Prenatal genetic diagnosis currently exists in the form of invasive procedures, which carry small risks of miscarriages. But technology in genomics is bringing significant change to the forefront. “Genomics has an influence on prenatal diagnosis in several ways. “For instance, we can now analyse cell free DNA in the mother’s blood, and because this contains foetal as well as maternal DNA we can test for genetic conditions in the foetus by analysing maternal blood samples. We can test for conditions such as cystic fibrosis in families who we know are at increased risk,” said Prof. Dame Lyn Chitty, who holds the unique title of Professor of Genetics and Fetal Medicine at the University College London Great Ormond Street Institute of Child Health (UCL GOS ICH) in the UK. 

This approach to prenatal diagnosis of monogenic conditions gives fast and earlier results compared to standard invasive techniques, reduces risks to the mother and unborn child by eliminating unnecessary invasive procedures, and ensures optimum labour management as professionals can advise where the baby needs to be delivered to receive a particular type of treatment. An expert in prenatal diagnosis, Prof. Dame Chitty not only leads research in rapid and non-invasive techniques, but she also created the foetal size charts currently used in many units in the UK. Prof. Dame Chitty also worked on the UK Government-funded 100,000 Genomes Project led by Genomics England which involved sequencing whole genomes from the patients of National Health Service (NHS).

Related: Genome sequencing drives population genomics and precision medicine

Prof Chitty was recently bestowed with the title of Dame Commander of the Order of the British Empire for services to medicine. She was also recognised by the Academy of Medical Sciences for her outstanding contributions to the advancement of biomedical and health science. Her accolades are a testament to her ongoing research to offer families safer testing options to learn about the health of their unborn child.

To date, Prof. Dame Chitty and her team at Great Ormond Street Hospital have performed non-invasive prenatal diagnosis tests for around 200 genetic conditions for nearly 400 families with accurate results. Speaking about the procedure, she explained that it is now possible to track down the abnormal gene in recessive conditions after gathering genetic material from parents and siblings.

“In England, we can also perform the more complicated relative haplotype dosage analysis and offer a definite diagnosis for families at risk of cystic fibrosis, Duchenne and Becker muscular dystrophy, congenital adrenal hyperplasia, and spinal muscular atrophy. We are also validating beta-thalassemia and can start offering this testing to consanguineous families soon,” she added.

Related: Genomics and its rapid evolution in the Middle East

The future of foetal medicine is promising with the rise of in-utero gene therapies for conditions such as spinal bifida and congenital diaphragmatic hernia, according to Prof. Dame Chitty. Addressing the potential of gene therapy in other areas, she added: “We have done a study with the Karolinska Institutet looking at mesenchymal stem cells prenatally to help alleviate osteogenesis imperfecta in babies. There is huge potential here, and in the future at Great Ormond Street Hospital, we will be exploring the possibility of taking some of the therapies from the neonate stage to the foetus.”

If successful, experts would be able to treat certain conditions that start in the uterus and may be able to prevent or reduce damage. “We are also extending the range of non-invasive prenatal diagnosis (NIPD) that we offer for monogenic conditions, working on validating new tests, e.g., for sickle cell where we are looking at new approaches such as digital PCR. We are also looking at long-read sequencing to see if we can improve the diagnostic rates from invasive tests. There are a lot of exciting things going on,” she concluded.

This article appears in Omnia Health magazine. Read the full issue online today.

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Back to Laboratory

Aspartame, a type of artificial sweetener widely used in food and beverage products, recently underwent a risk assessment investigating whether its consumption could cause cancer. Carried out by the International Agency for Research on Cancer (IARC), World Health Organization (WHO) and the Food and Agriculture Organization (FAO) Joint Expert Committee on Food Additives (JECFA), the assessment cited “limited evidence” for carcinogenicity in humans.

IARC classified aspartame as “possibly carcinogenic” to humans, while JECFA highlighted that there was no sufficient reason to change the previously acceptable aspartame intake of approximately 40 mg/kg body weight.

