Accelerating towards online

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How digitization can tackle Philippine healthcare’s pressing issues

The healthcare landscape in the Philippines has been seeing both developments and challenges in the previous months and years. With the signing of the Universal Health Care (UHC) law, as well as the acceleration of digital across industries, the healthcare industry is expected to thrive and further meet the needs of many Filipinos.

Reports have spotted the main issues that the entire healthcare sector encounters. A report last year from the Oxford Business Group (OBG), for instance, pointed out what it regards as the “triple burden” on the local health system. These are: the outbreaks of communicable diseases (CDs) such as human immunodeficiency virus, dengue, and measles; the increasing prevalence of non-communicable diseases (NCDs), such as diabetes and cardiovascular conditions, as well as growing mental health concerns like depression and suicide; and the increasing impact of climate change and natural disasters, which are creating a strain on the health system.

Furthermore, a report from Asian strategy consulting firm YCP Solidiance noted other issues, especially within the healthcare system.

First, with the prevalence of both CDs and NCDs, the demand for healthcare is apparently increasing and becoming more complex. “As health conditions evolve, the need for more advanced and specialized treatments emerge,” the report read. “Policy makers, healthcare providers, and pharmaceutical firms are compelled to scale up their research and development efforts to meet these changing needs.”

The report also notes the rising costs of healthcare. Its consolidated research noted the steady growth in health expenditure, the latest of which indicated an increase of 20% from 2015 to 2017.

“This growth trend has been evident since 2012, in which per capita health expenditure growth surpassed per capita GDP growth. The gap continued to widen over the five years thereafter,” the report stressed.

It also noted the consistently large share of household out-of-pocket payments (OOP) in the total health expenditure in the country.

“In 2017, OOP spending was at 54.5%, amounting to PHP 372.8 billion. The majority or about 50.1% of the OOP was spent on buying medicines,” it explained. “Government and compulsory contributory healthcare financing schemes came in second at 33% and voluntary healthcare payment schemes, which include insurance and managed healthcare (HMOs), had the smallest share at 12.5%.”

Infrastructure limitations are also seen as a challenge in healthcare. “There are only about 1,224 hospitals in the country, 35% of which are government hospitals. These hospitals are not enough to attend to the country’s population of about 108 million people,” the report pointed out.

In spite of these challenges and risks, steps have already been taken to address them. The hallmark among these actions is the Republic Act No. 11223, more known as the UHC Law. It was signed by the President last Feb. 20, 2019, and its implementing rules and regulations were signed by the secretary of the Department of Health (DoH) in October of the same year.

Among the key provisions of the UHC Law is the automatic enrollment of patients into the National Health Insurance Program; provision of basic care benefits package to all patients through assigned primary healthcare providers; adjustment of payment mechanisms among health providers to prevent balance billing and excessive hospital bills; and the clarification of roles and responsibilities between DoH, PhilHealth, and other healthcare stakeholders.

“[T]he UHC system should lead to the strengthening of primary care services and the empowerment of community health centres, as all Filipinos will be entitled to an extensive range of preventative, curative and rehabilitative health services such as free check-ups,” OBG noted in its report.

Another legislation that is related to healthcare is being pushed. Created to complement the UHC Law, the Philippine eHealth Bill aims to digitize healthcare delivery systems.

“The bill pushes for the standardization of data records, digital health platforms, and systems to ensure interoperability and to facilitate data sharing,” YCP Solidiance’s report read.

The approval of this bill, the report recognized, is critical in orchestrating an industry-wide digital transformation.

Digitization

Aside from putting these crucial legislations in place, another main driver seen for the healthcare sector is digital transformation. YCP Solidiance’s report highlighted that digitization is key for the UHC Law to be successfully implemented since digital health technologies can offer cost-effective solutions that will effectively provide healthcare access for all Filipinos.

The report also points out that opportunities for digitization are emerging in the Philippines, and these aim for increased efficiency, improved accessibility, and more enabled research and development.

Through digitization, processes and tasks can be accomplished faster and with fewer resources. Technologies such as Hospital Information Systems (HIS), Electronic Medical Records (EMRs), automated claims reimbursement (eClaims), and digital prescriptions, can help stakeholders aim for cost-efficiency.

Digitization is also seen to help address constraints and increase access for both stakeholders and patients through several solutions. Telemedicine applications, for instance, allow patients to consult with doctors, while telehealth applications are seen to help patients avail of other services within a mobile phone’s access. Online learning for health workers and pharmacies for remote communities are also seen to increase healthcare accessibility.

Another capacity seen in digitization is further enabling research and development as data increases and healthcare systems become more complex. “Digitization of healthcare data increases the accuracy and efficiency of analysis, leading to even more advanced services, such as epidemiology surveillance,” the report read.

The data gathered through digitized processes are seen to give way to various applications, including fraud detection, epidemic monitoring, drug development, targeted treatment, and evidence-based policy development.

With these various technologies and advancements, however, challenges are observed to arise. “Healthcare digitization requires the participation and cooperation of all key stakeholders working within the value chain; and unfortunately, this is not yet the case for the Philippines due to external and internal factors,” the report pointed out.

The internal factors spotted by the report include the lack of human resources and costly implementation; while external factors include resistance to change among doctors and patients, inadequate infrastructure, and lack of standards and regulation.

The report recognized that one of the most basic challenges to digitization is the lack of infrastructure, especially with the availability and reliability of Internet connections remaining a pressing issue on our end.

“Without adequate Internet connection, efficient data storage and transmission become difficult,” the report pointed out. “This prevents technology providers from reaching a wider base of health providers and providing the full functionality of their services. It also hinders them from innovating new solutions.”

Given these factors challenging the digitization of healthcare, YCP Solidiance recommends that public and private sectors should continue to invest and collaborate in order to drive digitization initiatives forward.

In particular, it encourages collaboration between health tech firms or start-ups, rich with new technologies and digital-centric business models, and big corporations like health maintenance organizations and pharmaceuticals, with their huge amounts of capital and wide networks of hospitals, clinics, and doctors. Such collaborations, the consulting firm believes, can lead to high-impact programs.

Doctors also play an integral role in this matter as they are the main users of digital technologies such as EMRs and telemedicine platforms. Their support is critical to enable digitization completely.

As digitization makes the country’s healthcare systems integrated and connected, the report noted, the possibilities are endless for Philippine healthcare to evolve into becoming more holistic, evidence-based, and cost-effective. – Adrian Paul B. Conoza

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