'Converge' Report - The disruption of Healthcare in Southeast Asia

Converge - The disruption of healthcare in SEA
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Converge
The disruption of healthcare in SEA
January 2019

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About
Converge
Converge is a series of reports by Deloitte Southeast Asia
Innovation that provides insights into the technology trends and
startup ecosystem in Southeast Asia1
.
Each report provides a snapshot of the upcoming technology
trends in a particular sector and introduces promising startups
that are driving new ideas and taking on challenges that are unique
to Southeast Asia.
Join us in discovering interesting and potentially disruptive startups
and initiatives across a myriad of industries, and feel the pulse of
Southeast Asia’s thriving digital revolution!
Who the report is for:
• Corporations exploring innovation capabilities and startup
engagement
• Individuals who are keen to understand technology and
innovation trends driven by the startup ecosystem in
Southeast Asia
About Deloitte Southeast Asia Innovation
Deloitte Southeast Asia (SEA) Innovation is a cross-function, cross-
country innovation unit dedicated to driving the innovation agenda
as a culture and value creator across the region.
Have feedback on Converge? Drop us a note at
SEAinnovation@deloitte.com!
Footnote 1
Limitations: While we try our best to ensure that this report is up-to-date and
is accurate in the presentation of trends as of the date of publication, there
are some limitations to this report. Some startups choose not to disclose their
funding rounds and/ or funding amounts. As such, the data might not reflect the
exact situation.
Sources: This report draws from startup databases such as Tracxn, Crunchbase,
and Tech in Asia, e27, as well as reported data from local, regional and global
news sources, and respective company websites.

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With a diverse demography that lies across a wide
socio-economic spectrum, Southeast Asia is a
fragmented healthcare market. While healthcare
infrastructure and the availability of medical
professionals are lacking in some countries, this region
has its more developed countries like Singapore as well
(see Figure 1).
One thing that the region does share is the
unstoppable march towards progress and
digitalisation. Much has been said about the
phenomenal growth of mobile internet and
smartphone adoption in Southeast Asia, which has
emerged as one of the first mobile-first internet
regions in the world. This has fueled new business
models and consumer habits through e-commerce,
ride-sharing and other mobile internet-enabled
arrangements that mark a new age of economy, with
Indonesia at the helm. According to research by Google
and Temasek, the Indonesian internet economy is
poised to grow to US$100 billion by 2025, up from the
US$27 billion clocked for 2018, which is already more
than three times that of 2015 (see Graph 1).
These same influences are affecting the healthcare
industry in this region. Non-traditional healthcare
companies now exist in the form of technology
and data-driven startups. Southeast Asia may not
feature prominently across the full spectrum of global
emerging technology trends affecting healthcare in
areas like robotic surgery, immunotherapy or CRISPR,
but in areas where disruptions in healthcare provision
and delivery models are noticeable, the promise of
impact is no less powerful.
In this report, we take a snapshot of what some
startups and players in this region are doing that are
paving the way for a digital healthcare revolution. While
some offer locally-relevant products and services to fill
healthcare provision needs, those with a core rooted in
data and technological solutions get to aspire to scale
beyond their shores.
Figure 1: Density of Physicians Per 1000 Population
Germany
2015
USA
2014
China
2015
Cambodia
2014
4.191 2.568 1.812 0.143
Indonesia
2012
0.201
Thailand
2015
0.47
The Philippines
2004
1.11
Malaysia
2015
1.533
Singapore
2016
2.276
Country (Year Reported) Density Of Physicians per 1000 Population
Source: World Health Organisation
Density Of Physicians per 1000 PopulationCountry (Year Reported)

