BMI Core View: Telecare will generate significant revenue in both developed and emerging markets. Growth in the number of mobile phone users and wireless subscribers and advances in the innovative application of communication technology will transform the delivery of healthcare across the world, providing significant opportunities to companies looking to invest in the telecare sector.
BMI defines telecare as the use of mobile and internet technology to provide clinical care and non-clinical services such as health education, disease surveillance and drug monitoring. It is our view that a number of factors - including the continued growth in demand for and delivery of healthcare, the continued growth in mobile and broadband subscribers and penetration rates, and the growing sophistication of the infrastructure of communication networks - are driving new opportunities in telecare across the globe.
The Australian government has announced the expansion of the national personally controlled electronic health record (PCEHR) to include pathology and diagnostic imaging results in the eHealth records of patients. Information such as blood test and X-ray results will be stored online once the functionality is launched in early 2014. PCEHR was introduced in July 2012 and has approximately 520,000 individual records.
We maintain our view that countries will increasingly implement e-health solutions to facilitate access to medical records, and to provide better medical care, as patients will not be required to remember many details prior to first consultations with a new doctor. BMI believes that there are a few criteria to successful implementation of eHealth:
Economic Development Level
Generally, we believe that countries with higher development levels will have more success in implementing their eHealth network, as they have the financial ability, infrastructure as well as the commitment to provide better healthcare services of the population. Some of these countries include Australia (where government health expenditure as a percent of the total reached 68.1% in 2012), South Korea (56.8%), Japan (80.0%) and New Zealand (83.3%). Singapore remains the only exception, where the government health expenditure only reached 30.6% of total health expenditure. We highlight that this is due to its 3M policy (Medisave, Medishield and Medifund), where the population generally contributes to the bulk of their own healthcare expenses.
On a related note, due to rising development, we highlight that developed countries will have the necessary infrastructure to implement their eHealth network. While seemingly simple, the use and maintenance of eHealth requires various considerations including the security of the system, the ability for medical professionals and patients to access their records at all times, seamless integration between different eHealth software providers, as well as the ability of the system to contain sensitive medical records for a large population. Given that there are no data for these criteria, BMI uses the number of internet users as a proxy as it highlights connectivity within the country. In 2012, we highlight that developed Asia Pacific countries topped the chart in having the most number of internet users per 100 inhabitants; with the high penetration rates, there will be a greater acceptability of and higher accessibility to eHealth systems.
| Higher Connectivity In Developed Countries |
|Number Of Internet Users Per 100 Inhabitants|
Select Countries With Some Form Of eHealth
In April 2011, the first phase of its US$144mn national electronic health record (NEHR) system went live. The first phase was expected to be completed in June 2012, however the roll-out is still ongoing, indicating slight difficulties in moving to the next phase. The contract was awarded to three companies - Accenture, Oracle and Orion Health. According to a May 2013 parliamentary response, Singapore's Minister of Health Gan Kim Yong stated that SGD172mn (US$136mn) had been spent on NEHR phase one to date, and the annual maintenance costs of the system amount to SGD20mn (US$15.8mn). The country initially aimed roll out the system in 2010, but it was delayed until April 2011. We highlight that if a country like Singapore with a small population of 5mn experiences difficulties in introducing NEHR, such delays will be even more common for countries with larger populations.
Australia's former health minister, Nicola Roxon, unveiled an AUD$467mn (US$480mn) e-health plan in September 2011. Under the programme, Australians will be able to opt for a PCEHR from July 2012, which allows them to control which healthcare providers are able to see their information. Through separate web portals, patients and medical professionals from both the private and public sectors can access information when permitted by patients. The system was implemented in 2012; however, with only 520,000 patients on the scheme, it covers just 2.3% of the Australian population.
The national health IT plan was published in 2010, involving two phases. The first phase is to promote the increased use of health IT among healthcare organisations, allowing various functions such as easy access to health information and transfer of this information between healthcare organisations, while phase two will deliver a shared care capability covering a patient's past medical records, a care plan for the patient's future course of care and decision support to deliver optimal delivery of care.
According to the National IT Health Board, as of April 2013, the majority of the district health boards (DHBs) are either operating a local IT solution that is aligned with the agreed regional solution, or are already operating on the agreed regional solution. However, some DHBs do not appear to operate any supported IT solutions.
The Philippines announced its plans to deliver rural ehealth services in August 2011. Together with SmartCommunications, the Philippines Department of Health will implement a Secured Health Information Network and Exchange (SHINE) to boost healthcare delivery by cutting the time spent documenting patients' data. Under the programme, health workers will be able to access patient data through mobile phones equipped with the SHINE system.
According to a 2012 presentation by the Philippines Department of Science and Technology, the country has an eHealth Strategic Framework (2010-2016) which seeks to establish frameworks for the implementation of eHealth to ultimately allow dissemination of health information to citizens and medical care providers.
The country implemented a form of eHealth between 1991 and 1995 that is designed to manage drug inventory and health management information reporting among other processes. Hospital Selayang was designed to have a Total Hospital Information System (THIS) system where it aimed to be a paperless and filmless hospital. However, according to Dr Ilias Adam Yee from the Health Informatics Centre at the Ministry of Health, integration became a problem whenever IT vendors updated their applications. The country aimed to have THIS for all government-owned hospitals by 2020.