Non-communicable diseases (NCDs), also known as chronic diseases, remain one of the major healthcare concerns in the world today, claiming over 40 million lives every year. It is also a key driver of healthcare expenditure for households as the chronic nature of NCDs requires long-term care, which can pose a huge financial burden for patients and their families.

A study highlighted that adequate and reliable social protection interventions, on top of existing health coverage plans, must be introduced to help families who are struggling with the financial pressure that comes with managing the chronic conditions of their loved ones.

Additionally, with the rise of an ageing population, poor lifestyle choices, and urbanisation, there has been a substantial increase in NCDs in Southeast Asia as well. According to WHO, 55 per cent of deaths in the region are caused by NCDs, which is nearly eight million people every year.

The growing incidence of chronic diseases in this region has also strained healthcare systems, especially in developing countries. These areas often struggle with poor healthcare and finance infrastructure, inadequate manpower resources, and vulnerable information systems. Although there is an emergent need for the management of chronic diseases, patients who are central to this care paradigm continue to face challenges in their healthcare journeys.

Significant gaps persist in patient journeys

System complexity

With multiple administrative and clinical processes overlapping one another, our healthcare systems are complex by nature. Accompanied by the usage of technical language, these intricacies may seem overwhelming for patients. If not guided properly, it can affect their overall healthcare experience and their ability to make informed choices.

According to the Bain Front Line of Healthcare APAC survey 2021, more than 90 per cent of consumers surveyed in Asia said that they preferred a single touchpoint to manage all their healthcare needs.

Also Read: Healthtech data: The race for new oil in Southeast Asia

Furthermore, the National Institute for Health and Care Research in the UK reported that 23 per cent of patients raised concerns about their healthcare experience, with most of their concerns relating to communication between healthcare providers and patients.

Lack of integrated healthcare guidance

With the pandemic bringing healthcare to the forefront, patients are more invested than ever in health maintenance, treatment options, and preventive care. They are willing to pay for healthcare guidance both digitally and in-person through online education, diagnostic health check-ups and chronic care treatment.

For example, according to a 2018 Deloitte survey, Americans are increasingly looking for convenient, reliable, and affordable healthcare services, with nearly one-third of them using digital apps for health coaching and identifying symptoms.

However, while technological advancements have made access to virtual health and care possible, more remains to be done regarding remote chronic disease management for patients. Nearly two in five adults in the world are managing two or more chronic diseases.

This makes the widespread adoption of remote monitoring tools difficult as different chronic conditions require care from doctors specialising in that field. Therefore, creating a unified patient experience that considers multiple chronic conditions across the clinical workflow is critical in driving adoption and scale.

Health insurance-related challenges

Most insurers in Asia highlight morbidity rather than the well-being of people, with little to no focus on health insurance. As a result, consumers in many markets are often not informed about health insurance, let alone understand the scope of coverage and benefits.

Moreover, product descriptions and recommendations can be difficult for consumers to comprehend due to the usage of technical lingo, making it challenging for them to make an informed decision.

Technical jargon, accompanied by costly premiums, is a key barrier for consumers. For example, in major developing markets across Southeast Asia like Indonesia, the gross written life insurance premiums grew at 11 per cent per year between 2013 to 2017.

Additionally, less than a third of policyholders feel sufficiently covered by insurance, with Indonesians, in particular, feeling least protected.

According to Willis Towers Watson’s 2022 Global Medical Trends Survey, the primary driver of medical costs remains the misuse of care due to the “overprescribing” of health services by medical professionals for their patients.

Additionally, 38 per cent of insurers surveyed said that the underuse of preventive services was a significant cost driver of increased year-over-year costs due to the avoidance of medical care during the pandemic.

These rising costs continue to serve as a key barrier of entry for consumers, especially with the onslaught of COVID-19. Across the Asia Pacific, consumers have become more price sensitive towards insurance purchases amidst concerns over financial stability post-COVID-19.

Poor healthcare delivery

Although patients are the core of the healthcare industry, their healthcare journeys are often fraught with challenges. At least 5.7 million people lose their lives in low and middle-income countries every year due to poor quality healthcare, while 2.9 million die due to lack of access to care.

