Can Digitization Fix The Philippines' Healthcare Challenges?

CAN DIGITIZATION FIX
THE PHILIPPINES’
HEALTHCARE CHALLENGES?
OCT 2019
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Table of
Contents +
Executive Summary 3
Overview of Healthcare in 4
the Philippines
Regulatory Landscape 9
Digital Prospects in the 12

Philippine Healthcare Industry
Barriers to Digitization 24
Recommendations for a 28
Future Digital Transformation
Conclusion 32
Authors 33
www.ycpsolidiance.com 3
EXECUTIVE SUMMARY
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Digitization has proven to revolutionize various industries
through efficient data capture and management, automation
of processes, and big data analysis. We see digital
transformation to be most advanced in the finance, media,
trade, and manufacturing industries; however, the need for
digitization is evident for all sectors – healthcare being no
different.
In the Philippines, the healthcare industry faces many issues

such as rising costs, changing medical needs, and lack of
infrastructure, and it is sacrificing the quality of services being
offered to patients. More so, some patients do not receive any
healthcare service at all. The objective of this paper is to talk
about how digitization initiatives on various levels are working
to address gaps in the healthcare industry and what the
opportunities are for achieving a total digital transformation.
Healthcare digitization spans across the entire value chain

and applies to various stakeholders, but YCP Solidiance has
determined that regardless of what the process is or who
fulfills it, digitization initiatives all have similar goals:
To increase efficiency
To make knowledge and services more accessible
To analyze data for research and development
For each goal, we identified key industry players who provide

the technology to healthcare providers, payers, and policy-
makers in the country. These industry players are either
local or international, public or private, big corporations or
start-ups. Despite growing participation from the industry,
implementation challenges cannot be avoided, which is
why we recommend areas and opportunities for further
collaboration and investment in the industry. Overall, we
see a growing momentum and a positive outlook for digital
healthcare in the Philippines.
OVERVIEW OF
HEALTHCARE IN
THE PHILIPPINES
Healthcare in the
Philippines is
Growing to be More
Complex, Costly,
and Constrained
by Lacking
Infrastructure
Healthcare needs are

becoming more complex
Similar to what is happening in other Asian countries,
the rise of technology has affected the lifestyles of
Filipinos. Filipinos are working longer hours, eating
more processed food, and are increasingly getting
exposed to pollution. This change in lifestyle translates
to higher risk for diseases and other health conditions,
effectively increasing demand for healthcare.
In 2016, the prevalence of communicable diseases

(CDs) and non-communicable diseases (NCDs)
for every 100,000 population were 82,024 and
91,189, respectively. The Philippines has the highest
prevalence rate for communicable diseases among its Prevalence of CDs and NCDs per 100k population (2016)
Southeast Asian neighbors while it ranks second to
Thailand in terms of non-communicable diseases. 91.189 91.796
86.665 88.840 89.462
82.024 81.007
71.323 69.523
+ 34.561
CDs NCDs
Philippines Malaysia Singapore Indonesia Thailand
Sources: YCP Solidiance Research & Analysis, World Health Organization, OECD
CDs and NCDs are among the top causes of death in the Philippines, with
ischaemic heart disease being the leading cause of death in 2016. It is followed
by respiratory and other heart diseases, and other chronic diseases like diabetes.
NCDs account for about 67% of deaths in 2016.
Top 10 Leading Causes of death in the Philippines (2016)

Total Percent
All causes of death 528,183 100.0
Ischaemic heart diseases 74,134 12.7
Neoplasms 60,470 10.4
Pneumonia 57,809 9.9
Cerebrovascular diseases 56,938 9.8
Hypertensive diseases 33,452 5.7
Diabetes Mellitus 33,295 5.7
Other heart diseases 28,641 4.9
Respiratory tuberculosis 24,462 4.2
Chronic lower respiratory infections 24,365 4.2
The remainder of diseases of the genitourinary system 19,759 3.4
Other causes of death 168,858 29.0
Sources: YCP Solidiance Research & Analysis, Philippine Statistics Authority, Vital Statistics Division
As health conditions evolve, the need for more advanced and specialized
treatments emerge. Policy makers, healthcare providers, and pharmaceutical firms
are compelled to scale up their research and development efforts to meet these
changing needs.
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Healthcare costs are rising

The increasing prevalence and complexity of diseases and other health
conditions in the Philippines lead to rising healthcare costs. Total health
expenditure grew from PHP 593 billion in 2015 to PHP 712 billion in 2017,
which translates to an increase of 20% in just a span of two years.
This growth trend has been evident since 2012, in which per capita
health expenditure growth surpassed per capita GDP growth. The gap
continued to widen over the five years thereafter.
Growth Rate of Health Expenditure

per Capita VS GDP per Capita
Health Expenditure GDP
150
140 134
127
130 122
120 116
109 120
110 114
100 110 111
100 107
100
90
80
2012 2013 2014 2015 2016 2017
Notes: index year 2012 = 100

