Digital Health Ecosystem In Singapore - Q4 2017

Introduction

Singapore’s strategic geographical location coupled with its strong information technology infrastructure and favorable climate for innovation due to strong government support makes it an ideal destination for a digital healthcare hub in the Asia Pacific region. The country has seen increasing interest from global multinationals, accelerators and startups to establish the country as a base to address the emerging digital healthcare needs of people across several countries in the entire region.

The strong R&D infrastructure, favorable government policies and abundance of growth opportunities make Singapore an ideal destination for exploring the digital health growth in the South Asian region.

Basics on the Healthcare System In Singapore

Singapore’s healthcare system is designed to ensure that everyone has access to different levels of healthcare in a timely, cost-effective and seamless manner. The country offers universal healthcare coverage through a mixed financing system. Singapore’s government controls and pays for much of the medical system itself. More than 80 percent of the hospital beds in Singapore are in public hospitals, and those hospitals are cut into different “wards” with different levels of amenities: The high-end, single room, air-conditioned A-ward patients and the dorm-style C-ward patients are paying for their own care, but at different price points, because the government is absorbing the direct cost of care in the C-wards. The government’s subsidies shape patient and provider decisions and influence pricing.

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The basic structure of Singapore’s insurance system is built around the “three M’s”: Medisave, Medishield, and Medifund. Medisave is a mandatory health savings account. Every employee contributes 8% - 10.5% (depending on age group) of his/her monthly salary to a personal Medisave account. Patients can only use their Medisave accounts to purchase pre-approved drugs, and the government subsidizes many medical bills directly. Medishield is a nationwide catastrophic insurance program with higher deductibles. Together, Medishield and Medisave form the core of Singapore’s more market-oriented health insurance system. Medifund, which is based on a $3 billion endowment, helps the Singaporeans who are not able to afford medical help even with Medishield and Medisave.

Attractiveness Of Singapore

Singapore has established itself as a medical hub in the region and is considered a favorable destination for medical tourism as well. The country’s government is working hard to continuously improve the nation’s medical infrastructure and services by fostering innovation with a strong focus on operational efficiency, cost effectiveness and optimization of healthcare operations.

Many leading global organizations are attracted to Singapore due to its favorable business climate supported by efficient operating environment, reliable legal framework and favorable R&D and IP protection environment. The country’s readiness in terms of internet and technology infrastructure is also very strong.

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Healthcare Spend & Growth Expectations

The Singaporean government only spends 2% of its GDP on healthcare. However, increased spending is anticipated. 1 in 5 residents in Singapore will be over 65 years of age by 2030 and close to two-thirds of the elderly will have at least one chronic disease. 

As Singapore’s population ages, the government’s annual healthcare spending has doubled over the last five years, with enhanced subsidies and expanded services bringing the total to S$10 billion last year. Healthcare expenditure is projected to rise by S$900 million – up 9.6% – mainly to cater for higher patient subsidies as capacity, patient numbers and services expand. (Singapore’s Finance Minister Heng Swee Keat)

The projected increase in spending will therefore bode well for the future of healthcare companies.

 (Source: https://sias.org.sg/)

(Source: https://sias.org.sg/)

Digital Healthcare System

 The National Electronic Health Record System was started in 2011 in the country and the government still spends about $15 million each year in maintenance costs.

The country is now moving towards a new digital healthcare model by moving healthcare information to the cloud. The project, named hCloud, will cost $37 million in the first 10 years of operations. There are also plans to use data and analytics to assist in decision making at point of care as well as by the Ministry of Health for national planning.

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A 2016 survey by Accenture found that around 90% of residents in Singapore believe that doctors can provide better care by accessing their EHR. Around 78% of consumers and 81% of doctors believe that wearables have a positive impact on the patient’s engagement with their health. However, only 22% have reported that their doctors have recommended them to use wearable technology to track their vital signs or fitness.

 (Source: Accenture)

(Source: Accenture)

Digital Health Startup Scene

Some prominent and well funded digital health startups in Singapore include:

Attune Technologies: One of the most well funded startup with over $15 million in fund raising across various rounds, Attune is a cloud based software provider for healthcare delivery organizations.

