Digital Health in Vietnam - Market Intelligence Report - assets.kpmg

 
Digital Health in Vietnam - Market Intelligence Report - assets.kpmg
Digital Health
in Vietnam
Market Intelligence Report

  Department for International Trade
  report prepared by KPMG and Oxford
  University Clinical Research Unit
  —
  December, 2020
Digital Health in Vietnam - Market Intelligence Report - assets.kpmg
Table of Contents
04         06                        18                           22                          32                       36
Foreword   Overview of               Digital health               Key areas in                Digital health           Market access
           Vietnam’s economy         ecosystem                    digital health              regulation               strategies for
                                                                                                                       UK companies
           Macroeconomic             Overview of digital health   Health information          Decision 4888/QD-BYT -
           indicators                market in Vietnam            technology                  National agenda for
                                                                                              e-health adoption
           Vietnam’s healthcare      Local digital health         Telehealth / Telemedicine
           sector overview           ecosystems                                               Cyber Security Law
                                                                  Consumer health             and Regulation
           Telecom Infrastructure:                                electronics
           Connectivity                                                                       Big Data / AI-based
                                                                  AI and Big Data in          medical devices
                                                                  digital health
                                                                                              Potential hurdles
                                                                  Opportunities for           for UK companies:
                                                                  UK companies                legal perspectives on
                                                                                              procurement process
Digital Health in Vietnam - Market Intelligence Report - assets.kpmg
Foreword
W     elcome to the Digital health in Vietnam – Market intelligence report!

In an age of growing challenges from non-communicable diseases, and emerging threats from infectious diseases
                                                                                                                            O    ver the past two decades, Vietnam has achieved laudable improvements in key quality of life metrics such
                                                                                                                                 as life expectancy, infant mortality, and access to affordable medicines. This success is the result of the
                                                                                                                            government’s concerted effort to modernise the health system and expand access to affordable care. At the time
such as COVID-19, digital health has the potential to offer new solutions and alleviate pressure on overstretched           of writing, Vietnam has extended Universal Health Coverage (UHC) to 90% of the population, and targets to reach
health systems. Digital health technology can empower patients to actively participate in their care, improve clinical      95% by 2025. This coverage ratio leads its regional peer markets. The country nevertheless still has a relatively
                                                                                                                            high out-of-pocket expense ratio while spending the highest amount of GDP on healthcare. It is therefore likely
outcomes and enhance operational efficiency.
                                                                                                                            that if Vietnam hopes to continue to expand access to quality care and maintain sustainable health financing, the
Innovation and technology have touched many aspects of life in Vietnam and healthcare is no exception. In a                 health system will need to find a way to provide more services, while expending fewer resources per patient.
concerted effort to embrace Industry 4.0, the Vietnamese government has committed to a national agenda that                 Digital health is one answer to achieving scale of access while improving clinical outcomes and maintaining costs.
seeks to harness the potential of digital solutions across the health system. This has set a solid foundation for digital   To do this, the government needs to expand market access and encourage international business and clinical
transformation in Vietnam.                                                                                                  partnerships.

Vietnam and the UK share many of the same aspirations. We seek to utilise digital innovation to expand equitable
                                                                                                                            UK companies have many of the missing digital pieces Vietnam needs to accelerate progress towards its
access to quality care, in line with United Nations Sustainable Development Goal 3, on good health and wellbeing. At
                                                                                                                            healthcare development goals. At the same time, digital health companies that understand Vietnam’s unique
the early stage of digital transformation, Vietnam has plenty of opportunities for innovative solutions from the UK. In     population health challenges and can provide collaborative solutions will gain access to one of Asia’s fastest
this comprehensive guide, we provide insight into current market opportunities across health informatics technology,        growing healthcare markets. Through this market access, companies can achieve early-entrant advantage and
telemedicine, AI and Big Data. The report also explores the future direction of digital healthcare transformation in        meaningfully help Vietnam’s financial and physical burden of disease.
Vietnam and potential challenges facing new entrants to the market.
                                                                                                                            This document is intended as an introductory guide to Vietnam’s digital health market. Please do not hesitate to
The UK and Vietnam have a rich history of collaboration, and this year we celebrate 10 years of strategic partnership. I    reach out to its authors or Department for International Trade as you begin your exploration.
am delighted to support UK organisations interested in entering the Vietnamese market and I wish you every success
in exploring long-term partnerships in Vietnam that will further strengthen our bilateral healthcare ties.
                                                                                                                            Enjoy the read
For more information on these opportunities and how we can help you do business in Vietnam, please reach out to
our team.

                                                                                                                            Luke Treloar                         Guy Thwaites                         Louise Thwaites
                                                                                                                            Managing Director –                  Director                             Senior Clinical Research Fellow
                                                                                                                            KPMG Global Strategy Group           Oxford University Clinical           Oxford University Clinical
Emily Hamblin
                                                                                                                            National Head –                      Research Unit                        Research Unit
Department for International Trade in Vietnam                                                                               Healthcare and Life Sciences
December, 2020                                                                                                              Vietnam and Cambodia

                                                                                                                            Contributors

                                                                                                                            Vo Thi Kim Ngan                      Du Vu Hoang Tuan                     Le Hang Nga
                                                                                                                            Associate Director                   Manager                              Assistant
                                                                                                                            KPMG Global Strategy Group           KPMG Global Strategy Group           KPMG Global Strategy Group
                                                                                                                            Vietnam and Cambodia                 Vietnam and Cambodia                 Vietnam and Cambodia

4   Market Intelligence Report                                                                                                                                                                                          Market Intelligence Report   5
Digital Health in Vietnam - Market Intelligence Report - assets.kpmg
Overview of
                                                                                                                                      Economic development
                                                                                                                                      Over the last several decades,               Implications to digital health
                                                                                                                                      Vietnam has achieved rapid
                                                                                                                                      economic and social development,             Indicator      Issue                               Implication
                                                                                                                                      which has driven the demand for              Increased      An increase in living               Some of the most notable
                                                                                                                                      more advanced healthcare services.