Sources: YCP Solidiance Research & Analysis, World Health Organization, BMI Report
Furthermore, out of the total health expenditure in the country,

household out-of-pocket payments (OOP) still account for the biggest
portion of the pie. In 2017, OOP spending was at 54.5%, amounting to
PHP 372.8 billion. The majority or about 50.1% of the OOP was spent
on buying medicines. Government and compulsory contributory
healthcare financing schemes came in second at 33% and voluntary
healthcare payment schemes, which include insurance and managed
healthcare (HMOs), had the smallest share at 12.5%.
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Healthcare delivery is Number of Hospitals in the Philippines
constrained by infrastructure
limitations 13%
22%
Healthcare providers are also facing challenges in
healthcare delivery. There are only about 1,224 hospitals
in the country, 35% of which are government hospitals.
These hospitals are not enough to attend to the country’s
population of about 108 million people. To address the lack 14%
of hospitals and rural health units, barangay health stations
are put up. However, these facilities do not have the same
equipment and resources that hospitals have.
51%
NCR Rest of Luzon Visayas Mindanao
Source: World Health Organization
In terms of coverage, 64% of the total hospitals are

concentrated in Luzon, where the National Capital Region
is located. Other regions in Visayas and Mindanao have
fewer than 100 hospitals each. Because the country is
an archipelago with more than 7,000 islands, healthcare
providers find it difficult to reach farther, more remote areas.
Both public and private healthcare stakeholders recognize

the need for alternative solutions to providing healthcare
access to all.
REGULATORY
LANDSCAPE
Amid a Changing Landscape,

Healthcare Stakeholders are
Starting to Recognize the Need
for Digital Solutions
Digitization is integral to the

successful implementation of
the Universal Healthcare Act
In the midst of rising healthcare challenges and risks, the

government is already taking steps to mitigate them. The
Universal Healthcare (UHC) Act, signed by the President
on February 20, 2019, creates a positive outlook for the
industry and the entire nation by promising access to quality
healthcare for all Filipinos. It is meant to address the country’s
highly fragmented and private sector-driven system by
providing a comprehensive solution.
Key Provisions
PATIENT PROVIDER POLICY-MAKER

Automatic enrollment into the Adjustment of payment Establishment of the Health
National Health Insurance Program mechanisms to prevent balance Technology Assessment
under two membership types: billing and excessive hospital bills Council (HTAC) to oversee the
contributory and non-contributory All government health facilities development of new health
Health delivery to be classified into: will be required to retain their policies and programs
1) Population-based, and income Clarification of roles and
2) Individual-based All health providers will be responsibilities between
Basic care benefits package to be required to submit clinical and DOH, PhilHealth and other
provided to all patients through transactional data healthcare stakeholders
assigned primary healthcare Reorganization within the
providers PhilHealth Board of Directors
with strict qualifications
The timely and focused implementation of this law remains to can be accessed and shared among the regulating bodies,
be seen, as the Implementing Rules and Regulations are still the healthcare providers and financers, and the patients
being developed. Furthermore, there are certain mechanisms themselves. In order to feed data into the central database, all
that must be in place so that compliance to regulations healthcare stakeholders should be able to digitize their own
can be ensured. One of these is a centralized database of systems.
patient data where all clinical and transactional information
There is a push for the

approval of the eHealth Bill
“ There is no universal healthcare

without digital health.
”
Dr. Eric Tayag, Head of Knowledge Management
and Information Technology Systems (KMITS),
Department of Health
The Philippine eHealth Bill was created to

complement the UHC Act with the goal of digitizing
healthcare delivery systems. This bill recognizes that
eHealth practice is equally important as any other
method of healthcare delivery. The bill pushes for
the standardization of data records, digital health
platforms, and systems to ensure interoperability and
to facilitate data sharing. Policies on ethics and data
privacy and security are also included to mitigate risks
that come with the sharing of patient data.
The approval of the eHealth Bill is critical in

orchestrating an industry-wide digital transformation,
but this has not stopped individual healthcare players
from developing initiatives of their own.
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DIGITAL
PROSPECTS IN
THE PHILIPPINE
HEALTHCARE
INDUSTRY
Opportunities for
Digitization are
Emerging in the
Philippine Healthcare
Industry
Digitization is already making its way in the

Philippine healthcare sector through healthcare
providers – establishing health information
systems, utilizing electronic patient records,
and offering online services to patients and
automating certain operational processes. Similar
developments are seen in healthcare payments,
such as the digitization of health reimbursements
between hospitals and HMOs.
A thorough scan of the industry indicates that

most digitization initiatives have three main
goals: efficiency, accessibility, and research and
development. It is through the achievement of
these three objectives that healthcare stakeholders
can create the most value for their customers.
A. Digitization can reduce cost through

increased efficiency
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Digitization improves efficiency by cutting down the time
and resources needed to complete certain processes and
tasks. Utilizing fewer resources and workforce effectively
reduces the cost for healthcare providers while maintaining
the quality of their service.
Healthcare stakeholders aim for cost-efficiency using the

