Roy Chiang

In this webinar, insights were gained on the steps Taiwan has taken towards creating a cohesive digital healthcare ecosystem as well as what is required to create a strong foundation in digital health.

Upon its completion, the platform will first be used by policyholders from participating insurer Great Eastern in a pilot before being scaled nationwide.

Space 95 – an IT services company in Seychelles – has launched "Contak", a contact tracing app that will enable users to register places they have visited. Contact tracers at the Public Health Authority can leverage the app to better track individuals who might have been exposed to COVID-19. Public Health Commissioner Jude Gedeon mentioned in a press conference that the Ministry of Health "welcomes this app and is working closely with the developers". HOW IT WORKS At present, the app can only be downloaded from Google Play through an Android phone. A version that is compatible with iOS devices will be released later. Personal information such as an individual’s name, contact number, and National Identification Number must be provided during the registration process.  Users of the app will need to scan a QR code at the entrance of a venue. Alternatively, a door attendant will scan the app-generated QR code of the user or the QR code of other individuals whom the user has frequent contact with. Once the QR code has been scanned, the information will be safely stored and encrypted on the smartphone. Only the user will be able to gain access to this information.  Those who do not own a smartphone can have another person register their personal details on the app and print a personal QR code for them. Similarly, a person can obtain a QR code ID card supplied by the PHA. Individuals who have tested positive for COVID-19 can share their stsatus through the app to inform health authorities, and others who were at the same location as them will receive an alert. This allows for groups of people to be alerted much more quickly if they have been in close contact with someone who has tested positive for the virus. WHY IT MATTERS Currently, Seychelles citizens will need to call the MOH to alert officials that they are a potential contact. Contact tracers will then evaluate the situation to determine if they were a close contact before letting them know what the next steps are. The app will be able to complement the Seychelles government’s contact tracing efforts.  Andy Noel, Chief Operations Officer at Space 95 mentioned that some of the problems encountered with traditional contact tracing include people being unable to accurately recall all the places that they have been to or people providing false information in visitors' logbooks as there is a lack of privacy. THE LARGER TREND To help mitigate the spread of this virus, many nations have developed contact tracing and warning apps. These apps have helped health authorities to swiftly isolate individuals who have come into contact with those who have tested positive for the virus. Healthcare providers have increasingly been developing ways to simplify the contact tracing process using technology, such as the Methodist Hospital of Southern California using an automated contact tracing system. ON THE RECORD "If you are found to be positive with COVID-19, one simply needs to go to the app and upload the diary to the health agency using Wi-Fi or internet data. This information is uploaded to a server at Department of Information, Technology and Communication, allowing the relevant authority to access the information. Someone who has scanned the same poster the same time as you will receive an alert, letting them know that they are potential contacts," Noel said.

Digital health group Cardihab has partnered with Tasmania’s health department and the Royal Flying Doctor Service, an aeromedical organisation, to roll out its Cardihab app in public hospitals throughout the state. The app will enable patients in Tasmania with heart disease to undergo rehabilitation programmes and receive medical advice at home through weekly phone calls and video consultations.  WHY IT MATTERS Cardiac disease is the leading cause of death in Tasmania, with its fatality rate higher than the national average by 9.8 deaths per 100,000 people. A study by RFDS researchers also showed that Australians living in rural areas are 1.6 times more susceptible to be hospitalised for coronary heart disease and 1.3 times more likely to die as compared to their counterparts who reside in urban developments. RFDS also released another statement stating that four out of five deaths resulting from premature cardiac disease could be prevented if there were cardiac rehabilitation services available in rural areas. THE LARGER TREND COVID-19 has accelerated how healthcare organisations can leverage virtual care to keep people safe during a highly contagious pandemic. Increasingly, healthcare providers have also been coming up with innovative solutions to care for patients in rural areas who may not be able to access health services easily. In the United States for example, Abbott updated its app-based neuromodulation platform with remote programming to enable in-app live video conversations with chronic pain and movement disorder patients, as well as prescribe new settings for their neuromodulation therapies from afar. ON THE RECORD "It is an ideal solution for people whose busy lives prohibit them from attending traditional face-to-face clinics, people living in remote areas, patients who are less mobile and throughout COVID-19," said Helen Souris, Chief Executive of Cardihab.  John Kirwan, Chief Executive of RFDS in Tasmania further explained how the use of such rehabilitation programmes would grant greater accessibility and open up more options for “those who would ignore rehab due to barriers of time, cost and distance.”  