Vietnam’s economy
                                                                                                                                                                                   living         standards and healthcare            examples include consumer
                                                                                                                                      Beginning in 1986, the Doi Moi               standard       expenditures will likely            health electronics (e.g. hi-
                                                                                                                                      reforms initiated a broad-based                             expand Vietnam’s access             tech wearables) and telehealth
                                                                                                                                      economic transformation, which                              to digital health, which            (e.g. remote health diagnostics,
                                                                                                                                      opened a largely closed economy                             can be provided at a                monitoring, intervention, and
                                                                                                                                      to international markets and trade                          lower incremental cost              education). The application
                                                                                                                                      and began a series of ‘pro-business’                        than traditional models             of telehealth will play an
                                                                                                                                      reforms. As a result of these                               of care.                            important role in supporting
                                                                                                                                      policies, Vietnam achieved high                                                                 the diagnosis and treatment of
                                                                                                                                      economic growth rates that lifted                                                               non-communicable diseases
                                                                                                                                      the country to Emerging Market                                                                  across the population. However,
                                                                                                                                      economic status. This strong                                                                    this poses a challenge for the
Macroeconomic indicators                                                                                                                                                                                                              lower income groups with
                                                                                                                                      economic expansion will likely
                                                                                                                                      continue to benefit the country by                                                              less access to technological
Population                                                                                                                            creating an attractive growth story                                                             advances, particularly those in
                                                                                                                                      that will further attract Foreign                                                               remote, underdeveloped, or
                                                                                                                                      Direct Investment (FDI) (growing                                                                rural areas. To attain universal
Population overview                                  Implications to digital health                                                                                                                                                   health coverage for the entire
                                                                                                                                      by 13.5% per annum from 2014
                                                                                                                                      to 2019 in terms of registered                                                                  population, further government
At the time of writing, Vietnam has                  Indicator    Issue                         Implication
                                                                                                                                      capital), which in turn will bring                                                              support and policy incentives will
a population of 96.5 million, making                 Golden       Among the working-age         Vietnam is well positioned to
                                                                                                                                      much needed technology and                                                                      be required.
it the 15th most populous country                    population   population, nearly half are   adopt digital health solutions.
in the world, 8 th in Asia and 3rd in                                                                                                 knowledge transfer 3. Vietnam has
                                                     structure    under 34 years of age,        For instance, there will be a
Southeast Asia (behind Indonesia and                                                                                                  signed 13 Free Trade Agreements              Vietnam’s GDP per capita and real GDP growth from 2017 to 2025f
                                                                  which is favourable for       potentially large addressable
Philippines)1. Despite the addition of                                                                                                (FTAs) further accelerating inbound
                                                                  the adoption of innovative    market for consumer health
around 1 million people per annum,                                                                                                    FDI. Most notably of which are
                                                                  science and technology.       electronics in the country.
the rate of Vietnam’s population                                                                                                      the ASEAN Free Trade Agreement
                                                                                                                                                                                       Vietnam’s GDP per capita and real GDP growth (2017 to 2025f)
growth has slowed gradually, from                    Ageing     The golden population           The application of Big Data           (AFTA), the Comprehensive
approximately 2% per annum in the                    population structure is also               and AI can bring geriatric care       and Progressive Agreement of                      5,000                                   8.2                                  9.0
                                                                                                                                                                                                                                                             4,303
early 1990s to around 1.1% throughout                           associated with an ageing       solutions. Vietnam can apply          Transpacific Partnership (CPTPP),                                  7.1                                         3,964           8.0
                                                                                                                                                                                                 6.8            7.0                          3,656
                                                                population. The faster          passive sensors and other near-       and more recently the EU Vietnam                  4,000                                                                        7.0
the 2010s. By 2024, the county’s
                                                                growth rate of the people       patient monitoring technologies       FTA (EVFTA). These trade                                                               3,120
population growth rate is expected to                                                                                                                                                                               2,828                                            6.0
                                                                                                                                                                                        3,000           2,567 2,715                            6.4    6.4     6.4
slow to 0.8% per annum, reaching a                              aged 65 years and above         to enable remote care solutions       agreements are lowering tariffs                           2,366                                  6.0                           5.0
total population of 101.1 million2.                             will create a burden on         that link an individuals’ behaviour   on many goods including medical                                                                                                4.0
                                                                                                                                                                                        2,000
                                                                healthcare facilities and       to treatment.                         equipment and will help position                                                                                               3.0
As Vietnam’s birth-rate declines, its                           demand for care services.       At the same time, electronic          Vietnam as an attractive investment                                              3.0                                           2.0
                                                                                                                                                                                        1,000
average population age will continue                            This will be particularly       health records will pave the          and trade destination. At time of                                                                                              1.0
to rise. Currently, Vietnam is enjoying                         acute for elderly-care in       way for more efficient medical        writing, Vietnam is in discussions                   0                                                                         0.0
a so-called “golden structure” in its                           the country.                    information management.               with the UK on a possible bilateral                       2017 2018 2019 2020e 2021f 2022f 2023f 2024f 2025f
age demographics, with 70% of the                                                               Governments and policymakers          agreement. Such an agreement
                                                                                                                                                                                                        GDP per capita (USD)                 GDP Growth, % y-o-y
population aged 15 to 64 years. This                                                            can utilise relevant population-      would extend similar market access
age structure has been a key driver                                                             based data to initiate preventative   benefits to UK-based organisations.
                                                                                                programs and make decisions                                                            GDP Growth & Healthcare expenditure per capita in 2019
in the country’s recent economic
development and will continue to                                                                at a health-system level.             Growth in FDI is driving GDP per
                                                                                                Health workers will be able           capita and the rapid expansion of                                                  GDP             Healthcare expenditure
push its transition from a largely                                                                                                                                                              Country
                                                                                                                                      an urban middle class. This middle                                              Growth (%)          per capita (% of GDP)
agrarian economy to one led by                                                                  to deliver healthcare services
export manufacturing and domestic                                                               more effectively, thanks to the       class is expected to account for
                                                                                                                                                                                                Vietnam                  7.1%                        6.0%
consumption. After 2030, Vietnam will                                                           availability of historical health     up to half of the total population
however begin to age rapidly, with the                                                          records and related training          by 2035 4 and will, according to the                      Philippines             6.2%                         4.6%
over-65 years of age cohort growing                                                             programs.                             World Bank, drive growth in per
at an anticipated 5.3% per annum.                                                               The adoption of remote                capita healthcare expenditures.                           Malaysia                4.7%                         4.0%
This could drive the growth of the                                                              monitoring and telemedicine           This expansion in healthcare
current “retirement age” population                                                             of elderly patients will lessen       expenditures will be more apparent                        Indonesia               5.2%                         3.7%
distribution 300% by 2050, potentially                                                          hospital overcrowding by allowing     in higher-end care and in urban
straining health and related resources.                                                         doctors to monitor patients from      areas, which could expand rural                           Thailand                4.1%                         3.7%
                                                                                                their homes, and thus freeing         healthcare access inequalities.
                                                                                                hospital resources such as beds
1.   World Population Prospects, the 2019 Revision                                              and saving administrative costs .     3. The Ministry of Planning and Investment
2.   Fitch Solutions                                                                                                                  4. Fitch Solutions                           Source: Fitch Solutions