following technologies:
1. Hospitals and clinics establish their own Hospital

Information Systems (HIS) to facilitate faster
data sharing, effectively cutting down the time to
complete transactions
2. Doctors utilize Electronic Medical Records (EMRs) to
reduce consultation time
3. Both health maintenance organizations (HMOs) and
hospitals automate the process of claims reimbursement
(eClaims) to ensure the timely transfer of funds
4. Pharmacies have also started using digital prescriptions
for easier recordkeeping
Key Players
Digital
Company HIS EMR/EHR eClaims Prescription
BizBox Inc.
Segworks Technologies Corporation
Cerebro Diagnostics System
Comlogik Business Systems, Inc
LexSysTechnologies Incorporated
Simple Softech Solutions
EMED Healthcare Solutions
Geodata Solutions, Inc.
Exist
MEDIX
Eurolink Network International Corp.
(Easy Claims)
Medilink Network Inc.
Total Transcription Solutions Inc. (TTSI)
BAM Software Solutions
Stash
Health Blocks
SeriousMD
Indra
MedCheck
mediXserve
Vigos Health Technologies (AC Health)
Ascendant Technologies
MedProjects
mClinica
PPD e-prescription
Source: YCP Solidiance Research & Analysis

Hospital Information Systems (HIS)

Hospital Information Systems (HIS) or Hospital Management
and Information Systems are central systems that capture
health providers’ operations and finances. This includes features
such as billing and claims, inventory management, and records
management. HIS may have different modules depending on the
needs of the target user. A specialty clinic may not need the same
features that a big hospital with complex operations requires. It
may also have an integrated EMR module for the use of doctors
within the hospital. This is what companies like BizBox Inc., Indra,
and Simple Softech Solutions offer to their clients.
Electronic Medical Records (EMR)

Electronic Medical Records (EMR) or Electronic Health Records
(EHR), on the other hand, include the patient’s medical history,
as well as drug history. EMRs ideally can be shared among the
different health institutions so that the patient’s medical history
can be captured even when the patient transfers to another
hospital. EMRs could also potentially generate data for research
and analytics. Ascendant Technologies, Inc. developed the first
EMR software called iMD back in 2005 and eventually more
developers like MedCheck, MedProjects, Health Blocks, and
SeriousMD came in to offer a similar service. The newest players
in the market are MediXserve, founded only last year, and Vigos
Health Technologies, AC Health’s health tech arm also launched
last year. MediXserve’s strategy is to acquire EMR platforms in
the market and then integrate blockchain technology into its
portfolio.
Patient Medical
Records
Appt. Pricing
Scheduling
Hospital
Information
System
Claims Reimbursement
(eClaims)
Inventory Patient Financial

Mgmt Records
eClaims
Payment for Healthcare Services
Membership LOA Delivery of

LOA Request Billing Reimbursement
Verification generation Service
Health Maintenance Organization (HMO) Hospital HMO
eClaims is the technology that automates the process of biggest health insurance organization, has accredited at least
reimbursement of the healthcare provider to the insurance 13 technology providers to enable eClaims among its public
company or HMO. It may be offered as a separate service health providers. Among these firms is Stash, a health tech
or as a module of an HIS platform. This feature includes startup that originated in Singapore. The company’s goal is to
verifying the member’s eligibility for a specific health plan automate the end-to-end process of payment for healthcare
prior to consumption and validating the claim against services in order to help hospitals reduce turnaround time for
the member’s health plan after the transaction has been claims and properly manage their funds. Through better data
made. Transactional data is then captured and analyzed capture and monitoring, this software can potentially prevent
for trends in health plan utilization. PhilHealth, being the the incidence of fraud.
Digital Prescriptions
Medicine Prescription
Generate Visit Receive Record-

Consultation
Prescription Pharmacy Prescription Keeping
Doctor Patient Pharmacy
Digitizing prescriptions can be done from the generating drug than what was prescribed. Aside from understanding the
end, in which the doctor creates a prescription using medication behavior of patients, this application is perceived
an application, or from the receiving end, in which the to deliver several benefits such as the monitoring of disease
pharmacist digitizes the written prescription to enter outbreaks as well as drug supply which can combat the spread
information into their database. of counterfeit drugs. It will be used by the FDA to mandate the
digitization of logbooks in all pharmacies by 2020.
What the health tech startup, mClinica, was able to do is
to digitize the prescriptions through the latter. mClinica While there is no mandate for doctors to digitize their
developed an application called the Electronic Drug Safety prescriptions yet, there are some applications in the market
System (eDSS) that allows pharmacists to take a photo that offer this service. One of them is PPD e-Prescription,
of the prescription in order to digitize the information. It an application that allows doctors to generate prescriptions
was first tested in 2017 and generated findings such as the electronically and send them to their patients via email. This
behavior of Filipino patients to buy a smaller dose of the application is currently offering the service for free.
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B. Digitization can address constraints

and increase access
Digitization provides an alternative means for healthcare providers

to reach their patients. Using online portals and applications,
patients can receive health services without going to a physical
health facility. In addition, firms can also use applications to better
equip their staff with knowledge and skills. This addresses the
limited infrastructure and logistical challenges the industry is
currently facing.
Healthcare firms aim for increased accessibility using several digital

solutions:
Telemedicine applications are being developed to allow patients to
consult with doctors remotely
Telehealth applications allow patients to avail of other health
services at the convenience of their mobile phone
Online Learning is also made available to health workers to equip
them with knowledge and skills specific to their function remotely
and at a lower cost
ePharmacies enable remote communities to gain access to
medicines and other medical products
Key Players
Online ePharmacy/
Company Telehealth Telemedicine Marketplace
Learning
mediXserve
Allied World Healthcare
mClinica
RxBox (National Telehealth Center)
medgate
MyPocketDoctor
KonsultaMD
MyDocNow
Maria Health
Muramed.com
MedExpress
Rose Pharmacy
Mercury Gamot Padala
Watsons
MedGrocer (AC Health)