Related: Rising cancer incidence to fuel US$24.22 billion growth in cancer vaccine market by 2033

However, the agencies emphasised that further research is required to establish a consensus. This opinion is mirrored by healthcare experts, who expressed that it would take a significant amount of aspartame consumption to pose a danger to health.

Impact on the consumption of artificial sweeteners

Dr. Donald D. Hensrud, Internist at the Mayo Clinic in the US, who is an expert in public health, infectious diseases, and occupational health, shared that the term “possibly carcinogenic” in the report does not define the exact risk.

Commenting on the report’s impact on consumers, he said: “This is speculation, but some people may decrease their intake of foods that contain aspartame in response to this new information. The absolute risk of cancer is low, and it would require a fair amount of aspartame consumption over many years to increase the risk even by a small amount. Even if people changed their behaviour and decreased their consumption, it may not greatly change healthcare outcomes.”

Ali Tariq, Founder of Fivescore Labs, a UAE-based consumer longevity brand, added: “The updated classification of aspartame may indeed have implications around promoting healthy dietary choices and managing chronic diseases related to sugar consumption. This new classification would likely encourage further research into the safety of aspartame and its alternatives. There might also be increased monitoring of health outcomes associated with aspartame consumption amongst broader population groups.”

Public awareness on the intake of artificial sweeteners

According to Dr. Hensrud, the actual outcome and exact risk would need to be determined in population studies that compare the use of aspartame against a control.

To understand the risk better, healthcare systems and regulatory bodies need to collaborate to conduct further research on the potential health effects of aspartame, such as population studies, clinical trials, or lab-based studies.

Related: Harness the power of cancer immunotherapy 

According to Tariq, data sharing would be necessary across stakeholder groups to achieve this. Global healthcare systems could provide data on health conditions that may be linked to aspartame consumption, while regulatory bodies could provide data on food and drink consumption, product safety assessments, and the regulatory status of aspartame in various countries.

As for public policy around matters regarding healthcare, this is a complex issue that may require balancing the risks associated with aspartame consumption against the risks associated with sugar consumption and obesity, including diabetes and heart disease.

“The ultimate goal would be to guide the public towards the safest and healthiest dietary choices,” concluded Tariq.

In 2018, long before the artificial intelligence (AI) bandwagon started careening down the mainstream, DeepMind, a subsidiary of Google parent Alphabet, developed a program named AlphaFold to predict protein structures faster and more accurately than biologists. Predicting protein shapes is a key aspect of drug development, disease treatment, and treatment research, but it is a traditionally long and arduous process. Faster, more affordable medication may soon be within reach thanks to AI automation across the entire drug development pipeline.

However, even this promised panacea had its Achilles’ heel. MIT researchers found that AlphaFold is only concretely useful in one step of drug discovery: modelling the structure of the protein. The system cannot model how a drug physically interacts with the protein. AlphaFold may not be a catch-all in drug discovery, but it started a conversation that is now funnelling millions of dollars in investment into key markets across Asia and beyond. According to Deep Pharma Intelligence, investments in AI-backed drug discovery have tripled over the last four years, reaching a staggering US$24.6 billion in 2022.

The post-COVID-19 factor

During the pandemic, economies worldwide relied on AI-based medication discovery rather than traditional vaccine detection processes, which take years to create and are equally expensive, contributing to the market’s growth. For example, Pfizer collaborated with AI businesses to develop COVID therapies, which were approved in less than two years, compared to the typical 10-year process.

Related: AI-powered growth in healthcare: early trends and learnings

By using big scientific databases, reviewing drug candidates in silico, and expediting high-content screening tests with automated data processing, AI has proven its mettle in cutting drug discovery costs and delays. Now, the industry is making strategic decisions to bounce back post-COVID-19 through a big R&D push to bring advanced and accurate AI software to the market.

