Fusing medical tourism with telemedicine
Ability to receive diagnosis and medications from home has adherents, writes William Hicks
While a relatively new service in Thailand, telemedicine has become a fast-growing sector, complimenting already established medical tourism and even exporting the expertise of Thai doctors overseas.
Organisations such as Bumrungrad Hospital and Bangkok Dusit Medical Services (BDMS) are putting dozens of their doctors on call for telemedicine appointments for Thais and patients coming from overseas as a way to cut down on medical costs and attract new patients.
For the domestic market, the Thai startup Doctor Raksa has been first to market and the market leader with its mobile application of the same name.
The company partnered with Bumrungrad Hospital, which provides eight part-time doctors to take telemedicine appointments. These doctors can diagnose many minor ailments and even write prescriptions that can be purchased through Bumrungrad’s virtual pharmacy and sent to the patient’s home on the same day through a courier.
“I’m very bullish on telemedicine,” said David Boucher, chief business transformation officer, Bumrungrad
Hospital. “If you look at Kaiser Permanente in the US, half of their patient visits are done through telemedicine.”
Mr Boucher said the service works best for ailments like conjunctivitis, dermatitis, flu-like symptoms and sinusitis, as well as before and after consults for surgeries.
While Bumrungrad’s telemedicine programme is more geared towards patients within the Bangkok area, with consultations costing 500 baht, the app also has a tool for overseas medical tourism patients to consult with a doctor before making the trip to Thailand.
“We knew it would be a work in progress and is a major shift for physicians who are used to laying hands on patients,” he said.
Jaren Siew cofounded Doctor Raksa in 2016 and said the service has around 500 doctors available on the app, with about 270,000 users.
“Through our app, Bumrungrad’s patients can access their electronic health records, and then any consultation they get on the app gets updated in the hospital’s system,” Mr Jaren said. “This kind of synchronisation takes a lot of time and effort and I think we are one of the pioneers in this field.”
In 2018 Bumrungrad invested US$3 million in Doctor Raksa’s Singaporean parent company. By February of 2019, Doctor Raksa closed series A funding with a total of $5 million.
He said his company plans to add more hospital partners this year and make the service available nationwide with 200- to 300-baht consultations.
Mr Jaren said telemedicine will help rural Thais without hospitals nearby to easily access healthcare expertise. Urban users in Bangkok can forgo heavy traffic and get basic prescriptions without leaving their homes.
“People are lining up at hospitals at 5am to get medicine and tests, then going home at 4pm after only talking to the doctor for five minutes,” he said. “With telemedicine, patients can talk to a doctor for 10 minutes then get medicine delivered to their house.”
But his business could really take off if telemedicine becomes covered under nationwide social security. Mr Jaren said the health minister is interested in telemedicine and there may be legislation proposed this quarter to cover it under social security.
“Even without legislation coming out, we have still been growing sixfold year-on-year, but with the legislation we could grow by 50 times,” he said.
BDMS recently announced a partnership with China-based Ping An Good Doctor (PAGD), one of the largest telemedicine companies and a subsidiary of Ping An Insurance, to provide telemedicine to Chinese patients over its platform. BDMS also has its own domestic telemedicine service, Samitivej Virtual Hospital.
The hospital group is allocating over 100 doctors from eight hospitals to focus on providing consultations in areas such as orthopaedics, oncology, neuroscience, cardiology and paediatrics.
These services are recommended for Chinese patients that have already been diagnosed. For instance, patients diagnosed with a type of cancer can then seek consultation and advice from a BDMS doctor before seeking further treatment in China or Thailand. The telemedicine patient will then be issued a report in Chinese that is also sent to a PAGD physician.
These kinds of cross-border online doctor exchanges operate in a legal grey area, as doctors are technically only allowed to practice medicine in their own country. But with online apps such as PAGD and Doctor Raksa, access to healthcare services is available to anyone, anywhere who can access a doctor in any country.
“The more organisations that use telemedicine, the more people will become aware of it and become interested in the service,” Mr Boucher said. “There is a potential risk that patients could go to other sites for telemedicine, but I think our reputation for quality, credentialed physicians will keep patients coming to us.”
‘‘ People are lining up at hospitals at 5am to get medicine and tests, then going home at 4pm after only talking to the doctor for five minutes.
JAREN SIEW
Co-founder, Doctor Raksa