Telehealth vs. Telemedicine
Applications of Telehealth
Diagnosis
(Telemedicine)
Health Staff Home Care

Training
Medical Personal
Info Sharing Health Apps
TELEHEALTH
Personal
Health Records
Patient Health Monitoring

Portal
Although telehealth and telemedicine are sometimes diagnostic data captured through the device and transmit
being used interchangeably, they are not equal in scope. the data electronically. This technology essentially enables
Telehealth is a much broader term, referring to health- diagnosis for patients in remote communities.
related services delivered through telecommunication
technology. On top of diagnosis and treatment, it may also Allied World Healthcare, a social enterprise seeking to
include preventive and promotive aspects. It also spans deliver basic health services in underserved communities,
across different disciplines such as dentistry, counseling, developed a telehealth application called Curis. Curis
physical therapy, home care, and others. serves various functions such as facilitating health
consultations, health data collection, and community
Telemedicine, on the other hand, focuses more engagement.
on the interaction between a doctor or an allied
health professional and a patient who are separated Currently, telemedicine applications in the market are
geographically. The medical service is focused more medgate, MyPocketDoctor, MyDocNow, and KonsultaMD.
on monitoring, diagnosis, and treatment of a patient’s All are using the triage system in which the patient will
condition. first be connected to a telemedicine assistant to assess the
patient’s needs before connecting him/her with a doctor.
For instance, conducting training among health After the consultation, the patient may be issued a digital
professionals using a mobile application or offering prescription and will also be given the option to have the
Continuing Medical Education (CME) through a video medicine delivered to his/her home. KonsultaMD is a joint
conference is considered telehealth but not telemedicine. venture between Globe Telecom, Global Telehealth, Inc,
and Salud Interactiva. Users can pay for the service using
The University of the Philippines Manila hosts the their Globe account.
National Telehealth Center, an organization focused on
developing telehealth solutions to increase healthcare
access in underserved communities using information and
communications technology (ICT). One of their projects
is called RxBox, a telehealth device that combines the
function of a blood pressure monitor, pulse oximeter, ECG,
fetal heart monitor, maternal tocometer, and temperature
sensor all rolled into one. The device is capable of digitizing
Case Study: PhilCare

PhilCare is one of the country’s pioneering Health Maintenance Organization (HMO) firms, with more than
300,000 members and more than 1,000 affiliated hospitals and clinics nationwide.
BPO employees, comprising a significant portion of PhilCare
Problem
members, find it difficult to schedule consultations and obtain
a medical certificate due to their abnormal work hours. To get a
certificate, they are forced to go through the Emergency Room
(ER) and pay six times the price of a standard consultation.
PhilCare’s mobile application called Hey Phil helps members

find accredited doctors, hospitals, and even generate a Letter of
Authorization (LOA) using their phones. To address the problem
of scheduling consultations during off-peak hours, PhilCare
Solution
introduced a new feature to the app called Digimed, which allows

members to consult with doctors digitally. It was described
as the “Uber of telemedicine” by PhilCare’s VP of Information
Technology, Mr. James Indino because it matches a patient
looking to consult with a doctor who has indicated availability.
Since it was launched, Hey Phil has had 70,000 downloads and
Impact
Digimed has on-boarded 50 doctors. PhilCare members now

benefit from lower costs, giving them a more convenient option
for their medical needs.
Online Learning
The problem of healthcare access does not only +
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concern patients but health workers as well. Health
+
workers need continuous education and training in
order to attend to the needs of patients effectively.
However, conducting regular training that is tailor-fit
to the functions of each health worker can be costly.
mClinica, aside from its e-prescription application,
also created a solution to educate pharmacists using a
mobile app. SwipeRx is a social media platform meant
to create a network of pharmacies exchanging relevant
information. Through this platform, pharmaceutical
companies can deploy training modules and market
insights, while governments and other organizations
can disseminate public health announcements. Allied
World Healthcare offers a similar solution connecting
and educating health workers in remote areas,
called MediConnect. In order to make it available to
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communities in remote areas, the application content is
first downloaded using a hotspot connection and then
made accessible offline.
+
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ePharmacy and Marketplace
Providing access to healthcare also means providing

access to medicines, which is why pharmaceutical
industry players are expanding their customer reach
through online channels. Traditional drugstore chains
like Mercury Drug and Watsons are slowly moving into
the e-commerce space, while health tech firms like
Muramed.com and MedGrocer (under AC Health) are
focused on offering their services online.
There is more to healthcare e-commerce than just