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Digital Health in Vietnam - Market Intelligence Report - assets.kpmg
Vietnam’s healthcare sector overview

Health status in Vietnam                                                                                                                          Healthcare structure in Vietnam
The World Health Organization (WHO) recently estimated that non-communicable diseases now account for 77%                                         Healthcare system
of all death and disability in Vietnam. Of these, cardiovascular disease and cancer are the two most common
contributors to premature death and loss in disability-adjusted life years (DALYs), followed by diabetes/chronic kidney                                           ORGANISATIONAL STRUCTURE OF                                                                                 HEALTHCARE
disease as the 3rd most common cause of death and 4th cause of DALYs. Many of these deaths can be prevented                                                           HEALTHCARE SYSTEM                                                                                      INSTITUTIONS
with improved diagnosis, monitoring, and tech-enabled early-stage interventions.
                                                                                                                                                                                Administration Levels                                          Hospitals                    Health centres              Academic institutions
There is increasing recognition of the important interactions between non-communicable diseases co-existing with
infectious diseases, particularly cardiovascular diseases. For example, hepatitis C Virus infection is associated with                                           Ministry of Health (MOH)
an increased risk of cardiovascular disease and represents a global burden of the loss of 1.5 million DALYs. This                                                                                                                                                                                                      
tragic burden falls disproportionately on low-income and middle-income countries. Risk of type 2 diabetes mellitus                                               MOH is a government al agency responsible for

                                                                                                                                                                                                                           TERTIARY
                                                                                                                                                                 national management and regulation development,                                                                                                 Medical and
is increased by almost 70% in Hepatitis-C infected patients. Similarly, in people living with HIV, increased risk of                                             management of national hospitals, research and
                                                                                                                                                                                                                                          Central general and                     Central
                                                                                                                                                                                                                                       specialty hospitals (Class I         preventative health                pharmaceutical
cardiovascular disease has been noted. Whilst there is limited data on co-existing cardiovascular and infectious                                                 Pasteur institutes, universities and colleges.                                   & II)                           centres                 universities and colleges
diseases in Vietnam, the high rates of both means that improving diagnosis and management of these is likely to have
a particularly significant impact in Vietnam.                                                                                                                    Other ministries                                                          Public       Private              Public       Private
                                                                                                                                                NATIONAL
                                                                                                                                                                 Other ministries including MOD, MOT, MOIT, and
Implications to digital health                                                                                                                                   MARD run healthcare network of hospitals and clinics

Indicator                 Issue                                                     Implication                                                                  Department of Health
                                                                                                                                                                                                                                                                                                                       