The current drug discovery process involves a time-consuming and costly trial-and-error approach. It costs approximately US$1.3 billion and 10 years to bring a new therapeutic drug to market, and this cost is expected to rise.

Clinical trials also have a notoriously high rate of failure — over 90 per cent by some estimates — which means eliminating trial and error might save businesses a lot of money while getting drugs from the lab to market more quickly.

The potential revenue is enormous; financial analysts at Jeffries estimate that Takeda’s move may generate up to US$3.7 billion in annual sales. Morgan Stanley estimates that the next 10 years may spawn up to 50 new AI-driven medicines worth more than US$50 billion in sales.

AI is a long-term strategy

Huawei Cloud is adopting a long-term investment strategy in AI-assisted drug design. The Huawei Cloud Pangu Drug Molecule Model, developed with the Shanghai Institute of Materia Medica, helps pharmaceutical companies build small[1]molecule drugs. The model uses data from over 1.7 billion compounds to streamline the process for researchers to then run targeted experiments to verify efficacy.

“AI could effectively function as a virtual chemist, helping researchers design and identify novel molecules that are likely to interact with drug targets,” says Dr. Qiao Nan, Head of Huawei Cloud EI Health.

According to Qiao, AI could shrink R&D costs by up to 70 per cent while helping scientists discover novel lead compounds in months rather than years.

Related: The Future of Medicine: AI's Journey in Healthcare

“This would make more potential drug candidates available for clinical trials, lifting the overall success rate in what traditionally has been hit-or-miss process and increasing the odds that a new chemical compound will eventually become an effective, life-saving drug.”

On the back of this success, Huawei launched a unique AI-assisted commercial pharmaceutical SaaS platform in China to help companies reduce the costs of trial and error, while accelerating the discovery of lead compounds from several years to just one month. The SaaS platform is slated to expand internationally, starting with APAC, the Middle East, and further afield.

Building a strong AI talent pipeline

AI applications lower the R&D gap in the drug manufacturing process and aid in targeted medication manufacturing. As a result, biopharmaceutical companies are turning to AI to increase their market share. However, AI for drug discovery requires machines to replicate human intellect to address complex drug development difficulties — a tall order for any platform that is meant to be a tool. Its success depends on how and by whom it is used.

Currently, China is leading the global AI industry, housing over 60 per cent of big data experts across sectors. As more industry segments begin to rely on AI, players in healthcare will need to start preparing for a gap between supply and demand for talent. The alternative, as seen by incumbents including Sanofi, Merck, and GSK, is growth through collaboration or acquisition.

As the demand for messenger RNA (mRNA) vaccines in Southeast Asia increased during the pandemic, Singapore quickly established itself as a hub for AI, robotics, and manufacturing for leading pharmaceutical companies to open their regional headquarters. The small city-state is home to 30 contract manufacturing facilities, most of which are foreign-owned, if not partially backed.

According to GlobalData’s Contract Service Provider database, Merck currently owns three facilities in Singapore, and Novartis and GSK each own two facilities. “New opportunities will emerge as the biomanufacturing industry undergoes major changes brought about by the rapid pace of digitalisation, Industry 4.0, and the need for greater sustainability,” says Lim Keng Hui, Assistant Chief Executive of Singapore’s Science and Engineering Research Council, A*STAR.

Recently, Japan’s Takeda Pharmaceutical has partnered with AI tech startups and hired additional data scientists to address this. AI is part of Takeda’s long-term strategy to save money and time by speeding up the medication development process.

In May, the global pharma giant acquired US-based AI startup Nimbus Therapeutics for US$4 billion. The start-up used AI and machine learning algorithms to pick a compound to treat psoriasis out of thousands of other molecules. The experimental drug has already passed the first two phases of human trials, meaning it could be one of the first therapies discovered with AI if it passes the final trials this year. AI is shifting the drug discovery paradigm by extracting hidden patterns and evidence from vast biomedical data, dramatically improving the clinical trial process while mining old drugs for new applications. The result is expected to bring treatments to patients faster.