Improvement in healthcare delivery is of utmost concern today since a person has a greater chance of dying due to poor quality care rather than the absence of care. The Singapore Ministry of Health (MOH) Patient Satisfaction Survey (2015) reported that although 85 per cent of patients were satisfied with the service at hospitals and polyclinics, they cited long waiting times, health procedures and facilities as areas that needed urgent improvement.

Technology as an enabler

Digitalisation is revolutionising the healthcare delivery system by redefining patient access to care, enhancing patient engagement, and providing them with the opportunity to actively participate in their healthcare journeys.

Also Read: How mental health startup Intellect’s founder catalysed his personal battle with anxiety

Purpose-built, patient-centric technologies can help overcome various patient pain points – from personalisation and optimisation of healthcare delivery to reliable management of chronic diseases.

More specifically, intuitive artificial intelligence (AI) based tools can improve patient journeys by providing a one-stop integrated platform that brings together patients, payors, and providers at every step of the treatment continuum.

For example, AI technologies and apps can be used to provide patients with personalised chronic disease management plans, including automated monitoring of changes in vital health-related parameters, check-up reminders, and early warning signals.

Patients are also provided with reliable guidance via patient self-service facilities (chatbots) and computer-aided detection systems for diagnosis. By capturing data and utilising it effectively, such tools can enhance efficiency and reduce time and expenses spent on unnecessary procedures.

These digital ecosystems can also connect hospitals and insurance systems to enhance efficiency across the board. For example, it can help to streamline health insurance claims processes, thereby reducing claims turnaround time and fraud and leading to better outcomes for patients, payors, and providers.

They also ensure the safe and integrated handling of medical information, allowing healthcare professionals to leverage the power of analytics and create personalised treatment plans that better address the needs of patients.

AI can thus enhance the overall patient experience so that patients are kept informed and empowered at every step of their healthcare journey. However, it is important to remember that technology does not substitute in-person medical care and attention but instead complements it.

With technology as an enabler, patients can anticipate simpler and more convenient healthcare processes and services which helps in building trust and accountability and is critical in protecting the relationship between healthcare practitioners and patients while making healthcare accessible and affordable for all.

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If we are talking about edutech startups in Indonesia, most of the time, the names that come to mind would be those that target K-12 education, such as Ruangguru and Zenius. But there are also companies that are targeting higher educational institutions with Neliti being one of them.

Neliti is a free-to-use website builder and content management system (CMS) that creates aesthetically pleasant web interfaces for academic content providers.

In an email interview with e27, Neliti CEO Anton Lucanus writes that the company is aiming for three different types of academic content providers: institutional repositories, academic journals, and academic conferences.

“Our users are librarians and academic journal publishers. They simply sign up to our website for free and are then provided access to a publishing management system,” he explains.

” … They can perform important steps in the creation and management of their repositories and journals, such as creating a website with their own custom domain name, managing and editing research articles, indexing their articles in databases like Google Scholar, analysing the usage of their research (views, downloads, citations, etc.), as well as a lot of other important technical capabilities that repositories and journals need,” he continues.

Also Read: In this age of digitalisation, is edutech a bane or boon for educators?

Why is this solution better than the existing ones?

Lucanus begins his answer by explaining the two main types of existing solutions: free open-source solutions (such as OJS for journals or ePrints for repositories) or paid solutions (such as Silverchair for journals or Pure for repositories). But these free solutions are not user-friendly, requiring them to learn how to host and build their own websites.

“But because the users are librarians or academics, not trained web developers, the resulting websites are often ugly and riddled with bugs. Paid solutions are unaffordable to most institutions and reserved only for wealthy institutions in developed countries,” he says.

“We aim to make a free solution that is infinitely easier to use than existing free solutions yet produces infinitely more beautiful and functional repositories than even the most expensive paid software. We want even small universities in the middle of a developing country to produce more beautiful and functional websites than wealthy publishers who have paid hundreds of thousands of dollars for their websites – how disruptive would that be? This has been a huge focus of our UI/UX team.”