medicines and medical supplies, and one local health-
tech start-up has proven that. The team behind Maria
Health recognized that many families or individuals do
not get enough information to choose a health plan
that fits their specific needs. As a solution, they came
up with an online marketplace the features all the
available health plans offered by the biggest HMOs
and health insurance companies, making it easy for
people to compare. Upon choosing the most suitable
plan, individuals can then buy at the convenience of
their own electronic device. Similarly, Allied World
Healthcare’s online marketplace application is called
Pica, and it offers a mix of non-profit and private
sector health products and services. Medicines and
other products are delivered through their last-mile
logistics application called DisperGo.
C. Digitization can enable more

complex research and development
As the efficiency of healthcare delivery improves and becomes accessible to

more patients through digitization, the amount of data increases and healthcare
systems become more complex. As a response, there ought to be continuous
improvement of healthcare services from both the public and private sectors,
and this can only be done with the help of historical data analysis. Digitization of
healthcare data increases the accuracy and efficiency of analysis, leading to even
more advanced services, such as epidemiology surveillance. This is already being
done in the country through various forms:
Data visualization and analytics of (anonymized) patient data
gathered from EMRs
Detection of fraud in reimbursement claims
Evidence-based policy development (as stated in the UHC Law)
Applications of Health Data Analytics
Epidemic
Monitoring
Policy Population
Development Health
Targeted Genomics
Treatment
Health Data
Analytics
Fraud
Detection
Drug Health Insurance

Development Programs

Medical Data Analytics

MedCheck is a health tech startup that offers its EMR software to doctors for free. Their goal is to gather medical data related to non-
communicable diseases and perform data analytics in order to promote medical practice that is based on real-world evidence. The
company was able to identify many use cases for patients’ clinical data, and these are the following:
For Pharmaceutical
For Health Practitioners For Governments
Companies
It helps doctors and other health practitioners Pharmaceutical and The government can use findings
provide targeted treatment. In oncology, for biotech companies can from clinical data analysis in policy-
instance, individuals have different reactions to significantly reduce making, such as deciding which drugs
specific types of drugs. Through data analysis, their research and should be included in the Philippine
doctors can identify patterns related to drug development cost National Drug Formulary (PNDF). In
effects and will be able to prescribe a drug that by analyzing existing fact, MedCheck has been involved in
matches a person’s physiological profile. medical data the development of the Cancer Bill.
IDIAH, Allied World Healthcare’s data management platform, is more focused on population health specifically for the communities
it seeks to serve. The application utilizes the health data gathered from remote communities to enable non-profit organizations and
local government units to gain insight and develop initiatives toward improving patient conditions.
Transactional Data Analytics

As mentioned earlier, data gathered from the automation of claims processing may
lead to the detection of fraud. This is what Medilink, an eClaims solution provider, was
able to do with the use of machine learning. As more data is gathered and monitored,
the machine will be able to identify anomalous patterns that may be attributed to
fraud. Fraud detection is only one of the benefits of analyzing transactional data.
Health insurance organizations could also use data findings to come up with better
health packages and programs.
Case Study: The Medical City

The Medical City (TMC) is one of the biggest hospital chains in the Philippines with five
hospitals and more than 50 clinics nationwide. Since 2015, TMC has embarked on several
digitization initiatives in line with its goal to convert information into knowledge and
intelligence that will help them serve patients better.
Challenge Digital Solution Actual/Expected

Impact
There was no centralized Easier access to patient

TMC established an HIS platform with
repository of patient data. data
an EMR module to fully integrate
HIS and EMR Manpower and equipment Faster information sharing
hospital operations and capture more
resources were not across departments
comprehensive patient data
optimized. Faster patient turnaround
New patient growth TMC expanded marketing channels Increased market

Digital remained stagnant due to to email, SMS and social media to
Marketing penetration
low market awareness. reach a targeted audience.
There was no efficient The Intelligent Virtual Assistant The goal of CILLINE
method for sharing (CILLINE) is used in the knowledge is to strengthen
announcements and management site of TMC in order to collaboration, synergy
other information across assist in training course registration, and connectedness
TMC hospitals and access to marketing campaigns and across TMC’s network
clinics. other critical information. of hospitals and clinics.
Artificial
Intelligence There was difficulty in Business intelligence application Use of the Qliksense
capturing relevant data Qliksense has the AI powered application will allow
to serve as basis for analytical insights that can assist TMC management
optimization initiatives the management in analyzing the to come up with
within the emergency dashboard of the ER patient journey actionable and
department. that will cover triage to hospital exit. evidence-based
Big data analytics is used to convert insights to improve
hindsight to foresight. patient experience.
TMC expanded the utility of their Hospital experience

Patient feedback used to Customer Feedback Management ratings increased by
Data Analytics platform using technologies such as
be limited to telesurveys 3% in 2018
+ Artificial data analytics and business/artificial
and does not accurately TMC’s Net Promoter
Intelligence intelligence. Through the upgrade,
reflect overall patient Score increased by 6%
experience. they are now able to gather feedback Response and
from social media and various resolution rates
sources rather than just telesurveys. exceeded target
The goal of this

