The global healthcare sector is on the cusp of a tipping point and this is more acutely evident in South-East Asia as the region grapples with key issues such as a rapidly aging population, a chronic Non-Communicable Diseases (NCDs) epidemic and a steady rise in healthcare cost, to name a few.
As the world population expands and ages, total global health spending is expected to accelerate at an average of 5.3 per cent a year over the next four years (from 2014 to 2017), compared to the 2.6 per cent spent in 2013.
This growth will put enormous pressure on governments, healthcare delivery systems, insurers and consumers in both developed and emerging markets as they focus on issues that will continue to place more demands on the healthcare sector, including an aging population, the growth of chronic diseases, ballooning costs and imbalanced access to care due to healthcare workforce shortages and infrastructure limitations.
In Singapore, for example, government spending on healthcare rose from US$3.3 billion (8.5 per cent of the government’s budget) in 2010 to US$5.7 billion in 2014. The total healthcare spending is anticipated to rise by an average of 7.9 per cent annually until 2017, according to the Economist Intelligence Unit.
Average life expectancy is also projected to rise from 72.6 years in 2012 to 73.7 years by 2017, while the number of high-income households earning over US$25,000 a year is anticipated to increase by about 10 per cent to over 500 million, with over half of that growth coming from Asia.
NCDs are responsible for 60 per cent of deaths in South-East Asia, principally cardiovascular diseases, diabetes, cancers and chronic respiratory diseases.
NCDs are also the biggest healthcare threat for the rest of the world, with over 63 per cent of global deaths in 2008 attributed to chronic diseases.
As the population grows older and more affluent, this will boost demand for more healthcare as the number of people afflicted with chronic NCDs rise in tandem.
All these factors will increasingly contribute to the healthcare system’s burden and the industry will be tested to its limits to cope with the ever-expanding volume of patients seeking treatment in hospitals and healthcare institutions.
On the flip side, there is also heightened global awareness on the dangers and causes of NCDs, which include tobacco use, unhealthy diet, inadequate physical activity and obesity.
Education continues to be a key determinant in reducing the occurrence of NCDs and the proliferation of the Internet and better education have helped in spreading the message on the types of preventive measures people can take to improve their health.
To address the issue of NCDs across the ASEAN region, Philips Healthcare embarked on a mission to support the development of recommendations for governments on managing NCDs in each country since 2013. The support from has seen the formation of the ASEAN NCD Network that comprises of key industry stakeholders from each country in the region. The Network has developed a White Paper, sharing best practices and recommendations on innovative NCD management approaches. The Network aims to address the scourge of NCDs by sharing best practices, fostering collaboration, and thereby co-creating solutions to enact real change on the ground in each country and in the region.
Advancement in medical technologies over the past few decades have helped drive down the cost of home-based health monitoring products, which include heart rate, blood pressure, diabetes, and Body Mass Index (BMI) monitors. These products can all be easily found at one’s neighborhood pharmacies.
More dollars are spent on vaccines and other means of preventing or reducing the incidence and severity of chronic diseases like cancers and conditions such as diabetes.
The latest in wearable technologies have sparked a greater interest amongst people when it comes to managing one’s health and activity levels.
The Google Glass, for example, has paved the way for doctors to quickly get the information they need, when they need it most and is proof of how emerging technologies can be applied in the healthcare system to improve patient care. By connecting game-changing technologies, this is the first proof of concept for the seamless transfer of patient vital signs. The Google Glass demonstrates how clinicians can benefit from hands-free, voice-controlled access to critical data while in the operating room or on the go in the hospital.
Wearable technology puts a patient’s real-time personal health data into his own hands, giving sufferers of chronic diseases such as Parkinson’s or diabetes a better peace of mind as they are empowered with the tools to better manage their condition, make better lifestyle decisions and treat symptoms early.
At the same time, the information that is shared with the doctors via the wearable technology can help physicians e-diagnose and advise their patients remotely – cutting out travel time and cost–so caregivers and patients can receive the medical attention they need in a timely and effective manner.
The increase in awareness of chronic diseases and associated symptoms has also led to more cases of diagnoses, often at earlier stages of the disease.
Early detection means patients can seek medical attention at the onset of the disease, which can help improve survival rates and prolong life expectancy.
Due to the chronic nature of NCDs, this also means medical institutions will see a surge in cases, further putting pressure on an already strained healthcare system.
In Singapore, for example, acute care hospitals are running at unsustainably high bed-occupancy rates of well over 90 per cent, pushing some hospitals to lease beds from the private sector in order to satisfy demand.
This is an issue that is not unique to Singapore. Medical overuse has become a worldwide epidemic. In the United States alone, unnecessary medical costs US$250 to US$300 billion annually according to conservative estimates.
In addition, there is the danger of hospital-acquired infections, which are avoidable, further adding to a nation's healthcare bills.
Hundreds of millions of patients are affected by hospital-acquired infections globally each year. Of every 100 hospitalised patients, seven in developed and 10 in developing countries will acquire at least one healthcare associated infection. By reducing the number of unnecessary hospitalisations, mortality rate from hospital-acquired infections can be greatly reduced.
With the widening strain on hospitals, healthcare systems around the world are recognising the need for innovation and restructuring care delivery models to manage the use of resources.
Adoption of new digital health information platforms such as electronic medical records, telemedicine, mobile health applications and electronic medical prescriptions heralds a promising future in the way healthcare can be delivered in the coming years.
