State commitment boosts Hong Kong’s healthcare sector

FIRST State commitment boosts Hong Kong’s healthcare sector

HONG KONG

Astrong government commitment to healthcare will largely be positive for the healthcare sector in Hong Kong, as the sector remained as one of the most significant spending priorities in the city, according to a report from Fitch Solutions.

Hong Kong’s government has allocated 15% of the 2021 budget, which is earmarked at $93.7b (HK$731.1b), Finance Secretary Paul Chan said in the Budget 2021/2022 speech. The sector saw the second largest allocation after social welfare.

The government aims to step up COVID-19 surveillance and testing efforts and The Department of Health will receive a total of $670m (HK$5.2b) over the next three years to help them.

At the same time, another $3.4m (HK$27m) will help fund health IT systems to implement anti-epidemic measures. Further, the government pledged $1b (HK$8.4b) to buy and administer the vaccines. Hong Kong’s free mass vaccination programme started for the general public on 26 February, with the most vulnerable citizens prioritised.

A sum of $18m (HK$147m) has also been pledged to support hospital and community psychiatric services to enhance juvenile and elderly mental health services run by the Hospital Authority (HA). About $15.9m (HK$124m) will also go towards the HA’s cancer services.

The budget documents reported that the HA will press ahead with the implementation of the first 10-year Hospital Development Plan (HDP) and the planning of the second 10-year HDP.

“The HA will review the design of hospital projects under the two 10-year HDPs considering the experience in combating Covid-19 and incorporate required provisions for two to three general wards in each selected hospital, so that they can be readily converted into Tier-2 isolation wards when the need arises,” Fitch said.

The report noted that for the past several years, the government’s budget for medical health services has grown YoY. The country has established a dual medical economy in which the government has been involved in both the funding and provision of health services mainly through tax financing and personal insurance.

“In recent years, leveraging on available capacity and capability in the private sector through public-private partnership has become a key strategy for managing demands for and enhancing patients’ access to clinical services, ultimately leading to an overall improvement in healthcare service quality through the combined efforts from both the public and private healthcare sectors in Hong Kong,” Fitch said.

Hong Kong’s projected expenditure

Source: Fitch Solutions

OFFICE WATCH SOUTH KOREA xxxx Exports of South Korea’s virus-related medical goods surged fourfold in 2020

South Korea’s exports of test kits for COVID-19, protective masks and other virus-related goods soared to $5.9b in 2020, from $1.28b in the previous year according to a report on the latest data compiled from the country’s Ministry of Trade, Industry and Energy.

Exports of medical test kits surged more than fourfold on-year to reach $4.5b in 2020, whilst those of masks also soared sixfold to reach $723m. In 2020, the country’s overall exports came to $512.8b, declining 5.4% from the same figure in 2019.

The ministry attributed the robust performance to the country’s relatively successful efforts to contain the spread of the virus, which led to higher credibility of local products. Since reporting its first patient in 2020, South Korea has so far reported a little more than 103,000 cases.

At the same time, South Korea plans to speed up the exports of medical supplies through official development assistance (ODA) projects, whilst seeking to penetrate deeper into existing markets, including the United States and Europe as well.

The country also plans to help local companies win overseas approval for medical supplies, including from the U.S. Food and Drug Administration and to foster more potentially lucrative export goods as low dead space (LDS) syringes designed to minimize wasted vaccine doses with its reduced spacing between the needle and plunger.

Common area Community bar The library

South Korea exported $5.9b virus-related medical Pantry goods in 2020, up from $1.28b in 2019

Technological advancements are now pushing the growth for orthopedics, making it easier for patients to get the care they need

Taking a technology advantage when it comes to fragility fracture care

More and more hospitals in Asia Pacific are gaining access to a fracture liason service that is changing the way hip fractures are operated on, with strong outcomes for patients.