Backlogs for payment
Robotic TMC utilized a robotic process initiative is to achieve
of doctor’s professional
Process automation to improve turnaround operational excellence
fees increased due to
Automation time for processing professional fees in 10 departments
slow turnaround time.
(RPA) within TMC
BARRIERS TO
DIGITIZATION
Digitization Initiatives in
the Sector are Still at a
Nascent Stage and Many
Implementation Challenges
Continue to Arise
Despite the efforts of both the public and private healthcare sectors in digitizing their
processes and services, there are still many challenges. Healthcare digitization requires the
participation and cooperation of all key stakeholders working within the value chain and
unfortunately, this is not yet the case for the Philippines due to external and internal factors.
Internal Factors
Lack of Costly
human implementation
resources
Organizational Insitutional
Resistance to Inadequate
change among infrastructure
doctors and
patients
Lack of standards and
regulation
External Factors
1. Lack of Human Resources
Smooth and successful digitization initiatives are driven (ICT) skills. IT staff, on the other hand,
by people who carry knowledge and skills in both have minimal healthcare knowledge. It
healthcare and information technology. Unfortunately, is a challenge to hire IT professionals
the shortage of talent is apparent on all sides - because while many of them have
policy- making, technology services, and healthcare high-level IT skills, they do not have the
delivery. Policy-makers need people who have a good credentials required to be government
understanding of the digitization needs in the sector employees.
in order to create effective policies: IT providers need
a healthcare team to come up with targeted solutions, Despite the efforts to train and
and hospital management needs people who can educate healthcare staff, most of
implement them. these individuals move on to find
opportunities for work overseas. Thus,
In the Department of Health (DOH), for instance, foreign countries benefit from the
healthcare staff, especially the older generation, are knowledge and skills of Filipino workers
low on information and communications technology instead.
2. Costly Implementation
Not all healthcare providers have enough resources existing paper records. Working back to encode thousands of
and capabilities for digitization. First and foremost, paper records will necessitate additional time, manpower, and
a digital transformation requires significant cost. It could be one of the key factors that discourage hospitals
investment. Public health institutions need funding from undergoing a digital transformation.
from the government in order to put new systems
in place. As for private institutions, especially the
big hospital chains, larger investment is needed
to ensure standard deployment for all branches.
Second, as more data is captured, storage also
becomes an added cost. IT providers have identified
data storage as one of their biggest cost drivers.
Lastly, many hospitals are faced with the dilemma
of whether to digitize several years’ worth of their
3. Resistance to Change among Doctors and Patients
Another significant barrier to healthcare digitization is the

resistance of doctors, and even patients, to adopt new Patients, on the other hand, are mainly concerned about their
technologies. Doctors play a crucial role in the deployment privacy. They are not comfortable with the idea of making their
of technologies such as the EMR or Telemedicine because entire medical history readily available and accessible.
they are the ones facing the patient and essentially
delivering the service and gathering their data. This This traditional mindset prevents healthcare institutions, firms, and
has become a real challenge for many companies and even the government from collecting and analyzing data that is
institutions because the older generation of doctors representative of reality.
prefers to maintain their traditional way of doing things.
According to some doctors, generating an electronic
medical record and sharing it with other parties is against
their ethics in medical practice. They also feel that
encoding information during a consultation sacrifices their
interaction with a patient.
4. Inadequate Infrastructure
One of the most basic challenges to

2017 Average Connection Speed
digitization, even in other industries, is
in Mbps
the lack of infrastructure. In a developing
20.3 country like the Philippines, the availability
and reliability of the Internet connection
16
continue to be an issue, especially in
remote islands. According to a report by
9.5 8.9 Akamai in 2017, the Philippines falls behind
7.2 its ASEAN neighbors with an average
5.5
connection speed of 5.5 Mbps.
Without adequate internet connection,

efficient data storage and transmission
Singapore
Thailand
Vietnam
Malaysia
Indonesia
Philippines
become difficult. This prevents technology