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Graph 1
As is the case in many other industries, the
advancements and affordability of telecommunication
technology for the consumers have been game-
changing for businesses. While the idea of consulting
with a doctor over the phone is not new, the ease at
which medical professionals can now conduct app-
based medical consultations remotely with patients
through messaging, voice calls and video conferencing.
Stacked together with other incidental consumer-facing
businesses that are enabled by the same efficacy
of modern communication technology, telehealth
startups that are providing services that are integrated
more horizontally have emerged in Southeast Asia
(Table 1), providing users a rich network of ancillary
services beyond the provision of medical advice.
Startup spotlight: Halodoc
Riding on change, changing the game for
doctors, pharmacies and insurers
Halodoc, a telehealth startup, facilitates several
thousand consultations a day between their
base of 2 million users and 20,000 doctors
in Indonesia. Beyond that, they are also
partnered with 1000 pharmacies and ride-
hailing behemoth Go-Jek, bridging physical
distances by providing medicine delivery. To
facilitate payment, they have also linked up with
insurance companies so that users can pay for
these services from existing health policies.1
Will this be the platform upon which doctors
set up clinics in the future, and how will this
affect the supply chains and arrangements with
pharmacies, insurers and other players in
the ecosystem?
Source: e-Conomy SEA 2018 Southeast Asia’s internet economy hits an inflection point, Google and Temasek (2018)
SEA Internet economy market size (GMV,$B)
28%
100B
27B
8B
5B
8B
5B2B
21B 21B 22B
43B
12B
7B 6B
9B
33B
3B
10B
49%
MalaysiaIndonesia SingaporePhilippines Thailand Vietnam
19%
16%
25% 13%
22%
25%
35%27%16%30%
2015 2018 2025 CAGR
The clinic is changing-
Telehealth and beyond

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Table 1: Telehealth and beyond— The Clinic of Tomorrow?
Startup Description Main
countries of
operations
Year
founded
Funding
MyDoc
https://www.my-doc.com/
MyDoc provides an integrated
online-to-offline platform that
streamlines all aspects of primary
healthcare into one easy-to-use
solution connecting patients to
doctors, pharmacies, diagnostic
laboratories, clinical-grade health
trackers, Fortune 500 and SME
employers, and insurers.
Singapore 2012
Series A -
6.8M USD
BookDoc
https://www.bookdoc.com/
BookDoc has an integrated
online ecosystem that allows
users to search and book
healthcare professionals, and
integrates with navigation,
transport, accommodation and
recommended restaurants and
attractions systems for a hassle-
free and enjoyable experience
to healthcare appointments.
Users can also earn rewards
and discounts from major retail
partners and service providers
for maintaining a healthy and
active lifestyle.
Malaysia,
Singapore,
Indonesia,
Hong Kong,
Thailand
2015 Undisclosed
Alodokter
https://www.alodokter.com/
Alodokter is looking to build an
integrated healthcare service
for users. It currently provides
Indonesia with a web and
app platform with the latest
health content, an interface to
consult with doctors, an online
platform to search for medical
service providers and to book
appointments.
Indonesia,
Thailand
(under
Pobpad.com)
2014
Series B –
12.1M USD
Halodoc
https://www.halodoc.com/
Halodoc is a healthcare network
platform connecting licenses
doctors to patients, as well as
to certified partner pharmacies
and licensed medical laboratory
services. Users can communicate
with these medical professionals
via chat, video and voice call.
Indonesia 2016
Series A -
13M USD
Source: Crunchbase, respective company websites.

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Specialist services and medical tourism
This same technology enabler raising the game for
general medical consultation is also doing so for
medical tourism and specialist services.
Startups are stepping into the fore to streamline
the process of helping well-heeled and increasingly
demanding customers get information and make
choices about getting the best niche medical
services for their needs. Discovery portals like
Medical Departures in Thailand provide reviews and
comparisons of packages by various providers for
different treatments for their users to consider, while
DocDoc from Singapore dives deeper into clinical
informatics and healthcare quality assessment to
recommend the right doctor for specific ailments, with
the help of artificial intelligence. Both startups boast of
a wide network of doctors in different specialisations
across many countries.
Startup spotlight: Medifi
A founder’s story: turning pain points
into cures
Born out of the founder’s personal difficulties
consulting with his USA-based doctor while
in the Philippines, Medifi is a startup that
gathers doctors from all over the world onto
its platform and provides a suite of telehealth
solutions to facilitate preliminary consultations
and post-treatment follow-ups, including
medical imaging management and health
profiling of patients. Medifi is also linking up
with popular health and wellness trackers to
automatically and accurately track vital signs,
bringing the industry of wearables into its fold
as well.2

