Digital Healthcare in Southeast Asia - UniMelb GMC 2016

0 Digital healthcare in Southeast Asia

Global Management

Consulting

August 2016

At a glance

As regional growth in

Southeast Asia booms, its

emerging economies seek

for new innovative

solutions to their healthcare

delivery problems.

Digital technology presents

itself as an emphatic tool to

deliver better quality

healthcare in a more

efficient manner.

Digital healthcare in

Southeast Asia:

Bridging development

gaps between ASEAN

emerging markets and

developed economies


Table of contents

Executive Summary 3

Characteristics of emerging markets and it’s

impacts on business models 5

Population demographics 6

Medical talent 9

Infrastructure capacity 11

Private-public-partnerships potential 13

Sources of finance 14

Regulation and governance 15

The value of digital healthcare 17

A shift to a new value chain 18

The leapfrog phenomenon 19

An affordable, proven model 20

Model success and business implications 21

Cut-and-paste models just won’t stick 22

Innovative uses of EHR in emerging markets 23

Hub-and-Spokes model 24

Telemedicine: connecting care 25

Self-management health applications 26

Penetrating the world of Big Data 27

A macro view for micro decisions 28

Next Steps - The Philippines 30

Conclusion 33

Bibliography 34

Characteristics of emerging markets 2

Contacts

This report is the product of a collective of students from The University of Melbourne as part of

the Global Management Consulting program:

Sophie Broadway Jake Fava

Bachelor of Commerce Bachelor of Commerce

Accounting and Management Economics

Shenyuan Liang Ethan Lim

Bachelor of Commerce Bachelor of Commerce

Accounting and Finance Economics and Finance

Bianca Pollock

Bachelor of Commerce

Accounting and Management


Executive summary

Fraught with geographical and economic barriers to

entry, distributing a high quality healthcare system to the

middle and low income populations in Southeast Asia

presents a complex conundrum. Despite significant

economic progress in the past decade and increased

efforts to propel plans that further support healthcare

development, the quality of healthcare services in the

region’s emerging markets lags significantly behind

developed economies.

The source of healthcare development inhibitions

unravels as the national profiles of India, Indonesia,

Malaysia, Philippines, Thailand and Vietnam reveal both

raw opportunities and significant obstacles. Healthcare

investors looking to ride the economic growth wave in

Southeast Asia should be aware of several the region’s

demographic characteristics:

A middle-class uprising and ageing

populations: The large majority of the predicted

3 billion additional middle-income earners are

expected to be found in emerging markets over the

next two decades. This evolution of population

demographics will significantly influence

consumer demand in the sector.

Depleted labour market conditions: Not

only is the nurturing of local medical talent

insufficient to meet rising local health sector

demand, but many graduates seek better

opportunities overseas given better wages and

training opportunities.

A lack of necessary infrastructure:

Equipment directly and indirectly related to the

healthcare sector cannot meet the present and

future demands of the Southeast Asian

population, requiring the sector to explore more

efficient and affordable options without sacrificing

quality.


The rise of Public-Private Partnerships: Support in the provision and development of

healthcare has increasingly been sought from a mindset of synergising resources and

knowledge in the private and public sectors.

Insufficient and inefficient finance: Reliance on small bank loans and inadequate

public sector funding has impeded sector growth and calls for new financing sources.

Fragmented business and healthcare regulation: Legal systems are still developing a

coherent and sophisticated legal structure supported with effective enforcement, with many

nations yet to establish specialised legal protection for industry developments such as

eHealth.

Developed economies lead the way in innovatively integrating digital technology and healthcare as a

means of further advancing their healthcare sectors. The exponential development of digital

applications has seen all branches of the health industry integrate digital operations and networks

into production and provision. From sophisticated Electronic Health Records (EHRs) to the

provision of health services through online communications and mobile applications, the birth of a

new era in healthcare provision reveals unprecedented benefits for all those who harness the

technology.

However, a “cut-and-paste” approach to the models of the developed world is met with severe

resistance. Built for well-resourced nations with sophisticated healthcare industries, these models

do not accomodate the fundamental characteristics of Southeast Asia’s emerging economies.

Transplanting them into Southeast Asia’s regional economic body would see them rejected by

market forces.

This is not to say digital technology would completely fail in the region. On the contrary, it calls for

innovators to mould and develop new applications of digital technology that diagnose and treat the

symptoms experienced by the region’s health system, considering the sector’s demographic, legal

and economic environment within the respective Southeast Asian nation.

Many companies have already successfully built digital business models that address issues relating

to their host nation. All have utilised the available digital resources to maximum efficiency in order

to address small, intricate issues within the healthcare system and seek to expand their operations

within and outside their headquartered nation. Potential entrants to these markets should look to

those who have achieved success, building on their progress and filling the gaps in health sector

development in Southeast Asia’s emerging markets.

Of all the emerging nations, the Philippines presents itself as the shining light for healthcare

investors. Whilst the nation lags its own regional neighbours in many facets, it has engaged in a

redevelopment phase, working with businesses and other countries to accelerate its development

and converge with newly established regional standards. Given the Philippines’ geographic

fragmentation, a model that increases connectivity and accessibility to all its islands is a necessity

for future development, providing unique potential for innovators and investors.


Characteristics of

emerging markets

and it’s impacts on

business models

Emerging markets are characterised by their economic potential. As

these markets transition from once under-developed economies,

overall population welfare rises and prompts greater demand for

quality good and services – especially for healthcare as a stable of

sustaining a quality lifestyle. This provides an incentive for

entrepreneurs to chase the market gaps where supply does not meet

demand. However, to take advantage of the emerging market

potential, business models need to be customised for various factors

that differ to that of developed markets. The population demographics,

lack of talent and infrastructure, access to finance and uncertain

regulatory demands mean that business models need to adjust to

capture the opportunities and combat the challenges of Southeast

Asia’s emerging markets.


Population demographics

The volatile demographics of emerging markets mean market segments and consumer preferences

are changing rapidly. Emerging markets differ from developed economies due to their population

growth, their capacity to handle population aging, the urban-rural distribution of the population and

the growing middle class. These four key demographic factors differentiate emerging markets from

developed markets, making the application of developed market business models futile.

Population growth

By the year 2050 developed

markets within Asia are

forecasted to have reached

their population peak and

start to plateau, or even

decline (see Figure 1.1). In

stark contrast, many of the

emerging markets’

populations are snowballing

rapidly.

Given already insufficient

infrastructure cannot develop

at the same rate as population

growth, the strain on

resources presents a

significant challenge for the

healthcare sector of growing

emerging markets.

Consequently, business

models in these markets

should prioritise efficiency

and scalability. If managed

effectively, the growing

market presents an

opportunity for businesses to

utilise economies of scale,

keeping costs low and

servicing a wider market.

Population aging

As shown in Figure 1.1,

Thailand and Vietnam’s

growth in population shadows

the trends of developed

Asian-Pacific markets, with

Thailand’s population

forecasted to peak between

2025-2030 and Vietnam

beginning to plateau by 2050.

Thailand and Vietnam’s aging

population are the catalyst for

this trend, with the portion of

the population aged over 65


expected to triple by 2050

(see Figure 1.2). Business

models therefore need to be

tailored to an older market,

responding to the shift in

consumer preferences by

focusing on accessibility and

user-friendliness to ensure

the needs of elderly

consumers are met.

Aging populations place a

large strain on healthcare

infrastructure, therefore a

niche exists in these

economies for affordable,

innovative solutions that can

alleviate this strain, especially

through education and by

enabling care to be provided

by means other than

traditional healthcare

providers (such as mobile

apps and wearables).

Urban-rural

population distribution

The large rural population in

emerging markets makes

accessibility a challenge for

businesses. With the rural

percentage of the population

reaching as high as 67% in

India and similarly high levels

in Vietnam, Philippines and

Thailand (see Figure 1.3),

innovative distribution

models need to be a greater

priority than in developed

markets. When designing a

business model in these areas,

half of the population cannot

be ignored – especially for an

industry as indispensable as

healthcare. Therefore,

digitising processes and

making more efficient use of

existing resources is key to

increasing the reach of

organisations, without major

capital outlay.

Rise of the middle class

The increasing proportion of

middle class in Southeast

Asian emerging markets

provides an incentive for

private organisations to enter

the market to satisfy

increased consumer

expenditure. As the middle-

class of the Asian-Pacific

region are expected to

dominate consumer demand

within the next 50 years (see

Figure 1.4), consumer

expectations shift from simple

access to healthcare to quality

healthcare services.1 Private

companies face significant

potential for success by

leveraging the opportunity

presented by consumers’

increased willingness to

spend in the Asian-Pacific

region.

Rising per capita wealth also

alters the healthcare needs of

the market, with Asia

expected to experience the

highest levels of non-

communicable deaths by

2020.2 Additionally, with 66%

of the global middle class

forecasted to belong to the

Asia-Pacific region by 2030,3

power significantly shifts

towards consumers, meaning

business models will need to

adapt to local consumer

preferences to capitalise on

these opportunities.


Medical talent

The existence of highly-skilled talent is widely considered to be one of the top indicators of

determining a country’s competitive aptitude and success.4 However, in recent times the insufficient

access to and retention of this talent has materialised into a world-wide crisis.