providers from reaching a wider base
of health providers and providing the
full functionality of their services. It
Source: Akamai Report
also hinders them from innovating new
solutions.
5. Lack of Standards and Regulation
In order for the three goals of digitization to fully At worst, when the patient goes to another hospital whose
realize, there ought to be regulations that will establish systems are not yet digitized, he/she would have to go through
the standards for all systems installed and utilized by the entire process of creating a new handwritten record and
health providers and other healthcare stakeholders. explaining it to the doctor, effectively wasting both the patient’s
Unfortunately, even with the approval of the UHC and doctor’s time.
Act, these standards are not yet in place. As a result,
different technology providers develop systems that The DOH has made efforts to standardize digitization
are not compatible and interoperable with other initiatives, starting with the claims reimbursement requirement
systems. For instance, when a hospital with an existing of PhilHealth. PhilHealth partners are not able to receive
management and information system wants to upgrade reimbursements unless they submit electronic claims. This
their digital capabilities, they face limitations with the resulted in hospitals digitizing records to an extent, but
type of software and provider that they can engage. only those that are connected to PhilHealth for the sake of
compliance.
The quality and uses for the data gathered from
electronic medical records are also sacrificed
because most softwares do not have the capability to
communicate with other systems. For instance, when
a patient with an EMR at a certain hospital decides to
consult with a specialist in a different hospital and this
same specialist ends up unable to access the EMR due
to inaccessibility, the fundamental purpose of an EMR,
which is to provide easy access to medical histories and
records, ends up defeated.
RECOMMENDATIONS
FOR A FUTURE
DIGITAL
TRANSFORMATION
Continuous Investment
and Stronger
Collaboration among
the Public and Private
Sectors are Needed
to Drive Initiatives
Forward
The healthcare industry is highly regulated, and it is easy to say that the
implementation of the UHC Act along with the potential approval of the
eHealth Bill will partially address the barriers to digitization by giving
the mandate to all stakeholders. This ideal scenario will not come easily,
therefore, the industry must continue finding solutions to progress and
improve systems toward achieving better quality healthcare. We created
a diagram below to help key players recognize how they mutually
benefit each other.
Investment / Resources Digital Services
HMOs & Pharma Technology Provider Healthcare Provider
Digital Services & Expertise Revenue
Digital Expertise Incentive & Accreditation
Government
HMOs/Insurance, Pharmaceutical
Firms & Technology Providers
Technology providers are the IT firms, health tech start-ups and
social enterprises that offer innovative solutions but lack funding
and resources. HMOs, insurance, and pharmaceutical firms are the
companies that have access to huge capital and a wide network
of healthcare providers. If the technology providers can tap on the
resources that these big corporations have, then they can expand
their services to a wider customer base and further improve their
technology.
What do HMOs and pharmaceutical companies get in return? If

they invest in a start-up that matches their business goals, they can
augment their services and improve their research and development
capabilities. Start-ups can also maximize an HMO’s wide network of
doctors by educating them on the benefits of digitization.
Government & Technology Providers

The government must increase participation from the private sector
through incentives. PhilHealth now has a list of accredited Health
Information Technology Providers (HITPs) but most of them are
focused on offering eClaims. There are many other firms offering
a wider range of services with better quality. If the government
structures incentives that can attract more innovative firms, it will get
access to more digital expertise. In addition, the technology providers
will also be encouraged to meet accreditation standards set by the
government such as interoperability features.
Healthcare Providers &

Technology Providers
As more hospitals and clinics seek to digitize their systems, technology
providers gain more revenue. However, choosing the right IT partner is
important. By following comprehensive selection criteria that involve
interoperability and data security, healthcare providers are effectively
creating demand for products and services that meet industry
standards.
+
With Ample Opportunities

for Change and
Innovation, Digital
Healthcare Transformation
is Imminent in the
Philippines
We have identified notable collaborations and early adopters which
indicate a positive outlook for digitization in the healthcare industry:
Philhealth has engaged IT providers to automate claims

reimbursement for partner providers
Big conglomerates like the Ayala Group have started to invest in digital
health
Big hospital chains like The Medical City are actively implementing
digitization initiatives
Traditional drug stores like Mercury Drug and Watsons have expanded
into digital channels
International start-ups and social enterprises such as mediXserve,
Stash, mClinica, and Allied World Healthcare have entered the
Philippines to deploy new technologies
These comprise only a small part of the growing evidence for digital
progress in the Philippine healthcare sector. Once the Universal
Healthcare Act is in full swing, there will be greater incentives for
healthcare players to digitize their systems and processes. Assuming the
current momentum continues, the Philippines will be in a good position
for digital health transformation in the future.
Conclusion
Digitization is key to the successful implementation of the UHC Act.
Providing healthcare access for all requires cost-effective solutions that
digital health technology can offer. Earlier, we mapped out the different
technologies under three main objectives – efficiency, access, and
research and development – all of which are fully in-line with the goals
of the UHC Act. Policy-makers and industry players must work hand-in-
hand to utilize the benefits of digitization for universal healthcare.
Digitization efforts in the industry are slowly gaining momentum

but continue to be fragmented. Due to the lack of industry standards
governing digitization efforts, digital health technologies such as EMRs
are not maximized to its full functionality. Furthermore, public and
private health providers struggle to gather comprehensive and high-
quality data from their patients. Most systems are not interoperable,
preventing any opportunities for communication and collaboration.
Health tech start-ups drive innovation, but network and resources

lie with the big corporations. Health tech start-ups drive innovation
by introducing new technologies and business models around digital
health but do not have access to huge amounts of capital and a wide
network of hospitals, clinics, and doctors that big corporations have.
Collaboration between health tech firms and industry leaders such as
HMOs and pharmaceuticals can lead to high-impact programs.
Doctors play an integral role in digitization, so getting their buy-

in is critical. Doctors are the ones encoding information into an
electronic medical record and are also the ones interacting with patients
through telemedicine. These platforms will not function without the
participation of doctors. Therefore, getting their support is an important
consideration. Both technology providers and hospitals must take steps
to educate and influence doctors to be more open to new technology.
Once healthcare systems become integrated and connected, the