Neliti also aims to completely handle the entire tech stack for its users, such as hosting, indexing content, and more. According to Lucanus, no other free software has achieved this.

“We want our users to be free from any technical burden and focus on what they’re good at [which is] publishing impactful research.”

Also Read: Edutech in a post-pandemic world: Where do we go from here?

Academic orientation

The story of Neliti began in March 2015 when Lucanus was interning at the Eijkman Institute for Molecular Biology in Jakarta, a leading research institution in Indonesia. Founded in 1888, the government-funded institution conducts basic medical molecular biology and biotechnology research. Its founder Prof. Dr Christiaan Eijkman received the Nobel Prize in Medicine for his work in 1929.

During his internship, Lucanus found that the institute had “an enormity of impactful data that was previously unavailable publicly.” This includes data on Japanese Encephalitis rates in Central Java and the genetic sequencing results for Indonesia’s first-ever case of Zika.

“I built the first version of Neliti as a way to deposit this data publicly, should it ever be needed by local or international health authorities. Beginning as a small repository for my laboratory only, Neliti expanded rapidly (and entirely organically) to include over 1,000 other institutions and receive millions of monthly users,” Lucanus explains.

“We are trying to solve access to scientific knowledge. A lot of important scientific knowledge is hidden behind paywalls or sometimes not available online at all! We believe that research is key to solving the world’s biggest challenges and that scientific knowledge is so vital that it deserves to be free. By providing free tools that help with publishing and accessing knowledge, our mission is to improve accessibility to scientific knowledge and move one step closer to an open-access world.”

In developing the platform, Neliti started by conducting ideation on what solutions our users need.

“We then review about 100 websites/platforms with such solutions – both in the academic industry and outside – to see trends and use cases. Our UI/UX team then creates a design and UX that aims to improve on all previous solutions. We then ship it to our CTO and development team, who begin work on JIRA and handle the entire development side,” Lucanus says.

Also Read: How edutech is solving the global teacher’s crisis

As a platform, compared to many other startups operating in Indonesia, Neliti has a very specific target audience. Interestingly, the company has not made any particular acquisition moves to secure its customers.

“All customers have come to us organically (e.g. via word-of-mouth) – that is, 1,000 institutions and 3,000 journals. And the demand is only growing, so our existing resources are spent catering to this demand rather than trying to increase it. It’s a good problem to have!” Lucanus says.

The year of expansion

From its base in Jakarta, Neliti is currently run by a team of seven that includes Lucanus himself. The company is largely bootstrapped but has received equity-free grants from both the Indonesian and Australian governments.

“We may aim to raise capital in the future when we are ready to take things to another level,” Lucanus says.

One might wonder how a platform with a strong academic orientation such as Neliti monetises. According to Lucanus, it monetises through various advertising opportunities –from banners to sponsored content- and through the provision of essential tools in the publishing workflow.

Also Read: Edutech is surging, but here are the 3 issues it is facing

“For example, we offer a digital object identifier (DOI) registration feature, where users have to pay for every article that they register. DOIs are a unique code that almost all modern academic articles have; it is really important and stores all the metadata for that article,” Lucanus explains.

“They are particularly important in the academic citation because they are more permanent than URLs, ensuring that readers can reliably locate the article’s source as journal articles can often be found on multiple different websites and databases. Think of it like every book’s’ ISBN’ on its barcode. Unfortunately, registering DOIs is a cumbersome process fraught with technical difficulties that laymen just cannot understand! We handle that entire DOI registration process and charge our users for it.”

The company is also looking forward to implementing more business models, such as premium features and plagiarism checking.

Now that they have secured their place in the Indonesian market, Neliti is looking forward to expanding its business to other markets.

“We are currently really popular in Indonesia and have worked with almost every major Indonesian institution. In 2023, we want to focus on expanding geographically to other developing countries. We’ve already received some users from other developing countries, including Malaysia, Uzbekistan, Ukraine, Kazakhstan, Nepal, India, Pakistan, Vietnam, and dozens of others. We’re a bit spoilt for choice on which countries to focus on, and the early part of 2023 will be focused on an expansion strategy,” Lucanus closes.

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