This article appears in Omnia Health magazine. Read the full issue online today.

Access the must-read eBook on AI here to discover perspectives on its transformative role in the healthcare industry.

Back to Technology

With the recent popularity of AI, healthcare organisations are beginning to experiment with its usage towards decision-making, revenue growth, and other business  requirements. Healthcare providers are on the cusp of a new era where AI can become a powerful enabler of growth. With some early adopters who are charting the path ahead, some useful learnings are emerging. Whether it is standalone tools (e.g., ChatGPT) or complex solutions that integrate with the various IT platforms, there is a lot that is possible in healthcare business and management.

AI-enabled C-Suite for growth

A C-Suite that is fully empowered with data integration for future predictions is soon going to be a reality. A predictive tool integrated with the EMR, and the ERP systems can forecast the occupancy rates, profitability, budget shortfalls, staff requirements, OT utilisation and many other KPIs with reasonable accuracy. 

Related: AI and digital accessibility drive holistic well-being

Once the machines learn the previous data and trends. This will enable C-Suite to take preventive actions and prioritise well in advance. Imagine the power that a management team will have if business volumes, requirements, and bottlenecks can be predicted months in advance. It is a given that a proactive, AI-enabled CEO will have an upper hand over his/her adversaries who are still in the older, reaction-based management world.

Automation in healthcare 

Automation is another key aspect that can influence AI-powered growth for healthcare players. By implementing standalone or integrated automation solutions, healthcare organisations can streamline various basic workflows and reduce manual tasks, thus bringing costs down. Robotic Process Automation (RPA) has been around for some time and can further be leveraged for more efficiency.

RPA can be applied for appointment scheduling, insurance pre-approvals, patient reminders and follow-ups, and a host of other things that require basic and mundane manual tasks. With automation, the speed is higher and the chances of human errors are minimised. What’s more, an automated robot program works seven days a week and 24 hours a day.

Related: AI-powered tools drive diagnostic precision in anatomical pathology

One great use case can be a chatbot or a virtual assistant that uses Natural Language Processing (NLP) to provide automated and personalised interactions with patients. In fact, some large global brands are planning virtual clinics based on this model where initial diagnosis or triage can be done with no or minimal human involvement. 
Imagine, an international patient gets triaged in advance for his treatment in another country through a completely automated bot. The bot reads his reports and processes his demographic data to ascertain the treatment pathway before the actual journey even begins. 

It must not, however, be presumed that human involvement in healthcare will be reduced and jobs will become redundant. What may happen is that the human element will be more available for tasks that need empathy, understanding, complex decision-making, and listening, instead of repetitive mundane work.

Personalisation for patient retention

Personalisation plays a crucial role in patient experience, and subsequently, retention. Leveraging AI capabilities, healthcare providers can analyse patient medical history, preferences, and transaction data to deliver highly personalised care and messages. This personalised approach can extend beyond treatment recommendations to include preventive healthcare, cross referrals to other services, fitness plans, dietary advice, and relevant product suggestions. 

Further, the messaging for all these additional suggestions and advice can be created using various AI tools and patients can be engaged through SMS, e-mails, chatbots, and more. Eventually, the conversion and compliance can be measured and patients who drop out of the loop can be retrieved using a well-designed process.

Content generation

AI tools facilitate the generation of relevant and engaging content for healthcare marketing. Automated content creation, such as blog posts, social media updates, and educational materials saves time, money and other resources while maintaining a consistent online presence. 

Some suggested tools that can add value to a hospital’s marketing team are as follows.

• Beautiful AI: Create presentations in seconds. 
• Audo.ai: Automatically removes background noise and enhances your speech using the latest advancement in audio processing and artificial intelligence.
• Qissa.ai: A content writing tool like ChatGPT, however, seems to have a better quality of content.
• Notion.ai: Content creation, grammar check, and translation into other languages.
• Klaviyo: SMS/Newsletter creation. SMS creation keeps in mind mobile-compliant regulations as well.
• Carma: AI-enabled media monitoring
• Veed: Create and edit videos fast for social media.
• Jasper AI: Copywriting tool that creates content automatically.
• Runway: Video editing software: change the video background and delete items in videos.