possibilities are endless. The integration allows better capture of
data on patient medical history, public health, drug purchase and use,
hospital transactions, and healthcare financing - and the analysis of
these data leads to solutions. Healthcare in the Philippines can evolve to
become more holistic, evidence-based, and cost-effective.
Authors
U-Yun Wong Partner
U-Yun is a Partner at YCP Solidiance, based in our Singapore office, with operational oversight on our
Myanmar, Malaysia, and Philippines offices. He brings over 10 years of management consulting experience,
and formerly headed up the consulting offices of Thailand (2003 - 2004) and Hong Kong (2004 - 2007)
at a regional consulting firm. He has led more than 100 strategic consulting engagements for Fortune
500 and Government clients across varied industries focusing on corporate strategy, M&A advisory, and
organizational transformation. He holds an MBA from the University of Chicago Booth School of Business,
and a Bachelor of Engineering from the Royal Melbourne Institute of Technology, Australia.
Anna Rellama Director

Anna is a Director with extensive experience across Southeast Asia, Oceania, and the Middle-East,
most especially in the Philippines. During her tenure with YCP Solidiance, she has worked on nearly 10
engagements in the healthcare, medical technology, medical devices, and the pharmaceutical industries
in the region, particularly on growth strategy, competitive intelligence, commercial feasibility, commercial
due diligence, and market entry. Academically, she brings with her a Bachelor of Science degree in
Management Engineering from the Ateneo de Manila University and a Master of Science degree in
Strategic Management (with highest honors) from HEC Paris.
Louise Reodica Associate

Louise is an Associate based in our Manila office. Prior to joining YCP Solidiance, she has worked on
market research projects with a biotech firm specializing in cancer diagnostics as well as an international
healthcare advisory group in Singapore. She brings four years of experience in strategic planning, with
focus on industry and market analyses, and corporate performance evaluation and reporting and has also
led strategic initiatives involving strategy communication and project portfolio management. She holds an
MBA from the National University of Singapore and a Bachelor’s Degree in Management Engineering from
Ateneo de Manila University.
About Us
What We Do What We Focus On
YCP Solidiance is an Asia-focused strategy We focus on advising our large client base across
consulting firm with offices across 18 key Asia Pacific a wide spectrum of strategic consultancy areas,
countries and other regions. Asia-focused with identify breakthrough growth opportunities and
global presence, we define new business models develop execution-ready strategies & roadmaps.
and help clients drive their business growth through Our Asia-focused market entry and growth
strategic solutions. We deliver high-impact advisory strategy services provide the required insights to
services by tailoring our services to suit different capture a profitable market share in the region.
business needs. To learn more about our services
visit: https://ycpsolidiance.com.
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We are present in Abu Dhabi, Amsterdam, Bangkok, YCP Solidiance
Beijing, Beirut, Ho Chi Minh City, Hong Kong, Jakarta, @ycpsolidiance
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CAN DIGITIZATION FIX

Digital Prospects in the 12

In the Philippines, the healthcare industry faces many issues

Healthcare digitization spans across the entire value chain

For each goal, we identified key industry players who provide

Healthcare needs are

In 2016, the prevalence of communicable diseases

Top 10 Leading Causes of death in the Philippines (2016)

Healthcare costs are rising

Growth Rate of Health Expenditure

Notes: index year 2012 = 100

Furthermore, out of the total health expenditure in the country,

Healthcare delivery is Number of Hospitals in the Philippines

NCR Rest of Luzon Visayas Mindanao

Source: World Health Organization

In terms of coverage, 64% of the total hospitals are

Both public and private healthcare stakeholders recognize

Amid a Changing Landscape,

Digitization is integral to the

In the midst of rising healthcare challenges and risks, the

PATIENT PROVIDER POLICY-MAKER

There is a push for the

“ There is no universal healthcare

The Philippine eHealth Bill was created to

The approval of the eHealth Bill is critical in

Digitization is already making its way in the

A thorough scan of the industry indicates that

A. Digitization can reduce cost through

Healthcare stakeholders aim for cost-efficiency using the

1. Hospitals and clinics establish their own Hospital

Source: YCP Solidiance Research & Analysis

Hospital Information Systems (HIS)

Electronic Medical Records (EMR)

Inventory Patient Financial

Membership LOA Delivery of

Health Maintenance Organization (HMO) Hospital HMO

Generate Visit Receive Record-

Doctor Patient Pharmacy

B. Digitization can address constraints

Digitization provides an alternative means for healthcare providers

Healthcare firms aim for increased accessibility using several digital

Source: YCP Solidiance Research & Analysis

Telehealth vs. Telemedicine

Health Staff Home Care

Patient Health Monitoring

Source: YCP Solidiance Research & Analysis

Case Study: PhilCare

BPO employees, comprising a significant portion of PhilCare

PhilCare’s mobile application called Hey Phil helps members

introduced a new feature to the app called Digimed, which allows

Digimed has on-boarded 50 doctors. PhilCare members now

ePharmacy and Marketplace

Providing access to healthcare also means providing

There is more to healthcare e-commerce than just

C. Digitization can enable more

As the efficiency of healthcare delivery improves and becomes accessible to

Evidence-based policy development (as stated in the UHC Law)

Applications of Health Data Analytics

Drug Health Insurance