Converge The disruption of healthcare in SEA · Converge - The disruption of healthcare in SEA 2 About Converge Converge is a series of reports by Deloitte Southeast Asia Innovation

Converge - The disruption of healthcare in SEA

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Converge The disruption of healthcare in SEA

January 2019


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About ConvergeConverge is a series of reports by Deloitte Southeast Asia Innovation that provides insights into the technology trends and startup ecosystem in Southeast Asia1.

Each report provides a snapshot of the upcoming technology trends in a particular sector and introduces promising startups that are driving new ideas and taking on challenges that are unique to Southeast Asia.

Join us in discovering interesting and potentially disruptive startups and initiatives across a myriad of industries, and feel the pulse of Southeast Asia’s thriving digital revolution!

Who the report is for:

• Corporations exploring innovation capabilities and startup engagement

• Individuals who are keen to understand technology and innovation trends driven by the startup ecosystem in Southeast Asia

About Deloitte Southeast Asia Innovation

Deloitte Southeast Asia (SEA) Innovation is a cross-function, cross-country innovation unit dedicated to driving the innovation agenda as a culture and value creator across the region.

Have feedback on Converge? Drop us a note at [email protected]!

Footnote 1 Limitations: While we try our best to ensure that this report is up-to-date and is accurate in the presentation of trends as of the date of publication, there are some limitations to this report. Some startups choose not to disclose their funding rounds and/ or funding amounts. As such, the data might not reflect the exact situation.

Sources: This report draws from startup databases such as Tracxn, Crunchbase, and Tech in Asia, e27, as well as reported data from local, regional and global news sources, and respective company websites.


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With a diverse demography that lies across a wide socio-economic spectrum, Southeast Asia is a fragmented healthcare market. While healthcare infrastructure and the availability of medical professionals are lacking in some countries, this region has its more developed countries like Singapore as well (see Figure 1).

One thing that the region does share is the unstoppable march towards progress and digitalisation. Much has been said about the phenomenal growth of mobile internet and smartphone adoption in Southeast Asia, which has emerged as one of the first mobile-first internet regions in the world. This has fueled new business models and consumer habits through e-commerce, ride-sharing and other mobile internet-enabled arrangements that mark a new age of economy, with Indonesia at the helm. According to research by Google and Temasek, the Indonesian internet economy is poised to grow to US$100 billion by 2025, up from the US$27 billion clocked for 2018, which is already more than three times that of 2015 (see Graph 1).

These same influences are affecting the healthcare industry in this region. Non-traditional healthcare companies now exist in the form of technology and data-driven startups. Southeast Asia may not feature prominently across the full spectrum of global emerging technology trends affecting healthcare in areas like robotic surgery, immunotherapy or CRISPR, but in areas where disruptions in healthcare provision and delivery models are noticeable, the promise of impact is no less powerful.

In this report, we take a snapshot of what some startups and players in this region are doing that are paving the way for a digital healthcare revolution. While some offer locally-relevant products and services to fill healthcare provision needs, those with a core rooted in data and technological solutions get to aspire to scale beyond their shores.

Figure 1: Density of Physicians Per 1000 Population

Germany2015

USA2014

China2015

Cambodia2014

4.191 2.568 1.812 0.143

Indonesia2012

0.201

Thailand2015

0.47

The Philippines2004

1.11

Malaysia2015

1.533

Singapore2016

2.276

Country (Year Reported) Density Of Physicians per 1000 Population

Source: World Health Organisation

Density Of Physicians per 1000 PopulationCountry (Year Reported)


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Graph 1

As is the case in many other industries, the advancements and affordability of telecommunication technology for the consumers have been game-changing for businesses. While the idea of consulting with a doctor over the phone is not new, the ease at which medical professionals can now conduct app-based medical consultations remotely with patients through messaging, voice calls and video conferencing. Stacked together with other incidental consumer-facing businesses that are enabled by the same efficacy of modern communication technology, telehealth startups that are providing services that are integrated more horizontally have emerged in Southeast Asia (Table 1), providing users a rich network of ancillary services beyond the provision of medical advice.

Startup spotlight: Halodoc

Riding on change, changing the game for doctors, pharmacies and insurersHalodoc, a telehealth startup, facilitates several thousand consultations a day between their base of 2 million users and 20,000 doctors in Indonesia. Beyond that, they are also partnered with 1000 pharmacies and ride-hailing behemoth Go-Jek, bridging physical distances by providing medicine delivery. To facilitate payment, they have also linked up with insurance companies so that users can pay for these services from existing health policies.1

Will this be the platform upon which doctors set up clinics in the future, and how will this affect the supply chains and arrangements with pharmacies, insurers and other players in the ecosystem?

