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How telehealth will change the future of health care

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7 minute read 27 Sep 2021

Health care providers and other ecosystem players must collaborate to address privacy and security risks as telehealth demand grows.

In brief
  • Telehealth demand in Southeast Asia has surged during the pandemic and is expected to rise further.
  • A centralized health record system that adequately addresses privacy and security risks is crucial to promote telehealth adoption.
  • Health care providers must work with other ecosystem players to effectively meet consumer demand for combined health and wellness offerings.

The COVID-19 pandemic has changed many aspects of life. Due to city lockdowns, people have adapted to new ways of coping with day-to-day activities. In particular, EY analysis found that the take-up of telehealth has increased, with Southeast Asian countries seeing an upsurge in demand during the pandemic, given greater adoption by patients and physicians alike. 

Some may attribute the sharp growth in telehealth usage to the low baseline during the pre-pandemic days. However, it is undeniable that telehealth demand will continue to grow, even after the pandemic eventually eases. The authorities’ role in promoting or boosting adoption of telehealth to support the sector and encourage mass adoption is significant. In Indonesia, for example, the health authorities have partnered with sector players to provide COVID-19 diagnostics in remote areas.1 Singapore’s Ministry of Health has allowed the use of Government subsidies and a national medical savings scheme (MediSave) to pay for the video consultations of regular follow-ups of all approved chronic diseases. 2

As consumers become accustomed to on-demand and self-directed experiences in various areas of their digital lives, more are expected to continue using telehealth after experiencing its convenience. 

Data risk amid ecosystem growth

To enhance the consumer experience, health care is no longer restricted to doctor visits or teleconsultations. Health care providers are recognizing the need to combine health and wellness offerings to meet consumer demand as well as working with other players — even non-health care providers — to create their own ecosystem and offer an expanded scope of services to users.

For example, there are some telehealth platforms that provide more than just teleconsultations. They also connect users to pharmacy, diagnostics and chronic disease management service providers as well as non-clinical services, such as weight management services, home workout coaches or even insurance advisors.

In addition, some non-clinical care providers have similar health and wellness digital ecosystems. For example, a global insurer’s digital ecosystem provides lifestyle offerings covering health and wellness services, while partnering with health care providers to provide telehealth. Hence, the insurer’s clients can seek medical consultation online, purchase prescribed medications and arrange for their delivery, book laboratory tests, get a second opinion from other physicians and schedule appointments at hospitals with a single mobile app.

Yet, as consumers benefit from more convenient and comprehensive services that address their health and lifestyle needs, there is a by-product of the entire process that needs careful management: data. More data than ever before will be generated and collected by, and on behalf of, individuals. 

As these providers and ecosystems create data with ease, the risks around technological, regulatory and cultural challenges associated with the ownership, sharing and usage of personal health data need to be considered. With partnerships on the rise — and some requiring data-sharing arrangements — this obviously increases the privacy and security risks for patients.

In Singapore, the National Electronic Health Record (NEHR) has been progressively deployed to both public and private health care institutions across the country to support the One Patient, One Health Record initiative since 2011. Owned by Singapore’s Ministry of Health and managed by the Government technology agency, Integrated Health Information Systems (IHiS), the NEHR system collects summary patient health records across different health care providers. This enables authorized health care professionals to have a holistic and longitudinal view of their patients’ health care history as well as provides data security for individuals. 

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Digital patient twin and enhanced health outcomes

Beyond current patient care, the integration of data from various health, lifestyle (such as wearables) and even social fronts has the potential for health authorities and policymakers to develop digital patient twins. With this digital twin, health authorities and policymakers can map health care situations against social determinants, such as residential regions or postal codes, transportation networks, education levels, social statuses and availability of food and resources, to gain better insights for population health planning and management. 

 

For example, with the integrated data, authorities may be able to identify that chronic diabetes is not well managed in a particular residential district vis-à-vis others, and determine if more resources, education or facilities are needed to improve disease management in the region. Governments and health care authorities in countries like the UK are already exploring this. Importantly, as the various data points needed to compile the digital patient twin reside in different government agencies, strict policies to safeguard privacy need to be in place during data transfer.

 

Currently, health care authorities in Thailand and Indonesia are using telehealth to monitor COVID-19 patients in home isolation. Even when the pandemic eases, telehealth is expected to stay — although utilization will shift toward a hybrid model of care.

 

For chronic disease management in particular, health care providers will be able to continue providing in-person consultations but follow up with more regular monitoring via telehealth. For mental wellness management, where patients may be reluctant to seek treatment due to stigma or lack of access, telehealth can make consultation and treatment easier for them. 

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Lessons to be learned

A centralized or connected health record system requires a regulatory framework on sharing of electronic health records as well as strong government support and investment in a centrally managed system.

 

A critical element for a connected health system infrastructure is good data governance to establish user trust, privacy and security. This system-level infrastructure will serve a three-part purpose: safe clinical care, appropriate automation of clinical and back-office operations, and the delivery of personalized care and prevention.

 

Lessons from other industries are insightful. Open banking, for example, caused a significant shift in the financial sector. Built on strengthening consumers’ control of their own data, open banking has allowed secure and authorized sharing of financial data with accredited third parties through application programming interfaces.

 

The challenge is creating a ubiquitous IT infrastructure built on data persistence, extensibility and true interoperability. This requires a networked, modular information framework between public and private health care providers and related agencies and their ecosystem partners.

 

Such a sizable ambition has its challenges. In Singapore, for example, integrating data from wearable health devices and mobile apps into the NEHR system requires meeting stringent technical and security requirements, which can be difficult for smaller players.

 

Another major consideration is data confidentiality and security. Should any health and wellness provider fail, what will happen to the data held by these firms? In Singapore, the current Personal Data Protection Act 2012 will soon be enhanced with a data portability obligation. When this comes into force, individuals will be empowered to request an organization to transmit a copy of their personal data to another organization. This makes it more convenient for consumers, and service providers can provide more tailored services.

 

Such data portability comes with new challenges. For a start, many organizations currently do not have the ability to manage and protect sensitive health data. There are also regulatory concerns on protecting the personal and activity data as well as the methods to seek consent from individuals for data portability. Again, mitigating the issues will require a central data intermediary or standard platform for porting data. Equally important will be more programs to educate consumers.

 

Data portability, if done right, can drive business innovation and help fuel the new digital economy by lowering barriers to entry for new start-ups and allowing the provision of more targeted and personalized services.

 

There are numerous opportunities to leverage telehealth to enhance patient care and population health management. As the care model shifts toward incorporating health, lifestyles and wellness, policy attention needs to align governance and institutional factors with how public and private health care and wellness organizations and their ecosystem partners can effectively work together.   


Crucial elements of a centralized health record system include a regulatory framework on sharing information, strong government support, good data governance, data portability and programs to educate consumers.

Summary

Telehealth demand is expected to increase. While there are opportunities for combined health and wellness offerings on telehealth platforms, this requires careful data management through a centralized health record system.

As public and private health care providers collaborate with other ecosystem players to implement such a system, they must address several key elements to mitigate privacy and security risks. These include a regulatory framework on sharing information, robust government support and data governance, data portability as well as consumer education programs.

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Smart Health
Health
Government and Public Sector
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