NCD impact on             The nature of ill health in Vietnam is                    Telehealth can promote a healthy lifestyle
                                                                                                                                                              Department of Health is an agency under the                                Provincial general and                  Provincial
health                    changing from communicable to non-                        and encourage preventative measures through                               Provincial People’s Committee, supporting provincial                     specialty hospitals (Class I
                                                                                                                                                                                                                                                                                                             Provincial secondary
                                                                                                                                                                                                                                                                            preventative health
                          communicable diseases. This trend is                      patient risk-factor monitoring in pre-disease                                                                                                                                                                              medical schools
                                                                                                                                                              healthcare management and preparing decisions,                                      & II)                           centres
                          expected to continue, which will create a                 stages. The utilisation of Big Data and AI in              PROVINCIAL directives, plans, etc. across all aspects of the
                                                                                                                                               (63 provinces) healthcare sector on the provincial level.

                                                                                                                                                                                                                           SECONDARY
                                                                                                                                                                                                                                           Public       Private              Public       Private
                          greater need for long-term and coordinated                digital health allows for real-time, population-
                          healthcare services that cater to chronic                 based, forward-looking data that can help avoid
                          diseases. Digital health is well-positioned to            or mitigate non-communicable diseases while                                  District Health Bureau                                                                                              
                          help address these challenges.                            enhancing care delivery.
                                                                                                                                                                 District Health Bureau is an agency under the District                 District general hospitals          District preventative
                                                                                                                                                                 People’s Committee, supporting districts’ healthcare                       (Class II, III & IV)              health centres
Top causes of death in 2019 & percentage change from 2009 - 2019                                                                                                 management and preparing decisions, directives,
                                                                                                                                                DISTRICT         plans, etc. across all aspects of the healthcare sector
    % change from 2009-2019                                                                                                                    (645 districts)                                                                              Public      Private              Public       Private
                                                                                                                                                                 on the district level.

          31%             18%               52%            45%              25%             32%            28%         63%            30%
                                                                                                                                                                 Commune Health Centre
                                                                                                                                                                                                                                                                                      
                                                                        107,659

                                                                                                                                                                                                                           PRIMARY
                                                                                                                                                                                                                                                                              Commune health
                                                                                                                                                                 Commune Health Centre is an agency under the                                                                    centres
                                                                                                                                                                 Commune People’s Committee, supporting communes’
                                                                   86,130                                                                      COMMUNE           healthcare management (providing primary health care
                                                                                                                                                  (11,162        services, most basic care and health education).                                                            Public        Private
                                                        38,005                                                                                  communes)

                                                  26,191                                   24,002
          22,489                   19,758
 17,118                                                                           18,227                                                                                                                                                         Availability of public /                 Non-availability of public /
                   13,825 11,387
                                        9,391                                                                                  11,044 14,367                                                                                                     private sector                           private sector
                                                                                                    2,0452,614   1,2572,054
    Lung cancer    Tuberculosis      LRI*         Ischemic heart      Stroke         COPD            Cirrhosis   Alzheimer’s     Diabetes        Source: The Ministry of Health, World Health Organization
                                                     disease                                                       disease
Source: World Health Organization

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Digital Health in Vietnam - Market Intelligence Report - assets.kpmg
Hospital capacity
Hospital numbers                                                                                        Healthcare professionals

Vietnam’s public sector has a decentralised hospital system classified into four groups                 Vietnam ranks on the lower end of countries with regards to trained Healthcare
corresponding to four administrative levels. At the central level, specialised and general              Practitioners (HCPs) per capita. This shortage is particularly acute in
hospitals provide secondary and tertiary care, and are active in research, and function as              specialised care, such as cancer, palliative care, geriatrics, and mental health.
teaching hospitals. At the provincial or city level, hospitals and medical centres mostly provide       The distribution of health workers between urban and remote areas is also a
secondary and tertiary care, combined with outpatient services. Each province is divided                challenge, with higher concentrations in urban areas.
into roughly 20 districts. District health centres offer primary and some secondary care
services. Finally, at the communal level, Communal Health Centres (CHCs) offer primary and              When compared with regional peer markets, one can see Vietnam’s shortages
preventative health services. Communal healthcare centres are generally the first point of              are particularly acute in trained nurses. As of 2018, there are 77,995 physicians
contact for much of the population, especially in rural areas.                                          and 128,386 nurses in the country, which is relatively low compared to the
                                                                                                        total population (around 1 physician and 1.3 nurses per 1,000 residents).
The Vietnamese private healthcare sector has started to play an important role as a provider of
care in major cities. The percentage of private hospitals is projected to increase rapidly in the              UK                       2.12
                                                                                                                                                                          6.38
coming years as domestic corporations develop hospital groups and clinic chains across the                                0.47
                                                                                                          Thailand                             2.6
country. Some of the examples include Hoan My Medical Corporation, and Vinmec Hospital
                                                                                                          Vietnam            0.82
Network of Vingroup. Main drivers behind growth are:                                                                             1.34
                                                                                                        Philippines             1.25
                                                                                                                                                                                         8.54
01         Many public hospitals lack needed infrastructure investment;                                   Malaysia                      1.99
                                                                                                                                                         4.31
                                                                                                         Indonesia        0.36
           Rising personal income allows patients to increase out-of-pocket payments for                                         1.29
02                                                                                                      Singapore                         2.39
           private sector and/or premium healthcare services and                                                                                                    5.84
                                                                                                                      0            2                 4             6               8                10
           FDI encouragement policies allows foreign investors to build wholly
03
           foreign-owned hospitals.                                                                        Physicians per 1,000 of total population         Nurses per 1,000 of total population

