Shifting demographics will require a new approach to healthcare in Asia

Victims of Our Own Success

When we think of Asia, words such as frenetic, fast-paced, and bustling usually come to mind. Rapid urbanization has indeed created vibrant marketplaces and rising economies.  However, implicit within this growth has been an observed increase in non-communicable diseases and associated chronic illness.  Shifting socioeconomic demographics (i.e. psychological stress of an increasingly urbanized population, increasing economic freedom with access to unhealthy lifestyle choices such as smoking/alcohol abuse/illicit drug use, westernized diets, and physical inactivity) have largely contributed to this observed phenomenon.  Moreover, the increased prevalence of non-communicable diseases such as coronary atherosclerotic disease and heart failure have become a leading cause of death in Asia. 

An Expanding, Aging Asian Population with Capacity Gaps in Health Care Access

According to a UN DESA (United Nations Department of Economic and Social Affairs) report, the world's population is expected to increase (from 7.3 billion) to 8.5 billion by 2030, 9.7 billion by 2050, and 11.2 billion by 2100.  This increase will be disproportionately higher in Asia.  Moreover, by 2025 about a quarter of Asia’s 3.7 billion population will be over the age of 50 years.  For example, in Singapore the population aged above 50 years has doubled in the past 2 decades. As older patients live longer, the disease complexity and associated co-morbidities will promulgate a greater demand for longitudinal support from health care systems: Both preventative and therapeutic.

The increasing demands on health care systems throughout Asia could expose capacity gaps that currently exist.  This will pose challenges to governments throughout the region as they endeavor to seek equipoise between maintaining federal budget neutrality and expanding health care access for their citizens.  Alternative strategies that hitherto were not traditionally entertained might now have to be considered.  To that end, it is highly plausible that more support and collaboration between multiple stakeholders might be required than has been traditionally observed in other regions of the world. This includes, but is not limited to, public-private partnerships.  Finally, it will be incumbent upon Asian regional medical professional societies, industry trade associations (such as the Asia Pacific Medical Technology Association) and patient advocacy groups to play a larger role in collaborating and engaging with public health authorities to mobilize and facilitate the required change.

A Brave New World:  Digitizing Health Care To Improve Patient Outcomes

The wellness of populations across Asia could be greatly enhanced with the adoption of effective decision-making paradigms that facilitate responsible therapy access to patients in a timely manner.  Through public-private partnerships, disruptive e-platform technologies could help educate health care providers and guide patient treatment paradigms.  Prudent adoption of these cost-effective platforms would provide an essential construct to help track, quantitatively measure, and improve the quality and efficiency of medical care.

The market for digital healthcare applications is expected to achieve rapid growth globally, with a compound annual growth rate of 42% through 2021. In the United States under provisions mandated by the Affordable Care Act, performance measures focused on patient clinical outcomes will become mandated through digital online registries.  Analytics and data collected from these online platforms could profoundly influence patient care paradigms in rapid fashion with real-time reporting of actionable data metrics to clinicians, individual hospitals, or hospital networks.  This system provides a mechanism to mitigate fraud, waste, and abuse while potentially reducing treatment costs for unnecessary hospital procedures and prolonged hospitalizations due to patient complications.  Moreover, these platforms would serve as a compelling foundational tool in developing evidence-based paradigms for best medical practices, provide real-time actionable feedback to stakeholders (industry, hospitals, health care providers), and improve quality of care and outcomes.  Incorporation of such nationwide digital platforms in markets throughout Asia will require public-private partnerships.

A recent white paper published by McKinsey and the Asia-Pacific Medical Technology Association (APACMed) identified professional education and procedural training of health care providers as a significant gap in Asia. As such, health care firms are currently developing e-training/e-proctoring platforms for health care providers to address this ostensible gap.  One example is the EDUCARE Virtual Training Institute (VTI) developed by Boston Scientific, used to complement a comprehensive procedural training paradigm for physicians across multiple sub-specialities in medicine.

With developed markets (such as Singapore) anticipating significant growth in healthcare workers by 2020, online education platforms could putatively enhance training programs across the health care continuum by providing on-demand access to training. Such platforms can be tailored to the personalized needs of a health care provider while providing real-time support to potentially improve patient outcomes.  For instance, the VTI has become a comprehensive and holistic knowledge resource repository for physicians across 4 continents (Asia, Australia, Middle East/Africa, Europe).  In addition to physician-contributed content, it has aggregated commercially neutral disease-state specific procedural training curricula. The platform includes procedural videos and animations, clinical case studies, therapy and disease-state focused presentations, medical news highlights, clinical abstracts and recorded/live webcasts at marquis regional and international medical conferences.  Through effective implementation of this digital platform in Boston Scientific's EDUCARE professional education program, over 16,000 physicians were trained across Asia, Australia, Middle East, and Africa in 2016.

Shifting demographics with an associated exponential increase in illness will mandate an acceleration in a collaborative paradigm. Public-private partnerships, a notion considered anathema to some in academic medicine or government institutions, will undoubtedly be the cornerstone to take us to that next epoch in medical care. We are indeed approaching a brave new world in medicine: Digitization of Healthcare, Genotype-specific targeted therapies, Stem Cell Transplantation, Microrobotics (miniature robots <1mm in size that will repair healthy or attack deadly cells), etc. When asked about his voyage westward in search of Indian spices and discovering the Americas, Columbus responded, "Following the light of the Sun, we left the Old World".

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