Advancing the Digital Health Ecosystem in Southeast Asia

The article emphasises the importance of infrastructure, trust, and innovation for fostering a thriving digital health ecosystem in Southeast Asia. This article highlights the significant boost in digital health adoption during the pandemic and the crucial role of ASEAN governments in sustaining this momentum by embedding digital transformation strategies into broader national health plans.

By Katrina Navallo, Programme Manager at the Research and Policy Advocacy Team, ASEAN-Japan Centre and Keith Detros, Programme Lead, Tech For Good Institute

With access to medical care heavily disrupted by COVID-19, the adoption of digital health technologies had an unprecedented uptake in Southeast Asia. Notably, ASEAN countries were quick to shift to telehealth as governments adapted existing medical regulations and policies to allow for teleconsultation and promote remote access to medical care during the pandemic.

This rapid digital transformation of the healthcare industry highlighted the potential of digital health services to transform how societies can access and efficiently receive medical care unconstrained by time and geographical location. At the same time, it provided much-needed momentum for health service providers and digital startup companies to showcase their innovative solutions in the fields of medicine, health, and biotechnology.

Although huge strides have been made in digital health adoption in recent years, there are still fundamental challenges for Southeast Asia to address to foster a thriving digital health ecosystem. Regional countries need to develop digital transformation guidelines specific to the healthcare sector. In addition, governments need to overcome policy implementation issues to fully embrace the digital revolution in healthcare. At the same time, some patients still prefer an in-person mode of healthcare delivery due to a lingering lack of trust in digital services.

To gain a deeper understanding of these issues, it is essential to assess Southeast Asia’s progress in fully embracing digital health.

 

The State of Digital Health Readiness in Southeast Asia

A recent report by the World Bank outlined three stages leading toward the maturity of digital health demand and supply: digitalisation, digital-for-health, and digital-in-health. The first stage, “digitalisation”, lays the architectural framework and administrative processes for health information systems, connecting health providers and facilities, and collects standardised medical data. The second stage is “digital-for-health”, where medical data and digital technology become part of daily business processes. Last, the final stage is the full realisation of “digital-in-health”, which envisions the merging of digital technology and health data into a seamless process embedded in mature and transformed health systems.

Based on ongoing research on digital health readiness in ASEAN by the ASEAN-Japan Centre and the Tech for Good Institute, most countries in the region are in the early stages of digitalisation. Roadmaps are currently being developed to integrate health information systems, digitise medical records, and improve digital infrastructure to allow inclusive access. While this is a step in the right direction, there are key fundamental pillars of digital health that need attention from policymakers.

Through interviews with thought leaders and health experts in Singapore, Malaysia, Philippines, Lao PDR, and Vietnam, key themes identified to advance the digital health agenda include: a) setting up the digital infrastructure, b) building trust among users and service providers, and c) fostering innovation by promoting the digital health startup ecosystem. 

 

Developing Standards for an Interoperable Digital Health Infrastructure

Among ASEAN countries, the lack of established and integrated digital health data infrastructure remains one of the main challenges. At the most basic level, some countries have started digitising medical records at the national level. Singapore, Malaysia, and Indonesia have made efforts towards a national electronic medical records system, though they are at different stages of implementation. However, the seamless utilisation of medical data across various platforms remains a challenge among these countries. This has implications for the continuity of care and adds friction to the experience of digital health users.

Experts identified that the lack of data standards and alignment were key stumbling blocks against fully leveraging the potential efficiency gains of electronic medical health records. For example, public and private hospitals may use different platforms to encode medical data, which also come in different data formats, in recording a patient’s medical history. Without clear data standards, harmonising digital systems and improving interoperability remain a daunting task.

Data encoding is another challenge for developing a data ecosystem for the healthcare industry. Some level of digital literacy is needed for healthcare professionals to transition from paper-based records to electronic data. This is especially important for medical care facilities in rural areas where training is needed to ensure healthcare professionals are familiar with digital technologies.

 

Building Trust Through Data Protection and Governance

On top of improving the interoperability of the data ecosystem in healthcare, promoting trust among users is also crucial to advancing the digital health ecosystem in the region. Digital health experts highlight the need for strong regulatory frameworks and mechanisms that balance innovation and data protection. Getting this right is critical as it would promote trust in the ecosystem. Trust is a key element in promoting digital health technologies to users, especially for patients using electronic health solutions for the first time.

Patients must be able to access digital health services with confidence that their data is stored, used, and shared responsibly. Hospitals and medical facilities must also adhere to set standards and guidelines as provided by the law to ensure that patient data records are safe and secure.