Recent research postulated

that by the year 2020, the

global shortage of highly

educated individuals could

reach up to 40 million, with

the gap in the healthcare

sector already reaching 7

million.5, 6

Emerging markets

represent over one-third of

the countries that are severely

impacted by this shortage,

with Southeast Asian nations

suffering in crisis

proportions. 7

Human capital is the core of a

country’s healthcare system,

however this component of

the health-system is often

neglected in emerging

markets.8 The World Health

Organisation (WHO)

stipulates that there should be

a minimum ratio of one

doctor per every 1000 people,

nevertheless this is often not

satisfied (see Figure 1.5), with

the severe lack of physicians

posing as a major obstacle in

many countries.9

When juxtaposing Japan’s

level of talent with Thailand

or Indonesia in Figure 1.5, the

talent gap is clearly

discernible. It is therefore

apparent that a business

model that mirrors that of a

developed country will be

ineffective in an emerging

market due to significantly

less skilled human resources.

With high exportation of

medical talent, an increase in

population growth and non-

communicable diseases, and a

stark disparity in rural-urban

distribution,7 the lack of

quantity of talent is

exacerbated. Pioneering

solutions are essential to

address these dynamics.

Emerging markets also suffer

because of unsustainable

high-quality healthcare

delivery.10 Despite absolute

strategic importance, there is

seldom sufficient funding for

education and often out-dated

delivery methods. Thus,

emerging markets are not

producing the quality of

education the industry

requires.


Furthermore, there is often an

incongruity between training

and real-life practice, a

shortage of qualified

instructors to impart

knowledge and a weak or

non-existent continuing

medical educational system,11

making it difficult for

physicians to keep up-to-date

with the latest medical

advances. Figure 1.6 portrays

several high-level education

rankings in Asia, exemplifying

the inadequate education

methodologies in many

emerging markets. Therefore,

despite recent evidence

suggesting that there have

been attempts to improve

technical and vocational

training in these countries12

the need for innovation is still

crucial as emerging markets

cannot meet this demand in

the short term.


Infrastructure capabilities

The current infrastructure in Southeast Asian emerging markets is insufficient to keep up with the

rapid development of the regional economy. According to Business Monitor International (2016), a

chosen sample of Brunei, Cambodia, India, Indonesia, Laos, Myanmar, Philippines and Vietnam

revealed a constant average healthcare expenditure level of 3%-4% of regional GDP. This is despite

significant population growth and aging population concerns.

Infrastructure deficit and

quality problems in Southeast

Asia’s emerging markets have

not dissipated over the

decades. Rankings of the

infrastructure quality

revealed a 40% gap between

Southeast Asia’s emerging

economies and the developed

nations of the US, China and

Japan.14 Underinvestment

follows unprecedented growth

in population size and income

over the past two decades in

emerging Asia-Pacific

nations. There is need for

significant improvement in

infrastructure if such nations

are to achieve and sustain

healthcare quality levels of

the developed world.

Not excluded from this

infrastructure chasm are the

hospital facilities and Internet

infrastructure of Southeast

Asia’s emerging nations, both

of which are imperative to the

development of digital

healthcare and convergence

to developed economy

standards.

Healthcare

infrastructure

Many of the economies in

Asia’s emerging markets are

struggling with a relatively

underdeveloped public

healthcare system. As a result,

the region has a chronic

shortage of hospital beds and


problems regarding hospital

distribution.

As shown in Figure 1.7 the

number of hospital beds per

thousand persons in emerging

markets is significantly less

than developed countries. To

meet the standards of

developed economies,

extensive investment into the

health sector is necessary but

excessively expensive. For

example, India urgently needs

to add 100,000 beds this

decade, at a prodigious

investment of $50 billion.15

Digital infrastructure

Mobile phone and Internet

subscription are imperative

for successful implementation

of digital healthcare in any

economy, including mobile

health. However, there is a

profound difference in digital

network infrastructure

accessibility between

developed and emerging

market countries.

In recognition of this

concerning disparity,

government investment into

Internet and mobile

broadband infrastructure has

seen it develop with pace in

recent years. As demonstrated

in Figure 1.8, emerging

markets have recently

exceeded the developed

markets in terms of mobile

cellular subscription, as well

as in other facets of digital

infrastructure

implementation. Forecasts

predict that India, China and

Indonesia will be the sources

of the most dynamic growth

in digital consumption.16

Implication for

business models

Financially, many of

Southeast Asia’s emerging

economies will struggle for

some time to fill the

infrastructure deficiency.

Rather, these nations need to

find affordable and more

efficient options that can help

to meet patient demand until

those gaps are filled.

Digital healthcare provides

such an opportunity. The likes

of mobile health means more

patients can be treated at

home rather than visiting a

medical practitioner in

hospital. This would reduce

the pressure on hospital beds

as more patients can be

treated at home.

Furthermore, the rise in

digital infrastructure growth

means that

the

capabilities of

digital

healthcare are

ever

expanding,

with an ability

for high

quality digital

technology to

be used in

urban and

rural areas.


Public-Private-Partnerships potential

The recognition of necessary interdependence between the public sector and private sector rapidly

expanded the formation of Public-Private-Partnerships (PPP) in many countries. Government alone

could not suffice the required improvements in every area and private players found entry into an

unregulated market too uncertain and expensive. In order to improve domestic healthcare services

and lower the financial burden, a PPP provides a win-win situation.

According to The World

Bank’s database (see Figure

1.9), China and India has been

the frontrunners in PPP due

to strong support from the

government, whereas

Malaysia and Philippines are

leading pioneers in Southeast

Asia regions.17 Government

support region-wide is

strengthening and their

perception of private players

in healthcare has changed.

Governments are seeking

active participations from the

private sectors by relaxing

regulations, thereby opening

more opportunities for

investors. For example, China

and India now allow 100%

foreign direct investments

(FDI) of hospitals.

Furthermore, the percentage

of FDI in healthcare has been

continuously growing in many

emerging countries.18

However, challenges still exist

for investors. The PPP

generally with long-term

commitment, where some

contracts established for up to

30 years. Additionally,

government transparency

within the Asian-Pacific

region is problematic, with

some investors unconfident in

in the integrity of government

given relatively higher levels

of corruption in the Southeast

Asian region.19


Sources of finance Globally, the healthcare sector

has been growing at about

3.6% each year, with growth

rates of emerging markets

higher than developed

markets.20

However, despite rapid

growth, businesses still find

difficulties in accessing

finance, relying on small local

bank loans as their main

source of financing. There is

some support from non-

government organisation

(NGO’s) and non-for-profit

organisations (NPO’s), as well

as donations and some direct

FDI, but these contributions

are typically small.21

Furthermore, government

support and expenditure in

the healthcare sector is

insufficient to meet total

demand. Several governments

of emerging markets are

presently experiencing budget

deficits and difficulties in

managing inflation and public

debt.22

Naturally, under these

circumstances, out-of-pocket

healthcare expenditure levels

tend to be high and

expenditure is more focused

on private sectors. Figure 1.10

reveals a stark contrast

among Asian countries: More

developed countries show

higher proportion of public

healthcare expenditures and

lower out-of-pocket

expenditures, whereas

developing countries reveal a

reversed trend.

Overall the above findings

suggest an untapped

opportunity for investors. The

healthcare sector’s reliance on

private providers and high

out-of-pocket expenditure

with rapid growth rate

exposes a profitable

investment opportunity.

Nevertheless, there are

challenges to be resolved.

Most investors are unaware of

the healthcare market in

emerging countries and

perceive such opportunities

risky, even though healthcare

industry is less volatile during

economic downturns given its

nature as a necessary service.

In addition, the fragmented

nature of healthcare

businesses in emerging

markets further complicates

investment. In developing

countries, most services are

provided by multiple

fragmented small-medium

enterprises,21 meaning that

profits are either drawn from

a small niche in the supply

chain, or significant

investment is required to

disperse and integrate

services across multiple

functional and geographical

dimensions of a nation’s

healthcare sector.


Regulation and governance

Political, legal and economic development is staggered throughout Southeast Asia. Where the likes

of Singapore mirror the living standards of Western developed nations, other nations such as

Myanmar and Laos are only beginning to refashion their economies.

However, Southeast Asia is presenting itself as a prime region for investment among the emerging

market realm. Economic growth of Southeast Asia’s emerging economies is forecasted at 5.2% over

2016 to 2020 – lead by the Philippines – as the region seeks to boost living standards.23

Ease of Doing Business

The World Bank’s Ease of

Doing Business 2016 report

exposes the diversity of

economic and legal

development in Southeast

Asian emerging economies.

Middle-income nations such

as Malaysia and Thailand,

whilst still resolving gaps in

their legal and economic

framework,24 have made

significant reforms that rank

them highly against the rest of

the developed world. Whilst

the nations of Vietnam,

Philippines and Indonesia

struggle to make the next step

towards a developed

economy, given inefficient

legal institutions and

lacklustre legal

enforcement.25

Health and privacy

laws

Where developed nations

such as the United States have

started to build new digital

health laws atop their

fundamental privacy and

industry legal framework,

Southeast Asia has made

lesser progress. Much of the

basic and intermediate

privacy, security and industry

regulation remains

fragmented,26 requiring

businesses and the judicial

system to rely on intertwining

non-specific acts and

inferring legality of actions.

For example, Sarabdeen and

Ishak discovered that even in

the relatively sophisticated

legal environment of

Malaysia, the country does

not enforce a specific,

comprehensive act regarding

privacy in e-health data.27 As

a result, intimidation sets into

the decisions of businesses,

especially foreign companies

unaccustomed to the legal

operations in Asia’s

developing nations, who are

considering new business

ventures in Southeast Asia.

The ambiguity is inherently

inefficient for economies who

are pursuing new ways to

propel their progression in

heath and economics to

developed standards.

