Digital Healthcare: How telemedicine can transform – and save – medical tourism

This article first appeared in Digital Edge, The Edge Malaysia Weekly, on March 29, 2021 - April 04, 2021.
DoctorOnCall allows patients to communicate with doctors remotely (Photo by DoctorOnCall)

DoctorOnCall allows patients to communicate with doctors remotely (Photo by DoctorOnCall)

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When the country’s borders were shut last year, the Malaysia Healthcare Travel Council (MHTC) saw revenues by its member hosptials drop almost 75%, according to the agency. 

However, despite not being able to travel, some overseas patients were still hoping to continue their consultations with local specialists, observes Yazmin Azman, acting CEO of MHTC.

“We had patients who had to take a step back from their treatments. They had been doing oncology treatments in Malaysia and using more advanced drugs that are not available in their home country,” she says. 

MHTC, an agency under the Ministry of Health (MOH), is tasked with promoting the medical tourism industry by collaborating with industry players and partners, which comprise private healthcare institutions. 

Malaysia is often listed as one of the top destinations for medical tourism and has won multiple awards from the International Medical Travel Journal over the years. 

According to MHTC, it recorded RM1.7 billion in healthcare travel revenues, which measures hospital spend, in 2019. MHTC was originally optimistic about reaching RM2 billion in 2020, but had to postpone the Malaysia Year of Healthcare Travel 2020 campaign for obvious reasons.

"Covid-19 really accelerated the adoption of technology in hospitals. Our specialists were forced to get acquainted with using devices to talk to patients around the world.”- Zul (Photo by MHTC)

This led MHTC and its partner hospitals to accelerate their efforts to digitalise the healthcare industry, starting with setting up telemedicine platforms so patients can continue seeking care from doctors remotely. 

Some of MHTC’s partner hospitals set up their own telemedicine platforms. In January, MHTC struck a partnership with start-up DoctorOnCall to provide an alternative for hospitals to go online. 

It is not the first time MHTC is looking into telemedicine, says Yazmin. But it was only when the pandemic hit that the urgency to digitalise was felt in the industry.

“Covid-19 really accelerated the adoption of technology in hospitals. Our specialists were forced to get acquainted with using devices to talk to patients around the world. We want to keep up this momentum,” says Zul Idris, vice-president of business sustainability at MHTC. 

Meanwhile, DoctorOnCall is already servicing overseas patients through online consultations and medication deliveries, says Maran Virumandi, its founder and managing director. 

“We’ve already been seeing a trend where around 10% of traffic onto our website comes from other countries,” says Maran. 

"The portability of medical records, of course, is relevant to medical tourism, but I think we’ve come to an age where data is king, and how we protect it becomes important.” - Yazmin (Photo by MHTC)

What is the role of telemedicine in medical tourism? 

Obviously, medical tourism involves individuals physically travelling to Malaysia to pursue healthcare services, which translates into revenues for the local hospitals and related service providers like the hospitality sector. 

Telemedicine cannot completely replace that activity, as the medical procedures and complex consultations still need to be done in person. 

But it can be useful in several cases. From Maran’s experience, many overseas patients, especially those from Southeast Asia, like to seek a second opinion from Malaysian doctors because they find them to be of a high standing.

With telemedicine, these patients can easily set up consultations with Malaysian doctors and arrange an in-person treatment session later on. 

“A lot of people opt to do things such as fertility and heart treatments and hip or knee replacement surgeries in Malaysia,” says Maran. 

"On average, medications offered through DoctorOnCall tend to be 30% to 60% more cost-efficient than clinics or hospitals because of our sourcing and procurement capabilities.” - Maran (Photo by DoctorOnCall)

Telemedicine is also helpful for patients who are researching the best treatments. “This is what hospitals in India and Thailand do. On their websites, they have information about their doctors and treatment modalities in various languages, alongside pricing and telehealth consultation opportunities,” he adds.

“They have already been doing it for the past five to 10 years, which helped these two countries become the medical tourism centres of the world.”

Both of these cases highlight the role telemedicine can continue to play in a post-Covid world. It can promote the services of Malaysian doctors abroad and allow overseas patients to engage in pre-consultations before making a decision to visit Malaysia. 

“It also allows patients to take better care of themselves. If a follow-up session requires you to fly to Malaysia, you may opt out of doing so, to the detriment of your health. But if it means just speaking to the doctor online, people would invest more in their health,” says Yazmin. 

Telemedicine is also used by some overseas patients for conditions like the flu or fever. This is applicable for employees of some multinational companies, says Maran. “When I was working in Jakarta, some of the multinational companies had a policy where you can fly to Singapore for any medical condition because there was a lack of trust in the local medical system.”

The pricing of drugs is another factor, he adds. “On average, medications offered through DoctorOnCall tend to be 30% to 60% more cost-efficient than clinics or hospitals because of our sourcing and procurement capabilities.”

What else can be done?

To fully exploit the benefits of telemedicine, some technological innovations are needed. They include a platform to share medical records and prescriptions safely across borders, as well as technology to enable remote monitoring of health conditions. 

“As countries reopen their borders, we have to look at how we can assess the integrity of vaccine passports. The portability of medical records, of course, is relevant to medical tourism, but I think we’ve come to an age where data is king, and how we protect it becomes important,” says Yazmin.

In March, China became one of the first countries to roll out a vaccine passport, which will be embedded in the WeChat app. 

Additionally, since digital healthcare is a relatively new area in Malaysia, DoctorOnCall is actively working with MOH to ensure that patients are getting secure services through the platform, says Maran. 

This year, it will focus on onboarding doctors to the platform, so they can get used to online consultations and managing patient healthcare records online. Going forward, it would like to explore the use of interconnected devices for remote health monitoring.

“I think that will be a crucial factor to [help doctors] monitor patients across borders and to ensure continuity of care,” says Maran.

He is also excited about the possibility of using artificial intelligence to help doctors arrive at more accurate diagnoses, as well as connecting global insurers to patients through DoctorOnCall.

“In the next evolution of our app, we will be using blockchain to track health certificates. Information like prescriptions or [documents that state] whether you’ve been vaccinated or tested for Covid can be open to abuse. By using blockchain technology, we can ensure the integrity of our information,” says Maran.

Meanwhile, MHTC plans to continue expanding its telemedicine capabilities and educating its partner hospitals about the importance of adopting technology. 

“This partnership with DoctorOnCall is just the beginning of many things we want to do on the digital front. We are looking into more potential partnerships. The moment medical tourism bounces back, we want to be stronger,” says Zul.