                                                                                                        Source: Fitch Solutions
Number of hospitals in Vietnam (2013-2018)

1,069      1,063     1,071    1,077    1,085    1,094                                                   Indicator          Issue                     Implication
                                                          CAGR                     ’13-19
                                                                                                        Hospital           Congested and             Digital health can help address capacity
                                                          Total hospital numbers   1.3%                 capacity           overcrowded               constraints faced by public hospitals By
                                                                                                        and                hospitals remain a        introducing solutions such as telehealth
                                                          Public hospitals         1.2%
                                                                                                        professional       challenging issue         and electronic health records, more
     165       165      169      171      185       193                                                 staffing           in Vietnam. This          patients, even in rural settings, can
                                                                                                                           strains resources         gain access to needed healthcare, thus
                                                          Private hospitals        1.6%                                    in central and            also improving hospital efficiency and
 2013       2014      2015     2016     2017     2018                                                                      provincial                reducing patient crowds. From a health-
                                                                                                                           hospitals                 economics viewpoint, telehealth and
           Public hospitals     Private hospitals
                                                                                                                           and creates               electronic health records can also help
Source: Fitch Solutions, World Health Organization, General Statistics Office of Vietnam                                   inefficiencies at         healthcare providers cut cost by reducing
                                                                                                                           the district and          paperwork, improving safety, eliminating
                                                                                                                           community levels.         duplicative tests, and improving health
                                                                                                                                                     outcomes. The latter drives economic
                                                                                                                                                     benefit by lowering readmittance
Hospital beds                                                                                                                                        through long-term remote monitoring.
                                                                                                                                                     AI and wearable tech have the potential
Over the past five years, according to Fitch Solutions and the General Statistics Office of                                                          to improve quality of care while reducing
Vietnam, approximately 6,000 hospital beds per annum have been added to the healthcare                                                               cost of care in Vietnam. By extending
system, corresponding to a CAGR of 2.5% (from 2013 to 2018). Of these additional hospital beds,                                                      patient access to AI-enabled wearable
nearly 16% are at national level, while 43% and 41% are added to provincial and district levels,                                                     devices, healthcare professionals
respectively. This demonstrates the effort of the government in alleviating the overloaded capacity                                                  can gain a real-time view of patient
of hospitals across Vietnam.                                                                                                                         conditions and make more accurate and
                                                                                                                                                     faster diagnoses. Layering AI and Big
However, the proportion of private hospital beds remains low (5%), mainly due to the marginal                                                        Data into the monitoring and diagnosis
volume of private hospitals. Nevertheless, the government has indicated its intent to grow the                                                       process will give clinicians the ability
ratio of private hospital beds to 20% of total hospital beds through public and private partnerships.                                                to analyse multiple patient data sets
                                                                                                                                                     simultaneously to identify irregularities
In terms of the number of hospital beds per capita, there are large regional variations. More                                                        and take early-stage preventative action
specifically, Vietnam’s North Central and Central Highlands have far fewer hospital beds per capita                                                  when interventions are more effective
compared to other regions. Recently, the shortage of hospital beds has increased: bed to patient                                                     and cheaper.
occupancy rates has reached 120-160% in some public hospitals. This increase is often most
pronounced in central hospitals in major cities.

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Digital Health in Vietnam - Market Intelligence Report - assets.kpmg
Healthcare insurance system in Vietnam                                                                                                      Healthcare quality and access