In February, Qantas completed a trial run of the CommonPass Digital Health app on an international repatriation flight from Frankfurt to Darwin. Through the use of this app, health or border officials and airline staff will be able to easily verify COVID-19 test results and vaccination history of an individual.  The app links customers with certified testing labs to allow their results to be automatically uploaded onto it. In accordance with stipulations made by the federal government, customers would have to first show proof of a negative COVID-19 test result to board repatriation flights on Qantas.  Stephanie Tully, Qantas Group’s Chief Customer Officer said, “We want to get our international flights back in the air and our people back to work, and a digital health pass will be a key part of that.” WHY IT MATTERS As mass vaccination programmes are being rolled out globally, vaccine passports have become a major topic of discussion. Countries will need to look at convenient and secure ways for verifying COVID-19 test results and vaccination information at airports and borders. The International Air Transport Association (IATA) has also called for a “global standard to securely record digital proof of vaccination”.   THE LARGER TREND Similar digital solutions are being developed in several other countries around the world to enable travel again. For instance, travellers from Singapore will receive a notarized certificate following a negative COVID-19 test that they can present at airports around the world. Another example is France taking part in a month-long trial of a vaccine passport that leverages a smart phone app.  ON THE RECORD Tully added, “COVID test results and proof of vaccine will be required in many countries for quarantine-free travel, just as it has been for polio and yellow fever vaccinations in the past. Ultimately, we’re focused on ensuring that the process will be as seamless as possible for our customers to share this information so they can travel internationally again.” Paul Meyer, CEO of The Commons Project Foundation, shared, “As we initiate the upcoming trials with Qantas, we aim to provide Australians with a secure, private and trusted experience as they return to their home country.” 

A study conducted in December 2020 by TheCareSide, a home healthcare provider in Australia, found that a majority of the respondents anticipated receiving the COVID-19 vaccine. The survey saw 1122 Australians being interviewed to find out more about acceptance levels of the COVID-19 vaccine among the general public in Australia, with 69% of them interested in getting vaccinated. “Our research suggests the country is in a strong position as the vaccines roll out. The overwhelming majority of Australians plan to get vaccinated and believe the national government has done a good job of managing the pandemic so far. This is good news for the whole country, but especially for the elderly and other vulnerable groups. The government's ongoing communication strategy will be critical to ensure that there's trust in the safety and efficacy of the vaccines,” said Gareth Mahon, CEO of CareSide. WHY IT MATTERS The elderly expressed the most interest in getting inoculated, with more than three out of four of them planning to do so. Young adults aged between 18 and 39 also demonstrated similar levels of interest, with 71% of them planning to receive the vaccine. For respondents aged 40-64 years old, the results indicated that only 57% of them wanted to receive the vaccine. In addition to the Pfizer and Astra Zeneca vaccines which have been officially approved for use in Australia in February 2021, ten other vaccines have also been approved globally. Australia has also fared relatively well in comparison to the majority of other developed countries, with only 29,000 diagnosed cases and 900 deaths in total so far. 79% of the participants also felt that the steps taken by the Australian government were effective in the handling of the COVID-19 situation. This sentiment was similar across all the ages groups – with 79% of those aged 18-39, 80% of those aged 40-64 and 73% of those 65 and older in agreement. THE LARGER TREND In a poll conducted by the University of Michigan during the final months of 2020, the results showed that nearly half of the older adults indicated that they were unsure about receiving the COVID-19 vaccination. However, in a subsequent poll, there was a huge shift in their attitudes, with 71% of respondents aged 50 and above indicating that they are willing to be inoculated. The results are consistent with the survey conducted by The CareSide, with older persons being more receptive to the vaccine as they are the most vulnerable to it. ON THE RECORD “Overcoming a global pandemic is as once in a generation challenge. It requires leadership at the macro level from the Australian government and international organizations like the WHO. But that alone isn't enough. It necessitates a community-wide effort from schools, local businesses, and volunteers. We all play a role – Australians have committed to prioritizing each others’ well-being over the last year,” said Gareth.

