Op-ed: Thai Healthcare in the Digital Age

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Author: Sutapa Amornvivat, Ph.D.
Published in Bangkok Post newspaper/ In Ponderland column 15 August 2018

A few weeks ago, I participated in a workshop to rethink the master plan for the Thailand Centre of Excellence in Life Sciences (TCELS), the committee of which I serve as a director. This reaffirmed my belief in Thailand's potential within the medical sciences and healthcare industry. As a country, we are already renowned as a medical service hub of Asia. With recent advancements in technology, we can further build on the strong foundations especially in the area of research and development (R&D).

The major breakthrough that could leapfrog the healthcare industry is the combination of two key technologies: Internet of Things (IoTs) and data analytics. These technologies are significantly complemented by the aggregation of data which provides a great source of information for medical research. These advances will have a resounding impact on modern society, and deserve consideration by the highest level of decision-makers.

The first key enabler that has fuelled the boom in data technology is the capability to collect new data, anytime, anywhere at a reasonable cost. More data on nearly every aspect of our everyday lives are constantly being collected than ever before.

This is made possible from advancements in sensor technology.

Today, it is likely that you are already walking around with a bundle of sensors. There are approximately 24 million smartphones in Thailand; each of which is equipped with an accelerometer, gyroscope, magnetometer, and several other sensors embedded in a tiny chip to collect our data and facilitate interactions with the phone.

The most widely adopted IoTs today, aside from smartphones, are perhaps wearable fitness trackers such as Fitbit and Garmin that can typically monitor movement, sleep cycles, and heart rates. The market for IoTs, especially in healthcare alone, is expected to reach US$163 billion within a few years from now, according to research by Accenture.

There are also advanced sensors dedicated for specific purposes, especially for monitoring of patients with chronic diseases such as cancer and diabetes. For example, iTBra is a dual breast patch that can monitor circadian metabolic changes in heat, correlated to cellular activity common in breast tumors.

Such devices allow for monitoring of our health data like never before. Moreover, as the size of these wearable devices shrinks even further to something implantable, injectable, or swallowable, they will become a part of daily life more easily. Earlier this year, scientists from China's National Centre for Nanoscience and Technology and Arizona State University jointly developed nanorobots that can enter the bloodstream to target cancerous cells.

In addition to the capability to collect data, advancements in data analytics are another key enabler that will help revolutionise the healthcare industry.

Artificial intelligence (AI) algorithms can find meaningful patterns from data streaming in from these devices. By detecting anomalies, AI can predict and warn users to take actions pre-emptively. These changes in technology trends will allow us to move from a "sick-care", where we respond passively to our symptoms, to true healthcare.

Aggregating data will be crucial in connecting the dots for better healthcare. At the individual level, Apple's Health app on iPhone demonstrates an example of data aggregation from its built-in sensors and IoT devices and presents the data in a way that help users engage in their own health and well-being. Healthcare providers, including Thai hospitals, are moving towards better data aggregation with Electronic Medical Records (EMR).

Beyond the individual level, aggregation of health data can lead to strong value creation especially in research. For example, accumulated data from patients can be used to reveal information for drug discovery. Powered by AI algorithms, a pharmaceutical start-up, Berg, analyses the differences in patterns between mutated cells and healthy cells among cancer patients to develop a cure for pancreatic, breast and liver cancers.

Such tasks are not possible without massive amounts of data from many patients. Imagine what a well-structured data-sharing system for health research can offer. The Thai healthcare/medical research community will benefit greatly if these initiatives are implemented.

The sharing of health data will be key to future breakthroughs that can transform healthcare industry. The data, once anonymised and secured properly, should be thought of as public goods. We can focus on the technology that allows easy anonymisation and security such as blockchain.

Governments can also play a role of data aggregator by providing infrastructure. Initiatives like the government cloud can promote collaboration between healthcare providers, patients, and researchers into fruition. Certainly, the use of new technology does not come without risk and challenges. Laws regarding data privacy and security must be in place.

Last month, Singapore has just suffered a healthcare data breach of 1.5 million records. SingHealth, a major governmental healthcare group, was infected with malware from a single office workstation, which allowed the hackers to access the entire healthcare database. This is a wake-up call to companies who own sensitive customer data to step up measures in cyber-security.

After the incident, SingHealth imposed additional security measures such as Internet Surfing Separation — where internal staff networks are isolated from the wider internet which reduces the exposure of government healthcare data to cyberattacks. This case serves as an important lesson but should not be considered as a roadblock to long-term technological progress.

With more shared data, researchers can ask better questions and discover better solutions to our health problems, leading to an era of proactive healthcare.

Improved healthcare data infrastructure will benefit all players in the medical/health ecosystem — not just patients, but also doctors and researchers. By allowing more access to these data given proper governance, we have a chance to attract the top domestic and international talent to the industry. We need to admit we should not be too Thai-centric, and admit a talent shortage. A strong technological foundation will prove crucial in enticing the best professionals, and further expanding Thailand's position beyond the medical service hub of Asia into a research hub as well.

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