Indonesia still struggles with one of the highest rates of maternal death in the developing world that can be largely attributed to a lack of access to healthcare for mothers and children.
To address this growing concern, Philips partnered with the Indonesian Reproductive Science Institute (IRSI) at PT Bundamedik and the Padang city government to conduct a year-long Mobile Obstetrics Monitoring Solution (MOMS) pilot project in Medan. An Android mobile application software is utilised to collect data such as blood pressure, weight, and fetal movement from pregnant mothers at local clinics or even at home. The data is uploaded by the app onto a central server, enabling obstetricians or gynecologists to remotely monitor patients from the hospital or home.
This shift highlights the transition from hospital-centric to patient-centric view to better optimise resources, while patients will be given more opportunities to take charge of their own health and medical symptoms under the watchful eye and support from qualified healthcare professionals.
While hospitals and medical institutions remain as providers for treatment of acute symptoms, the volume of chronic disease cases seen at these providers can be alleviated by shifting the focus to more location based clinics and outpatient services.
This presents another challenge that is facing the industry on a global level, as many people living in rural areas still lack access to hospitals and medical facilities. Finding innovation solutions to bring healthcare to them presents an opportunity for disruptive technological advancements.
In the hospital setting, there is a gradual shift from surgical solutions to minimally invasive procedures, which have been applied to many surgical specialties from cardiothoracic, orthopaedic, urological, vascular and neurological procedures.
These procedures are performed using small incisions, where endoscopes are plugged-in to operate from within a body cavity.
Minimally invasive surgery is low-risk and offers a safe, feasible and patient-friendly treatment, leading the way to a swift recovery and shortened hospitalisation period.
In the field of oncology, interventional oncology is adopted to treat difficult-to-reach tumours or tumours in patients who are deemed unsuitable for surgery with tumour embolisation procedures. This minimally invasive treatment starves tumours from its blood supply and is an effective procedure in improving patient outcomes.
Advancements in science and medical research also mean progressively, patients are being treated on a personalised level. Personalised therapies illustrate how patients can be treated more optimally and effectively and at a lower cost with the right combination and dosage of drugs to tackle each case.
Increasingly, there is a steady move away from judgment-based medicine to evidence-based medicine. A report by New York Times magazine highlighted how one hospital used evidence-based medicine to cut its death rate for heart surgery by half and data on outcomes will help improve future treatments.
Riding on this trend, the first-ever Breast Cancer Cell Bank was recently established in Singapore to conduct research on breast cancer tumours from this region so targeted therapies could be developed to revolutionise breast cancer treatment and improve survival rates.
This includes customised treatment for patients who develop resistant tumours over the course of treatment – the research will identify novel drug combinations that will overcome limitations of standard therapy and lead to better outcomes for Asian breast cancer patients.
The Breast Cancer Cell Bank will house tumour cell lines from patients in Singapore, which will be available to research facilities in the Asian region.
Such innovations will collectively help reduce the need for prolonged hospital stay so patients can be discharged early and given tools to help them manage their recovery process at home.
With the help of wearable sensors, mobile health applications and other emerging healthcare innovations, patients can be monitored remotely by qualified healthcare professionals so doctors can be freed up to treat other patients with acute symptoms.
Elderly and chronically ill patients often experience mobility issues.
With the help of telemedicine and mobile monitoring systems, caregivers and patients can reduce the need to travel to the doctor’s office or the hospital and seek real-time medical advice from healthcare professionals when necessary, from the comfort of their homes.
As the global healthcare system continues to experience a shortfall of qualified doctors, there is a gradual move towards nurse practitioners, physician’s assistants and others in treating and caring for patients.
Telehealth technicians will also come into play as a form of healthcare professional to help patients remotely when it comes to treating mild symptoms.
Collectively, these shifts will improve accessibility, affordability and quality in healthcare delivery in the coming decades as medical care moves from medical institutions to the home.
The Hospital of the Future
As we shift from healthcare to health systems, hospitals will become visionary partners in clinical advancement and technological innovation; leading to improved outcomes, better health, lower costs, and a more sustainable system.
With new innovative technologies delivering more measurable outcomes that result in healthier patients, hospitals can renew their resolve to provide the best care for those in the most need.
References are available at www.asianhhm.com
Arjen Radderis the President for Asia Pacific of Philips Healthcare and a member of the Philips Healthcare Global Executive Team. He oversees the Healthcare business across Asia Pacific including India, Japan, Korea, Australia New Zealand and ASEAN. Radder joined Philips in 2002 and holds a PhD in Medicine.
- World Healthcare Outlook, Economist Intelligence Unit, 14 August 2013
- 2EIU Healthcare Briefings & Forecast: Singapore Healthcare and Pharmaceuticals Report, Economist Intelligence Unit, 1 March 2013
- 3World Healthcare Outlook, Economist Intelligence Unit, 14 August 2013
- 4The Lancet: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61506-1/abstract
- 5WHO Database: http://www.who.int/topics/chronic_diseases/en/
- 6Is that surgery really necessary? Ensuring the Medical Necessity of Care, World Bank news, 30 July 2014, http://www.worldbank.org/en/news/feature/2014/07/30/is-that-surgery-really-necessary
- 7Health care-associated infections fact sheet, WHO, http://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf