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The emergence of telehealth in post-COVID-19 Southeast Asia

COVID-19 sent the world into various levels of social lockdowns and pushed many healthcare systems to their breaking point. Yet the pandemic created new opportunities in telehealth/telemedicine, an area already growing pre-pandemic.

For Southeast Asia, telehealth’s emergence may have been a pandemic-induced blessing.

Telehealth is no longer just about video and phone consultations with doctors. It’s expanding into areas such as screening, coaching, and remote monitoring. Some emerging players are also accommodating multiple nations and languages, an impressive potentially lucrative feat.

Southeast Asia’s digital-forward countries are offering case examples to which the world should be paying attention.

What is telehealth/telemedicine?

Telehealth is the delivery of healthcare services using information and communication technology (ICT), where patients and providers do not meet in person.

Telehealth broadly covers a wide variety of healthcare services such as telemedicine, mobile health, telenursing, and telepharmacy. It let medical professionals provide diagnosis, treatment, and prevention via a PC or mobile device.

It’s an especially potent tool for managing a highly contagious virus like COVID-19, as patients and medical providers can communicate at safe distances. Especially in the earlier stages when every doctor, nurse, and staff member was under continual duress, telehealth helped reduce infections among indispensable personnel.

How COVID-19 advanced telehealth in Southeast Asia

The pandemic pushed people toward “digital self-care,” using mobile messaging apps, chatbots, call centres, helpdesks, and websites to fulfil health-related needs at a safe distance. In Southeast Asia, with its young population and widespread mobile penetration, this wasn’t so alien.

“Social distancing” became a standard and telehealth was an ideal fit. Telehealth allows people to receive medical care without venturing into congested healthcare facilities. And it can reach people in remote areas where health services are limited.

When COVID-19 hit, some Southeast Asian governments worked with the private sector to promote telehealth use.

The Indonesian government, for instance, partnered with digital health platform Alodokter on free teleconsultation for COVID-19 patients. Telehealth platforms were also used for self-assessments, tracking, and contact tracing.

Also Read: Meet the 6 Indonesian healthtech startups of SEHAT Impact Accelerator

Telehealth use in Southeast Asia has varied depending on factors such as policy and governmental involvement. One study found that no Southeast Asian countries have specific laws on telemedicine.

Medical councils in Malaysia, Indonesia, Singapore, and Vietnam tend to still focus more on healthcare professionals rather than telemedicine services and platforms. In Indonesia and Vietnam, only registered health facilities can offer telehealth services.

Another study found that during the first few months of the pandemic’s initial hit, the number of telehealth platform users grew four times. It reported that 94 per cent of Southeast Asian respondents intend to continue using digital services post-COVID-19.

Commercial interest in telehealth has certainly risen. While many Southeast Asian countries have below the global average number of physicians per (apart from Brunei, Malaysia, and Singapore), demand will continue to rise.

A McKinsey report estimated that telemedicine and remote monitoring would account for US$37.1 billion of the projected US$100.4 billion Asian digital health market by 2025.

Key players in telehealth/telemedicine

HonestDocs (Indonesia and Thailand)

HonestDocs, with Indonesian and Thai platforms, targets two of ASEAN’s most future-forward populations. Users can chat with a pharmacist for free or post a question on the Q&A forum to get replies from licensed medical practitioners for as low as 200 baht (about US$6). The HonestDocs app also links to HDmall, with 12,000+ health, dental, beauty, and even pet services.

Doctor Anywhere (Singapore)

Doctor Anywhere offers a platform with 500+ general practitioner clinics, 15+ diagnostic centres, 300+ specialist clinics, and 100+ dental, traditional Chinese medicine, and physio clinics. Video consultation with a general practitioner on the platform costs SGD$20 (US$15).

Doctor Anywhere’s home-based supervised self-swab COVID-19 antigen rapid tests via video consultation were especially useful for travellers using the Vaccinated Travel Lane. As the need for such tests declines, this robust platform can easily refocus or replace the service.

Alodokter  (Indonesia)

Alodokter had more than 32 million visitors since Indonesia’s first confirmed COVID-19 case in March 2020, based on a report. It now has the most registered hospitals with the largest coverage of provinces in Indonesia. The platform’s directory of doctors includes their personal details.

Alodokter offers Aloproteksi, which gives users unlimited 24-hour chat with specialist doctors for as low as 39,000 rupiahs (US$2.75) per month.

DoctorOnCall (Malaysia)

The Ministry of Health of Malaysia partnered with DoctorOnCall to provide free access to consultations on COVID-19. In multicultural Malaysia, the platform is available in English, Malay, and Chinese.

It provides consultation across 50 specialities and doctor consultation is priced at 19.99 ringgit (US$4.75) per consultation. The platform also offers cashback for every purchase and referral, a common B2C tactic familiar to mobile users.

VieVie Healthcare (Vietnam)

The VieVie telehealth platform treats more routine medical conditions such as colds, allergies, pregnancy care, and skincare. It offers free doctor consultations via chat or phone, but accessing certain doctors requires payment or a premium upgrade. Users can receive a quick response from a licensed doctor within 10 minutes.

Also Read: What telemedicine and Health Tech holds across SEA amidst COVID-19

Challenges for telehealth moving forward in Southeast Asia

A WHO report shows the challenges to telehealth adoption, mainly categorized into four groups.

Policy

A standardised framework and repayment policies are still needed to regulate telehealth platforms. Recent policy changes during COVID-19 have reduced barriers to telehealth, but data privacy and personal information are still major concerns for users. Countries like Thailand and Malaysia have general data protection legislation that protects personal data.

A uniform repayment scheme is also needed to facilitate insurers to reimburse telehealth services fairly within and across countries. Countries including Malaysia and Thailand provide free telehealth services. Singapore has a national insurance scheme that includes telehealth rebates and subsidies.

Organisation

The lack of trained staff, sustainable funding, insufficient technical infrastructure, and technological barriers are problems that need addressing. During COVID-19, Southeast Asian governments worked with the private sector to promote digital health services that addressed the pandemic. The Ministry of Health of Malaysia, for instance, worked with DoctorOnCall to provide free consultations.

Technology

Telehealth is centred on ICT, making technology an ongoing focus. Dispersed archipelago countries such as Indonesia and the Philippines pose geographical challenges for installing ICT infrastructure.

The lack of ICT infrastructure in most Southeast Asian countries can be overcome by using existing resources and free mobile health apps with affordable consultation fees. Public hospitals in Southeast Asian countries like Malaysia, Vietnam, and Thailand have in some cases provided free telehealth services.

Individuals

Scepticism still exists on telehealth’s true usefulness. A study in Indonesia showed that Indonesian users were more likely to use telehealth if thought the technology was easy to use. For some users, cultural and language differences are a challenge. However, some platforms, such as DoctorOnCall, meet the challenge with multiple languages.

Southeast Asia is a global example of telehealth

Southeast Asia’s unique combination of a dynamic, young, future-forward population and broad multicultural diversity push it to innovate technologically and cross-culturally. Its telehealth advances offer some potentially compelling best practices for the rest of the world.

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