To conclude, AI is here to stay. Healthcare providers who adopt early and learn to harness its power will stand to gain a competitive edge. They will excel at improving patient care, increasing retention, and optimising operational efficiency. Their teams will be able to communicate and promote the brand better using personalisation, 
automation, and content generation. In addition, AI can result in overall cost reduction for healthcare.

The leaders of these organisations will be at a greater advantage as they can use predictive analysis and current data in the form of real-time dashboards. This will enable proactive and better decision-making. These are exciting times with plenty of new learnings on the cards. Only if you learn, you can grow. 

Vivek Shukla is a Senior Healthcare Growth Advisor

This article appears in Omnia Health magazine. Read the full issue online today.

Access the must-read eBook on AI here to discover perspectives on its transformative role in the healthcare industry.

Back to Technology

A novel strain of COVID-19, named Eris has been labelled as a variant of interest by the World Health Organisation (WHO) despite being assessed as low risk to public health.

Eris, also known as EG.5, comes from the lineage of Omnicron or XBB.1.9.2. Its prevalence is rapidly expanding worldwide, affecting countries like the UK, China, and the US and most recently, the Middle East region.

Health authorities in Kuwait have confirmed that the latest strain of COVID-19 has been detected in the country.

Although the acute chapter of the pandemic was a thing of the past with WHO declaring COVID-19 as no longer a global health emergency, the emergence of the Eris has witnessed cases of COVID increase in recent weeks, with infection numbers rising to 7.2 per 100,000 in the last month.

Spread of Eris strain worldwide

EG.5, is a sub-variant of the Omicron strain of COVID-19. Omicron initially gained notoriety for triggering a surge in infections around the world in late 2021. WHO designated EG.5 as a variant of concern as it is currently spreading in over 51 countries, including Australia, Canada, China, France, Spain, and the UK.

Related: The rise of Omicron: what does it mean for the healthcare community?

In the US, EG.5 has taken a significant hold, becoming the dominant strain of COVID-19. According to data from the US-based Centers for Disease Control and Prevention (CDC), approximately 17.3 per cent or one in six new COVID cases in the country can be attributed to its sub-variant, EG.5.

Symptoms and impact of Eris

EG.5 presents a range of symptoms that varies from person to person. For most individuals, the symptoms are relatively mild and include a dry cough, headaches, runny nose, sneezing, sore throat, and fatigue. However, the overall impact and severity of the COVID variant remain subjects of ongoing research and investigation, according to Dr. Kristin Englund, Infectious Disease Specialist at Cleveland Clinic.

Healthcare system response and vulnerable populations

Healthcare systems, including institutions like the Cleveland Clinic, have observed a slight increase in COVID-related cases and visits to emergency departments. “COVID is contagious, and anyone can get the virus. However, we know that there are populations who are at an increased risk for serious illness and hospitalisation if they get it,” said Dr. Englund.

Related: Latest COVID spike raises alarm: What's next?

EG.5, like its predecessors, is highly contagious, affecting individuals across all age groups. However, certain populations are more vulnerable to severe illness and hospitalisation. The CDC highlights that older individuals, those who are immunocompromised, individuals with specific disabilities, and those with underlying health conditions are at high risk.

Preventive measures to control the spread of Eris

Health officials stress the importance of individual and collective actions to control the spread of EG.5 and other COVID variants. The most effective method of protection is getting vaccinated against COVID-19 and receiving booster shots when recommended.

In addition to vaccination, Dr. Englund recommends:

• Hand hygiene: Wash hands with soap and water regularly or use hand sanitisers.
• Mask usage: Use masks, especially in crowded or poorly ventilated settings.
• Staying home when sick: Avoid public spaces and gatherings when experiencing symptoms of illness.
• Avoiding crowded spaces: Minimise time spent in enclosed areas with poor ventilation.