The healthcare landscape has transformed drastically over the years and we have found ourselves in a situation where both patients and consumers alike are becoming more engaged and involved in their own health. Consequently, this has given rise to a need to find a more personalised way of managing healthcare for each individual. In addition, the onset of the COVID-19 pandemic has also forced us to adapt and switch to utilising digital technology to treat medical conditions instead of delivering more traditional face to face episodic care. This further cemented the dire need for a sound digital infrastructure to cater to the differing healthcare needs of each individual.  A salient reason for the creation of a Personalised Health Index specifically in APAC was due to a need to measure the readiness of health systems across the region to embrace more tailored care as well as the learning which could be derived from this diversity. The Personalised Health Index is built on 4 different vital signs –policy context, health information, personalised technologies and health services. Measures are made based on these vital signs and calibrated across the different health systems. Through this, health systems can identify where they are performing and areas of opportunity to prioritise focus and resources for the most impact can be highlighted.  Rachel Frizberg, Area Head of Asia Pacific Roche Pharmaceuticals stated, “We need to reimagine a different healthcare system – one that allows the right treatment for the right patient at the right time. The Asia-Pacific Personalised Health Index helps create a data-driven dialogue about the areas where countries are performing well and where they might look to learn from others to improve their future readiness.” Such benchmarking encourages countries to have a deeper form of appreciation of the context, challenges as well as approaches of other countries which may in turn encourage collaboration.  LESSONS IN DIGITAL HEALTH FROM COVID-19 The pandemic has served to demonstrate to us how regulatory agility has proved to be crucial in allowing the swift approval of innovative vaccines whilst ensuring that the data used remains confidential and secure. Countries in the APAC region should take steps to embrace this “new normal” and support innovation as well as ensure that the digital infrastructure is in place to enable personalised care to be delivered to patients when there is a need for it.  ENABLING REGULATORY AGILITY TO PROVIDE GREATER PERSONALISED CARE IN THE APAC REGION While the Personalised Health Index encouragingly shows there has been progress by all countries in the region, there are factors which may still prove to be a hindrance to the enabling of more personalised care in APAC.  John Lim, Professor and Executive Director of Regulatory in Duke NUS explained that there is still insufficient regulatory knowledge and capacity throughout the region which is particularly important to realise the potential of data to inform personalised healthcare. Regulatory requirements also remain fragmented despite numerous years of harmonisation and convergence efforts largely because of individual country requirements. Regulatory science and policy innovation could also be improved amongst governments and industries in the APAC region.  An all-encompassing framework has to also be set up in order to better facilitate regulatory agility within APAC. Healthcare organisations require a strong sense of trust in their government which serves as an impetus for the adoption of innovative therapies as well as the advancement of personalised digital health and tele-health solutions. There should also be transparency between the governments and citizens when it comes to how this captured data will be used.  Training to expand the regulatory capabilities for therapeutic and policy innovations will be essential as well. Regulatory sandboxes have to be set up in order to allow for the testing of new implementation or systems within a country. For instance, in Singapore, telemedicine was already going through a sandbox approach prior to COVID-19 and the pandemic served to proliferate its use across the nation.  Trans-national bodies should also look to be established to help facilitate the coordination, collaboration and information exchange within APAC. This would have to be supported by robust cross-jurisdictional frameworks which promote interoperability and the easy exchange of data. Lastly, healthcare organisations have to act quickly in order to meet the needs of patients when providing personalised healthcare.  FUTURE OF PERSONALISED HEALTHCARE The greatest strengths in APAC lie in health information as well as its digital infrastructure which shows promising growth. However, there are still vast differences amongst countries in terms of their policy environments as well as their future plans for personalised healthcare. This is a clear indication of the existing differences in regulatory, innovation as well as implementation capacities between governments in the region. To establish a clear personalised healthcare ecosystem within APAC, nations should look to leverage their strong existing digital infrastructure to help them achieve regional data interoperability and develop regulations to aid in the implementation of personalised healthcare solutions in the years to come. Click here to watch a webinar discussing the potential of a personalised healthcare ecosystem and how a new policy tool—the Asia Pacific Personalised Healthcare (PHC) Index—is helping countries build more patient-centric and sustainable healthcare systems  

The Australian Digital Health Agency (ADHA) has publicly stated on 17 February that it has completed its final stages of integration between South Australia Health’s Sunrise Electrical Medical Records (EMR) and patient administration system (PAS) to the country’s My Health Record (MHR). This will grant healthcare providers the access and ability to upload information directly onto the MHR platform. An embedded tab within the Sunrise EMR provides clinicians with access to MHR which creates a unified view of a patient’s interactions across the health care system. This contains shared health summaries from general practitioners, pathology and imaging reports as well as prescription information from a patient’s visit both within South Australia and interstate. WHY IT MATTERS By providing a more holistic view of the patient’s past medical records as well as information on any medical care that was previously administered, clinicians will be able to provide more personalised medical care which would potentially translate into better patient outcomes. As a result of this integration, hospital staffs are also more willing to use MHR due to the easy availability of information. Previous research conducted in Australia showed that there was one omitted medicine from the medication history among every two patients who were admitted. These could ultimately result in disastrous outcomes for the patient if a new caregiver were to take over and provide medical attention to the patient without being fully cognizant of the patient’s medical history. Being able to fully access the patient’s medical records would allow for them to provide more appropriate medical care and prevent such situations from occurring. THE LARGER TREND The demands and pressure put on healthcare organisations have been rising steadily over the years as we progress in this digital era. There has been a shift towards providing more patient-centred care as well as empowering patients. Patients are expecting more personalised medical care and want to be more involved in their own treatments and be kept in the loop about issues pertaining to their health. Through the integration of EMR and MHR, both medical experts, as well as patients, can have easier access to their medical history, allowing them to be more informed. ON THE RECORD “South Australian patients will now benefit from the improved handover of care as a result of access to information spanning their health journey and a reduction in user errors by having a solution that enforces patient context,” explained Cattermole, the CEO of Australian Digital Health Agency. “The transient nature of these patients, past history in human services guardianship, and limited trust in the system mean the records we have access to within the hospital and local health network only represent a fraction of their medical history. The MHR tab has created a single view of the patient’s encounters with different parts of the health care systems and networks in SA and Interstate” Tracie Nikolai, Associate Nurse Unit Manager and Clinical Documentation Specialist at Port Augusta Hospital elaborated.

The Commonwealth booking platform will be used by the Department of Health as part of the COVID-19 vaccination info and booking service

Clinicians can have ready access to an online platform that facilitates the upload of COVID-19 vaccination records to the Australian Immunisation Register