Digital future for health management

Managing director and national head of Healthcare Luke Treloar and Vo Thi Kim Ngan, associate director at KPMG’s Global Strategy Group

Over the past two decades, Vietnam has achieved laudable improvements in key quality of life metrics such as life expectancy, infant mortality, and access to affordable medicines. This success is the result of the government’s concerted effort to modernise the health system and expand access to affordable care.

Up to now, Vietnam has expanded its universal health coverage to 90 per cent of the population, and targets to reach a 95 per cent coverage ratio by 2025, while maintaining a commitment to sustainable healthcare financing. This coverage ratio and ambition leads comparable regional markets.

The country’s potential is nevertheless still constrained by a relatively high out-of-pocket ratio, while spending the most in-region on healthcare as a share of GDP. If Vietnam wishes to continue to expand access to quality care and maintain sustainable health financing, the health system will need to find a way to provide more services to more patients, at a lower incremental cost.

Digital health is one way to achieve scale of access, improve clinical outcomes, and lower incremental costs. To do this, the government needs to expand market access, and encourage international business and clinical partnerships to drive innovation.

Vietnam is rapidly transitioning from a paper-based medical records system to a digital system. Government-funded hospitals of 24 provinces have committed to deploy electronic health records, with six leading as pilot provinces. At least 80 per cent of patients will have access to digital health records services at national and provincially-controlled hospitals in the near-term, and this access should be extended to at least 95 per cent of the nation by 2025.

Though still on a small scale, telemedicine is expected to serve as a stepping stone to the wider adoption of digital health in Vietnam. During the pandemic, the Ministry of Health (MoH) has piloted telemedicine to encourage social distancing and reduce nosocomial infection risks.

At the same time, the government worked with several hospitals such as Hanoi Medical University to enable remote care in satellite facilities and even patient’s homes.

Vietnam is now seeing the slow but gradual application of AI and big data in healthcare. IBM’s supercomputer Watson is now operating in several Vietnamese hospitals on complex cancer diagnoses and treatment recommendations. Also, the Stanford University machine learning AI platform “RAPID” is now deployed by hospitals like People’s Hospital 115 to diagnose and treat stroke victims.

Digital health can help address capacity constraints faced by most public hospitals – and from a health-economics viewpoint, telehealth and electronic health records will help healthcare providers cut costs by reducing paperwork, improving safety, eliminating duplicate tests, and improving health outcomes and lowering readmittance.

The government is encouraging investors to participate in the development of digital health in Vietnam, and the steps above are a testament to this. We will likely see a further expansion of both domestic and international investors eager to enter the market in line with the government’s commitment to the digitisation of the healthcare system.

However, to fully realise growth potential, remaining issues around technology infrastructure, reimbursement, and regulatory framework should be first addressed.

In 2018, the MoH issued a circular which set the regulatory groundwork for telemedicine by allowing doctors to remotely consult patients, subject to certain IT infrastructure and license requirements. It also provides guidelines for a range of telemedicine activities such as consultation, radiology, and even remote surgery.

However, it does not provide guidance on digital health payment schemes from Vietnam’s Social Security or private insurance providers. Also, there is no legislation specifically governing big data and AI health applications yet, which will slow the implementation of these technologies.

The government can take concrete steps to accelerate digital health adoption through several methods.

First is developing regulations – clarifying regulations governing paying for digital health and using technologies like AI to diagnose and treat patients. Second is expanding health infrastructure digitally in rural clinics to improve access to quality care.

Next up is providing overseas scholarships, by developing collaborations with overseas institutions to train doctors, nurses, and researchers in digital health best practices.

Finally, incentive packages such as tax credits must be created to target the development of digital health infrastructure, in order to promote industry development.

Should these steps be achieved, Vietnam can unlock the full potential of the Vietnamese workforce by promoting the foundation of a digital health ecosystem. Doing so will fuel economic and social development, and further distinguish the country as a regional leader in access to quality medical care.