Biorithm: Biorithm is a medical signal processing company which has spun off from academia to provide cutting edge signal analysis to the medical community. Working with doctors, Biorithm is dedicated to providing solutions for current and future medical problems especially in the field of wearables and monitoring sensors.

Cardiatrics: Cardiatrics is an innovative heart disease prevention program pioneered by leading Doctors.

Clearbridge Biomedics: The company manufactures devices for cancer diagnostics.

Connexions Asia (CXA Group): The company is billed as “Asia’s first insurance and wellness marketplace” and raised $25 million Series B funding recently.

Cornea Biosciences: Founded in 2011, th company is focused on bio-engineered corneas and has also established the corneal transplant foundation. The company raised $500,000 by the Indiana Lions Eye & Tissue Bank, Indianapolis, USA.

DocDoc: Online health appointment and medical information portal that has raised around $9 million.

EndoMaster: EndoMaster is a medical device company that is developing a novel robotic-assisted surgical system that will significantly advance current endoscopic surgeries. This will enable surgeons to perform incision-less surgery that could only be performed by open and laparoscopic surgery before. The company closed Series B of $14.6 million recently.

Healint: Healint is the startup behind Migraine Buddy, a leading migraine tracking app on Google Play. Migraine Buddy has access to huge data-sets that enable patients, doctors and researchers to diagnose the real-world causes and effects of neurological disorders.

I3 Precision: The company develop systems that address medication safety and productivity issues from the time the medication is prepared to the time it gets consumed by the patient.

Klinify: Klinify provides a document management system, helps private specialist clinics manage patient records while preserving their existing workflow.

MyDoc: The digital platform of the company integrates various healthcare players and gives users access to different healthcare services, including doctor consultations, online prescriptions, and long-term disease management programs. The company recently raised funding of US$ 5.2 million from UST Global.

Ospicon: Ospicon offers a slumbering mat that can monitor a baby’s breathing sequence via installed fiber optic sensors.

OurHealthMate: The company has developed a platform for online medical appointment reservations.

Privi Medical: Privi provides immediate and effective relief from grade I and grade II internal hemorrhoid bleeding and pain.

Px Plate: Px Plate prescribes you with meals that are designed precisely for your body's individual health. 

RingMD: The company is an online directory for therapists, wellness experts, and doctors.

Smartmissimo Technologies: Smartmissimo provides connected wearable muscle stimulators. It offers PowerDot, a wearable personal training device that allows athletes to focus on their workout and recover their muscles. 

uHoo: uHoo is a smart indoor air quality sensor, about the size of a soda-can, that detects allergens and toxins in the air you breathe to help prevent asthma, rhinitis and allergies through practical and personalized alerts, insights and recommendations delivered on your smartphone.

Vault Dragon Healthcare: Vault Dragon aims to provide a cloud-based, patient-centric platform for users to have secure, real-time access to their health records. The company has digitized more than 700,000 unique patient records and is the first vertically integrated record company in South East Asia, offering end-to-end medical record solutions for doctors.

Progressive Government Support and Strong Initiatives to Drive Digital Healthcare

 Singapore’s government unveiled a $13 billion USD five year R&D plan in 2016 with a major emphasis on innovation in health and biomedical sciences. Health tech innovation is also promoted strongly by government agencies in close partnership with private sector organizations. EDBI, the government’s dedicated investment arm, has a strong portfolio of health tech firms.

The government has undertaken extensive efforts to promote the thriving startup ecosystem in Singapore, be it investing in building citizens' entrepreneurship skills or fostering legal, patent and regulatory systems trusted by investors and entrepreneurs. Singapore

Incubators, Accelerations & Investors: Leading The Innovation Game in Digital Healthcare

 International research organizations such as John Hopkins University, Duke University and American Association for Cancer Research have made Singapore their base for accelerating drug discovery and exploring novel therapies for unmet needs of the healthcare sector.

EDBI and Philips announced a joint investment partnership in early 2016 to drive the creation and commercialization of connected health solutions aimed at Asian markets. The focus of this program is on mid to late stage digital health companies.