One key best practice to foster trust while ensuring that appropriate guidelines are in place is through adopting sandbox practices. Digital health sandboxes enable the testing of new technology solutions in a controlled environment before public rollout. This presents an opportune time for regulators to ensure the implementation of clear data governance, robust cybersecurity guidelines, and data protection policies. Currently, Singapore, Malaysia, and Indonesia have sandbox programs for digital health technologies.

 

Promoting Digital Startups to Foster Innovation

Aside from having traditional healthcare industry players such as hospitals and clinics adopt digital technologies, digital health experts point to the importance of startup companies in advancing the digital health ecosystem. Startups play a huge role in developing tech-enabled solutions that can further promote digital health adoption for users and introduce innovative business models.

To foster innovation in the healthcare industry, countries such as Singapore and Malaysia have established dedicated agencies to support digital health startups. For example, Startup SG provides funding, training, and infrastructural support for startups, accelerators, and investors while Malaysian Research Accelerator for Technology and Innovation (MRANTI) is an accelerator that provides research incubation support from ideas to market access and scaling-up.

However, identifying a successful business model and proof of concept with actual market value and demand is just one step in promoting innovation. Governments should also promote market entry for digital startups by enabling a level playing field. Allowing startups to scale and grow is crucial for them to have a meaningful impact on the healthcare industry.

 

Moving Forward

The use of technology will be critical in Southeast Asia, not for short-term gains in efficiency, but for the long-term care of its citizens. As World Health Organization (WHO) data shows, the region is slowly transitioning to an ageing population. WHO estimates that 13.7% of Southeast Asians will be 60 years old and above by 2030, a number that is expected to increase to 20.3% by 2050. Leveraging digital health technologies will help to promote access and improve the quality of care as Southeast Asia faces new health challenges brought about by an ageing population.

While digital health adoption has experienced a significant boost during the pandemic, it is crucial to emphasie the role of ASEAN governments in sustaining this momentum moving forward. Embedding digital transformation strategies into broader national health plans would guide the focus of digital health ecosystem players on infrastructure, trust, and innovation, ultimately propelling the digital health agenda forward.

 

About the Writers

Katrina Navallo, Programme Manager at the Research and Policy Advocacy Team, ASEAN-Japan Centre in Tokyo, and Keith Detros, Programme Lead at the Tech for Good Institute in Singapore, express their opinions and views in this article. These views are those of the respective authors and do not represent their organisations’ positions on the topic.

This article was originally published as part of ASEANFocus Issue 2/2023, released in September 2023, and was subsequently published online on Fulcrum on September 21, 2023. Download the full issue here.

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Mouna Aouri

Programme Fellow

Mouna Aouri is an Institute Fellow at the Tech For Good Institute. As a social entrepreneur, impact investor, and engineer, her experience spans over two decades in the MENA region, South East Asia, and Japan. She is founder of Woomentum, a Singapore-based platform dedicated to supporting women entrepreneurs in APAC through skill development and access to growth capital through strategic collaborations with corporate entities, investors and government partners.

Dr Ming Tan

Founding Executive Director

Dr Ming Tan is founding Executive Director for the Tech for Good Institute, a non-profit founded to catalyse research and collaboration on social, economic and policy trends accelerated by the digital economy in Southeast Asia. She is concurrently a Senior Fellow at the Centre for Governance and Sustainability at the National University of Singapore and Advisor to the Founder of the COMO Group, a Singaporean portfolio of lifestyle companies operating in 15 countries worldwide.  Her research interests lie at the intersection of technology, business and society, including sustainability and innovation.

 

Ming was previously Managing Director of IPOS International, part of the Intellectual Property Office of Singapore, which supports Singapore’s future growth as a global innovation hub for intellectual property creation, commercialisation and management. Prior to joining the public sector, she was Head of Stewardship of the COMO Group and the founding Executive Director of COMO Foundation, a grantmaker focused on gender equity that has served over 47 million women and girls since 2003.

 

As a company director, she lends brand and strategic guidance to several companies within the COMO Group. Ming also serves as a Council Member of the Council for Board Diversity, on the boards of COMO Foundation and Singapore Network Information Centre (SGNIC), and on the Digital and Technology Advisory Panel for Esplanade–Theatres on the Bay, Singapore’s national performing arts centre.

 

In the non-profit, educational and government spheres, Ming is a director of COMO Foundation and Singapore Network Information Centre (SGNIC) and chairs the Asia Advisory board for Swiss hospitality business and management school EHL. She also serves on  the Council for Board Diversity and the Digital and Technology Advisory Panel for Esplanade–Theatres on the Bay, Singapore’s national performing arts centre.

 

Ming was educated in Singapore, the United States, and England. She obtained her bachelor’s and master’s degrees from Stanford University and her doctorate from Oxford.