Vietnam has made great strides in expanding health insurance coverage. After introducing compulsory insurance in
2015, Vietnam now aims to grow the coverage rate of health insurance, setting the goal of reaching 95% in 2025.                             Patient journey                                              Medical tourism
Nevertheless, out-of-pocket expense ratios in Vietnam are some of the highest in ASEAN, which puts considerable
                                                                                                                                            Inpatient and outpatient care                                Inbound medical tourism
financial pressure on lower income households.
                                                                                                                                            In Vietnam, outpatient visits outpace inpatient              Medical tourism has flourished globally over the past
It should be noted however, Vietnam has made substantial progress in lowering out-of-pocket expense from 61% in
                                                                                                                                            admissions by two orders of magnitude. Overall, both         decades and is now valued at over USD53 billion. This
1999 to 45% as of 2019.
                                                                                                                                            inpatient admissions and outpatient visits remained          value is expected to grow at 12.9% through 2025 8.
                                                                                                                                            consistent from 2014 to 2019, with 5,600,000 cases           Asia Pacific is a top source of, and destination for,
Healthcare expenditure                                                                     19.5      CAGR               ’14-19     ’19-24   admitted to hospitals and approximately 156,000,000          medical tourism patients. This, however, is still in the
                                                                                                                                            outpatient visits served per year respectively7.             early stages in Vietnam. While competitively priced, the
                                                               13.8          14.4                    Total                                  Overcrowding remains prevalent, given the fact that          number of foreign patients in Vietnam is still relatively
                                                   13.1                                                                 4.3%        6.3%
      11.7           11.8            12.2                                                  59.6%     expenditure                                                                                         small compared to Singapore, Thailand, and Malaysia.
                                                   53.3%      54.4%         55.5%                    Public                                               hospitals often run inpatient care at over-    Most of Vietnam’s inbound medical tourists come from
     51.5%           50.2%         51.7%                                                                                5.9%        7.8%
                                                                                                     expenditure                                          capacity levels, meaning more than one         Laos and Cambodia. For now, Vietnam is not considered
                                                                                           40.4%                                                          patient is assigned to the same hospital       as a top destination for medical treatment due to a lack
     48.5%           49.8%         48.3%           46.7%      45.6%         44.5%                    Private
                                                                                                                        2.5%        4.3%                  bed, and                                       of health infrastructure investment and regional brand
                                                                                                     expenditure
      2014           2015            2016          2017        2018         2019           2024                                                           healthcare facilities will often see between   recognition.
                                                                                                                                                          5,000-8,500 outpatients visit per day,
                                Private (USDbn)            Public (USDbn)                                                                                                                                Outbound medical tourism
                                                                                                                                                          particularly at central hospitals.
                                                                                                                                                                                                         As the local healthcare sector continues to experience
Source: Fitch Solutions, World Health Organization, General Statistics Office of Vietnam
                                                                                                                                                                                                         capacity constraints, a significant number of upper-
                                                                                                                                            Vietnam’s efforts to reduce the average inpatient stays      middle to high income patients have chosen to receive
                                                                                                                                            have not yet seen success. Average stays remain at or        healthcare services abroad from regional countries such
                                                                                                                                            above a week since 2013. While this is comparable to
Public healthcare insurance                                                                                                                                                                              as Singapore, Thailand, Malaysia, or even further afield
                                                                                                                                            levels seen in the Philippines and Indonesia, Singapore,     in the United States. The total amount paid for these
                                                                                                                                            Malaysia and Thailand have managed to shorten this           services abroad is estimated to be USD2 billion yearly 9.
                                                      Person working in the agriculture,                            88% Population          indicator to less than 5 days. For patients, a lengthier
                                                      forestry, aquaculture and salt
                                                                                                                     Coverage (2018)        stay means higher costs and risk of nosocomial               Critical factors for why patients prefer overseas
                                                      industry; household members
                                                                                                                                            (“healthcare-acquired”) infections from other patients       treatment to local care can include,
                                        Children under age six, near poor individuals,                                                      at the hospital. At the same time, for hospitals, higher
                                        and students
                                                                                                                                            length of stay results in lower patient capacities.
                             Employees in non-state enterprises with more than 1                                                                                                                                     reputation of foreign facilities,
                             employee, other organisations, war veterans, and the poor

             National Assembly Representative, People’s Council member,
             preschool teachers, social welfare groups, dependents of police and                                                                                                                                     qualifications and experience of
             armed forces staff                                                                                                                                                                                      foreign doctors,
 Civil servants, employees in state enterprises, employee in private enterprises with
 more than 10 employees, pensioners, and people on subsistence for the elderly                                        2% Population
                                                                                                                      Coverage (1992)
                                                                                                                                                                                                                     availability of medicines, and
 1992         1998            2005          2008                   2018

                                                                                                                                                                                                                     better service and overall quality of care.
Private healthcare insurance
In 2018, 33 million people (35% of total population)                            However, after the increase in healthcare fees at
were covered by some forms of private health                                    large public hospitals brought about by the so-called                                                                    As well, inconsistency in diagnosis between local
insurance. This coverage, however, only represents 2%                           ‘autonomy mechanism’, more people are expected to                                                                        healthcare facilities can also play a role in the decision
of total health expenditures5. Low coverage rates are                           join private health insurance policies to gain access to                                                                 of patients to seek second opinions abroad.
largely due to                                                                  higher reimbursement rates and more comprehensive
                                                                                coverage. Furthermore, continued growth in private
      strict regulations imposed for non-life insurance
01                                                                              sector employment will likely expand employee-benefit
      companies operating in the market;
                                                                                insurance packages as a share of total private insurance.
      high insurance premiums compared to public
02                                                                              Compared to peer market countries, insurance
      options; and
                                                                                penetration rates (calculated by total premium over total
      low brand awareness of private insurance                                  GDP) for Vietnam remains on the low range, accounting
03
      packages.                                                                 for only 2.4% of total GDP in 2018. This indicates
                                                                                room for further growth6. According to the Insurance        7.   Fitch Solutions
5. News articles                                                                Association of Vietnam, the insurance penetration rate      8. KPMG Analysis, PR Newswire
6. Fitch Solutions                                                              is expected to reach 3-4% in the near term.                 9.   KPMG Analysis, PR Newswire

12   Market Intelligence Report                                                                                                                                                                                                          Market Intelligence Report   13
Digital Health in Vietnam - Market Intelligence Report - assets.kpmg
Implications to digital health                                                                                                   Smart phones