In the absence of artificial a person’s risk of breaking their bones. In countries patients are responsible for paying for intelligence (AI) detecting tools, up He worked hand-in-hand with an IT such as Taiwan, their own treatment, in the majority of to 70% of compression fractures company to establish AI software that patients need cases, when a compression fracture is can go unnoticed. This calls for an captures compression fractures on CT to pay for not identified,” Chan said. opportunity to use other technology scans for opportunistic compression their own Such programmes are also in to detect underlying osteoporosis and fracture analysis. treatments, development in Australia. The profile of for earlier intervention, Taipei Medical “There are so many missed cases unless they secondary fracture prevention has been University’s Department of Radiology and signs that we should interpret have a -2.5 rising in the country, said Jacqui Close, chief Wing Chan said in an interview as osteoporotic, like an empty box T-score, plus member of the APFFA Joint Steering with the Asia Pacific Fragility Fracture appearance, the deformity of the one or more Committee and co-chair of APFFA’s Alliance (APFFA) earlier this year. vertebrae, and also some thinning or compression Hip Fracture Registry Working Group.

Chan has spearheaded the building erosion of the end plate,” Chan said. fractures A report from the Australia and New of a comprehensive fragility fracture In countries such as Taiwan, patients Zealand Hip Fracture Registry found a care programme at Wan Fang Hospital need to pay for their own treatments, steady increase in availability of fracture within the Taipei Medical University unless they have a -2.5 T-score, plus liaison services over time which rose to comprising 33 technologists that he has one or more compression fractures. 41% in 2020, up from 15% in 2013. trained personally. Their mission has This often means patients go without Close said that this is a reflection of been to standardise and provide quality preventative medication. state policies that have mandated that assurance in osteoporosis care. Chan said that most patients don’t all health districts in New South Wales

Particularly, Chan has take preventive medication despite have to have a fracture liaison service. implemented technology to make it doctor recommendations. possible to automate the reporting of “Most of the patients don’t take Lacking widespread knowledge dual-energy X-ray absorptiometry, preventative medication, despite the However, the country is facing certain which scans bone density to evaluate doctors’ recommendations. In Taiwan, challenges in rolling out fracture liaison

services across the country. Close noted that the country is still at a stage of having to remind the public and the health system that osteoporosis is a chronic disease that is associated with significant morbidity and mortality, and that it needs to be managed and resourced in the same way.

She also found that the funding arrangements for health in Australia created a challenge particular to the country, with general practice and primary care funded by the Commonwealth government, whilst hospitals are funded by the various state governments.

“It is the states that bear the brunt of the impact of osteoporosis in terms of managing fractures, yet the responsibility for treating osteoporosis largely sits with the Commonwealth government,” Close said.

APFFA also emphasized the need for better registry data to highlight the challenge the sector faces and the progress it has made over time. The Hip Fracture Registry data revealed that only 37% of hip fracture patients are on treatment for osteoporosis 120 days after their hip fracture, despite medications being widely available.

In Taiwan, the resources available in local hospitals are often limited, making it difficult for clinicians to promote optimal osteoporosis care in local clinics.

Chan advised for hospitals to adhere to international dual-energy X-ray absorptiometry (DEXA) scanning standards, utilise databases to reach 30% of post-menopausal women who are at risk of osteoporosis, and keep a record of positioning and beta analysis performed by technologists.

He also emphasized the need to invest in an innovation culture and train for an opportunistic ‘capture the fracture’ concept, train colleagues to optimally detect compression fractures, and offer support, passion and consistency.

Across the six clinics, there are currently 700 cases of hip fracture. To date, data has been collected from more than 50,000 cases of quality DEXA reports.

Comeback for orthopedic procedures

The number of orthopedic procedures performed in Australia was estimated to decline in 2020 compared to 2019 due to the pandemic.

A report by GlobalData found that the total number of orthopedic procedures performed in Australia was about 11 million in 2019 and about 55% of the orthopedic procedures performed in the country were elective.

“The impact of the Covid-19 pandemic will have many unintended and long term consequences including our ability to provide surgical interventions which significantly enhance the quality of a person’s life and enables them to function and live independently,” Close commented.

However, the outlook for 2021 is comparably more promising and optimistic as the number of COVID-19 cases are declining, resulting in a rise in the number of orthopedic, especially for elective, procedures performed.

GlobalData’s medical devices analyst Anusha Kaushik noted that a decline in COVID-19 cases is expected to free up beds and reduce the pressure on the country’s healthcare system which can mean elective procedures can be expected to resume.

Close also commented that additional government funds have been made available in Australia to ramp up surgical capacity to address long waiting lists.

Meanwhile Kaushik emphasized that urgent elective procedures are expected to resume first.

“The length of stay at hospitals can be reduced and telemedicine can be used for postoperative visits by the discharged patients.The use of technology is expected to result in more elective procedures being performed as doctors get to spend less time on patient consultations,” Kaushik said.