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countries of
operations
Year
founded
Funding
Medical Departures
https://
www.medicaldepartures.com/
Medical Departures
is a medical service
marketplace that helps
patients find, compare and
book medical appointments
around the world.
Thailand 2014
Series A –
2.5M USD
DocDoc
https://www.docdoc.com/
With a network of more
than 23,000 contracted
doctors and extensive
proprietary data on
outcome, price, and
experience, DocDoc helps
patients find the highest
quality care for their
unique medical needs with
their artificial intelligence
powered doctor
discovery engine.
Singapore,
Indonesia,
Hong Kong,
The Philippines
2012
Series
B- 14.1M
USD
Medifi
https://medifi.com/
Medifi delivers remote
medical diagnostic
solutions through an online
platform that connects
medical professionals to
patients. Their platform
features include health
profile management
for patients, video
consultations, and medical
imaging support.
The Philippines 2014
Seed –
0.5M USD
Table 2: Telehealth and beyond— Finding specialist services
Source: Crunchbase, respective company websites

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While improvements to the telehealth industry mean
avoiding painful traffic jams that are common in the
major cities, or getting the best healthcare services
from abroad, it is humbling to remember that this new
format of clinics may well be the first access to formal
healthcare for some others, especially in countries
facing a scarcity of doctors.
For healthcare services providers, improvements
in telehealth services mean that they now have a
wider reach to patients and customers, with more
touchpoints and communication channels beyond
the physical clinic.
This means more data points and logistics to manage,
but when properly utilised, the hope is that they can
better manage and optimise resources for a better
workflow and for patient experience, thus elevating
the overall level of healthcare services in their
widened community.

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The Internet of Things (IoT) has made it possible for
practically anything to be transformed into a digital
touchpoint. From consumer wearable devices like
fitness trackers and smartwatches, to medical devices
like patient implants or even hospital equipment, there
is a great wealth of healthcare and even lifestyle data
being generated and waiting to be tapped on by
the market.
While the adoption of smart devices across Southeast
Asia is not as yet as widespread as in more developed
IoT markets like China and USA, the nature and value of
data easily transcend geographical boundaries, freeing
data solution providers within the healthcare sector
from the constraints of physical geography.
Most of the noteworthy solutions from startups
emerging from this region are linked to Singapore, and
they are collecting, processing and harnessing value
from data from all over the world, for users and for
science alike.
Startup spotlight: Healint
Leading the world on migraine matters
Singapore-based Healint is a startup that
develops applications to help users track
symptoms for neurological conditions and for
clinical trials. With 300 million health events
recorded, Healint’s data provides real-time
insights not just to patients and their doctors
on individual conditions, but also to healthcare
industry players that seek to understand
population-based trends as well.
One of Healint’s products is the Migraine Buddy
application, which has about 1 million registered
users. In June 2018, Healint and pharmaceutical
giant Novartis presented a study on the
impact of migraine on work productivity at the
Fourth Congress of the European Academy of
Neurology, based on user-reported data from
the Migraine Buddy application. Extending
from that, they shared new insights on the
US migraine user base, noting that chronic
migraines may induce anxiety and depression,
instead of the other way around as more
commonly thought.3
Startup spotlight: UCARE.AI
Beyond healthcare, a peace of mind
Healthcare is costly, and it does not get cheaper
with chronic diseases needing prolonged
treatment. A Singapore-based startup, UCARE.
AI uses publicly available data and data from
private partners to create a predictive engine to
help providers and caregivers manage patients
throughout their illnesses, reduce preventable
hospitalization, and lower healthcare costs
where possible.
In partnership with the Parkway Pantai group,
UCARE.AI was able to deploy their artificial
intelligence-powered solution for more accurate
and personalised hospital bill estimation in
November 2018. They have reported an average
of 82% accuracy rates in the estimations,
and have reduced the average gap between
estimated and actual bill by 60%. Such
estimations are based on patients’ medication
history, background, visit frequencies and other
vital details such as blood pressure.4
Harnessing
the value
of data in
healthcare

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With predictive and artificial intelligence layered on
to improve real-time and large-scale data analytics,
startups using big data can help identify potential
disease outbreaks, be it among certain demographics,
or within geographical areas and environments. In
some instances, risk factors for individuals can also
be worked out from these analyses, which would help
patients better anticipate and manage their conditions,
or be more mindful of their lifestyles and habits in general.
While data from these startups will not replace the
need for scientific research methodologies and further
studies, data can certainly provide useful early signals
for everyone to act on – for users to safeguard
individual health and peace of mind, and for healthcare
organizations to find the best new initiatives to pursue.