As the situation with the COVID-variant Eris unfolds, health authorities focus on the need to be vigilant, staying informed through reliable sources, and following guidance from public health agencies. The collective efforts of individuals, communities, and nations are essential in navigating the challenges posed by this new phase of COVID variants, according to WHO.

 Timeline of COVID-variant Eris (EG.5)

Source: World Health Organisation (WHO)

• February 17, 2023: EG.5, a descendant of XBB.1.9.2 with a similar amino acid profile to XBB.1.5, was identified. 
• June 19 to July 23, 2023: EG.5 is most reported at 49.1 per cent. 
• July 19, 2023: It was designated a Variant Under Monitoring (VUM). It carries the F456L mutation compared to its parent subvariants and has a subvariant EG.5.1 with an additional Q52H spike mutation.
• August 7, 2023: Global Initiative on Sharing All Influenza Data (GISAID) received 7,354 EG.5 sequences from 51 countries, predominantly China (30.6 per cent), followed by the US (18.4 per cent) and Korea (14.1 per cent). EG.5 prevalence rose from 7.6 per cent to 17.4 per cent between weeks 25 and 29 of 2023. 

Despite its prevalence, the global public health risk of EG.5 is assessed as low, showing increased prevalence and immune escape properties without changes in disease severity. WHO recommends member states take actions, such as sharing growth advantage information, conducting neutralisation assays, and evaluating severity indicators. The risk evaluation will be updated as more data become available. 

Back to Management

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Haematology has recently witnessed remarkable advancements in laboratory techniques and technologies to assess blood coagulation and fibrinolysis. This has improved processes and is making an impact on the diagnosis, monitoring, and treatment of various haematological disorders.Automated coagulation analysers, for instance, have improved testing efficiency and accuracy, allowing a comprehensive assessment of coagulation profiles. 

The direct measurement of fibrinolytic components provided valuable insights into fibrinolytic activity and related disorders, while molecular genetic techniques, such as PCR and DNA sequencing, enabled the precise detection of genetic mutations associated with coagulation disorders. Advanced imaging techniques, including electron microscopy and confocal microscopy, have further shed light on clot formation and dissolution at the molecular level. “In the past years, blood coagulation and fibrinolysis monitoring has become crucial to diagnose causes of bleeding, assess bleeding risk, develop anticoagulant therapy, and measure the efficacy of the treatment,” explained Prof. Phandee Watanaboonyongcharoen, Associate Professor and Medical Director at the Department of Laboratory Medicine, Chulalongkorn University in Thailand.

Related: Improving Efficiency in the Haematology Laboratory

“Point-of-care testing for coagulation monitoring plays an important role in blood coagulation detection and treatment.”

Latest developments in flow cytometry

Recent advancements in flow cytometry is revolutionising the field of haematology. The introduction of high-dimensional flow cytometry has led to the simultaneous analysis of multiple parameters, enabling a more comprehensive understanding of haematological disorders. Additionally, the utilisation of mass cytometry, or CyTOF, has expanded the repertoire of markers that can be measured, offering increased sensitivity and specificity. Furthermore, the integration of single cell genomics and transcriptomics with flow cytometry has facilitated the identification of rare cell populations and the exploration of gene expression profiles within specific cell subsets. “Over the decades, flow cytometry has been used in various applications of haematology field to sort cells in accordance with their size and complexity. It can also be used to detect and quantify the amount of foetal red cells in maternal blood. To prevent obstetric-related complications during pregnancy, we used flow cytometry to predict medicine to prevent foetal-maternal haemorrhage,” Prof. Watanaboonyongcharoen added. These developments have greatly enhanced our ability to characterise and diagnose haematological conditions with improved accuracy and precision. 