Across Asia Pacific, the booming medical tourism industry is expected to drive the regional orthopedic devices market, according to a report from ResearchAndMarkets. The higher affordability of orthopedic surgeries in an emerging economy such as India is expected to lure in foreign patients.

“Such a cost difference is expected to bring a huge clientele to these countries in Asia Pacific, boosting its orthopedic devices market,” the report stated.

Globally, the market for orthopedic devices is expected to reach $59.69b by 2025 from $44.03b in 2020, surging at a compound annual growth rate of 6.3% between the two periods attributed to a rise of musculoskeletal injuries.

As the global healthcare system recovers from the pressure of COVID-19, it has been able to increasingly give more attention to elective surgeries. The market also stands to benefit from improving diagnostics that help in identifying osteoporosis fractures and musculoskeletal injuries.

According to the World Health Organization, about 20-33% of people around the world suffer from musculoskeletal conditions, a staggering indication that demand for orthopedic devices required for treating hip, vertebral, and forearm fractures will remain high between 2020 and 2025.

“Remarkable number of women taking part in sporting activities, upcoming sporting events such as Olympics 2021, and an active lifestyle are expected to result in injuries that will demand orthopedic devices for restoration joints,” the report added.

Globally, the market for orthopedic devices is expected to reach $59.7b by 2025 from $44b in 2020

Economies with higher affordability of orthopedic surgeries will lure in more foreign patients

A healthcare leader must be strong-willed and focused on the outcomes, while highly cognizant of the fact that the biggest barrier to quality care is cost

Predee Daochai President Kasikornbank Andres Licaros, Jr. CEO Asian Hospital 10 HEALTHCARE ASIA Medical Center

INTERVIEW Asian Hospital’s driving force behind its push to be a global site for healthcare research

CEO Andres Licaros, Jr. explains some of the hospital’s key goals and accomplishments over the past few years.

Aman with more than three decades of experience from various fields such as design and construction, feeds and livestock, confectionery, pharmaceutical and healthcare, Asian Hospital and Medical Center’s CEO Andres Licaros, Jr comes to the healthcare sector with a broader business background than most. That has been one part of his success in driving the Manila-based hospital’s success and long-term development of its integrated and multidisciplinary services.

With him at the helm, Asian Hospital has navigated through a challenging financial crisis, working with a strong determination to operate free of debt to better focus on growing the business, whilst still providing the best healthcare for everyone.

Healthcare Asia recently caught up with Licaros to learn more about the story behind his achievements as CEO, the challenges in healthcare, and also the shortage of medical professionals in the Philippines. He reveals what Asian Hospital and Medical Center has been doing to help address this concern.

Tell us what your typical work day looks like. How do you tackle everyday challenges?

Every day is an opportunity to do good. Our business is a consistent, quality healthcare service that assures each patient and family an easy and convenient access to the solutions they need no matter how difficult and complex they may be.

My day therefore is defined by the emerging issues brought about by the [COVID-19] pandemic whilst keeping focus on a greater responsibility to ensure the safety of our doctors and staff, because we must protect ourselves to be able to save and protect others.

What are the projects and achievements that you accomplished as CEO of Asian Hospital?

Since December 2011, when Metro Pacific Investments Corp. acquired majority ownership of Asian Hospital, my “North Star” has always been to create a stronger service delivery platform that provides wider access to Quality and Safe Patient Care among the communities here in the Southern corridor of Mega Manila.

We inherited a PHP1.8B loan (US$37m) from the previous operators, so it was always at the top of my to-do list. I had to grow the business whilst paying off a huge debt because we wanted to operate the hospital debt-free. We did that in October 2018.

We got our very first JCI Accreditation in November 2013, despite preparing for the week-long survey in just 10 months. We will go for our fourth survey in the middle of next year.

We established the Asian Cancer Institute in July 2015, fully embracing the responsibility of caring for a fastgrowing community of cancer patients here in the south [of Metro Manila].

By the end of 2019, we had established three more institutes, namely: The Asian Cardiovascular Institute; The Asian Brain Institute; and The Institute for Senior Wellness and Homecare. These are the pillars of our fully integrated and multi-disciplinary services that were patiently built to support our big dream of providing better outcomes at a lower total cost of care.

