mandaya Hospital Group; and Dr. Dewa Ayu Nyoman Martasari Badung, quality management representative of Premier Bintaro Hospital.

Widjaja underscored that healthcare digitalisation needs to happen now, while ensuring quality, safety, and improving medical personnel’s capabilities.

For her part, Badung stressed the need to implement electronic medical records and how it can help collect and analyse patient data and transfer records for referral to other healthcare facilities. She said the Indonesian government is actively promoting this practice as a standard in the healthcare industry.

Read the full event coverage at https://healthcareasiamagazine.com/

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Twelve speakers shared expert insights at the half-day Healthcare Asia Forum Jakarta
INDONESIA
Experts from various healthcare organisations reveal key trends and tech innovations applied in the industry to provide patients the best services. Dr. Susan Ananda Arathi Sasidharan

Ethical AI and more highlighted at HCA Forum Kuala Lumpur

Malaysia’s industry experts graced the Healthcare Asia Forum stage to discuss responsible AI use, preventive care, and evolving patient needs.

MALAYSIA

Healthcare consultants, hospital leaders, and other industry experts came together to reflect on the rising digital adoption in healthcare, particularly in Malaysia, and emphasised the need for its accurate and ethical use to ensure the utmost patient care. Equally important now in the healthcare ecosystem is preventive care, which was also thoroughly discussed at the Healthcare Asia Forum held in Impiana KLCC Kuala Lumpur on 24 May.

The event drew over 10 industry experts and healthcare professionals from private hospitals, investment firms, consultancy groups, and multinational hospitals to tackle digital healthcare trends, patient experience, and the changing ecosystem for genuine universal healthcare. Starting the forum’s discussion was Boston Consulting Group’s Anurag Agrawal, who talked about the benefits of generative AI in healthcare. He said the technology cuts time and costs to develop new drugs and therapies and reduces time in writing patient notes by 50%. But there are risks to AI dependency. If not used properly, one could be accused of generating

codes without attribution, creating content with bias based on data intake, and providing a confident response that is not accurate.

Agrawal advised developing and operating AI systems to have them align with organisational values and widely accepted standards of right and wrong. There should also be a set of tools that will evaluate and oversee the risks of AI.

Cutting-edge tech

Gleneagles Hospital Kuala Lumpur CEO, Hoo Ling Lee, said healthcare providers must regularly evaluate new treatments, services, technologies, and data to ensure value-based care for patients.

Hoo also said they have been applying AI tech in ophthalmology, cardiology, and radiology department. AI is now also used for screening patients, which helped them create seamless service whilst also cutting costs.

In eye care, AI was able to screen over 500 patients in the past two months. Five of these patients were correctly detected to have diabetic retinopathy and referred for treatment. As their hospital continues to maintain telemedicine, Hoo said

the top three disciplines it services are Psychiatry, Endocrinology, and O&G (Obstetrics and Gynaecology).

From Prince Court Medical Centre, Datuk Dr. Kuljit Singh took the discussion to future-proofing healthcare services. The medical director and consultant ENT surgeon said this can be done by embracing innovation, leading innovative healthcare delivery, and pioneering the future of private healthcare in Asia.

In Malaysian healthcare, the top challenges include ageing population, non-communicable diseases, delivering accessible but high-quality healthcare, and gaps in healthcare infrastructure.

Datuk Dr. Kuljit said hospitals may do their part in solving these issues by collaborating with industry partners such as technology and innovation, pharmaceutical and biotechnology companies, and medical device manufacturers. Citing some of their cutting-edge medical devices, he mentioned weight-bearing CT and radiotherapy machines.

Meanwhile, Anastasia Miros, KPMG director for healthcare and life sciences for APAC, led the panel discussion about the future of healthcare funding in Asia. Joining the panel are Associate Professor Dr. Lim Ren Jye, the medical centre at Sunway TCM Centre, and Dr. Kuljit.

Evolving patient needs

When the speaking session resumed at the Healthcare Asia Forum, Bain & Company Senior Manager Erik Lim opened his presentation with the perspective of patients. Patients’ demands include paying more for efficient healthcare service and using touchpoints to manage care.

As patient care continued to evolve, Lim enumerated the winning models of future healthcare—multidisciplinary care teams focused on an integrated approach to medical, behavioural, and social determinants of health; seamlessly connected experience enabled by digital tools and increasingly tech-savvy clinicians; and integrated omnichannel delivery across in-person, virtual, and homecare services.

Read the full event coverage at https://healthcareasiamagazine.com/

32 HEALTHCARE ASIA EVENT: HEALTHCARE ASIA FORUM KUALA LUMPUR
Panel discussion about the future of healthcare funding in Asia (Photo: Dr. Lim Ren Jye, Anastasia Miros, and Datuk Dr. Kuljit Singh)
AI systems must align with organisational values and widely accepted standards of right and wrong
Hoo Ling Lee Anurag Agrawal
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