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Table 3: Using data to improve healthcare
countries of
operations
Year
founded
Funding
Healint
https://healint.com/
Healint is the developer of the
world’s largest migraine tracking and
research platform Migraine Buddy.
Using deep analytics and machine
learning, Healint generates real-world
evidence for patients, physicians, and
researchers to improve treatment
outcomes and expedite clinical trials.
Singapore 2013 Undisclosed
BioFourmis
www.biofourmis.com
BioFourmis is leveraging the
revolution in biosensor technology
and personalised predictive
analytics to provide individualised
therapeutic decision support and
physiology insights, improving
remote patient monitoring and
patient safety at home.
Singapore,
USA
2015
Series A -
6.6M USD
Holmusk
https://holmusk.com/
Holmusk creates technological
products that track and analyse
symptoms for chronic diseases and
mental health, and also coach users
on managing their conditions. With
the combination of user data and
information databases, they help
users understand and act to improve
their conditions.
Singapore,
Malaysia
and USA
2015
Seed -
9.8M USD
UCARE.AI
http://www.ucare.ai
UCARE.AI looks to create accurate
predictions years into the future
for various stakeholders. Users can
obtain a personalised understanding
of their lifetime risks so they can
take preventive actions early
on, the resources needed for
personal healthcare can be better
estimated and thus planned for,
while healthcare providers will know
to focus on those who need their
expertise most urgently.
Singapore 2016
Series A -
8.2M SGD

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Lifestyle wearables: Fashion, function, future?
Data solutions require data, and the most accurate
data collection tools may well be the passive tracking
devices that record every moment of our lives, instead
of those that require active user input.
Biosensors and other medical devices are already
being used by startups like Biofourmis (see Table 3)
to monitor patients remotely. Medical-centric devices
aside though, it is the increasing popularity of health
trackers like Fitbits and smartwatches that have paved
the way for us to imagine how wearables can do more
for us. The Apple Watch, for instance, has evolved from
being an iPhone on our wrists to a personal wellness
device that tracks your heart rate and alerts you if
something is amiss. In a landscape where tech giants
are blending lifestyle with healthcare and wearables,
will the notion of a healthy lifestyle be moved up a
notch in future?
For some indication on where the wearables trend
may head in this region, it is interesting to note that
Singapore-based KaHa raised US$4.5million at the end
of 2017 to develop white label smart wearables and
platforms for clients. On the demand side, since 2015,
the Singapore government has backed an island-wide
health campaign called the National Steps Challenge,
giving out a Fitbit-like wearable to all qualifying citizens
for them to track steps taken, which would earn them
Healthpoints that can be used to redeem rewards.
Meanwhile, in Thailand, an eldercare monitoring
system was piloted in 2016 under the Saensuk Smart
City programme to explore how the municipality may
improve the quality of community care for its ageing
population through wearables and IoT, amongst other
smart city initiatives.5
The future of wearables for healthcare can only
get more exciting as more players jump on this
bandwagon. From smart buckles to smart bracelets to
smart belts, the possibilities are endless. Perhaps, the
big question is not so much about what technology
can do, but instead about how to ensure that the item
is worn or used regularly in the users’ daily lifestyle—
because only that can record the required data needed
to drive the purpose intended, such as a lifestyle change.

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Table 4: Internet of healthcare and lifestyle things
countries of
operations
Year
founded
Funding
KaHa
http://coveiot.com/
KaHa is a smart wearable
technology company that
provides an end-to-end IoT
platform for brands to launch
smart wearable products.
It provides manufacturing
services such as electronics
design and printed circuit
board assembly, as well
as app development, cloud
storage, data analytics, and
after-sales services.
Singapore,
China, India,
Switzerland
2015
Venture
Round
Undisclosed
- 4.5M USD
AEvice Health
http://www.aevice.com/
AEvice Health develops
wearable respiratory devices
for asthmatics. They have
invented a respiratory
monitoring wearable for
children with notification
features, such that when there
is an abnormality, parents can
be empowered to take early
medical intervention prior to
an asthma attack.
Singapore 2016
Seed-
Undisclosed
BAESLab
http://
www.baeslab.com/
BAESLab develops smart
wearables on its IoT platform.
They have collaborated with
the Saensuk Smart City project
to develop and deploy a
healthand wellness tracker for
the elderly residents within
the community, improving
community healthcare provision.5
Thailand 2013
Subsidiary
of SE-
Education
Public
Company
Limited6
Naluri
https://www.naluri.life/
Offering an app to journal and
manage user behavious, Naluri
offers coaching, guidance and
therapy through its platform
to help users strengthen
their mental resilience and
resolve to achieve and sustain
better health outcomes such
as weight loss, better stress
management, or reduction
in blood pressure or blood
sugar levels.
Malaysia 2017
Seed -
1M MYR