The Digital Health Accelerator by AIA and Konica Minolta runs a 12-week program in Singapore wherein they select upto 8 start-ups. This accelerator is powered by Nest.

Galen Growth Asia is an association building an integrated innovation network focused on HealthTech startups.  Some other prominent accelerators investing in the healthcare sector include Rockstart, FocusTech Ventures, Clearbridge, thebiofactory, TNF ventures, etc.

IBM is working with Parkway Pantai, one of Asia’s largest integrated healthcare groups, to enhance patient care quality. IBM is a major player in the region and is establishing its foothold with the deployment.

Prominent Venture Capital/Private Equity Firms investing in the healthcare sector in Singapore include BioVeda Capital, OWW Capital Partners, Venturra Capital, Qualgro Asean Fund, etc. Many prominent global VC/PE funds such as Temasek, 500 Startups, Sequoia Capital, TA Associates, Walden International, Silver Lake etc. are also active in the region.

World Class Healthcare Research Infrastructure

The research and innovation ecosystem in Singapore comprises of various ministries such as the Health ministry, R&D funding providers such as National Medical Research Council and R&D performers such as Hospitals, Universities and Research Institutes. Ministry of Health oversees policies and provides financing support to the academic medical centers and hospitals and runs the National Innovation Challenge on Active and Confident Ageing.

National Medical Research Council was established in 1994 and oversees development of medical research in the country.

Singapore Clinical Research Institute is a national academic research organization that works with clinicians to develop disease and practice focused clinical research networks.

Signature Programme in Health Services and Systems Research (HSSR), one of five Signature Research Programmes (SRPs) of the Singhealth Duke-NUS Medical School, Singapore, focuses on areas such as modeling, health economics, survey research and implementation and evaluation.  

Market Map

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Future of Digital Health In Singapore

The digital health ecosystem in Singapore will be driven further by a common theme - To make healthcare affordable and accessible with improved quality. Some of the most promising areas of growth would be in tele-health, remote patient monitoring, mhealth, data and analytics. Singapore is already focused on creating remote healthcare monitoring rooms and thus, tele-health would be of major focus in the coming times. Data and analytics will play a pivotal role in understanding the population’s health requirements as well as to offer targeted services to the patients.

Further, the strong regulatory environment encompassing digital health initiatives in Singapore will also pave way for success in deep technologies such as precision medicine where regulations play a major role in ensuring patient safety.

The Ministry of Health (MOH) has identified 5 therapeutic areas based on factors such as impact of disease, Singapore’s scientific prowess and needs of the country.

These are

  1. Cancers
  2. Cardiovascular diseases
  3. Diabetes mellitus and other metabolic / endocrine conditions
  4. Infectious diseases, and
  5. Neurological and sense disorders

The island offers tremendous growth, research and development and strategic benefits to digital health companies eyeing the attractive Asian market.

References

https://www.moh.gov.sg/content/moh_web/home/our_healthcare_system.html

https://www.vox.com/policy-and-politics/2017/4/25/15356118/singapore-health-care-system-explained

http://apps.who.int/nha/database

https://sias.org.sg/files/SGXMarketUpdates/23022017-Rising-Government-Spending-Bodes-Well-for-Healthcare-Sector.html

https://www.pwc.com/gx/en/issues/high-growth-markets/assets/the-digital-healthcare-leap.pdf

https://www.accenture.com/t20160627T034015Z__w__/sg-en/_acnmedia/PDF-22/Accenture-Digital-Health-Consumer-Survey-Research-Brief-Singapore.pdf

http://techonomy.com/2016/04/health-tech-innovation-blooms-in-singapore/

https://www.duke-nus.edu.sg/research/signature-research-programmes/health-services-systems-research

https://www.singaporebusiness.com/2016/singapore-a-gateway-to-southeast-asias-digital-healthcare-market.html

https://www.eiu.com/graphics/assets/images/public/Digital-Health-Report/Digital-Health-Breakfast-Briefing-in-Asia-2017-V2.pdf

https://www.nrf.gov.sg/rie2020/health-and-biomedical-sciences

https://www.techinasia.com/directory-of-early-stage-venture-capital-seed-funds-and-angel-investors-for-startups-in-singapore