Intellectual property:

no peace of mind

The legislative gaps do not

preclude intellectual property

laws in emerging Southeast

Asian economies. Not only are

such systems generally

underdeveloped, but a lack of

skilled and experienced

human resources, lacklustre

legal enforcement and

relatively minimal awareness

of the importance of

intellectual property rights for

economic growth has

stemmed its effectiveness in

ASEAN emerging

economies.28, 29 A lack of

confidence in the

enforcement of intellectual

property protection will

deteriorate business

investment, as domestic and

foreign investors alike are

likely to look at safer options

first when developing digital

healthcare technology.

Opportunities

Despite booming regional

growth, the ASEAN

community has become

increasingly aware that

continued development,

standardisation and

harmonisation of economic

policy is required to sustain

future progress. In response,

the ASEAN Economic

Community (AEC) was wholly

established in 2015, pursuing

the three overarching goals of

a single regional market,

equitable regional economic


development and regional

globalisation.30

The AEC mutual policies open

several opportunities for

greater domestic and foreign

direct investment, wider

inter-regional trade and more

favourable foreign trade

policies across many sectors,

including healthcare and

related sub-industries. For

example, the AEC plan to

initiate a ‘Single Window’

policy for Customs, where

subsequent Customs checks

on foreign goods that

circulate through the AEC

region will no longer occur

after a first initial check.31

It is widely acknowledged that

different countries are at

different stages of

development – the likes of

Thailand and Vietnam lag the

relatively comprehensive legal

frameworks of Singapore and

Malaysia. Furthermore, small

and medium enterprises

(SMEs) in the ASEAN region

are largely seen as

unknowledgeable and ill-

prepared given the

expectation of trade

legislation reformation over

the coming years.32 However,

the AEC is accommodating by

working with individual

countries to educate,

distribute information and

make it more accessible.


The value of digital

health care

The health sphere has experienced a great shift in their value chain by

moving to a more patient-centric focus. With this has come the

growing need to harness the increasing digital consumption and

resources that already exist in emerging markets. Digitalisation has

become the key to success in the recent decade by encouraging more

efficient and cost-effective delivery processes, and is likely to be key to

combating the healthcare issues experienced in Southeast Asia’s

emerging markets.


The shift to a new value chain

This century has seen

digitalisation flourish,

catalysing the emergence of a

completely new healthcare

value chain by changing the

way healthcare is delivered,

how patients are treated and

how data is managed.33, 34

With the increasing influence

of disruptors in the healthcare

environment there has been

great pressure for a surge of

innovation. This has resulted

in an expansion in

individualising patient care

which has markedly increased

the personalisation and

efficiency of delivery.35

The move to this

individualised system starkly

contrasts the traditional

system (see Figure 2.1), where

consumer options were quite

stringent in terms of their

providers, payment method

and insurance policies.36 A

recent RAND Corporation

study revealed that only

54.9% of recommended care

was prescribed to adults,35

highlighting the importance

of digitalisation given the

complexity and intricacy of

patient care and the flaws

underlining standardisation

within the traditional system.

Figure 2.1 demonstrates the

movement to an ecosystem

where delivery, research and

development, suppliers and

new entrants centre around

the patient and depicts how

emerging markets can

successfully mobilise and

coordinate this new

ecosystem.37 Although

digitalisation will not

decrease the scarcity of talent

or infrastructure in emerging

markets, it will connect

existing doctors to meet the

demand of the most deprived

and burdened areas. This can

be done by powerful health

platforms such as wearables,

cloud and data analysis that

permit a wider range of

accessibility, a deeper

knowledge for both the

provider and the consumer

and the ability to free up vital

healthcare resources.9, 38

The personalisation of

healthcare and the use of

digitalisation is the crux of the

healthcare challenge in

emerging markets as it will

sanction billions of new

people to be empowered by

this new ecosystem.39 Proper

design of digitalisation has

also enabled better patient

outcomes, a lower error in

diagnosis, greater

convenience and reduced

healthcare costs,35, 40 which

highlights the importance of

its adoption in emerging

markets.


The leapfrog phenomenon

The era of digitalisation has

sparked innovations in

emerging markets to respond

to the unique environmental

dynamics, creating an

economy-wide phenomenon

known as the “leapfrog

effect”. The leapfrog

phenomenon suggests that

the innovations implemented

in emerging markets may

eventually replace the

outdated technology

engrained in developed

healthcare systems.41., 42

Necessity breeds innovation

in emerging markets, often

resulting in more affordable,

accessible and high-quality

healthcare delivery.

Entrepreneurs can devise

these innovations by starting

with a blank slate. From this

they must consider how to

radically reduce expenses and

force innovation, thriftiness

and a sophisticated

understanding of the

environment.

This leapfrog effect was tested

with patients in Boston, who

were treated for HIV via a

program that was developed

in rural Haiti. The result was

a 40% decrease in medical

expenses,43 whilst

maintaining, if not improving,

the quality of treatment.

Thus, there is a potential for

emerging markets to bypass

development stages and

sidestep the pitfalls of these

entrenched systems.37


An affordable, proven model

Digitalisation has changed

people’s lifestyles and

revolutionised countless

industries. Now the world is

entering a ‘convergence’ era

where industries are

propelled into furthered

progress and reform via the

implementation of digital

technology. For example,

retail markets have

thoroughly shifted toward

online market, whilst fintech

and smart devices present

new frontiers never seen in

markets. Such innovations

improve market efficiency

and lower costs of businesses.

Within the healthcare sector,

digitalisation has introduced

telemedicine to emerging

economies - a new form of

healthcare provision

developed over the past five

years. By providing health

services via phones or other

digital communication

devices, the customer base

can expand dramatically as

the technology overcomes

geographical constraints.

Founder and CEO of

HealthCursor Consulting

Group spoke of how “remote

healthcare can give hospitals

better ROI. The telemedicine

centre that cost you 125,000

rupees ($2,120 USD) can give

you 25 percent margins by the

end of the year”.44 As a result,

telemedicine model has seen

rapid expansion among

hospitals or private

companies.

In addition to the benefits

digitalisation brings to the

healthcare sector,

continuously falling prices of

electronic goods and services

has supported the

digitalisation process. The

below data retrieved from the

US Bureau of Labour

Statistics (see Figure 2.2),

shows the steady decreasing

price level of most goods and

services in US. As

digitalisation becomes

increasingly common, the

price of these goods has

subsequently decreased,

making the service more

affordable and increasing the

implementation of

digitalisation in emerging

markets.


Model success and

business

implications

Asia’s developed markets have successfully implemented the complex

digital healthcare models seen in Western society, with Singapore’s

National Electronic Health Record (NEHR) leading the way.

However, the internal struggles of the emerging markets of Southeast

Asia rules out similar implementations of a “cut-and-paste” business

models for disturbers in their healthcare sectors. A tailored, bespoke

approach that addresses specific problems in Asia’s emerging

economies, whilst drawing from each nations strengths and

integrating neighbouring markets is essential for the successful

implementation of digital healthcare.


Cut-and-paste models just won’t stick

Singapore and South Korea as

developed Asian countries

have produced a sophisticated

digital healthcare

system. Singapore’s National

Electronic Health Record

System (NEHR)

systematically saves complete

patient health records and

conveniently shares it with

healthcare service providers.

However, the system’s

development laboured for

four years in order to prepare

and initiate the system,

representing a huge cost to

the nation. In fact, a cost-

benefit analysis revealed that

the breakeven point of the

NEHR will not be reached for

another 9 years.45 Whilst the

benefits will be immense for

Singapore, the system

presents an unfeasible

financial and time burden for

emerging markets.45

Additionally, digitisation at

the primary practitioner level

is immensely expensive.

According to a medical

economics report, U.S.

primary practitioners

experienced an average cost

of $162,000 to implement

health record systems, with

another $85,000

maintenance expense for the

first year.46

However, the problem runs

deeper than the cost of

implementation.

Fundamental gaps in every

aspect disrupt utilisation of

Information Communication

Technology (ICT) in

developing countries. Figure

3.1 demonstrates the gaps in

every pillar.

The lack of infrastructure and

talent results in very low

uptake of ICT in the

government, business, and

household sectors. Thus, the

potential impact of the ICT

will also be relatively lower.

However, with regards to the

affordability of ICT, emerging

countries show strength given

to cheap labour forces and

affordable market prices.47

Nevertheless, there still exists

examples of successful

businesses that changed the

healthcare sector in emerging

markets by introducing

digitalisation with

modifications. Successful

businesses used strategies

that incorporate the

characteristics of developing

countries, using unique

approaches to overcome

constraints.


Innovative uses of EHR in emerging markets

Whilst a fully integrated nation-wide EHR system may not be feasible for emerging markets given

their current level of infrastructure, certain innovative businesses are working to extract some of the

benefits of EHR without the large capital outlay. eKincare is one such example, using Personal

Health Records (PHR) as a means of facilitating the storage and transfer of medical records.

The value chain in healthcare

is becoming increasingly

patient-centric, changing the

way healthcare providers and

disrupters structure their

services. eKincare, an Indian

start-up, has used this

concept to develop their

business model which

facilitates patients’ ability to

consolidate their own PHR’s

and store them in cloud-based

software, extracting some

benefits of an EHR system at

a more affordable price.