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Citations and references
(1) https://asia.nikkei.com/Business/Business-Trends/Telehealth-apps-rise-in-Southeast-Asia-due-to-doctor-scarcity
(2) https://e27.co/philippines-medifi-enables-telehealth-consultation-doctors-patients-20151123/
(3) https://healint.com/press-release/2018/8/20/healint-announces-research-showing-increase-in-anxiety-and-depression-with-
higher-migraine-frequency-among-tens-of-thousands-of-us-migraine-patients
(4) https://sbr.com.sg/healthcare/more-news/parkway-pantai-and-ucareai-unveils-ai-powered-predictive-hospital-bill-estimati
(5) http://www.nationmultimedia.com/detail/Economy/30291464
(6) http://corporate.se-ed.com/c/document_library/get_file?uuid=d361291e-c6f0-4369-ac9a-4e4aa606b438&groupId=11406
(7) https://www.moh.gov.sg/our-healthcare-system/licensing-experimentation-and-adaptation-programme-(leap)---a-moh-regulatory-
sandbox
Advancements in technology are helping us reimagine
best practices in the healthcare industry at every stage,
from medical diagnostics to patient communication
and beyond. Startups in this region have demonstrated
how they could potentially shake up the traditional
model of service and medicine delivery, not just for
home markets but for the world as well.
The technologies described above are not at all far-
fetched, though we have yet to see the mass adoption
of any of these. If this is just the start of the digital
health revolution in Southeast Asia, will we see its
peak by 2025, given the trajectory of progress in this
region’s internet economy, or would the confluence of
all changes by then yet again revolutionise the way we
think about the internet economy and healthcare?
Then again, the path to mass adoption of digital health
solutions will not only be market-driven. With new
business and delivery models, regulatory concerns
are surfacing as we move into uncharted grounds,
and that poses potential friction. In 2018, Singapore’s
Ministry of Health initiated a regulatory sandbox for
telehealth providers, such that they can work with
service providers to develop the necessary policies
to safeguard public health and safety, as well as data
privacy for electronic health records, as telehealth
services become a norm in healthcare service delivery.7
It is welcomed progress on the regulatory front, for
governments to work with and learn from these
service providers.
Healthcare is a basic human requirement, and as
startups, corporations and governments continue to
experiment with emerging technology and trends to
solve this eternal population need, we can only expect
more disruption and new regulations to emerge in the
coming few years.

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About Deloitte Southeast Asia
Deloitte Southeast Asia Ltd – a member of Deloitte Touche Tohmatsu Limited comprising
Deloitte practices operating in Brunei, Cambodia, Guam, Indonesia, Lao PDR, Malaysia,
Myanmar, Philippines, Singapore, Thailand and Vietnam – was established to deliver measurable
value to the particular demands of increasingly intra-regional and fast growing companies
and enterprises.
Comprising approximately 340 partners and 8,800 professionals in 25 office locations, the
subsidiaries and affiliates of Deloitte Southeast Asia Ltd combine their technical expertise and
deep industry knowledge to deliver consistent high quality services to companies in the region.
All services are provided through the individual country practices, their subsidiaries and
affiliates which are separate and independent legal entities.
About Deloitte Singapore
In Singapore, services are provided by Deloitte & Touche LLP and its subsidiaries and affiliates.
Deloitte & Touche LLP (Unique entity number: T08LL0721A) is an accounting limited liability
partnership registered in Singapore under the Limited Liability Partnerships Act (Chapter 163A).
© 2019 Deloitte & Touche LLP

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