Southeast Asia mirrors global trends; people are living longer and there is a growing elderly population, and disease prevention is a key contributing factor. There’s also been a rise use of digital technology; for healthcare, digital innovation offers a way to improve care for millions of people.
Start-ups are a vital part of this digital health ecosystem, and Dr Hoe Siu Loon of Singapore Management University has examined the state of start-ups and digital technology applications in Southeast Asia to provide advice for organisations intending to pursue health-tech initiatives in the region.
Read some of their latest work here: https://doi.org/10.7545/ajip.2022.11.2.183
Image source: Aslysun / Shutterstock.com
Hello and welcome to Research Pod. Thanks for listening and joining us today. In this episode we’re talking about the digital health space in a rapidly growing part of the world: Southeast Asia. We’ll be looking into an exploratory study by Dr Hoe Siu Loon, Associate Professor of Information Systems at Singapore Management University.
He’s been examining the state of start-ups and digital technology applications in Southeast Asia in an attempt to provide valuable advice for organizations intending to pursue healthtech initiatives in the region. His paper also highlights some important issues that need to be addressed to increase the adoption rate of digital health tech.
Southeast Asia is a region that covers 600 million people in over ten countries, with an economy of roughly two and a half trillion US dollars. And it’s a region that has changed a lot in the past few decades. United Nations data shows significant shifts in the region’s demographic and health patterns. In general, Southeast Asia mirrors global trends, in that people are living longer and there is a growing elderly population. In 2015, only 9.4% of the Southeast Asian population was over 60 years old – this is expected to rise to around 22% in 2050.
The ageing population isn’t just caused by declining birth rates. Smaller family sizes, investments in medicine, plus new health and educations policies are all factors. Disease prevention is another key contributor, as advances in medicine mean far fewer people die from communicable diseases.
However, Southeast Asia does face some challenges in terms of non-communicable diseases, with the most prevalent causes of death including cardiovascular disease, cancer, and respiratory diseases. As in the Western world, these are rising. This rise in non-communicable diseases and an ageing population offers cause for concern – but also opportunity for the application of digital health technology.
There’s been a rapid rise in the advancement and adoption of digital technology in recent years, allowing geographically distant communities to become far more connected than they have been in the past. In terms of healthcare, digital innovation offers a way to improve the accessibility and quality of care for millions of people, at reduced cost.
Start-ups are a vital part of this digital health ecosystem. They disrupt existing practices with new innovations and help to create new jobs. Dr Hoe’s goal was to use information from various publicly available website databases to examine this digital health landscape, and offer recommendations to help boost digital health technology, and improve health outcomes for more people in Southeast Asia.
Before we go further, it’s worth making a distinction here between health and healthcare, as there’s a subtle difference. When we talk about healthcare, it relates more to primary care such as doctors and medication. Health covers a broader scope, referring more to someone’s whole state of physical, mental, and social well-being, rather than just the absence of disease.
Digital technology offers people a wide spectrum of ways to improve the various facets of their heath. Let’s take a look at three interesting categories of tech covered in Dr Hoe’s paper.
Firstly, the Internet of Things or IoT for short, which is where physical objects are digitally connected via sensors. In a health setting, this could mean someone’s health is remotely monitored through a personal device and then relayed to a health professional if need be. Or it could be data for the personal use of the owner, such as digital devices that track steps, heart rate, and quality of sleep – this data can be used either by professionals or secondary apps. Wearable sensors such as FitBits and Apple Watches have already seen widespread adoption.
Another is artificial intelligence, where technology such as natural language processing can be used to analyse patient reports and medical publications to support clinical decision making. An interesting use of AI is KroniKare, a smartphone app created by a Singaporean start-up that uses machine learning, thermal cameras, and image processing to help nurses assess wounds in hospitals.
Big data analytics is also used to collect and analyse huge volumes of medical data. This can influence individual treatment plans or even government health spending policy. For example, in Malaysia a government-supported initiative has been compiling hospital patient data into a central database enabling a more integrated approach to health research. The database is designed for stakeholders to be able to conduct analysis and generate insights from unstructured data.
These are all examples of technology that has been adopted and used in Southeast Asia, but there are also challenges to consider for start-up founders.
There are a few issues that hinder the adoption of health technology in Southeast Asia which Dr Hoe highlights in his paper. A key issue is concern over privacy and security. When sensitive data around health is concerned, it’s understandable people are worried about their personal data being collected then potentially sold for unauthorized secondary use, lost via a data breach, or accessed by cybercriminals. The 2017 WannaCry cyberattack on the UK National Health Service offered a stark warning about data privacy risks.
Another problem is the possible overreliance on health technology in the future. This raises ethical dilemmas around responsibility and accountability if mistakes are made by AI-assisted technology, rather than human beings. Could there be hidden biases within systems that lead to dangerous outcomes? Health technology is more appealing to people when presented as augmenting human physicians, rather than replacing them.
One concern raised by healthcare professionals is the unclear return on investment for digital health technology. There are high upfront and maintenance costs associated with the infrastructure and licensure for many digital health solutions, as well as harder to measure non-financial indicators like clinical outcomes or reduction in adverse events. It can be tricky to work out whether its worth investing thousands, or even millions, of dollars into a particular technology.
Finally, the steep learning curve associated with sophisticated health technology can be a barrier to adoption. Health professionals don’t always have the time and resources to gain the expertise they feel they need to minimise any potential risks.
Overall, the results of the study showed the digital health landscape of Southeast Asia to be dominated by IoT related companies, with 196 being recorded. For comparison, there were 30 AI-related companies, 21 medical device companies, and 13 big data related companies. It’s not totally surprising, as the Internet of Things covers a broad scope and can be applied to many areas that affect people’s daily lives.
Dr Hoe has a few suggestions for key stakeholders and governments to further increase the adoption rate of digital health tech. These include prioritizing the protection of consumer’s data, incentivizing healthcare providers to adopt new technologies, funding advance research and development, and introducing financial incentives for foreign companies to enter the healthcare sector.
And of course, regulations and tools would also need to be considered to keep people safe. Cybersecurity has to be at the forefront of planning when health data is concerned, in order to create public trust around health technology.
In terms of future research, Dr Hoe hopes to include small, medium, and multi-national enterprises in the region. A future study would also benefit from access to government databases, rather than just publicly available ones, for a more complete view of businesses in the region. For now though, it’s interesting to see the current landscape of digital health start-ups in Southeast Asia and understand the opportunities and challenges in the region.
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