Healthcare in Malaysia, with its dual public and private persona, faces unique challenges. Still, at a recent Galen Growth webinar, four healthcare venture CEOs agreed that COVID-19 is changing healthcare in Malaysia forever.
The Unique Challenge Facing Healthcare in Malaysia
“There’s a joke among doctors in Malaysia,” says Maran Virumandi, Managing Director of HealthTech startup DoctorOnCall, “as a medical practitioner you are always competing against one ringgit (the Malaysian currency) or five ringgit service providers.”
Umm, it seems the joke loses its hilarity in translation, but the point is well made: how do you compete with a subsidised service?
In Malaysia, there is a two-tier public health system — public and private. Public healthcare is subsidised by the government and funded by taxes. The result is a low-cost system available to all Malaysian nationals — who are asked to pay nominal fees for outpatient and hospitalisation services.
The public system is funded by payments from health insurance companies and out-of-pocket payments from patients.
“When the government already provides a good standard of care,” says Maran Virumandi, “— it is difficult to compete with a heavily subsidised competitor.”
That is where digital health enters to story: the Malaysian healthcare system can particularly benefit from digital health, because, digital “will allow the best in the industry to thrive, by creating transparency on price and service providers.”
The Malaysian Demographic Challenge
Like many countries, Malaysian faces a massive demographic challenge in the making. Between 1970 and 2009, the Malaysian fertility rate fell from 4.9 to 2.3. By 2019, the fertility rate was down to 1.8, compared to the 2.1 replacement rate. (The replacement rate is the birth rate required to each generation to replace the previous generation eventually.)
The percentage of people aged over 65 in Malaysia increased from 3.3 per cent in 1970 to 4.5 per cent in 2009, but by 2018 that percentage had risen to 6.7 per cent.
This is creating an enormous challenge, and it is increasing the overall cost of healthcare in Malaysia.
Digital health may, therefore, become ever more vital — not only can it help link the public and private healthcare sectors, but it can also drive greater efficiency too.
The government will see that “digital health is a key enabler” which will enable users “to choose, thereby creating a single-payer system,” says Maran Virumandi. “It just needs the political will and an open mindset amongst patients.”
So how might this come about? That’s where COVID-19 enters the story.
Support For The Elderly During COVID-19
Martin Yap and the company he founded, CARE Concierge, has a simple mission: to revolutionise the state of Aged-Care in Malaysia. Given the demographic shift, CARE Concierge provides the kind of service that you would expect to be in continually rising demand. But COVID and associated lockdowns have been particularly cruel upon the elderly. “I think COVID has changed everything,” but especially “seniors, who are the people mainly affected by COVID.”
It is not just about the risk of infection from the virus; he says: “because of the lockdown they could not meet up with family members, causing many to become depressed.” But the challenge creates innovative solutions, an app, for example, to enable people to check on “how their Mum and Dad are doing.” It also provides technology to help staff from the hospital provide their service to the home.”
Digital Transformation Of Healthcare In Malaysia
Pre-COVID, he suggests, that pushing digital healthcare in Malaysia was difficult. “Partly because of the mindset of the healthcare provider, we are reluctant to adopt new things when treating patients.”
The QueueMed offering was crafted by a group of doctors to assist clinics and hospitals in Digital Healthcare Transformation. It provides a multichannel appointment booking, mobile queue solution and E-payment solution to clinics and hospitals
“During the COVID crisis, we faced a lot of different requests, and we had to educate people on the benefits of digital health.” Then again, as they say, necessity is the mother of invention — and maybe it has another child, a desire to learn about invention. Educating people on the benefits of digital health becomes more viable when COVID is driving the need to understand it.
“The mindset of the healthcare professional has changed,” says Dr Kev Lim. He speculates that social distancing will be the new normal, and that means digital health will be more critical than ever.
The Need To Understand The Genome
The COVID-19 crisis has also highlighted the need for sophisticated genome sequencing technology. And that is the precise area that Advanx Health operates in. At least it is in the business of providing personal healthcare based on the findings of genetic testing.
Its Co-Founder and CEO, Yong Wei Shian, agrees that the COVID pandemic is a catalyst for change in digital health, but then he has an entirely different perspective.
“There are certain genotypes in some people that can make them more susceptible to COVID-19. This, in turn, creates the need and indeed opportunity to create sequencing technology to hasten the route towards getting treatment or vaccine. So, we understand at Advanx Health that genomic databases will see growth in the future because these sequences will help fight future pandemics.”
And so, it is that Advanx Health is talking to pharmaceutical companies about using digital channels to engage customers, creating the data.
But there is a challenge that comes with this technology which relates to human psychology — the genetic testing might create a kind of acceptance of a perceived inevitably. For example, based on genetic testing, a customer might think I am going to be obese anyway, what’s the point in trying to avoid that outcome? So, as Yong Wei Shian, says, genetic testing has to be accompanied by education, with digital a key enabler in providing this education.
Single Source Of Truth
DoctorOnCall is the telemedicine business. In addition to providing telehealth services, it is also a source of educational materials, with articles, videos and health forum.
It is not hard to imagine how COVID has affected demand for these services. Before COVID, “we already had a million visitors to our site,” said Maran Virumandi. But in the early days of the crisis, there was a lot of fake inflows and misinformation.”
So that was the first challenge, correcting the fake news. So DoctorOnCall’s first COVID related challenge was to create a single source of truth. “And we had five million visits to our site.”
It is a familiar story for those who have looked at how COVID has changed digital health.
But in Malaysia with its dual public and private healthcare, the challenge is perhaps more complex.
Digital health can be the means to bridge that divide, integrate the services — enabling the seamless flow from private to public, or vice versa.
Healthcare in Malaysia has its unique challenges, but as Maran Virumandi concluded: “COVID was like a catalyst, forcing everyone to live in this new paradigm.”
For More Information
This article is based on our recent Building an Effective HealthTech CEO Covid-19 Survival Strategy | Malaysia webinar. You can catch up the full webinar here, as well as others that you might have missed.