Primary research conducted

by eKincare’s founder, Kiran

Kalakuntla, revealed 87% of

individuals in India were

interested in digitising their

medical records either for

themselves or their aging

parents who may live

elsewhere.48 However, these

individuals were unwilling to

spend time filling out forms to

establish the record or pay for

the data storage. eKincare

mitigates these issues by

making the platform

completely free to use, with

no data limitations. Its

differentiating feature from

other PHR apps is its user-

friendliness; Once the user

has photographed and

uploaded the pictures of their

documents, eKincare then

translates the medical jargon

to a more accessible format,

updating the patients’

healthcare record in real time

and highlighting potential

health risks.

eKincare’s monetisation

strategy is to then use this

data to offer in-app purchases

or connect the user with a

specialist based on their

medical information.

eKincare has developed

partnerships with

practitioners and specialists

at over 1,500 locations across

India,49 enabling them to

recommend the appropriate

specialist based on the users’

health needs and provide

price discounts. These

practitioners have access to

the users’ medical records and

can track their health

remotely, allowing the

healthcare provider to

increase efficiency yet provide

a better quality of care due to

greater access to patient

information. The concept has

been recognised for its

innovation and social impact,

notably acknowledged in the

Global Digital Health 100

Award List for 2015.50

eKincare is gaining

momentum in India due to

the high volume of the

population with access to a

smartphone or PC and the

growing need for consumers

to manage their own health to

lessen the strain on the

healthcare infrastructure.

Countries with similar

demographics and consumer

needs, such as the

Philippines, where the

population is growing at an

expeditious rate, may also

reap the benefits of a similar

PHR platform. Another

aspect of eKincare that has

contributed to its success in

India is its ability to enable

users to monitor the health of

family members in addition to

their own. Vietnam and

Thailand’s aging population

could also be receptive to this

concept.


Hub-and-Spokes Model

It is said that necessity is the mother of invention – India’s ability to develop an innovative model of

healthcare distribution is a prime example of how this is true. The Hub-and-Spokes Model (HSM)

ensures affordable healthcare is accessible to the rural communities who are in dire need.

In India, only one fifth of

healthcare expenditure is

publicly financed and 70% of

workers in rural areas earn

just $3 a day.51 Medical care is

often non-existent or

insufficient in these rural

areas and transport facilities

are poor, limiting access to

the medical care facilities that

are sufficient.

This presents

a huge

challenge for

the healthcare

industry to

provide

services to the

67% of the

population

living in rural

communities

(see Figure

1.3).

HSM models

overcome this barrier

by increasing the

efficiency of existing

resources. This is

done using a central

hub where specific equipment

and doctors treat specialised

cases, and spokes located in

rural areas which provide

basic care. The innovation of

this model lies in the hub and

the spokes ability to

constantly communicate

using ICT. Patients with

specialised needs can then be

referred to the hub, where

their patient information and

history will have been

provided using ICT, enabling

the specialists at the hub to

provide a better quality of

care in less time. The

organisation is able to

increase the provision of

healthcare over a wider

geographic area and reduce

costs by using expensive

resources more efficiently in

the hub, avoiding the need to

replicate these resources in

the rural areas.52

ICT is paramount to being

able to keep the connectivity

between the hub and the

spokes and increase the

efficiency of both parties. The

healthcare workers at the

rural clinics are equipped

with devices such as laptops

connected to a secure

network, including wireless

network cards designed to

work in low connectivity

areas. The devices may also

come encrypted with defined

procedures and process flows

to maintain the quality of

care, security

features to

maintain the

integrity of patient

information, and

communication

tools such as

email, text and

instant messaging

to contact the

hub.51

HSM has the potential to

apply to other emerging

markets with similarly large

rural populations, however

this model of healthcare

provision would crumble

without the necessary ICT

facilities and proper usage. It

is therefore no coincidence

that this model is so

successful in India, which has

the highest rate of ICT literate

graduates and healthcare

workers as well as the most

affordable ICT infrastructure

and devices.51


Telemedicine: connecting care

Emerging markets require the

distribution of knowledge to

extend accessibility and

improve the provision of

diagnosis and treatment.

Telemedicine is one possible

avenue by repurposing

already existing infrastructure

to also increase

standardisation of care,

enable better decision-making

and improve labour force

efficiencies.41, 53

Despite some key

characteristic differences

between Southeast Asia’s

emerging markets, all could

experience the positive

impacts of telemedicine.

Figure 3.2 hypothesises just

how powerful the benefits of

telemedicine would be for the

US. These positive

externalities will be far more

intense in emerging markets,

as it can help the sector to

expand the patient base,

reduce overheads and

transport costs, minimise

brick-and-mortar rural

expansion costs and eliminate

follow up visits. This all

makes vital resources more

accessible.39, 54

Lifetrack medical

systems

One company that has reaped

the benefits by implementing

telemedicine is Lifetrack

Medicial Systems, a radiology

company based in Philippines

that innovatively embraces

telemedicine to address the

lack of resources. In a country

where 56% of its population is

situated in rural areas (see

Figure 1.3) it is crucial for

timely diagnosis and

treatment to avoid a deadly

bottleneck in medical

workflow.55 To access this

sub-population, Lifetrack

pairs an apprentice, often in

rural locations, to an expert

practitioner through a

digitalised feedback system.

This enables remote reading

of medical images as the x-

rays can be accessed and sent

to wherever a qualified

professional is available for

prompt analysis.55

Model implications

The advent of this technology

has improved efficiency by

encouraging timeliness and

quality of diagnosis. Further,

when looking at radiology

from a global perspective, the

acceptance of digitalisation

has reduced the demand for

overburdened radiologists by

roughly 20% in the last

decade.56 This highlights how

important the acceptance of

digitalisation is in emerging

markets from both a

consumer and provider

perspective.

Businesses could also analyse

the success of this model to

extrapolate the need of other

subdivisions in the industry.

Asian emerging markets,

particularly those with a

higher rural to urban

distribution such as the

Philippines, often experience

serious health complications.

Yet they are some of the most

deprived countries in the

world for other specialisations

– for example, pathology.56

Therefore, Southeast Asian

emerging markets represent

the most fertile ground for

digitalisation and

telemedicine, as it would

facilitate a more collaborative

global health ecosystem,

guaranteed improved patient

outcomes, reduced cost

inefficiencies and lower

occurrence of adverse or

preventable events.54


Self-management health applications

Under-resourced economies

in Southeast Asia face an

uphill battle to source the

financial resources necessary

to overhaul the accessibility

quality of their healthcare

systems. However, other

cheaper and effective

alternatives can be utilised by

these nations to boost the

effectiveness of the healthcare

sector in the short run whilst

the nations focus their

attentions to the long-run

solutions.

Self-management digital

health products are starting to

be implemented as a means of

reducing strains on healthcare

resources for common and

mild health issues. What

started as simple Google

searches for symptoms has

been consolidated into a more

reliable and updated data

bank with easy to understand

information. Simple

sanitation tips, proven

medical remedies, symptom

flags and digital treatment

schedules all help for an

individual to take better care

of themselves without

unnecessary aid from the

healthcare sector.

iClinic in India

iClinic, an Indian start-up

working with hospitals and

pharmacies in distributing

high quality healthcare

services to the general public,

have established their own

supplementary self-

management services on their

flagship website. A symptom

checker section allows

patients to input some basic

symptom information to learn

of a number of possible

illnesses they may be

suffering and provides scope

on details surrounding each

suggested diagnosis. An

online forum also publishes

authorised articles written by

doctors and patients alike,

providing a more detailed

description of several

illnesses.

The benefits of iClinic are

immense. Crucially, the

savings to consumers who

have the option between

expensive physical general

practitioner consultations and

a cheaper self-managed

mobile service for mild to

intermediate symptoms can

widen access to high quality

healthcare in Asia’s emerging

markets.

Other mobile application

health providers are also

adding self-management

capabilities. Aside from its

cloud-based personal health

records system, Singapore

start-up Vitalstrak provide a

mobile system that allows

users to input their

medications and set

reminders via the app, SMS or

e-mail service. Patients can

also record basic symptoms

into the app to take (or send)

to a doctor for diagnosis.

Model implications

One of the model’s most

important features is its

ability to integrate with other

forms of telemedicine and

digital health care services.

The model works best as a

complementary portal of

information that people in

need rely on first. If the self-

management service cannot

provide the relevant

information, be it a more

detailed diagnosis and

treatment plan to a new drug

prescription, patients can be

referred to the relevant source

provided the business model

integrates with other digital

health models.

This not only builds a digital

medical network that

consumers can tap into at any

time, but it allows developers

to connect a low-revenue

product that is digital self-

management products to

chargeable digital medical

services such as online doctor

consultancy and drug

purchases. Repeat customers

are established through this

complementary service given

consumer convenience and

product familiarity. This

approach is taken by most

telemedicine mobile

applications as they build a

self-management section into

their primary model if

medical assistance provision.


Penetrating the world of big data

Digitalisation can allow

pertinent data to be

aggregated and analysed

almost instantaneously. This

collation can assist in forming

a greater knowledge of future

trends and provide more

accurate and appropriate

diagnosis and treatment. One

way to penetrate the world of

big data to provide timely and

accurate solutions is through

artificial intelligence.

IBM Watson

Medical data is forecasted to

double every 73 days by 2020,

however 80% of data is

invisible or unstructured to

current systems, despite

three-quarters of the

information being clinically

relevant.57 IBM Watson is a

pioneering system that

creates a heightened level of

interaction between humanity

and technology with the

objective of redefining and

transforming global health.57

It is also a secure cloud-based

system that can promptly

analyse this previously hidden

data in light of modern

leading medical literature,

electronic health records and

other qualified physician’s

opinions.

