compression in order to transfer images and perform remote analysis. It will also enable the medical device company to deploy technologies to emerging markets across the world.283
Companies should also look to build relationships with community workers, NGOs, and schools and provide them with training to develop necessary skills.
Digital solutions — benefits
Enabling digital solutions will give medical devices companies the ability to gather data from users and access continuous insights around disease profiles, habits and needs. This will allow companies to respond in a highly focused way.
Digital solutions will also drive value for the
healthcare systems by improving access and quality.
It will potentially reduce the burden on healthcare infrastructure and doctors by improving productivity and efficiency.284
Doctors in China are extremely overworked, sometimes seeing more than 100 patients a day, and some earn less than US$500 a month. That means boosting doctors’ efficiency is crucial to managing caseloads, especially in places where hospitals are shorthanded.
VoxelCloud uses AI and cloud-computing
technologies to provide automated medical image analysis and clinical decision support for medical practitioners. VoxelCloud's goal is to use AI in healthcare to improve the current clinical workflow.
Diseases covered include coronary heart disease, lung cancer and retinal diseases. It not only frees up physician’s time spent poring over medical images but it can also help fill the gap in hospitals in smaller cities and rural villages where there is lack specialist doctors.
Example:
VoxelCloud using AI and Cloud Computing to Improve Healthcare Access and Quality in China282
PwC | The Future of ASEAN | 165
Case study: Singapore-developed AI to improve efficiency and accuracy in diagnosis of Diabetic Retinopathy (DR) and related eye diseases285
Background and context
Asia is home to 60% of the world’s total population with diabetes. China, India and Indonesia together with the United States of America are ranked the top 4 most populated countries in the world. The prevalence of diabetes in ASEAN, China and India range from 3% to 13.7%, with close to 300M people with diabetes. Diabetic retinopathy (DR), a diabetes- related microvascular complication, is the most common acquired visual loss amongst working adults.
Currently, annual screening for DR is a universally accepted practice and recommended by the American Diabetes Association and International Council of Ophthalmology (ICO) to prevent vision loss. However, implementation of DR screening programs across the world require human assessors (ophthalmologists, optometrists or professional technicians trained to read retinal photographs). Such screening programs are thus challenged by issues related to the need for significant human resources and long-term financial sustainability.
Solution
Singapore National Eye Centre (SNEC) and SERI partnered with the National University of Singapore (NUS) School of Computing to build an AI system to screen for diabetic eye diseases, in collaboration with several leading eye centres globally (Australia, China, USA, Mexico and Hong Kong). This AI system uses a deep learning system (DLS) that thinks and makes decision like human intelligence in differentiating those with and without these conditions. It provides clinical practitioners with automated medical image analysis services and diagnosis assistance using AI and cloud computing technologies as shown below.
Other than diabetic retinopathy, the AI technology can also screen for glaucoma and age-related macular degeneration – the first system in the world to do so according to the SNEC.
Impact and Benefits
This DLS can potentially save tremendous cost, manpower and improve efficiency of healthcare systems by allowing ophthalmologists and optometrists to concentrate on treating only DR cases that require treatment.
For countries with no existing screening programs, this DLS can also be utilized as a standalone software to automatically analyse retinal images to detect any diabetes eye-related conditions from the retina.
Source: SNEC, SERI
Singapore’s AI Solution to Diagnose Diabetic Retinopathy
The scan of the retina can be analysed by DLS in several settings – community, clinics and cloud-based
The system interprets retinal images – recognized intricate structures and patterns that may or may not be visible to human eyes
It provides doctors with comprehensive diagnostic assistance by classifying retinal images into those with and without referable diabetic retinopathy, referable glaucoma suspects and age- related macular degeneration
“ Induced collaboration among stakeholders (MOH, regulators, academics, healthcare providers, industry executives, and patient groups) and “solution-wrapped med tech innovation” could help remove some of the structural barriers. This will not only benefit patients with improved healthcare outcomes but will also benefit health care providers by providing access to the latest medical technologies, and optimal utilisation and work-life balance of its staff.
Bidur Dhaul
Senior Director
Business Head of Monitoring Analytics and Therapeutic Care Solutions, Health Sytems Philips ASEAN Pacific
”
PwC | The Future of ASEAN | 167
Conclusion
ASEAN is an attractive market for medical devices.
Healthcare demand is increasing due to rising incomes, ageing populations, and growing incidences of
chronic disease. However, many healthcare systems are underdeveloped and suffers from poor access, poor affordability, and poor quality. The penetration of medical devices is low, especially outside the main cities. Most of the medical devices are imported, and are not well suited for the needs of the people in ASEAN.
Medical device companies can play an important role in ASEAN to improve the access, affordability, and quality of healthcare and at the same time increase penetration of their devices in this market of 600 million-plus people.
Instead of using a “hand-me-down” approach to medical devices in ASEAN, medical device companies should look to build customised and affordable devices for the market. They should get closer to the customer to understand customer needs, have a local presence, and encourage local innovation.
The current systems of healthcare in ASEAN bear an ever-greater burden. Medical device companies should work with the public and private sector to provide care through alternative models in lower-cost settings such as home care.
Medical devices are also being disrupted by digital.
Companies should embrace technology such as mobility, big data, and artificial intelligence in their current product portfolio and use this technology to provide healthcare in remote areas at lower costs.
To make the alternative care models and digital solutions successful, companies need to work to
improve awareness of these solutions. They should look to drive shifts in the mind-sets and behaviours that result in slow adoption of changes in technology and delivery models.
One of the hurdles that medical device companies face in implementation of these strategies is the availability of skills and talent. Companies should play an active role in skill development. They should engage with the government and academia to develop relevant courses that will develop the skill base required for the industry. They should look to develop training institutes in partnership with healthcare providers, government, and academia to provide training for operating and maintaining the medical devices. They should also collaborate with healthcare providers to promote training and education of physicians and other technical personnel in the area of medical technology.
They should encourage the use of technology to accelerate and enhance medical education.
Governments in the region, too, need to support the industry and provide a favourable environment to companies playing a leading role in improving healthcare services in the region.
Governments should look to improve the regulatory landscape. There is a need for greater regional and although the AMDD is a step in the right direction, a tighter enforcement of these common regulations is needed. The establishment of a single body for the ASEAN medical device industry could be an innovative idea. Such a body could formulate and drive the regulations required for sustainable growth across the industry.
Government should nurture a crop of innovators, including building incubators and improving funding access for medtech startups, especially in the early research phase. Considering the long timeframe it takes to get returns from medtech innovations, governments should play a lead role in providing infrastructure, funding, and access to business networks.
There is also a need for industry stakeholders and governments to encourage collaboration between regulators, academics, healthcare providers, industry executives, trade groups, patient groups, and insurance companies.