Indicator         Issue                                                     Implication                                                          Smart phone sales volume (million)                           Smart phone sales value (USD billion)
Healthcare access The relatively low ranking of healthcare                  Increasing demand for ageing infrastructure and
and quality       access and quality index reflects some                    human resource shortages are driving hospital                    CAGR (14-19)       31.6%     CAGR (19-24)      2.4%            CAGR (14-19)     15.5%          CAGR (19-24)           5.5%
                  current challenging issues for Vietnam’s                  executives and government officials to leverage
                  healthcare system. More specifically,                     digital to optimise the patient experience and                                                                  32.4                                                                          4.9
                  overcrowded hospitals need the most                       create a health system without walls.                                                         29.6     28.6
                                                                                                                                                                 27.0                                                                     3.8      4.0
                  infrastructure investment.                                                                                                                                                                                                                 3.8
                                                                            Digital health technology and the medical                                  21.7                                                                 3.4
                                                                            tourism industry are converging to enhance                                                                                             2.7
                                                                                                                                              15.1
                                                                            patient experience and trust in the process. This                                                                           1.8
Patient journey          Even though Vietnam’s total number of                                                                       7.2
                                                                            effort will shrink the perceived quality of care
                         hospital beds and ratio of doctors per capita
                                                                            difference between Vietnam and other markets,
                         have reached national objective levels,
                                                                            which will help to stem the USD2bn in outbound          2014     2015      2016     2017      2018     2019     2024       2014       2015      2016      2017        2018      2019      2024
                         hospital capacity is still overcrowded. This
                                                                            medical tourism and strengthen Vietnam’s brand
                         indicates that availability of professionals and
                                                                            as a medical tourism destination.
                         facilities still does not meet the country’s
                                                                            Digital tools are increasing patient engagement      Key observations
                         needs.
                                                                            through direct patient-provider communication,
Medical tourism          Vietnam possesses many of the necessary                                                                 Overall, the market of smart phones has experienced rapid growth over the past five years (nearly 32% per annum),
                                                                            instant messaging apps, telemedicine, and
                         qualities needed to develop inbound medical                                                             and is on track to reaching a saturated status in the next five years. While growth is expected to slow down, the
                                                                            encrypted electronic records. AI-enabled
                         tourism, such as highly skilled professionals,                                                          demand for new products will continue to drive the market.
                                                                            technologies are just a few examples of digital
                         yet the industry remains in its early days.        integration in the medical tourism supply chain.
                         Vietnam has rapidly developed its private          Telemedicine over online video calls in pre-
                         hospital networks, some of which achieved          treatment diagnosis and assessment and post-
                         international standards such as Joint              treatment can be beneficial in that it lessens       Mobile-cellular telephone subscriptions
                         Commission International (JCI) accreditation.      the strain on physical medical infrastructure and
                         Nevertheless, building trust with patients will    empowers patients to have consultations on a                        Mobile-cellular subscriptions (million)                           3G and 4G subscriptions (million)
                         take more time.                                    schedule and location of their choosing.
                         The adoption of digital health will help           Bringing patient consultations into a digital                    CAGR (14-19)       -1.0%      CAGR (19-24)      2.3%            CAGR (14-19)     667.0%            CAGR (19-24)        11.9%
                         accelerate the development of patient trust        setting can improve clinical outcomes and
                         by increasing transparency and converging          lower costs for Vietnamese patients. Clinicians                                                                                  CAGR (14-19)         -9.5%         CAGR (19-24)        -22.5%
                         domestic care standards with the best              will have access to powerful new tools to
                         international practices.                           longitudinally track health outcomes and make

                                                                                                                                                                                             141.5
                                                                                                                                     132.5

                                                                                                                                                                           130.4
                                                                                                                                                        128.8

                                                                                                                                                                                    126.2
                                                                                                                                                                                                                                                                           79.2

                                                                                                                                               123.9

                                                                                                                                                                  120.0
                                                                            more personalised recommendations.
                                                                                                                                                                                                     28.7

                                                                                                                                                                                                                   0.1                                                      4.9

                                                                                                                                    2014      2015     2016      2017     2018     2019     2024     2014         2016        2018              2020        2022           2024

Telecom Infrastructure: Connectivity                                                                                                                                                                                                 3G                4G
                                                                                                                                 Key observations
Telecom infrastructure
                                                                                                                                 Along with the rise of smart phones, the number of mobile-cellular subscriptions is expected to increase steadily in
Mobile development                                                                                                               the next five years. This is driven by the surge of 4G since 2016 and 5G (estimated to launch in 2020), both of which
                                                Device and service affordability                                                 will replace the older generations 2G and 3G.
                                                            72.11
                                                     Maximum score: 100                                                          Source: Ministry of Information and Communications, Fitch Solutions

     Mobile network infrastructure                                                          Consumer readiness index
                 49.15                                                                                74.10
          Maximum score: 100                                                                   Maximum score: 100
                                                            Mobile
                                                          connectivity

     Mobile connectivity index                                                                Content and service availability
              63.03                                                                                       60.11
       Maximum score: 100                                                                          Maximum score: 100

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Digital Health in Vietnam - Market Intelligence Report - assets.kpmg
Internet and broadband infrastructure                                                                                                                       Internet usage trends in Vietnam
Internet development
                                                                                                                                                            Overview of internet usage and mobile
                                                                                                                                                                                           Internet penetration
                     Internet users (% of population)                                                  Internet bandwidth (Mbps)                                                                                rate

                                                                                                CAGR (14-19)     71.2%        CAGR (14-19)       41.4%                                       Internet
                                                                                                                                                                                     penetration rate