Model implications

Recent research conducted by

IBM Watson demonstrates

that 81% of healthcare experts

that are familiar with the

innovation believe that it has,

and will, provide a positive

impact on their business and

the health environment. This

innovation would provide

even greater benefits for

patients who live out of the

reach of world-class medical

healthcare providers; by

migrating to a cloud-system,

emerging markets would have

access to the same tools and

solutions as their wealthier

counterparts.58 This will allow

physicians in Asia’s emerging

nations to have instant access

to current healthcare

advances and procedures

which will assist with any

information gaps not

delivered by their medical

educational system. By

providing these solutions,

IBM Watson would increase

confidence and precision in

decision-making, particularly

when dealing with rare,

complicated or undiagnosed

diseases. Such a system would

also encourage safer

treatment by issuing proactive

and preventative solutions

that are more likely to be

error-free. Further, by being

more unencumbered by their

legal environment in regards

to data, as well as their

increase in digital

consumption, there is an

opportunity for emerging

markets to leapfrog over their

wealthier counterparts with

IBM Watson by targeting

more of their population.

This level of specificity is

creating value for both

consumers and providers in

many countries, such as India

and Thailand, by reducing

cost and providing electronic

health records.57 Further,

Thailand’s provision of cancer

care has improved by leaps

and bounds with IBM

Watson’s ability to

personalise treatments,57

demonstrating how it may be

a system of the future for

emerging markets.


A macro view for micro decisions

Efficiency is the ultimate goal for emerging ASEAN nations as they rely on limited finance and

resources to grapple with unforeseen healthcare issues. However, information deficiencies regarding

management of the healthcare sector inhibit effective policy implementation and resourceful

governance.

Macro data is the plug to all information gaps; Macro data can now be digitally collected, stored,

analysed and published to governing bodies in the healthcare sector. Transparent and accessible

evidence can thus strengthen the links in the healthcare decision chain and prompt prodigiously

efficient policy approaches.

Data harvesters are already working in conjunction with non-for-profits, universities, governments

and healthcare providers to reform current practices to improve diagnosis and treatment of the

healthcare system itself.

Redefining

Tuberculosis testing in India

With 23% of tuberculosis

sufferers residing in India,

significant challenges lie in

the provision of safe and

effective care and reducing

the prevalence of the disease.

Government initiatives such

as the Revised National

Tuberculosis Control Program

(RNTCP) struggle to identify

and treat the majority of

tuberculosis patients as the

non-standardised, cheaper

and largely unregulated

private sector laboratories

dominate the market. Issues

of misdiagnosis, delayed

diagnosis and mistreatment

are magnified as the private

sector avoid using World

Health Organisation (WHO)

endorsed testing systems, as

they are disincentivised by

lower profit margins it

delivers.

The Clinton Health Access

Initiative (CHAI) partnered

with the SAS Institute and the

Bill and Melinda Gates

Foundation, launching the

Initiative for Promoting

Affordable and Quality TB

Tests (IPAQT) in 2103.59 By

redeveloping WHO-endorsed

tests to maintain their quality

whilst reducing their costs,

CHAI were able to partner up

with current private test

providers. Costs savings were

guaranteed to be passed onto

patients with up to 50%

savings, whilst laboratories

largely maintained their profit

margins. Furthermore, CHAI

worked with local doctors to

educate them about the tests

and encourage greater

referrals, and more patient

data was sent to the RNTCP

program for greater

government support for

patients.

Positive Externalities

of Big Data’s Building

Blocks

Strengthening the data

network between patients,

providers and government

requires innovation in design.

The direct benefits provided

by macro data analysis can be

complemented with a number

of indirect positive

externalities, provided that

disturbers build them into

their business model. The

compounding nature on

financial and social returns is

often incentive enough for

new business innovations to

take them into account.

Utilising Existing

Infrastructure

Data collection is inherently

expensive, requiring complex

systems for systematic

collection, storage and

analysis of the data.

Successful macro data

business models in emerging

markets cut costs by

integrating existing

infrastructure, significantly

cutting upfront capital costs

and maximising economies of

scale.

Fast-tracked development of

telecommunication networks

in emerging markets is

increasingly being utilised by

macro data companies. In the


Philippines, mClinica use

phone networks to collect

data on the stocktake and

pharmaceutical purchasing

histories of consumers in

rural “mum-and-dad”

pharmacies, who incentivise

customers to sign up with

guaranteed discounts, on-

selling the data to big

pharmaceuticals. The system

maximises consumer reach

and circumnavigates health

literacy issues often

experienced in rural

Philippines.60

Creating a transferable data

system for emerging Asian

markets can further boost

financial and social returns to

scale. These costs savings can

then largely be passed on to

the low and middle income

consumers that struggle to

access high quality health

care.

Synergy of Knowledge

Collaboration between private

sector healthcare innovators,

governments, healthcare

providers, non-for-profits,

research centres and

universities establishes a

deeper pool of knowledge.

New, innovative ideas can be

developed faster, cheaper and

with greater effect if

businesses draw from the

ever-growing knowledge bank

when establishing and

delivering solutions to

complex health problems in

emerging Southeast Asian

markets.61

Establishing Quality

and Safety Standards

Regardless of the speed of

legal healthcare progress,

successful innovative

healthcare businesses in

emerging markets can lift and

standardise the quality and

safety of healthcare through

their own market initiatives.

By basing their ideas on

international standards and

striving for greater efficiency

and outcome effect,

disturbers can lead the way in

improving standards in

emerging markets.

Greater transparency of

collected data will also reveal

cases of fraud and

corruption,62 which is more

common in the emerging

ASEAN nations and

healthcare industries that are

predominantly privately

funded. Furthermore,

transparent markets and new

methods of information

delivery help reduce

information asymmetries in

price, quality and access,

further promoting efficiency

in emerging Asian healthcare

markets.

Utilising existing

infrastructure to

its maximum

potential

Next steps – The Philippines 30

Next steps – The

Philippines

The idiosyncrasies of Southeast Asian emerging markets are the

catalyst for barriers to entry. This has led to untapped opportunities

for investors due to the risk of entry and underdeveloped resources

outweighing burgeoning demand. However, as these markets

continue to introduce more ‘investor-friendly’ reforms and digital

penetration facilitates broader access to previously unreachable

consumers, these emerging markets hit their ‘sweet spot’ for

investment. The Filipino market epitomises this concept. Favourable

demographics, progressive reforms and gaps in the market mean that

the healthcare sector in the Philippines is ripe for investment.


A void in the market

The Filipino population is growing at the fastest rate of all the Southeast Asian economies,

forecasted to increase by 168% to 168 million in 2050 (see Figure 1.1). The healthcare infrastructure

in the Philippines is currently extremely under resourced with only 1 bed and 1.16 physicians per

every 1,000 patients.63 The lack of talent is exacerbated by 56% of the population located in rural

areas (see Figure 1.3). The result is a desperate need for innovative solutions to connect the limited

specialists with a rapidly growing and rurally based population.

Challenges for investors

Foreign direct investment (FDI) limitations and the highest corporate tax rate in the ASEAN

region64 have traditionally made the Philippines an uninviting landscape for business. Foreign

investors are restricted to a 40% ownership in local enterprises,65 whereas other ASEAN countries

such as Indonesia permit 100% ownership.18 The Philippines also ranks in the bottom half of

Transparency International’s Corruption Perceptions Index65 – making PPPs that are necessary to

stimulate growth in the healthcare sector riskier for foreign investors.

Furthermore, limited access to talent has made the implementation of healthcare initiatives

difficult. Skilled Filipino healthcare workers often migrate overseas in search of higher paying jobs.

This is illustrated by the Philippines being the third highest source of National Health Service staff

in the UK.66

Progressive reforms

Despite these challenges, recent reforms are working to mitigate FDI issues to encourage the

investment the Filipino healthcare sector desperately needs. The introduction of the ASEAN

Economic Community (AEC) is expected to increase FDI and may result in an increase of inbound

skilled healthcare workers, due to the ability to improve their English in the Philippines and the high

demand for physicians.67 Additionally, in an effort to begin resolving the talent deficit, the

University of the Philippines introduced a return service agreement in 2010, mandating that

students perform three years of medical research, further study or practice locally, or else pay back

the equivalent of 5 years’ tuition.66 The aim is to allay the Philippines’ rapid ‘brain drain’ and

incentivise doctors to work in the rural areas that are desperately in need of healthcare workers.

Unprecedented opportunities for digital healthcare

The Filipino government is currently putting unprecedented resources into the universal health

coverage in order to ensure 100% of the population is covered by the national health insurance

program (PhiliHealth) by the end of 2016.66 The effect of this is a demand for higher quality

healthcare services. The government is calling for the private sector to establish PPPs in order to

implement infrastructure projects and outsource the provision and management of healthcare

services. This should improve the overall quality of the healthcare sector and provide the private

sector with opportunities previously restricted.

Currently, market dynamics in the Philippines are extremely favourable for digital implementation.

The population is extremely receptive to digital forums, with the Philippines having the highest level


of brand engagement across all online content channels in Southeast Asia.68 Additionally, the

Commission of Information and Communication Technology (CICT) developed its Philippines

Digital Strategy (PDS) in 2011. The PDS aims to increase the access and use of ICT in IT-enabled

sectors. This is congruent with the government's focus on increased Internet connectivity, aiming to

provide WiFi connectivity in public facilities nationwide by the end of 2016.69 This improvement in

digital infrastructure means more opportunities for digital healthcare players to enter a historically

impenetrable market in areas such as mHealth, wearables, telemed and self-

management/educational healthcare applications.

Example: The Hub-and-Spokes Model

One potential model that could capitalise on the aforementioned opportunities is the

implementation of a Hub-and-Spokes Model (HSM) as a management and distribution model for

primary and general healthcare providers. For this model to be successful in providing quality

healthcare to rural communities, access to ICT and retention of skilled physicians are non-

negotiable criteria. The recent RSA and PDS schemes facilitate access to these factors, providing an

unprecedented opportunity for foreign hospital management companies to implement a HSM in the

Philippines.