Related: Spotlight on improving quality in haematology

Breakthroughs in the diagnosis of haematologic malignancies

The development of molecular and genetic technology played a critical role in the modernisation and modification of the 2016 WHO Edition for classification of haematologic malignancies, said Prof. Watanaboonyongcharoen. Targeted and novel therapies have been introduced for the treatment of haematological malignancies such as lintuzumab, midostaurin, ulocuplumab, and sorafinib. Current advancements in the diagnosis and treatment of haematologic malignancies have brought significant breakthroughs. Precision medicine and targeted therapies based on genetic profiling have improved patient outcomes. Immunotherapies, such as CAR-T cell therapy, have shown promising results, and advancements in stem cell transplantation techniques have enhanced curative potential for these malignancies. 

Latest screening methods and diagnosis tech

Methods and technologies for screening and confirming haemoglobinopathies have greatly advanced the diagnosis and management of these disorders.  Molecular techniques, such as polymerase chain reaction (PCR) and DNA sequencing, are now widely employed for detecting genetic mutations associated with haemoglobinopathies, such as sickle cell disease and thalassemia. High-performance liquid chromatography (HPLC) and capillary electrophoresis (CE) are utilised for rapid and accurate identification of abnormal haemoglobin variants. Additionally, newer technologies like next-generation sequencing (NGS) enable comprehensive analysis of multiple genes involved in hemoglobinopathies. These advancements have improved early detection, genetic counselling, and personalised treatment strategies for individuals affected by haemoglobinopathies. “Thalassemia diagnosis relies on measuring red blood cell indices and haemoglobin analysis and assessing the clinical severity of anaemia. DNA analysis could be useful to predict the clinical phenotype and pre-symptomatic diagnose of at-risk family members and prenatal diagnosis,” she said.

Prof. Phandee Watanaboonyongcharoen is the Associate Professor and Medical Director at the Department of Laboratory Medicine, Chulalongkorn University in Thailand. She will present opening remarks at the Haematology Conference in Medlab Asia 2023 on August 17

Learn more about Medlab Asia and Asia Health and click here to register for the event.

This article appears in Omnia Health magazine. Read the full issue online today.

Back to Technology

Digital health has experienced significant changes over the past decade in terms of technology, infrastructure, and adoption. The surge in telemedicine, remote patient monitoring, and artificial intelligence helped improve healthcare delivery to be more efficient, cost effective, equitable, and accessible to patients where they are.

The COVID-19 pandemic has certainly accelerated this transformation. The sophistication of mHealth technologies (such as wearables) and their integration into people’s daily lives opened doors to the wellness and lifestyle industry, bringing us closer to a more holistic patient care, where prevention is as important as treatment. However, truly remarkable is the quiet transformation brought by Digital Therapeutics. Digital is no longer only a support to clinical decision-making and delivery. It has become a viable form of healthcare intervention with these Digital Therapeutics, at the same level of clinical impact as pharmaceuticals or medical devices. In the last few years, studies have been published to demonstrate their effectiveness in chronic disease management, mental health, personalised care, and diagnosis. 

Related: Create a future health system paradigm to reform the industry

Since 2017, digital therapeutics has had the fastest growth of any healthtech segment, increasing by eight-fold in the last five years with an estimated global market value of US$28.7 billion in 2030. With the market projected to grow substantially, digital therapeutics holds immense potential for transforming healthcare systems to help cope with the rising demands of our society, both present and future.

Status of digital health adoption in the Asian market

According to Galen Growth, 27 per cent of digital health ventures were funded in Asia Pacific in 2022, making it the second largest ecosystem globally. Countries like China, South Korea, and Singapore are emerging as innovation hubs, fostering local start-ups. Research and online marketplace clusters captured 49 per cent of the total funds invested. The integration of e-commerce and healthtech has gained momentum, offering convenient access to medication and healthcare services, such as the internet hospitals in China. Telemedicine has been widely adopted and continues even after the COVID-19 pandemic. However, Asia-Pacific is a diverse and complex region. Variations in healthcare systems, legal and regulatory policies, economic and cultural disparities can be significant across different Asian countries. The contrasting and fragmented healthcare infrastructures are compounded by inconsistent levels of connectivity and digital literacy, particularly in rural areas. These challenges can limit the effectiveness and adoption of digital health solutions. 