Source: e-Conomy SEA 2018 Southeast Asia’s internet economy hits an inflection point, Google and Temasek (2018)

SEA Internet economy market size (GMV,$B)28%

100B

27B

8B 5B8B

5B2B

21B 21B 22B

43B

12B7B 6B

9B

33B

3B10B

49%

MalaysiaIndonesia SingaporePhilippines Thailand Vietnam

19%

16%25% 13%

22%

25%

35%27%16%30%

2015 2018 2025 CAGR

The clinic is changing- Telehealth and beyond


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Table 1: Telehealth and beyond— The Clinic of Tomorrow?

Startup Description Main countries of operations

Year founded

Funding

MyDochttps://www.my-doc.com/

MyDoc provides an integrated online-to-offline platform that streamlines all aspects of primary healthcare into one easy-to-use solution connecting patients to doctors, pharmacies, diagnostic laboratories, clinical-grade health trackers, Fortune 500 and SME employers, and insurers.

Singapore 2012Series A - 6.8M USD

BookDochttps://www.bookdoc.com/

BookDoc has an integrated online ecosystem that allows users to search and book healthcare professionals, and integrates with navigation, transport, accommodation and recommended restaurants and attractions systems for a hassle-free and enjoyable experience to healthcare appointments. Users can also earn rewards and discounts from major retail partners and service providers for maintaining a healthy and active lifestyle.

Malaysia, Singapore, Indonesia, Hong Kong, Thailand

2015 Undisclosed

Alodokterhttps://www.alodokter.com/

Alodokter is looking to build an integrated healthcare service for users. It currently provides Indonesia with a web and app platform with the latest health content, an interface to consult with doctors, an online platform to search for medical service providers and to book appointments.

Indonesia, Thailand (under Pobpad.com)

2014Series B – 12.1M USD

Halodochttps://www.halodoc.com/

Halodoc is a healthcare network platform connecting licenses doctors to patients, as well as to certified partner pharmacies and licensed medical laboratory services. Users can communicate with these medical professionals via chat, video and voice call.

Indonesia 2016Series A - 13M USD

Source: Crunchbase, respective company websites.


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Specialist services and medical tourismThis same technology enabler raising the game for general medical consultation is also doing so for medical tourism and specialist services.

Startups are stepping into the fore to streamline the process of helping well-heeled and increasingly demanding customers get information and make choices about getting the best niche medical services for their needs. Discovery portals like Medical Departures in Thailand provide reviews and comparisons of packages by various providers for different treatments for their users to consider, while DocDoc from Singapore dives deeper into clinical informatics and healthcare quality assessment to recommend the right doctor for specific ailments, with the help of artificial intelligence. Both startups boast of a wide network of doctors in different specialisations across many countries.

Startup spotlight: Medifi

A founder’s story: turning pain points into curesBorn out of the founder’s personal difficulties consulting with his USA-based doctor while in the Philippines, Medifi is a startup that gathers doctors from all over the world onto its platform and provides a suite of telehealth solutions to facilitate preliminary consultations and post-treatment follow-ups, including medical imaging management and health profiling of patients. Medifi is also linking up with popular health and wellness trackers to automatically and accurately track vital signs, bringing the industry of wearables into its fold as well.2


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Year founded

Funding

Medical Departureshttps:// www.medicaldepartures.com/

Medical Departures is a medical service marketplace that helps patients find, compare and book medical appointments around the world.

Thailand 2014Series A – 2.5M USD

DocDochttps://www.docdoc.com/

With a network of more than 23,000 contracted doctors and extensive proprietary data on outcome, price, and experience, DocDoc helps patients find the highest quality care for their unique medical needs with their artificial intelligence powered doctor discovery engine.

Singapore, Indonesia, Hong Kong, The Philippines

2012Series B- 14.1M USD

Medifihttps://medifi.com/

Medifi delivers remote medical diagnostic solutions through an online platform that connects medical professionals to patients. Their platform features include health profile management for patients, video consultations, and medical imaging support.

The Philippines 2014Seed – 0.5M USD

Table 2: Telehealth and beyond— Finding specialist services

Source: Crunchbase, respective company websites


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While improvements to the telehealth industry mean avoiding painful traffic jams that are common in the major cities, or getting the best healthcare services from abroad, it is humbling to remember that this new format of clinics may well be the first access to formal healthcare for some others, especially in countries facing a scarcity of doctors.

For healthcare services providers, improvements in telehealth services mean that they now have a wider reach to patients and customers, with more touchpoints and communication channels beyond the physical clinic.

This means more data points and logistics to manage, but when properly utilised, the hope is that they can better manage and optimise resources for a better workflow and for patient experience, thus elevating the overall level of healthcare services in their widened community.


