Three steps to wider telehealth adoption in Singapore

Globally, growing and aging populations, rising rates of chronic diseases and skills shortages are putting healthcare systems under immense pressure. In Singapore, for example, the government expects the population of people aged 65 years and older to double by 2030¹.

To help medical resources go further, and to provide better care for all, telehealth is being heralded as a silver bullet.

The World Health Organization describes telehealth as the use of telecommunications and virtual technology to deliver healthcare outside of traditional healthcare facilities – extending the reach of high-quality care and in-depth expertise to places like the home, as well as to remote and underserved communities. While the industry is still relatively new, it is estimated that the global telehealth market will reach USD$19.5 billion by 2025².

The good news is that in Singapore, two-thirds (64%) of healthcare professionals currently use some form of connected care technology for diagnosis, treatment or management of their patients’ conditions, according to our Future Health Index (FHI). This rate is higher compared to developed nations like the United States of America (46%), Germany (45%) and France (40%).

The growing adoption of telehealth is also driven by an ever more connected general population who is increasingly more prepared to embrace technology to improve their healthcare. Our 2018 FHI report found that in Singapore, half of the general population (50%) has used some form of connected care technology already to monitor health indicators such as weight, blood sugar levels, and medication intake. 

While it is positive to see that more healthcare practitioners and patients are embracing telehealth, there is still a long way to go before it reaches its full potential. Key to this will be for countries to ensure that they have the right policies and frameworks in place to support it, as many often fall behind when it comes to ‘new’ technologies.

In the case of telehealth, our FHI report found that many healthcare systems have not yet formalized reimbursement models and frameworks for data sharing, which are needed for its wider adoption and long-term success.  

To widen the adoption of it in Singapore, the government and the healthcare sector can take the following steps.

1. Make telehealth financially viable
   ·   Telehealth solutions require a substantial initial investment, so it is important for adopters to have a long-term mindset. Institutions may wish to start small to test the solutions first and then scale up because it may take time for the real value of the implementation to become apparent.
   
   ·    As telehealth is rolled out, policy-makers will also need to re-think traditional reimbursement models. Reimbursements are currently often tied to the number of patients physically visiting a doctor or facility. As telehealth enables patients to receive care remotely, the solutions could negatively affect the income of healthcare professionals and institutions unless traditional reimbursement models are changed. It is good to see that Singapore has already taken a step in the right direction with the Ministry of Health starting to pivot away from a fee-for-service model with its Beyond Quality to Value imperative.
   
   Moving forward, instead of only looking at volume, Singapore’s future reimbursement model must look at the value and positive outcomes telehealth delivers, and these must be tracked and measured in order to justify spending.
   
   
2. Develop a common language
   Healthcare professionals in Singapore are amongst the least collaborative according to the 2018 FHI report. One aspect that may be holding them back is that as the industry uses different technology, the data being collected, and the systems being used, may differ too. To realize the network benefits of seamlessly connecting clinicians across multiple locations, data needs to be collected and stored in a consistent way, at least at the level of individual specialties or practice areas. This standardized approach to data will then make it easier for doctors to share the information with each other, as they – and their systems – will speak the same language and adhere to the same core approaches when it comes to use of telehealth locally.
   
   
3. Build telehealth on recognition of differences
   While more standardization will be needed, it is equally as important for healthcare systems and practitioners to understand that telehealth will not look the same everywhere as it will be dependent on the local infrastructure and environment. This means that solutions that had proven positive results in one country may need to be modified for appropriate use in Singapore. Equally, if Singapore wants to expand their telehealth reach outside of the country, they too need to take a localized approach.