My 84-year-old grandpa anxiously refreshes a web page at 8:57 am online, ready to click when online appointments at one of Beijing’s leading hospital open at 9:00am sharp. It was just a few years ago that him and my grandmother would wake up at 5am and line up 3-4 hours for one of the daily limited spots to see an oncology specialist.
Stories like my grandparents point to the rapidly modernizing healthcare market in Asia.
Yet when we look deeper into the real world healthcare data generated in the area, question marks arise.
- Are there even any?
- If so, what’s the quality like?
- Is it even useful?
- What can we use it for?
- How hard is it to access the data?
- Once I get it, how do we make use of it?
A decade of progress in digitizing medical records in North America and Europe has brought us into the current era of using data to research and optimize care.
With Asia’s top 3 health care spenders (China, Japan and India) all outlining official plans to digitize medical records, why aren’t we seeing more healthcare data initiatives?
The short answer is: we are looking in the wrong place.
Where we expect real world data initiatives: Electronic Medical Records (EMR)
Looking at the top 3 health care spenders in Asia, all of them have official government policies supporting EMR Adoption. It makes sense that this would be the starting point for health care data in Asia.
What? 80% EMR adoption in China, that’s higher than the 59% adoption rate as of January 2016 in the US!
Digging deeper into the 80% EMR adoption, we find a much more interesting and representative story. The 80% is defined as all hospitals that have implemented a hospital information system of some kind.
A study of 848 general hospitals across China in 2014 has shown that 30.7% of hospitals use a standalone computer for information entry! The same study found that the majority of hospitals (31.7%) could only share data intra-department.
Only 1 out of 848 general hospitals had full close-loop data management for all process and full EHR implementation. 4
A quick look at HIMSS’ EMR adoption model evaluating US and Asia
Table Sources 5
Asia still faces a gap for difficult issues of interoperability, quality and adoption rates. That’s why EMRs are the wrong place to look for advances in working with healthcare data.
So, where should we look? Follow the money
Midyear analysis showed that the first half of 2016 was the strongest two quarters, with over $3.9 Billion invested compared with only $3.4 Billion in the same period last year.6 3 out of the top 5 largest investment deals this year were for digital healthcare companies in China.
Direct-to-consumer services that improve patient access to physicians are dominating the investment landscape in China. Whereas in the US, companies targeting physicians and hospitals with practice management tools and analytics are growing rapidly.7
This trend can be observed in the top investment deals. Ping An Good Doctor, backed by Ping An insurance firm, is an website and app that helps patients schedule healthcare appointments and access telemedicine options. Good Doctor directly competes with Chunyu Yisheng offering similar services. The 4th largest deal, Codoon, is a consumer mobile fitness application. Both US-based Centauri and Proteus target pharma companies and health systems as opposed to consumers.
It turns out, my grandpa books appointments on the Good Doctor website.
Clinical data straight from consumers leading the way for data initiatives
When we start looking at direct-to-consumer models, we find signs of a data boom gaining steady momentum. Going direct to consumer and providing telemedicine enable companies to access streams of clinical data while bypassing issues associated with traditional EMR data at hospitals.
Good Doctor, launched in 2015, leads the data movement with over 77 million registered users and 50,000 doctors handling requests from up to 250,000 users daily.8 The lead investor in Good Doctor, internet giant Tencent, also led the largest venture investment into India’s healthcare scene investing over $90 Million USD in doctor searching, appointment booking and telemedicine app Practo.9
In addition to the sheer amount of data Good Doctor is producing, its close relationship with one of the largest Chinese insurers Ping An make it an especially interesting data leader. Being both the provider and the payer creates an enviable closed-loop data analytics system.
Data from Good Doctor allows insurer Ping An to mass analyze clinical outcome data to identify which drugs and medical procedures are most effective for specific conditions. This enables the creation of attractive patient-management programs for their customers, especially large employers.
If this closed-loop data analytics model looks familiar, that’s because it is. Unitedhealth Group created Optum Insights, effectively leveraging a close-loop data between its hospitals, insurance group and data services. - But that’s another story for another day!
Join us next week as we continue to explore issues surrounding clinical and human-experience data coming from emerging markets.
Gao, Xiangzhu, Jun Xu, Golam Sorwar, and Peter Croll. "Implementation of E-Health Record Systems and E-Medical Record Systems in China." ITMR The International Technology Management Review 3.2 (2013): 127. ↩
Sharma, Meenakshi, and Himanshu Aggarwal. "EHR Adoption in India: Potential and the Challenges." Indian Journal of Science and Technology 9.34 (2016): n. pag. ↩
Yoshida, Yuichi, Takeshi Imai, and Kazuhiko Ohe. "The Trends in EMR and CPOE Adoption in Japan under the National Strategy." International Journal of Medical Informatics 82.10 (2013): 1004-011. ↩
Shu, Ting, Haiyi Liu, Foster R. Goss, Wei Yang, Li Zhou, David W. Bates, and Minghui Liang. "EHR Adoption across China's Tertiary Hospitals: A Cross-sectional Observational Study." International Journal of Medical Informatics 83.2 (2014): 113-21. ↩
"Electronic Medical Record Adoption Model (EMRAM)SM." HIMSS Analytics. ↩
"Digital Health Funding Rankings - 2016 Midyear Report." Startup Health Insights (2016) ↩
Baum, Stephanie. "How Do Health IT Investment Trends in China and U.S. Differ?" - MedCity News. ↩
"Medical Services App Ping An Good Doctor Raises US$500m." South China Morning Post. ↩
Arakali, Harichandan. "Tencent Leads $90 Million Investment In India's Doctor-Search Startup Practo." International Business Times. ↩