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The Internet of Things (IoT) has made it possible for practically anything to be transformed into a digital touchpoint. From consumer wearable devices like fitness trackers and smartwatches, to medical devices like patient implants or even hospital equipment, there is a great wealth of healthcare and even lifestyle data being generated and waiting to be tapped on by the market.

While the adoption of smart devices across Southeast Asia is not as yet as widespread as in more developed IoT markets like China and USA, the nature and value of data easily transcend geographical boundaries, freeing data solution providers within the healthcare sector from the constraints of physical geography.

Most of the noteworthy solutions from startups emerging from this region are linked to Singapore, and they are collecting, processing and harnessing value from data from all over the world, for users and for science alike.

Startup spotlight: Healint

Leading the world on migraine mattersSingapore-based Healint is a startup that develops applications to help users track symptoms for neurological conditions and for clinical trials. With 300 million health events recorded, Healint’s data provides real-time insights not just to patients and their doctors on individual conditions, but also to healthcare industry players that seek to understand population-based trends as well.

One of Healint’s products is the Migraine Buddy application, which has about 1 million registered users. In June 2018, Healint and pharmaceutical giant Novartis presented a study on the impact of migraine on work productivity at the Fourth Congress of the European Academy of Neurology, based on user-reported data from the Migraine Buddy application. Extending from that, they shared new insights on the US migraine user base, noting that chronic migraines may induce anxiety and depression, instead of the other way around as more commonly thought.3

Startup spotlight: UCARE.AI

Beyond healthcare, a peace of mindHealthcare is costly, and it does not get cheaper with chronic diseases needing prolonged treatment. A Singapore-based startup, UCARE.AI uses publicly available data and data from private partners to create a predictive engine to help providers and caregivers manage patients throughout their illnesses, reduce preventable hospitalization, and lower healthcare costs where possible.

In partnership with the Parkway Pantai group, UCARE.AI was able to deploy their artificial intelligence-powered solution for more accurate and personalised hospital bill estimation in November 2018. They have reported an average of 82% accuracy rates in the estimations, and have reduced the average gap between estimated and actual bill by 60%. Such estimations are based on patients’ medication history, background, visit frequencies and other vital details such as blood pressure.4

Harnessing the value of data in healthcare


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With predictive and artificial intelligence layered on to improve real-time and large-scale data analytics, startups using big data can help identify potential disease outbreaks, be it among certain demographics, or within geographical areas and environments. In some instances, risk factors for individuals can also be worked out from these analyses, which would help patients better anticipate and manage their conditions, or be more mindful of their lifestyles and habits in general.

While data from these startups will not replace the need for scientific research methodologies and further studies, data can certainly provide useful early signals for everyone to act on – for users to safeguard individual health and peace of mind, and for healthcare organizations to find the best new initiatives to pursue.


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Table 3: Using data to improve healthcare


Year founded

Funding

Healinthttps://healint.com/

Healint is the developer of the world’s largest migraine tracking and research platform Migraine Buddy. Using deep analytics and machine learning, Healint generates real-world evidence for patients, physicians, and researchers to improve treatment outcomes and expedite clinical trials.

Singapore 2013 Undisclosed

BioFourmiswww.biofourmis.com

BioFourmis is leveraging the revolution in biosensor technology and personalised predictive analytics to provide individualised therapeutic decision support and physiology insights, improving remote patient monitoring and patient safety at home.

Singapore, USA

2015Series A - 6.6M USD

Holmuskhttps://holmusk.com/

Holmusk creates technological products that track and analyse symptoms for chronic diseases and mental health, and also coach users on managing their conditions. With the combination of user data and information databases, they help users understand and act to improve their conditions.

Singapore, Malaysia and USA

2015Seed - 9.8M USD

UCARE.AIhttp://www.ucare.ai

UCARE.AI looks to create accurate predictions years into the future for various stakeholders. Users can obtain a personalised understanding of their lifetime risks so they can take preventive actions early on, the resources needed for personal healthcare can be better estimated and thus planned for, while healthcare providers will know to focus on those who need their expertise most urgently.

Singapore 2016Series A - 8.2M SGD



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Lifestyle wearables: Fashion, function, future?Data solutions require data, and the most accurate data collection tools may well be the passive tracking devices that record every moment of our lives, instead of those that require active user input.

Biosensors and other medical devices are already being used by startups like Biofourmis (see Table 3) to monitor patients remotely. Medical-centric devices aside though, it is the increasing popularity of health trackers like Fitbits and smartwatches that have paved the way for us to imagine how wearables can do more for us. The Apple Watch, for instance, has evolved from being an iPhone on our wrists to a personal wellness device that tracks your heart rate and alerts you if something is amiss. In a landscape where tech giants are blending lifestyle with healthcare and wearables, will the notion of a healthy lifestyle be moved up a notch in future?