We have become an official teaching/training institution since 2012 when we opened the country’s first Fellowship Programme in Minimally Invasive Surgery, followed by the Residency Programme in Pediatrics in 2013, the Residency Programme in Internal Medicine in 2014, the Fellowship Programmes in Critical Care Medicine in 2016, the Fellowship Programme in Pain Management in 2017, the Residency Programme in Surgery in 2018, and the Fellowship Programme in Cardiology in 2019.

This year we are opening three more training programmes, namely: residency programmes in OBgyne, neurology and otolaryngology, and rhinoplasty, head and neck surgery. This secures the future depth and quality of our bench of clinicians who are deeply committed to Asian’s Vision of being the best valuebased care provider in the Philippines.

More than any of these, we have built an organisation that takes pride in bringing the very best of ourselves each day in our desire to always do what is right, no matter how risky, challenging and difficult. We value our people more than anything else.

What are some of your recent challenges as a leader in healthcare?

The greatest challenge we face is the uncertainty that the coronavirus continues to bring in the midst of a business platform that has been brought down to its knees because of the risks we all face each time we provide direct care to a patient.

To respond with agility, our determined efforts towards transforming our business processes and care delivery platform into a more digital form allowed us to survive 2020 and still turn in a positive bottom line. This was despite the lost revenues and census brought about by the very long “lockdown” imposed since March 2020.

Our business is a consistent, quality healthcare service that assures each patient and family an easy and convenient access to the solutions they need

What do you think are the key factors to be a great leader in healthcare?

To my mind, a healthcare leader must be strong-willed and focused on the outcomes, while highly cognizant

This pandemic has accelerated the long overdue shift from fee-forservice models into valuebased care

Licaros address AHMC employees in a recent event.

of the glaring fact that the biggest barrier to access to quality care is cost.

I am a firm believer that every healthcare organization would successfully bring down its costs to provide quality care if they were to consistently pursue programs that improve clinical outcomes. Couple this with a digital transformation strategy that guarantees a safer environment and means of providing care at a lower cost, and it will lead to better patient outcomes (both clinical and patient experience).

The leader must always be authentic, laser-focused on their goals, and people caring.

Crisis presents opportunities, even in the healthcare industry. What current opportunities do you see as most likely to shape healthcare in the Asia Pacific region in the future?

A long and global healthcare crisis like the one we are having will always unmask the integrity of people and organisations who are truly capable and willing to face up to the responsibility and be accountable for the outcomes. This pandemic has accelerated the long overdue shift from fee-for-service models into value-based care. The organisation that can pivot and embrace a digital healthcare service delivery platform will survive and dominate the landscape long after this crisis wanes and becomes over.

Aside from the current battle with COVID-19, what urgent health concern do you see rising the Philippines? What has the Asian Hospital done to address this concern?

The growing shortage of healthcare professionals as the demand for them abroad continues to drain us of our best talents, and only a good and responsible management team that can put in place a stronger talent retention programme will survive.

By providing an environment for learning and growth at the workplace, Asian is able to sustain its growth and deliver on the higher expectations of a happy customer.

What initiatives have you been working on?

Asian Hospital has just been accredited as a Level 3 Healthcare Research Institution in December 2020 and this is a key initiative I have pursued from the start that is finally seeing its fruition. We will be a global site for major research agendas in Oncology, Cardiology, Neurology and Successful Ageing.

Do you see any dramatic change in the healthcare scene moving forward?

It has now become clearer than ever that the levers of power in healthcare have shifted to the payors and the patients. Unless a provider like us recognises and embraces this fact, we will not survive. Every patient needs to be consistently served with respect, compassion, and the utmost integrity.

A transparent, seamless, and real-time access to quality care from anywhere is the new standard of service and patient experience in healthcare.

What will the Asian Hospital be working on in the future? What will be your goals for the next five years?

Asian Hospital will be a fully wired hospital, a healthcare provider with no walls by end 2022. One that is capable of providing quality and safe patient care at a lower total cost of care, anywhere, anytime.

What are some recent healthcare trends have you observed in Asia Pacific?

The consolidation of small and big providers is inevitable to achieve greater efficiencies, lower the costs of care, and standardise the delivery of care. This will allow the creation of a network of providers that are committed to the same goal of value-based care. This is the only way we can truly impact on population health, create a stronger and healthier population and sustain economic growth despite the havoc the pandemic has created.