Previously foreign investors have not had the opportunity to control the management structure of

healthcare providers in the Philippines. Traditionally, private hospitals in the Philippines are

generally smaller and more specialised. However, increased PhiliHealth coverage will lead to the

construction of larger private hospitals that can provide general and primary care where HSM can

be implemented.66 Additionally, PPP, in the form of management contracts are becoming

increasingly encouraged.70. Such a contract would govern the outsourcing of the management of a

public facility, enabling foreign entities to implement HSM in public hospitals.71

One major priority for the Philippines’ healthcare system is to increase access to healthcare.72 A

HSM would be one way to facilitate this goal without adding expensive infrastructure and by using

existing resources. For example, Philippines has an average nurse to patient ratio of 1:15.73 Given a

ratio of nurses well beyond even the ideal nurse-patient ratios in developed countries (1:4 in

Australia74), there is sufficient supply for nurses to act as a surrogate doctor under a qualified

doctor’s supervision using telemed at the rural spokes. A HSM facilitated by ICT can decrease costs

and increase revenues by increased efficiency of equipment and specialists and increasing the

volume of patients served, providing a win-win for both investors and the healthcare sector.


Conclusion

Innovative business models are changing the healthcare sector in

Southeast Asian markets, and existing service providers are

accommodating the digital trend in a unique way. Disrupters reshape

the industry toward a more patient centred system, developing new

services as mobile health, while traditional businesses selectively

adopt new technologies as one part of harvesting strategy.

The seismic change is gathering momentum, advancing patient

treatment in every aspect gradually filling in the fundamental gaps

between developed and developing. Simultaneously, the change opens

new opportunities investors can grasp in countries such as

Philippines. Market conditions are ripe for investment, however

investors should keep in mind the characteristics of Southeast Asian

countries that make business unique from their current environments.


Bibliography

1. Pezzini, M. (2016). An emerging middle class - OECD Observer. Oecdobserver.org. Retrieved from http://www.oecdobserver.org/news/fullstory.php/aid/3681/An_emerging_middle_class.html

2. Deloitte. (2015). A perspective of future healthcare landscape in ASEAN and Singapore (p. 3). Retrieved from https://www2.deloitte.com/content/dam/Deloitte/sg/Documents/risk/sea-risk-future-healthcare-thought-leadership-noexp.pdf

3. EY. (2016). Hitting the sweet spot - The growth of the middle class in emerging markets (p. 4). Retrieved from http://www.ey.com/Publication/vwLUAssets/Hitting_the_sweet_spot/$FILE/Hitting_the_sweet_spot.pdf

4. Deloitte University Press. (2016). Emerging market talent strategies: Creating an effective global talent model. Retrieved from: http://dupress.com/articles/emerging-market-talent-strategies/

5. McKinsey & Company. (2012). The world at work: Jobs, pay, and skills for 3.5 billion people. Retrieved from http://www.mckinsey.com/global-themes/employment-and-growth/the-world-at-work

6. Forbes.com. (2016). Emerging Market Medical Education Goes Digital. Retrieved from: http://www.forbes.com/sites/techonomy/2015/03/17/emerging-market-medical-education-goes-digital/#3727ebf1b111

7. Nair and Webster (2012), Health professionals’ migration in emerging market economies: patterns, causes and possible solutions. Retrieved from: http://jpubhealth.oxfordjournals.org/content/35/1/157.full

8. Nair and Webster (2012), Health professionals’ migration in emerging market economies: patterns, causes and possible solutions. Retrieved from: http://jpubhealth.oxfordjournals.org/content/35/1/157.full

9. Hongoro, C. & McPake, B. (2004). How to bridge the gap in human resources for health. The Lancet, 364(9443), 1451-1456.

10. EY. (2015). Ripe for investment: the Indonesian health care industry post introduction of universal health coverage. Retrieved from http://www.ey.com/Publication/vwLUAssets/EY-ripe-for-investment-the-indonesian-health-care-industry/$FILE/EY-ripe-for-investment-the-indonesian-health-care-industry.pdf

11. Oracle. (2015). Oracle Cloud Talent Strategy for Healthcare: Finding and Retaining Scarce Talent. Retrieved from: http://www.oracle.com/us/industries/healthcare/healthcare-talent-mgmt-wp-2538994.pdf

12. ICEF Monitor - Market intelligence for international student recruitment. (2015). Challenges in Vietnamese higher education contributing to demand for study abroad. Retrieved from http://monitor.icef.com/2015/09/challenges-in-vietnamese-higher-education-contributing-to-demand-for-study-abroad/

13. Business Monitor International Ltd. (2016). BMI. Retrieved from: https://bmo-bmiresearch-com.ezp.lib.unimelb.edu.au/data/datatool/

14. World Economic Forum. (2014). Global Competitiveness Report 2014-15. Retrieved from: http://www3.weforum.org/docs/WEF_GlobalCompetitivenessReport_2014-15.pdf

15. Deloitte. (2015). 2015 Global health care outlook Common goals, competing priorities. Retrieved from: http://www2.deloitte.com/content/dam/Deloitte/global/Documents/Life-Sciences-Health-Care/gx-lshc-2015-health-care-outlook-global.pdf

16. Turner, P. (2010, November 24). growglobally. Retrieved from http://growglobally.org/?p=497

17. Kenny, J., Lavanchy, R., & Kjorstad, J. (2013). Emerging Partnerships. International Financial Corporations. Retrieved from http://www.ppiaf.org/sites/ppiaf.org/files/publication/emerging-partnerships.pdf

http://www.oecdobserver.org/news/fullstory.php/aid/3681/An_emerging_middle_class.html

https://www2.deloitte.com/content/dam/Deloitte/sg/Documents/risk/sea-risk-future-healthcare-thought-leadership-noexp.pdf

https://www2.deloitte.com/content/dam/Deloitte/sg/Documents/risk/sea-risk-future-healthcare-thought-leadership-noexp.pdf

http://www.ey.com/Publication/vwLUAssets/Hitting_the_sweet_spot/$FILE/Hitting_the_sweet_spot.pdf

http://www.ey.com/Publication/vwLUAssets/Hitting_the_sweet_spot/$FILE/Hitting_the_sweet_spot.pdf

http://dupress.com/articles/emerging-market-talent-strategies/

http://www.mckinsey.com/global-themes/employment-and-growth/the-world-at-work

http://www.forbes.com/sites/techonomy/2015/03/17/emerging-market-medical-education-goes-digital/#3727ebf1b111

http://www.forbes.com/sites/techonomy/2015/03/17/emerging-market-medical-education-goes-digital/#3727ebf1b111

http://jpubhealth.oxfordjournals.org/content/35/1/157.full

http://jpubhealth.oxfordjournals.org/content/35/1/157.full

http://www.ey.com/Publication/vwLUAssets/EY-ripe-for-investment-the-indonesian-health-care-industry/$FILE/EY-ripe-for-investment-the-indonesian-health-care-industry.pdf



http://www.oracle.com/us/industries/healthcare/healthcare-talent-mgmt-wp-2538994.pdf

http://www.oracle.com/us/industries/healthcare/healthcare-talent-mgmt-wp-2538994.pdf

http://monitor.icef.com/2015/09/challenges-in-vietnamese-higher-education-contributing-to-demand-for-study-abroad/

http://monitor.icef.com/2015/09/challenges-in-vietnamese-higher-education-contributing-to-demand-for-study-abroad/

https://bmo-bmiresearch-com.ezp.lib.unimelb.edu.au/data/datatool/

https://bmo-bmiresearch-com.ezp.lib.unimelb.edu.au/data/datatool/

http://www3.weforum.org/docs/WEF_GlobalCompetitivenessReport_2014-15.pdf

http://www2.deloitte.com/content/dam/Deloitte/global/Documents/Life-Sciences-Health-Care/gx-lshc-2015-health-care-outlook-global.pdf

http://www2.deloitte.com/content/dam/Deloitte/global/Documents/Life-Sciences-Health-Care/gx-lshc-2015-health-care-outlook-global.pdf

http://growglobally.org/?p=497

http://www.ppiaf.org/sites/ppiaf.org/files/publication/emerging-partnerships.pdf

http://www.ppiaf.org/sites/ppiaf.org/files/publication/emerging-partnerships.pdf


18. Zimny, Z. (2011). Foreign Direct Investment in Health Services. SSRN Electronic Journal, doi: 10.2139. Retrieved from: http://www.academia.edu/5675217/Foreign_Direct_Investment_in_Health_Services

19. Mitchell, M. (2008). An Overview of Public Private Partnerships in Health. Harvard School of Public Health. Retrieved from https://www.hsph.harvard.edu/ihsg/publications/pdf/PPP-final-MDM.pdf

20. Economist Intelligence Unit. (2010). World Industry Outlook: Healthcare and Pharmaceuticals. Retrieved from http://www.banyanglobal.com/pdf/Guide_for_Investors_in_Private_Health_Care_in_Emerging_Markets.pdf

21. International Finance Corporations. (2010). Guide for Investors in Private Health Care in Emerging Markets. Retrieved from http://www.banyanglobal.com/pdf/Guide_for_Investors_in_Private_Health_Care_in_Emerging_Markets.pdf

22. ESCAP. (2014). Sustainable Development Financing: Perspectives from Asia and The Pacific, United Nations. Retrieved from http://www.unescap.org/sites/default/files/UNESCAP-SDF-Paper-1July2014-share.pdf

23. OECD. (2015). Economic outlook for Southeast Asia, China and India 2016. Retrieved from http://www.oecd.org/dev/asia-pacific/SAEO2016_Overview%20with%20cover%20light.pdf