For some indication on where the wearables trend may head in this region, it is interesting to note that Singapore-based KaHa raised US$4.5million at the end of 2017 to develop white label smart wearables and platforms for clients. On the demand side, since 2015, the Singapore government has backed an island-wide health campaign called the National Steps Challenge, giving out a Fitbit-like wearable to all qualifying citizens for them to track steps taken, which would earn them Healthpoints that can be used to redeem rewards. Meanwhile, in Thailand, an eldercare monitoring system was piloted in 2016 under the Saensuk Smart City programme to explore how the municipality may improve the quality of community care for its ageing population through wearables and IoT, amongst other smart city initiatives.5

The future of wearables for healthcare can only get more exciting as more players jump on this bandwagon. From smart buckles to smart bracelets to smart belts, the possibilities are endless. Perhaps, the big question is not so much about what technology can do, but instead about how to ensure that the item is worn or used regularly in the users’ daily lifestyle— because only that can record the required data needed to drive the purpose intended, such as a lifestyle change.


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Table 4: Internet of healthcare and lifestyle things


Year founded

Funding

KaHahttp://coveiot.com/

KaHa is a smart wearable technology company that provides an end-to-end IoT platform for brands to launch smart wearable products. It provides manufacturing services such as electronics design and printed circuit board assembly, as well as app development, cloud storage, data analytics, and after-sales services.

Singapore, China, India, Switzerland

2015

Venture Round Undisclosed - 4.5M USD

AEvice Healthhttp://www.aevice.com/

AEvice Health develops wearable respiratory devices for asthmatics. They have invented a respiratory monitoring wearable for children with notification features, such that when there is an abnormality, parents can be empowered to take early medical intervention prior to an asthma attack.

Singapore 2016Seed- Undisclosed

BAESLab http:// www.baeslab.com/

BAESLab develops smart wearables on its IoT platform. They have collaborated with the Saensuk Smart City project to develop and deploy a healthand wellness tracker for the elderly residents within the community, improving community healthcare provision.5

Thailand 2013

Subsidiary of SE- Education Public Company Limited6

Nalurihttps://www.naluri.life/

Offering an app to journal and manage user behavious, Naluri offers coaching, guidance and therapy through its platform to help users strengthen their mental resilience and resolve to achieve and sustain better health outcomes such as weight loss, better stress management, or reduction in blood pressure or blood sugar levels.

Malaysia 2017Seed - 1M MYR



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Citations and references(1) https://asia.nikkei.com/Business/Business-Trends/Telehealth-apps-rise-in-Southeast-Asia-due-to-doctor-scarcity(2) https://e27.co/philippines-medifi-enables-telehealth-consultation-doctors-patients-20151123/(3) https://healint.com/press-release/2018/8/20/healint-announces-research-showing-increase-in-anxiety-and-depression-with- higher-migraine-frequency-among-tens-of-thousands-of-us-migraine-patients(4) https://sbr.com.sg/healthcare/more-news/parkway-pantai-and-ucareai-unveils-ai-powered-predictive-hospital-bill-estimati(5) http://www.nationmultimedia.com/detail/Economy/30291464(6) http://corporate.se-ed.com/c/document_library/get_file?uuid=d361291e-c6f0-4369-ac9a-4e4aa606b438&groupId=11406(7) https://www.moh.gov.sg/our-healthcare-system/licensing-experimentation-and-adaptation-programme-(leap)---a-moh-regulatory- sandbox

Advancements in technology are helping us reimagine best practices in the healthcare industry at every stage, from medical diagnostics to patient communication and beyond. Startups in this region have demonstrated how they could potentially shake up the traditional model of service and medicine delivery, not just for home markets but for the world as well.

The technologies described above are not at all far-fetched, though we have yet to see the mass adoption of any of these. If this is just the start of the digital health revolution in Southeast Asia, will we see its peak by 2025, given the trajectory of progress in this region’s internet economy, or would the confluence of all changes by then yet again revolutionise the way we think about the internet economy and healthcare?

Then again, the path to mass adoption of digital health solutions will not only be market-driven. With new business and delivery models, regulatory concerns are surfacing as we move into uncharted grounds,

and that poses potential friction. In 2018, Singapore’s Ministry of Health initiated a regulatory sandbox for telehealth providers, such that they can work with service providers to develop the necessary policies to safeguard public health and safety, as well as data privacy for electronic health records, as telehealth services become a norm in healthcare service delivery.7

It is welcomed progress on the regulatory front, for governments to work with and learn from these service providers.

Healthcare is a basic human requirement, and as startups, corporations and governments continue to experiment with emerging technology and trends to solve this eternal population need, we can only expect more disruption and new regulations to emerge in the coming few years.


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Converge The disruption of healthcare in SEA · Converge - The disruption of healthcare in SEA 2 About Converge Converge is a series of reports by Deloitte Southeast Asia Innovation