Thailand’s winning strategies amid the health crisis
By Roshel Jayasundera,Senior Director, Global Consulting, Axios International
How do you asses the current state of healthcare access in Thailand? What can be done to improve the situation so that a larger part of the population has consistent access to healthcare services?
The Thai government has always been committed to building an effective healthcare ecosystem in the country, and the Universal Healthcare Coverage (UHC) is a case in point. This system grants every citizen access to essential healthcare services in preventive, curative and palliative care, and has been ranked sixth on the Global Health Security Index.
The UHC has delivered remarkable results over the past decade, but it has limitations when it comes to funding lifelong medication for chronic diseases that are on a constant rise along with ageing population within Thailand.
The UHC or the government alone cannot effectively tackle all healthcare challenges, and there’s a need for both public and private sectors to collaborate in order to deliver sustainable healthcare access to the Thai population. These partnerships need to ensure that citizens do not have to pay for their medical expenses singularly, and the cost is split across different healthcare stakeholders so that healthcare access can be made affordable and sustainable in the long run.
Thailand has been grappling with high healthcare demands caused by an ageing population and a rapid growth in chronic diseases within the country’s population. How can Thailand’s healthcare system evolve to effectively cater to these needs over the entire patient journey?
An increasing rate of chronic diseases and ageing population require lifelong treatments to be made available and affordable to patients. Not only do these patients need financial support, but they also need educational and emotional support to adhere to treatment programs that typically run over a long time.
As I shared before, public-private collaborations are a key to addressing these healthcare challenges. These partnerships will ensure that people don’t have to go beyond their means to fund their treatment plans, and we also need to put proper measures in place so that treatment compliance can be achieved too.
Going forward, Thailand needs to strengthen its healthcare system in a way that both access and adherence are emphasized, which is the only way to empower people with sustainable healthcare access.
Thailand is working towards building a 5-G powered health information system for efficient healthcare delivery. What are your views about it?
5-G powered health information system is definitely an important element towards building an effective and efficient healthcare ecosystem. It will allow Thailand to leverage available data and technology to support an overburdened healthcare infrastructure, especially in rural areas. This initiative has facilitated virtual doctor visits and medicine delivery during the pandemic through a project led by the Ministry of Public Health (MOPH)across 27 hospitals in the country1.
Read Also: Medical Fair Thailand postponed to 2022 due to pandemic
The digital tools are highly versatile – they help build a connected healthcare ecosystem, ensuring efficient exchange of information between patients and different healthcare stakeholders leading to optimum results. Digitisation can streamline operations and optimise resources, enabling health facilities to improve their capacity and better support patients.
While digital technology is certainly necessary for better healthcare delivery, it is important to note that it is largely an enabler, and not a solution in itself. Our focus should always be to build a patient centric healthcare model and digital healthcare should be used as one of the ways to reach out to patients and fulfil their treatment requirements.
COVID-19 has had an economic impact all across the world, and healthcare systems are visibly under strain in order to vaccinate the public. What might a good vaccine rollout plan look like?
It is vital to ensure global access to vaccines in order to curb the spread of diseases. In terms of our organization, we believe that there are three critical components, or 3As, that must be met in order to secure mass vaccination: availability, accessibility, and acceptability.
Availability simply means having sufficient vaccine doses for all or making sure that all countries can purchase and receive the vaccines they need for their population. It is the most critical part, but availability alone will not solve the issue.
Accessibility is about getting shots into arms. It wouldn’t be of any help if the vaccines are available but not administered.
Acceptability is about people’s knowledge and understanding of the importance and benefits of the vaccines.
Once the availability issue has been resolved, it is important that vaccine accessibility and acceptability are also addressed. Every country needs to put in place complementary proactive mechanisms to reach people wherever they are. This doesn’t necessarily mean creating new systems or channels. The solution should integrate with and build upon the existing systems in order to provide a holistic view and take into consideration the needs of the different target groups. Private sector, general practitioners, and community resources should collaborate fairly, efficiently, and transparently to link the entire continuum which leads to a common goal, the herd immunity.
Communication is another important element to success. Countries need to start engaging people through mass communications tools such as social media and in-person community outreach. They need to utilize a combination of different mechanisms, not just one. These tools can also be used to combat vaccine hesitancy and address any knowledge gaps through trusted networks that already exist.
What will be the key healthcare access trends for Thailand and Southeast Asia going forward?
The healthcare access landscape has evolved significantly over the last decade, and with the ongoing pandemic and increasing patient needs, we see the following trends to be in focus going forward:
- Access goes beyond affordability – Access is a multi-faceted concept that needs to include treatment access as well as adherence solutions to ensure optimum health outcomes. A 2020 case study2 relating to Type 2 diabetes conducted in Chiang Mai revealed that whilst the UHC offered adequate medical management, less than half of patients achieved optimal control3. This is paving the way for a shift in healthcare management and healthcare ecosystems need to adopt a more comprehensive view on access that includes affordability, treatment education, family and community support for optimum outcomes.
- Access is being viewed as a long-term solution rather than a short-term strategy – Out-of-pocket payments and government reimbursements are not sustainable ways of managing healthcare costs for a country’s population. There’s a need for alternative access solutions such as patient assistance or support programs so that costs can be shared across different healthcare stakeholders, and patients can be empowered with sustainable healthcare access.
- Healthcare stakeholders need to reach patients outside hospital settings – The ongoing pandemic has highlighted that restricting healthcare within health facilities is an ineffective way of looking after patients. The ability to connect with patients consistently, irrespective of where they are, will be crucial going forward. And Thailand, with its digital technology is already taking sound steps for effective healthcare management. The Pattani Model4 that was developed following the onset of COVID-19 pandemic is an insightful model that helps manage patients optimally through various interventions including remote consultation and medicine delivery.
- Private sector is considering new creative ways to engage with the government on access- Healthcare access is a complex subject that requires a multi-dimensional and multi-sectoral approach. Private and public sectors need to collaborate so that the synergistic strength can deliver long-term healthcare benefits for the population. For example, Thailand’s Department of Consular Affairs teamed up with a MedTech startup5 during the pandemic to provide consultations for Thais living overseas – connecting them with specialist doctors, pharmacies, hospitals, insurance services, and other medical services. Leveraging digital technology, this initiative shows how collaborations can elevate healthcare access for people.
- Data is becoming more important to inform access decision-making -Healthcare access solutions can be designed better if the data resulting from access programs can be effectively captured and analysed. This data can provide breakthrough insights on the disease evolution, treatment, patients’ perceptions, outcomes and cost.
Additionally, for the above-mentioned challenges, my organisation’s response include using the Patient Financial Eligibility Tool (PFET), a unique tool that helps us assess the real financial capability of a patient and allows us to devise effective cost sharing programs that help facilitate long term treatment for our patients.
We conduct a needs assessment with each patient using Patient Needs Assessment Tool (PNAT), to better understand their unmet needs across the 5 dimensions of adherence: social and economic, therapy related, patient related, healthcare team and system, and condition related dimensions. We’ve also created a suite of innovative digital technologies that enable physicians to refer patients to access programs and check their progress remotely, as well as pharmacists to track product supply, even when they’re not in a hospital setting.
Sources:
1https://www.lexology.com/library/detail.aspx?g=a425ef17-8960-4b05-a2ef-460660c307c1
2https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-020-01233-7
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