24. Deloitte. (2016). 2016 Global health care outlook: Battling costs while improving care. Retrieved from http://www2.deloitte.com/content/dam/Deloitte/global/Documents/Life-Sciences-Health-Care/gx-lshc-2016-health-care-outlook.pdf

25. World Bank. (2016). Doing business 2016: Measuring regulatory quality and efficiency. Retrieved from http://www.doingbusiness.org/reports/~/media/GIAWB/Doing%20Business/Documents/Profiles/Regional/DB2016/DB16-East-Asia-Pacific.pdf

26. World Health Organization. (2012). Legal frameworks for eHealth. Retrieved from http://apps.who.int/iris/bitstream/10665/44807/1/9789241503143_eng.pdf

27. Jawahitha, S., Ishak, M., & Mazahir, M. (2007). E-data privacy and the personal data protection bill of Malaysia. Journal of Applied Sciences, 7, 732–742. Retrieved from http://scialert.net/fulltext/?doi=jas.2007.732.742

28. SEA-EU-NET. (2014). Intellectual property rights in Southeast Asia. Retrieved from https://sea-eu.net/object/document/130/attach/IPR_final24032014.pdf

29. Menon, J., & Melendez, A. (2015). Realizing an ASEAN economic community: Progress and remaining challenges. Retrieved from ADB Economics Working Paper Series: http://www.adb.org/sites/default/files/publication/160067/ewp-432.pdf

30. ASEAN Economic Community. (2015).ASEAN Economic Community Blueprint 2025. Retrieved from http://www.asean.org/storage/2016/03/AECBP_2025r_FINAL.pdf

31. ASEAN Briefing. (2016, May 31). The ASEAN economic community and what it means for intellectual property - ASEAN business news. Retrieved July 30, 2016, from ASEAN Briefing, http://www.aseanbriefing.com/news/2016/05/31/aec-intellectual-property.html

32. Menon, J., & Melendez, A. (2015). Realizing an ASEAN economic community: Progress and remaining challenges. Retrieved from ADB Economics Working Paper Series: http://www.adb.org/sites/default/files/publication/160067/ewp-432.pdf

33. ibm.com. (2016). Say Hello to IBM Watson. Retrieved from: http://www.ibm.com/watson

34. Forbes.com. (2016). 2016 Predictions: Digital Health’s Second Wave and Thirteen Transformative Healthcare Trends.

35. Topol, E. and Steinhubl, S. (2015). Moving From Digitalization to Digitization in Cardiovascular Care: Why Is it Important, and What Could it Mean for Patients and Providers? Publmed. Retreived from: http://www.ncbi.nlm.nih.gov/pubmed/26403346

36. PwC (2016). The birth of the healthcare consumer: Growing demands for choice, engagement and experience. Retrieved from: http://www.strategyand.pwc.com/media/file/The-birth-of-the-healthcare-consumer.pdf

http://www.academia.edu/5675217/Foreign_Direct_Investment_in_Health_Services

https://www.hsph.harvard.edu/ihsg/publications/pdf/PPP-final-MDM.pdf

http://www.banyanglobal.com/pdf/Guide_for_Investors_in_Private_Health_Care_in_Emerging_Markets.pdf




http://www.unescap.org/sites/default/files/UNESCAP-SDF-Paper-1July2014-share.pdf

http://www.unescap.org/sites/default/files/UNESCAP-SDF-Paper-1July2014-share.pdf

http://www.oecd.org/dev/asia-pacific/SAEO2016_Overview%20with%20cover%20light.pdf

http://www2.deloitte.com/content/dam/Deloitte/global/Documents/Life-Sciences-Health-Care/gx-lshc-2016-health-care-outlook.pdf

http://www2.deloitte.com/content/dam/Deloitte/global/Documents/Life-Sciences-Health-Care/gx-lshc-2016-health-care-outlook.pdf

http://www.doingbusiness.org/reports/~/media/GIAWB/Doing%20Business/Documents/Profiles/Regional/DB2016/DB16-East-Asia-Pacific.pdf

http://www.doingbusiness.org/reports/~/media/GIAWB/Doing%20Business/Documents/Profiles/Regional/DB2016/DB16-East-Asia-Pacific.pdf

http://apps.who.int/iris/bitstream/10665/44807/1/9789241503143_eng.pdf

http://scialert.net/fulltext/?doi=jas.2007.732.742

https://sea-eu.net/object/document/130/attach/IPR_final24032014.pdf

https://sea-eu.net/object/document/130/attach/IPR_final24032014.pdf

http://www.adb.org/sites/default/files/publication/160067/ewp-432.pdf

http://www.asean.org/storage/2016/03/AECBP_2025r_FINAL.pdf

http://www.aseanbriefing.com/news/2016/05/31/aec-intellectual-property.html

http://www.adb.org/sites/default/files/publication/160067/ewp-432.pdf

http://www.ibm.com/watson

http://www.ncbi.nlm.nih.gov/pubmed/26403346

http://www.strategyand.pwc.com/media/file/The-birth-of-the-healthcare-consumer.pdf

http://www.strategyand.pwc.com/media/file/The-birth-of-the-healthcare-consumer.pdf


37. Lamiaux, M. and Zarate, L. (2016). How Emerging Markets Use Partnerships to Leapfrog in Health Innovation. BCG Perspectives. Retrieved from https://www.bcgperspectives.com/content/articles/biopharmaceuticals-medical-devices-technology-health-systems-leapfrogging-emerging-economies/

38. Harvard Business Review. (2002). Let’s Put Consumers in Charge of Health Care. Retrieved from https://hbr.org/2002/07/lets-put-consumers-in-charge-of-health-care

39. Stern, C. (2016). Goldman Sachs says a digital healthcare revolution is coming — and it could save America $300 billion. Business Insider. Retrieved from http://uk.businessinsider.com/goldman-digital-healthcare-is-coming-2015-6?r=US&IR=T

40. Accenture.com. (2016). Singapore's MOH Holdings - Electronic Health Record System - Accenture. Retrieved from: https://www.accenture.com/us-en/success-moh-holdings-national-electronic-health-record-system

41. McKinsey & Company. (2010). The emerging market in healthcare innovation. Retrieved from: http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/the-emerging-market-in-health-care-innovation

42. Deloitte. (2016). Healthcare and Life Sciences Predictions 2020: A bold future? Retrieved from: http://www2.deloitte.com/content/dam/Deloitte/global/Documents/Life-Sciences-Health-Care/gx-lshc-healthcare-and-life-sciences-predictions-2020.pdf

43. Forbes.com. (2016). The Leapfrog Opportunity In The World’s Undeserved Heath Care Markets. http://www.forbes.com/sites/unitystoakes/2015/08/01/the-leapfrog-opportunity-in-the-worlds-underserved-health-care-markets/#6d517c8876fe

44. Lalmalsawma, D. (2014). Telemedicine in India Might Be Just What The Doctor Ordered. Retrieved from

http://blogs.reuters.com/india/2014/06/04/telemedicine-in-india-might-be-just-what-the-doctor-

ordered/

45. Muttitt, S., McKinnon, S., & Rainey, S. (2012). Singapore’s National Electronic Health Record (NEHR)

The Journey to 2012 and Beyond. HIMSS. Retrieved from:

http://69.59.162.218/HIMSS2012/Venetian%20Sands%20Expo%20Center/2.22.12_Wed/Marcello%20

4502/Wed_0945/95-21_Sarah_Muttitt_Marcello%204502/95Muttitt.pdf

46. McBride, M. (2012). Understanding The True Costs of An EHR Implementation Plan. Retrieved from:

http://medicaleconomics.modernmedicine.com/medical-economics/news/modernmedicine/modern-

medicine-feature-articles/understanding-true-costs-ehr-?page=full

47. Dutta, S., Geiger, T., & Lanvin, B. (2015). The Global Information Technology Report 2015. World

Economic Forum. Retrieved from: http://www3.weforum.org/docs/WEF_Global_IT_Report_2015.pdf

48. Amberber, E. (2015). The story of eKincare, Hyderabad based healthcare startup. YourStory.com. Retrieved from: https://yourstory.com/2015/01/ekincare/

49. eKincare. (2016). Ekincare.com. Retrieved from: http://www.ekincare.com

50. eKincare.com. (2016). eKincare featured in the Global Digital Health 100 Award List. Retrieved from https://blog.ekincare.com/2016/01/11/ekincare-featured-in-the-global-digital-health-100-list/

51. Devarakonda S. (2016). Hub and spoke model: making rural healthcare in India affordable, available and accessible. Rural and Remote Health; 16: 3476. Retrieved from: http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=3476

52. Private Sector Innovation Programme for Health (PSP4H), (2014). Understanding the India Low Cost Model of Healthcare Delivery: A Review of the Literature. Nairobi, Kenya: PSP4H. Retrieved from http://www.psp4h.com/wp-content/uploads/2014/05/Understanding-the-India-Low-Cost-Model-of-Healthcare-Delivery-3.pdf

53. Simon, P. (2015). The place of personalised medical e-consultancy in the practice of telemedicine. European Research in Telemedicine / La Recherche Européenne en Télémédecine, 4(3), pp.71-80.

