War on Diabetes – How HealthTech can Help Win the Battle
Diabetes is one of the most burdensome diseases to affect mankind, given its prevalence and potentially devastating morbidity if not managed well.
The world is currently suffering a diabetes epidemic and Singapore/Asia are no exception. As much as 6% of Singapore’s healthcare spending (more than $1 billion a year) has been devoted to diabetes and its complications.
The prevalence of diabetes in Singapore has risen to 12.3% in 2013, from 8.2% in 2004 and 9% in 1998, surpassing other Asian countries (2013) such as Hong Kong (9.5%), Japan (7.5%) and Taiwan (9.8%), according to International Diabetes Federation.
Galen Growth Asia, Padang & Co and Access Health International have come together to examine ways in which HealthTech can assist the War on Diabetes, response to the Singapore government’s declaration of ‘War on Diabetes’.
We are just beginning to see Asian HealthTech companies tackling the problem (e.g. Holmusk, Health2Sync, Connected Health) and we believe the sector will develop with appropriate support from the ecosystem.
Payers and governments around the world are also beginning to recognise the potential for HealthTech to significantly enhance diabetes management, with resultant long term cost savings to healthcare systems and better patient outcomes.
HealthTech solutions in diabetes are effective primarily since they provide:
- Better management of the disease through closer monitoring of blood sugar levels as well as real-time measurements of diet, exercise and other lifestyle determinants of disease outcome.
- Feedback to patients and alerts to caregivers allowing earlier intervention in cases of poor management and higher levels of patient engagement, particularly if solutions incorporate social media/gaming principles which can be very effective in driving behaviour change (one of the key determinants of disease outcome for diabetes
Through a project launched in August 2016, Galen and our partners aim to identify reasons for limited adoption of HealthTech in diabetes, and to work with selected start-ups in the space to assist and accelerate adoption.
We have published an interim White Paper which describes the findings from our initial work and outlines the barriers to HealthTech adoption for diabetes.
In summary there are 3 broad areas where more work is needed to implement approaches to support maximal adoption and effectiveness of HealthTech approaches in diabetes:
- Defining successful approaches to drive behavioral change in an Asian cultural context
- Encouraging innovation in payment approaches incorporating HealthTech intervention based on increased patient self-responsibility for their own health
- Addressing fragmentation in the healthcare delivery system to support effective rollout of HealthTech approaches in diabetes management
The full report can be downloaded from www.galengrowth.asia/research/. In summary, for each of the 3 areas of recommendation:
- Driving Behavioral Change. Startups and the supporting ecosystem will need to better define patient segmentation, develop targeted communication approaches and incorporate Social Media and gaming-driven approaches to developing interfaces with patients to encourage behavioural change.
- Innovation in payment approaches incorporating HealthTech interventions will be needed to drive revenue models for emerging HealthTech companies in Asia. Current payment mechanisms are largely based on a fee-for-service, episodic, reimbursement model. Innovative approaches are needed which can be developed by insurance companies as they rethink their own business models, e.g. lower-cost insurance for patients if they adhere to wellness regimes – including HealthTech-enabled tighter self-management of their diabetes. It will be critical for governments and payors in Asia to develop long-term, system-based views of the health economics of HealthTech interventions as a basis for funding decisions. Payors in the US are moving rapidly down this route but experience in Asia is so far limited, and will need to be built up through pilots and fostering a deeper understanding of HealthTech among payors in Asia, coupled with product innovation in insurance.
- Achieving effective rollout of innovative HealthTech approaches in early stage diabetes will require coordination to overcome fragmentation in healthcare delivery systems in Singapore and other Asian countries. HealthTech approaches are well placed to provide such coordination, although innovative business models will need to be developed to align interests across healthcare providers.
HealthTech can address many of these issues by providing connectivity and coordination across the healthcare delivery systems. HealthTech startups and collaborators will need to work closely with healthcare providers to develop effective approaches to address these challenges. Again, business model innovation and structuring partnerships across the ecosystem will be key to driving future change.
Having laid out the challenges above, Galen Growth Asia, Padang & Co and Access Health International plan to coordinate various parties to catalyse the industry towards achieving tangible solutions. This will involve gaining insights into various pilot projects conducted in coming months by 3 start-up companies.
We plan to support this process through a working group of industry collaborators (including re/insurance companies, medical device companies, healthcare delivery organisations in addition to the 3 HealthTech startups).
We will share learnings and other issues as we go along, and engage others (e.g. regulators, governments, payors) in our discussion as our conclusions develop. We believe that a guided, industry-led approach is the way forward and hope to shape the future of HealthTech in Diabetes in Asia through this work.
Through a project launched in August 2016, Galen and our partners aim to identify reasons for limited adoption of HealthTech in diabetes, and to work with selected start-ups in the space to assist and accelerate adoption. This project is led by Dr Ronald Ling, a co-founder of Galen Growth Asia.
Authored by: Dr. Ronald Ling
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