Telemedicine aids Thailand health

COUNTRY REPORT: THAILAND Telemedicine aids Thailand healthcare woes

The country’s healthcare system continues to advance digital technologies to improve healthcare services.

Whilst the challenges brought about by COVID-19 are becoming more manageable and with the community becoming more aware of the effects of the pandemic, essential practices and innovations in the treatment of the virus are also becoming ingrained in Thailand’s healthcare system.

The country, recognised as having one of the most advanced and efficient healthcare systems in the Asia Pacific region, was widely praised for its proactive response to the pandemic. Through a whole of society approach and ramped-up testing, Thailand has been able to deal with the virus successfully.

At the same time, the acceleration of digital technologies in clinical processes have also been beneficial to Thailand’s healthcare system, being able to assist facilities and streamline processes for a more efficient practice. The use of robots are utilised to provide food and medicine, as well as to collect medical information, to limit healthcare workers’ contact to sick patients and to prevent risks.

Several contract tracing applications by the government and other organisations have also been developed to locate high-risk areas and to monitor people’s movements, especially those coming from outside the country.

Keeping track of COVID-19 patients

The Thai government has built a telemedicine platform to monitor COVID-19 patients with mild symptoms at home and at isolation centres. Named BKK HI Care, the platform allows doctors to monitor and follow up patients who are isolating or receiving treatment at home.

Thanakorn Wangboonkongchana, Secretary to the Minister of the Prime Minister’s Office, assured on 04 August that “the new system will allow doctors to care for COVID-19 patients within the green and yellow levels of severity in home or community isolation.”

BKK HI Care keeps records of patients’ daily food intake, treatments, prescriptions, and temperatures. Patients can also report and receive treatment advice from doctors and nurses on their body temperature and blood oxygen saturation measurements at specified times and inform the results to the hospitals right away.

The platform is accessible for nurses and doctors via Windows, iOS, and Android smartphones, tablets and laptop/desktop computers.

Thanakorn noted that about 285 healthcare facilities are monitoring some 9,000 patients through the platform.

Moreover, the platform was built as beds at general hospitals, and field hospitals have been prioritised for more serious cases of COVID-19 patients. Those with milder symptoms can sign up with the government’s Home Isolation (HI) scheme, wherein their symptoms will be monitored continuously through the telemedicine channels. If home isolation is not possible, patients can also seek admission to community isolation centres.

Government agencies involved in BKK HI Care’s creation include the Digital Government Development Agency, the National Science and Technology Development Agency, the National Health Security

Thailand developed BKK HI Care, a telemedicine platform that will monitor Covid-19 patients

Thailand’s healthcare system has benefited from digital technologies in clinical processes

Thailand current health expenditure (% of GDP), 2000-2018

Source: World Bank

Offi ce, the Bangkok Health Bureau, and the state-owned National Telecommunications Company.

Improving digital health infrastructures

As emerging technologies continue to be seen in the healthcare industry advance, healthcare providers are also expected to keep up with the said development. Th ey are expected to improve their processes and to deliver better outcomes through the utilisation of medical technology.

In Th ailand, a project involving a 5G-powered intelligent medical information and the full-service system is currently in the works. Called the “Th ailand Health Data Space 5G,” the system for intelligent medical information is said to improve the country’s healthcare system across hospital transmission of information, diagnosis, follow-up, rehabilitation, and emergency treatment, as well as to aid in reducing congestion in the country’s healthcare system.

Th e organisations that will work on the project are Mahidol University’s Faculty of Engineering, the Medicine and Engineering Faculties of Naresuan University, the Permanent Secretary Offi ce of the Ministry of Public Health, and BPO fi rm Chanwanich.

“We are going to transform Th ailand into a sustainable society by connecting all sectors involved in the Th ai health system to transfer information more effi ciently. Th e use of technology and innovation will increase the effi ciency of work and accuracy of the information in [the] healthcare system. Th e fl ow of information is benefi cial to personnel and related medical departments,” said Anan Kanoksilp, Director of Information and Communication Technology Center, Permanent Secretary Offi ce of the Ministry of Public Health, in a press release.

“On the patient side, they benefi t from the speed, quality, and safety of medical services during emergencies. Th e patient will be able to collect their medical history to guide and direct care for [themselves] and family members,” the director added.

Meanwhile, Chanwanich chief executive offi cer Th anaphon Kongboonma mentioned that upgrading Th ailand’s fi rst innovative system for intelligent medical information serves the same purpose.

“Th is time, it happens through strong cooperation that will enable all sectors in the Th ai health and public health systems to systematically analyse health information via connectivity. Th e exchange of information will occur on the same platform under world-class standards accepted by many countries,” he said.

Under the 5G system, a telemedicine platform called Med Care will also be developed. Th e service has a high-speed digital 5G network which will be accessible for all Th ai people through mobile applications. Th e users can defi ne which hospitals are allowed to submit their information into the system and can notify the cancellation of permission with this application.

Med Care will off er four services: the Specialist Doctors app, a remote medical consultation system via smartphone; the People app which provides access to personal health information and medical resources; the Family Doctor Clinic app where health workers can contact patients and enter patient information; and the Village Health Volunteer app which is used for surveillance, prevention and disease control, health rehabilitation and consumer protection monitoring.