54. McKinsey & Company. (2014). Healthcare’s digital future. Retrieved from: http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/healthcares-digital-future

https://www.bcgperspectives.com/content/articles/biopharmaceuticals-medical-devices-technology-health-systems-leapfrogging-emerging-economies/

https://www.bcgperspectives.com/content/articles/biopharmaceuticals-medical-devices-technology-health-systems-leapfrogging-emerging-economies/

https://hbr.org/2002/07/lets-put-consumers-in-charge-of-health-care

http://uk.businessinsider.com/goldman-digital-healthcare-is-coming-2015-6?r=US&IR=T

http://uk.businessinsider.com/goldman-digital-healthcare-is-coming-2015-6?r=US&IR=T

https://www.accenture.com/us-en/success-moh-holdings-national-electronic-health-record-system

https://www.accenture.com/us-en/success-moh-holdings-national-electronic-health-record-system

http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/the-emerging-market-in-health-care-innovation

http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/the-emerging-market-in-health-care-innovation

http://www2.deloitte.com/content/dam/Deloitte/global/Documents/Life-Sciences-Health-Care/gx-lshc-healthcare-and-life-sciences-predictions-2020.pdf

http://www2.deloitte.com/content/dam/Deloitte/global/Documents/Life-Sciences-Health-Care/gx-lshc-healthcare-and-life-sciences-predictions-2020.pdf

http://www.forbes.com/sites/unitystoakes/2015/08/01/the-leapfrog-opportunity-in-the-worlds-underserved-health-care-markets/#6d517c8876fe

http://www.forbes.com/sites/unitystoakes/2015/08/01/the-leapfrog-opportunity-in-the-worlds-underserved-health-care-markets/#6d517c8876fe

http://blogs.reuters.com/india/2014/06/04/telemedicine-in-india-might-be-just-what-the-doctor-ordered/

http://blogs.reuters.com/india/2014/06/04/telemedicine-in-india-might-be-just-what-the-doctor-ordered/

http://69.59.162.218/HIMSS2012/Venetian%20Sands%20Expo%20Center/2.22.12_Wed/Marcello%204502/Wed_0945/95-21_Sarah_Muttitt_Marcello%204502/95Muttitt.pdf

http://69.59.162.218/HIMSS2012/Venetian%20Sands%20Expo%20Center/2.22.12_Wed/Marcello%204502/Wed_0945/95-21_Sarah_Muttitt_Marcello%204502/95Muttitt.pdf

http://medicaleconomics.modernmedicine.com/medical-economics/news/modernmedicine/modern-medicine-feature-articles/understanding-true-costs-ehr-?page=full

http://medicaleconomics.modernmedicine.com/medical-economics/news/modernmedicine/modern-medicine-feature-articles/understanding-true-costs-ehr-?page=full

http://www3.weforum.org/docs/WEF_Global_IT_Report_2015.pdf

https://yourstory.com/2015/01/ekincare/

http://www.ekincare.com/

https://blog.ekincare.com/2016/01/11/ekincare-featured-in-the-global-digital-health-100-list/

http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=3476

http://www.psp4h.com/wp-content/uploads/2014/05/Understanding-the-India-Low-Cost-Model-of-Healthcare-Delivery-3.pdf

http://www.psp4h.com/wp-content/uploads/2014/05/Understanding-the-India-Low-Cost-Model-of-Healthcare-Delivery-3.pdf

http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/healthcares-digital-future

http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/healthcares-digital-future


55. Forbes.com. (2016). Philippines Start-up Takes On Global Radiologist Shortage. Retrieved from: http://www.forbes.com/sites/techonomy/2014/11/08/philippine-startup-takes-on-global-radiologist-shortage/

56. Napolitano, A. (2015). How Telemedicine Answers Global Pathology Demands. Proscia Retrieved from: https://proscia.com/blog/global-crisis-digital-solution/

57. IBM, (2016). IBM Watson Health: Welcome to the New Era of Cognitive Healthcare. Retrieved from: http://www.ibm.com/smarterplanet/us/en/ibmwatson/health/

58. Harvard Business Review. (2014). IBM’s Emerging Market Strategy Has 3 Pillars. Retrieved from: https://hbr.org/2014/11/ibms-emerging-market-strategy-has-3-pillars

59. Clinton Health Access Initiative. (2016). CASE STUDY: Catalyzing the market for accurate tuberculosis testing in India’s extensive private sector through IPAQT. Retrieved from: http://www.clintonhealthaccess.org/content/uploads/2016/06/Case-Study-India-IPAQT-June-2016.pdf

60. Balea, J. (2014, October 31). Connecting Asia’s startup ecosystem. Retrieved August 1, 2016, from Tech In Asia, https://www.techinasia.com/mclinica-pharmaceutical-health-care-startup

61. WHO. (2015, February 26). Big data in global health: Improving health in low- and middle-income countries. Retrieved August 1, 2016, from World Health Organization, http://www.who.int/bulletin/volumes/93/3/14-139022/en/

62. Raghupathi, W., & Raghupathi, V. (2014). Big data analytics in healthcare: Promise and potential. , 2, . Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4341817/

63. NationMaster.com. (2016). Countries Compared by Health > Physicians > Per 1,000 people. Retrieved from: http://www.nationmaster.com/country-info/stats/Health/Physicians/Per-1,000-people

64. BusinessInAsia.com (2016). Taxes and mandatory contributions that a medium-size company must pay or withhold in a given year in Asia. Retrieved from: http://www.business-in-asia.com/asia/taxation_asia.html

65. KPMG. (2015). ASEAN: Poised for accelerated economic growth. Retrieved from: https://www.kpmg.com/SG/en/IssuesAndInsights/ArticlesPublications/Documents/ASEAN-Poised-for-Accelerated-Economic-Growth.pdf

66. Oxford Business Group. (2015). Universal health care drives health sector growth in the Philippines. Retrieved from: http://www.oxfordbusinessgroup.com/overview/universal-health-care-drives-health-sector-growth-philippines

67. Dam, R. (2015). Getting ready for the AEC. Legalbusinessonline.com. Retrieved from: http://www.legalbusinessonline.com/features/getting-ready-aec/69283

68. Wood, C. (2014). The Rising Digital Storm: SEO and Online Marketing in the Philippines. SEO Hacker. Retrieved from: https://seo-hacker.com/rising-digital-storm-seo-online-marketing-philippines/

69. O'Brien, R. (2015). Digital Asia: ASEAN in ascendance (p. 16). Retrieved from: http://www.tekes.fi/globalassets/global/ohjelmat-ja-palvelut/kasvajakansainvalisty/future-watch/digital_asia.pdf

70. Philippine Institute for Development Studies. (2014). Public Private Partnership Options Towards Achieving Universal Health Coverage in the Philippine Setting. Retrieved from: http://dirp3.pids.gov.ph/webportal/CDN/PUBLICATIONS/pidsdps1448.pdf

71. Philippine Institute for Development Studies,. (2014). Assessing the Feasibility of Public-Private Partnerships in Health in the Philippines. Retrieved from: http://dirp3.pids.gov.ph/webportal/CDN/PUBLICATIONS/pidsdps1449.pdf

72. World Health Organisation (WHO). (2014). Country Cooperation Strategy - Philippines. Retrieved from: http://www.who.int/countryfocus/cooperation_strategy/ccsbrief_phl_en.pdf

73. Philstar. (2016). State of Phl nurses today. Retrieved from: http://www.philstar.com/letters-editor/2015/06/08/1463396/state-phl-nurses-today

74. Australian Nursing Federation. (2016). Why investing in nurses makes sense (p. 7). Retrieved from: http://anmf.org.au/documents/reports/Issues_Ensuring_quality.pdf

http://www.forbes.com/sites/techonomy/2014/11/08/philippine-startup-takes-on-global-radiologist-shortage/

http://www.forbes.com/sites/techonomy/2014/11/08/philippine-startup-takes-on-global-radiologist-shortage/

https://proscia.com/blog/global-crisis-digital-solution/

http://www.ibm.com/smarterplanet/us/en/ibmwatson/health/

https://hbr.org/2014/11/ibms-emerging-market-strategy-has-3-pillars

http://www.clintonhealthaccess.org/content/uploads/2016/06/Case-Study-India-IPAQT-June-2016.pdf

https://www.techinasia.com/mclinica-pharmaceutical-health-care-startup

http://www.who.int/bulletin/volumes/93/3/14-139022/en/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4341817/

http://www.nationmaster.com/country-info/stats/Health/Physicians/Per-1,000-people

http://www.business-in-asia.com/asia/taxation_asia.html

http://www.business-in-asia.com/asia/taxation_asia.html

https://www.kpmg.com/SG/en/IssuesAndInsights/ArticlesPublications/Documents/ASEAN-Poised-for-Accelerated-Economic-Growth.pdf

https://www.kpmg.com/SG/en/IssuesAndInsights/ArticlesPublications/Documents/ASEAN-Poised-for-Accelerated-Economic-Growth.pdf

http://www.oxfordbusinessgroup.com/overview/universal-health-care-drives-health-sector-growth-philippines

http://www.oxfordbusinessgroup.com/overview/universal-health-care-drives-health-sector-growth-philippines

http://www.legalbusinessonline.com/features/getting-ready-aec/69283

https://seo-hacker.com/rising-digital-storm-seo-online-marketing-philippines/

http://www.tekes.fi/globalassets/global/ohjelmat-ja-palvelut/kasvajakansainvalisty/future-watch/digital_asia.pdf

http://www.tekes.fi/globalassets/global/ohjelmat-ja-palvelut/kasvajakansainvalisty/future-watch/digital_asia.pdf

http://dirp3.pids.gov.ph/webportal/CDN/PUBLICATIONS/pidsdps1448.pdf

http://dirp3.pids.gov.ph/webportal/CDN/PUBLICATIONS/pidsdps1449.pdf

http://www.who.int/countryfocus/cooperation_strategy/ccsbrief_phl_en.pdf

http://www.philstar.com/letters-editor/2015/06/08/1463396/state-phl-nurses-today

http://www.philstar.com/letters-editor/2015/06/08/1463396/state-phl-nurses-today

http://anmf.org.au/documents/reports/Issues_Ensuring_quality.pdf

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