Moreover, economic disparities necessitate well-designed business models to make digital health solutions affordable for sustainable implementation. However, there is currently no specific evaluation framework in the region to appropriately recognise the full value of these innovations, resulting in fragmented reimbursement coverage and under funding. This lack of evaluation framework tailored to digital health further limit and delay patient access in Asia-Pacific. The reimbursement pathways and evidence requirements are often unclear, and usually not suitable for many digital health technologies. Therefore, there is a need to better craft access strategies for digital health technologies to address these barriers.

Digital health tech vs. traditional health products

The rapid, incremental, iterative nature of digital health technologies make them stand out from traditional drugs or medical devices, making their evaluation more challenging. However, without an appropriate assessment, their value would be under-appreciated. This subsequently would have a significant impact on the willingness-to-pay, purchasing, and funding/reimbursement decisions. Unlike traditional drugs or devices, which remain relatively consistent while in use, digital health technologies are frequently updated. This dynamic nature can make less applicable to the traditional methods of evaluation designed for static products, such as randomised double-blinded clinical trials. 

Moreover, the causal effect between the intervention and the outcome of interest is not linear with digital health technologies, as with traditional health products. The effectiveness of these technologies hinges on product usage and user engagement. Variability in how users interact with these technologies can significantly impact their performance and outcome, a factor that traditional evaluation methods for drugs or devices might not fully account for. 

Related: AI-powered tools drive diagnostic precision in anatomical pathology

Lastly, digital health technologies integration into existing healthcare systems often requires a disruption of workflow and organisational change. Their health economic benefits can vary widely depending on the specifics of the healthcare system. Therefore, digital health technologies would need broader and more comprehensive, fit-for-purpose health technology assessment frameworks. 

Understanding their unique attributes is vital for developing evaluation models and processes that can accurately measure their overall value to different stakeholders in healthcare (patients, practitioners, providers, policymakers and payers).

Drivers for access of digital health tech in Asia

Despite its many challenges, Asia offers vast potential for digital health. Governments are investing in digital health infrastructure, such as India’s Ayushman Bharat Digital Mission. They should continue this positive trend by implementing supportive policies, providing funding for digital health initiatives, and creating a favourable regulatory and access environment. Until recently, policymakers in the region have tended to rely on existing medical device policies for Digital Health. However, the unique nature and characteristics of digital health call for revised policies that are fit-for-purpose. These innovations introduce a new paradigm for healthcare delivery, where much is still to be created and no one has all the answers. Thus, it is not only incumbent on governments to drive appropriate access and adoption approaches. It falls on all players in the ecosystem to collaborate. Manufacturers should work closely with other stakeholders to ensure their innovative digital solutions meet the needs of diverse populations and bring value. 

Healthcare providers and professionals can ensure effective integration into the healthcare delivery system. They can help articulate and educate patients and policymakers about the benefits of digital health and strengthen trust. Digital offers the possibility for patients to take ownership of their health. Hence, they need to be actively engaged in the development, implementation, and update of digital health solutions throughout the product lifecycle.

Collectively, we can improve the effectiveness of Digital Health Technologies for the care quality that everyone deserves, and simultaneously accelerate the time-to-market for innovations that will have wider socioeconomic benefits.

Anh Bourcet (Nguyen), PhD, is the Strategic Advisor at the Asia Pacific Medical Technology Association (APACMed). A seasoned global market access leader, she will present her topic on “Broadening Patient Access to Digital Health” at the Digital Health conference, and “Digital Health – Reimbursement Pathways” under the Doing Business in Thailand segment on August 16 and 18, respectively, at Asia Health 2023.

Learn more about Medlab Asia and Asia Health and click here to register for the event.

This article appears in Omnia Health magazine. Read the full issue online today.

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