Heralding in a New Healthcare Ecosystem
    Category: Health is Wealth By : Rhenu Bhuller, Frost & Sullivan Read : 961 Date : Tuesday, August 11, 2015 - 20:42:14

    The prevailing assumption is that as healthcare systems seek to adjust to financial pressures, trade-offs must be made with regards to new treatments and advances. The reality is that, without having to make many sacrifices, there is much wasteful spending that could be eliminated, and thus save the healthcare systems in most countries millions if not billions of dollars.

    Transformations Require Evolution of Business Models
    Change in the healthcare industry has historically been slow to enact due to a complex ecosystem of stakeholders ingrained in legacy systems and methods of operation. The patient experience within the healthcare system has largely remained unchanged over the past century. The assembly line-like handoff of patients between different types of clinical specialties and care facilities has rendered a system that is often redundant, in some cases contradictory, and highly inefficient. Financial pressures and other shifts are now accelerating the pace of change, and heightening the need to adapt. Staged and episodic disease management is becoming increasingly unviable and integrated models can ensure synchronization regarding patient and care providers.

    Six Big Themes for Healthcare
    1. Modernizing Care Delivery:
    Clinical practice needs to move faster from intuition-based decisions to more analytics and data based approaches.
    2. Rethinking the Customer: Patients can no longer be passive participants in the process, but need to take responsibility for their health from a preventive perspective, and interact more with their physicians on treatment choices to ensure a fit with their needs and compliance.
    3. Companies Revamping Strategies: Many industry participants cannot maintain viability without significantly changing their business model due to changes in the way healthcare spending is being controlled.
    4. Role of New Participants: The emergence of IT based tools and services encourage the rise of a new breed of competitors, especially for healthcare wearables and health monitoring.
    5. Who Pays? The spiraling costs of care to government and private payors is forcing the launch of new models for payment of healthcare services and products that requires consumers to make decisions on priority health areas and improved preventive healthcare strategies.
    6. New Partnerships: An industry has long operated in distinct silos is now being forced to integrate as healthcare gets delivered across platforms that may not necessarily be hospital based, and thus leading firms to seek new types of partnerships and collaborations.

    Implications for Indonesia
    These issues are increasingly becoming more relevant for Indonesia, with total population expected to reach 272 million by 2019, and total healthcare expenditure estimated to be close to $70 billion by 2019, a CAGR of 14.5% (2014 to 2019). Some of the key trends Frost & Sullivan predicts in Indonesia for 2015/2016 are:
    1. Jaminan Kesehatan Nasional (JKN) will boost all segments of the healthcare market. Demand for healthcare services, earlier disease screening, advanced medical technologies for early diagnosis, and low cost, high quality efficacious medicines for treatment will continue to accelerate as more patients get access to healthcare through the JKN. The already scarce medical professionals  (doctors and paramedical staff) which are way below the global and OECD averages, will be put under pressure by the burden of the increasing number of JKN patients requiring the use of technology to overcome the resource constraints.
    2. Private hospitals will move beyond key cities; nonconventional players will enter the market. The demand for hospital beds, especially outside greater Jakarta area, cannot be addressed by public hospitals alone—hence private hospitals will expand beyond the key cities to capture these new markets. More international as well as local investments are likely to be made in Indonesia, not only from the traditional healthcare services providers (hospitals), but also from unconventional players that want to diversify.
    3. Medical device companies will form PPPs to improve patient access and expand its products’ reach. Medical device companies will adopt collaborative business models to penetrate the rural markets with remote patient monitoring and tele-health devices that can improve patient access and increase awareness and reach of their products. Remote monitoring will be one of the key areas of implementation of such services that can improve access efficiently and cost effectively.
    4. The pharmaceutical market will be driven by the demand for generics and vaccines. With the need to cover almost a quarter of a billion people, the use of generics under the JKN is a cost effective measure. Local pharmaceutical companies have increased capacity to cope with the expected demand. Patients need to be educated on the importance of compliance to ensure non-wastage and continued care.
    5. The clinical diagnostics market will be driven by increased demand for basic tests covered by the JKN. The JKN covers first-level, referrals and advanced healthcare services at all health facilities that collaborate with BPJS Health. First-level outpatient services covered under JKH are simple laboratory diagnostic tests (blood tests, urine tests, stool tests and blood glucose) and early screening, which can help drive preventive health.

    On the patient side, an ownership of health in prevention and follow-on care when required will all lead to greater efficiency in healthcare spending and that of the overall population.