Th ailand Health Data Space signifi es the fi rst comprehensive development of the country’s Big Data Health Information platform, which has the following components: a big data infrastructure, a country-wide information system of hospital networks, and health service applications.

It can be noted that the country has been pushing for the adoption of 5G systems across industries for a while.

Rising opportunities for drugmakers

A Fitch Solutions report has noted that Th ailand’s epidemiological features will shape opportunities for drugmakers in the pharmaceutical market, as the burden imposed by cancer in the country is expected to grow signifi cantly over the coming years.

Th e number of new cancer cases in Th ailand is forecasted to rise to nearly 170,000 by 2025, according to data from Globocan.

In September 2020, the Government Pharmaceutical Organization (GPO) signed a memorandum of understanding with national oil and gas conglomerate PTT to build a factory that can produce all types of cancer treatment to allow Th ai patients easier access to

Healthcare providers are expected to keep up with emerging technologies in the healthcare industry

Thailand pharmaceutical market forecast (2019-2029)

medications at a more affordable price.

The comprehensive cancer-drugs plant will be located in Rayong’s Wanarom Industrial Estate and its construction is expected to cost ₿2.5b (US$80m). It is expected to begin construction in 2022 and commercial operations in 2027.

“The cooperation to develop a cancer medicine factory is a stepping stone to improving public health, science and technology, as well as the pharmaceutical sector and medical research in Thailand. The facility will also provide resources and knowledge for research and ease technology transfers with the world’s leading cancer drug manufacturers,” Fitch Solutions said in the report.

Producing drugs locally will cut the price by more than 50% and also reduce the burden of importing drugs, which costs more than ₿21b (US$670m) yearly, according to Deputy Prime Minister and Public Minister Anutin Charnvirakul.

He added that the project was aimed at the local production of all kinds of drugs and chemicals for all types of cancer, as medicines are expensive. Thailand currently imports all cancer-related drugs.

Meanwhile, Fitch Solutions noted that Thailand’s pharma market will continue to favour generic drugs.

“Regulatory reform to support innovative drug registrations and the development of active pharmaceutical ingredients in Thailand in the coming years will be offset by the country’s poor access to healthcare and low levels of affordability, ensuring continued bias toward generics in the market,” they said.

Generic drugs accounted for 60.7% of total prescription drug sales and 49.0% of the total market in 2019.

With Thailand’s healthcare system being historically underfunded, the government has been pushing for reduced drug prices in the country.

Fitch Solutions expects a continuation of this trend, especially with the COVID-19 pandemic and its consequent economic challenges, which will likely lead to limitations to healthcare expenditure and a greater drive towards cost containment whilst the economy recovers.

“These aggressive pricing policies will lead to a greater emphasis on generic medicines to enable wider accessibility of medicines. Increased consumption in more affluent, urban areas will offset these factors somewhat, providing growth opportunities for patented drugs in selected therapeutic areas, particularly chronic diseases,” they said.

Currently, pharmaceutical imports remain to be the dominant element of the country’s pharmaceutical trade landscape, and it is estimated to stay that way over the long term due to the lack of domestic manufacturers and local preference for patented medicines.

However, the firm noted that exports will see more robust growth due to high demand for generic medicines in both regional and global markets, supported by the government’s recent tax incentives for pharmaceutical investment into the country and plans to increase the pharmaceutical manufacturing sector, including the production of active ingredients.

At the same time, Thailand’s regulatory structures are expected to limit innovations as the demand for generic drugs increase.

“Thailand’s poor regulatory environment – defined by its weak patent enforcement and an unpredictable, delayed reimbursement system – will continue to limit the attractiveness of the country to innovative drugmakers; a new government system for reaching a decision on publicly funded patented medicines will lead to greater scrutiny by the authorities,” Fitch Solutions said in their report.

Looking into other concerns

Whilst it is important to recognise the efforts of Thailand’s healthcare system in its digital innovation and COVID-19 response, other issues faced by the country’s healthcare system are also worth looking into now that the country is seemingly prioritising healthcare in its agenda.

For instance, affordable and efficient healthcare services would not be possible without the country’s public healthcare program, the Universal Coverage Scheme (UCS). Since its initial introduction in 2002, however, a substantial number of beneficiaries has utilised healthcare outside the program’s boundaries, which might indicate a policy gap between the people’s needs and services available to them.

This indication, together with financial risks and the rise of ageing population, have been a concern and a pressing factor for the government to revamp the said scheme.

Whilst the people enjoy the benefits of the health coverage, Thailand’s healthcare expenditure has been steadily increasing for the past years. According to the latest data by the world bank, Thailand’s health expenditure in 2018 takes up nearly 3.8% of the country’s GDP.

This has caused questions on the sustainability of the country’s healthcare system in the long run, as the pressures brought by increasing ageing population and diminishing working force have become a factor to the steadily increasing government expenditures.

As such, it should be noted that the development of digital health infrastructures in Thailand would require large capital and an increased labor force if it wishes to maintain the stability of its current healthcare system.

The government would now have to look into sustainability measures, as the implementation of telemedicine and other digital innovations might get wasted if they cannot be maintained. by Vann Villegas

Regulatory reform supporting innovative drug registrations and the development of active pharmaceutical ingredients will be offset by Thailand’s poor access to healthcare

Sustainability measures will help maintain the implementation of telemedicine in Thailand