                                                                                 78%                                                         13,632.8                                              66%
                                                                                                                                                                               Daily use of internet
                                                       67%          66%                                                                                                          (% population)
                                53%       58%                                                                                                                                                                   66%
      41%          45%
                                                                                                                                                4,083.6     Daily use of internet
                                                                                         927.7
                                                                                                                                                                  (% population)
                                                                                          722.2
                                                                                                                                                                           94%                          Average time spent
                                                                                                                                                                                                        on daily internet use
     2014         2015          2016      2017         2018        2019          2024    2014       2015       2016          2017      2018          2019                               94%
                                                                                                           Domestic             International                                    Average time spent
Key observations                                                                                                                                                                on daily internet use
                                                                                                                                                                                         6H 42Min
The internet has become an integral part of Vietnamese people’s life, reflected upon its increase in the internet                                                                   Social media
                                                                                                                                                                                    penetration
penetration rate (66% of the total population as of 2019). Combined with the expansion of internet bandwidth (both                                                                                           6H 42Min
domestically and internationally), this lays the groundwork for digital development across all sectors in the country’s
socio-economy.                                                                                                                                                     Social media
                                                                                                                                                                    penetration
                                                                                                                                                                           64%
                                                                                                                                                                                                       Average time spent on
Broadband subscriptions                                                                                                                                                                                daily social media use
                                                                                                                                                                                        64%
                   Broadband subscriptions (million)                                                 Fixed broadband breakdown (%)
                                                                                                                                                                              Average time spent on
                  CAGR (14-19)           19.8%          CAGR (14-19)             16.1%                                       7%        2%          1%                         daily social media use
                                                                                                                19%                                                                      2H 32Min
                                                                                 61.0                 44%
                                                                   52.8                                                                                                                                      2H 32Min
                                                     44.9                                  78%
                                       36.2                                                                                  83%     92%          93%       Source: We Are Social, Hoosuite
                         31.8                                                                                   71%
           29.0
                                                                                                      47%
                                                            13.0          14.8
                                 9.3          11.3
     6.0           7.7                                                                     13%
                                                                                            8%         9%       10%          9%        6%          6%
      2014          2015          2016          2017          2018          2019
                                                                                                                                                            Implications to digital health
                                                                                           2014       2015      2016         2017     2018        2019

           Fixed broadband                           Mobile broadband                                  xDSL           FTTx           Others                 Indicator           Issue                                           Implication
                                                                                                                                                            Internet usage      Daily usage of internet in Vietnam has          The widespread popularity of internet and
Key observations                                                                                                                                                                become increasingly prevalent. On average,      social media, combined with the relatively
                                                                                                                                                                                an individual spends nearly 7 hours on the      young population, will foster a rapid adoption
Broadband infrastructure in Vietnam has seen rapid changes since 2014, with a significant increase in both fixed                                                                internet every day, nearly half of which are    of new communication technologies. In the
and mobile broadband. In terms of fixed broadband, the more modern FTTx has started to take over the traditionally                                                              on social media.                                context of digital health, this will open up more
dominant role of xDSL technology since 2015. This will further enhance the adoption of digitalisation in Vietnam in                                                                                                             opportunities for telehealth, consumer health
forthcoming years.                                                                                                                                                                                                              electronics, as well as healthcare Big Data and
                                                                                                                                                                                                                                AI applications in Vietnam.
Source: Ministry of Information and Communications, Fitch Solutions

Implications to digital health

Indicator                         Issue                                                         Implication
Telecom                           Telecommunication infrastructure has grown                    The continuous improvement of Vietnam’s
infrastructure                    significantly over the past five years across                 telecommunication infrastructure enables the
                                  both internet and mobile sectors.                             country to become better positioned to adopt
                                                                                                digital health solutions. Telehealth, consumer
                                                                                                health electronics, and electronic health records
                                                                                                will have a solid foundation to continue to grow
                                                                                                in the future.

16     Market Intelligence Report                                                                                                                                                                                                                       Market Intelligence Report   17
Digital Health in Vietnam - Market Intelligence Report - assets.kpmg
Digital health
ecosystem

                                                                                                                  Key drivers impacting the digital health market in Vietnam:

                                                                                                                                                                         Industry

Overview of digital health market in Vietnam                                                                                                                  •   Overloading and
                                                                                                                                                                  understaffing issues at
                                                                                                                                                                  existing healthcare public
Vietnam is now laying the foundation for a smart          medical records for patients and disease tracking.                                                      facilities
healthcare industry that includes disease prevention,     Since June 2018, Vietnam has set a clear target
                                                                                                                                                              •   Pressures from hospital
medical examinations and treatment, and health            that, by 2025, 95% of Vietnamese population will
                                                                                                                                                                  financial autonomy policies
management. Under Decision 4888 issued on                 have Electronic Medical Records. Meanwhile,
18 October 2019, the MOH set out a roadmap to             telemedicine solutions remain under a “pilot                                                        •   Increasing competition
digitise patient records at hospitals and establish       phase”, and the application of AI and Big Data in the           Government                              amongst public and private                    Patient
smart hospitals. This is the beginning of an ambitious    healthcare sector remains limited.                                                                      medical service providers in
                                                                                                                  •   Government’s initiatives                    terms of cost and efficiency   •   Rising demand for affordable
multidisciplinary journey that will benefit from access
                                                                                                                      to promote national digital                 both locally and regionally        access to healthcare services
to the global industry’s best practices.
                                                                                                                      transformation program                                                         is driven by an ageing,
Vietnam’s digital health market can be divided into                                                                   •   Decision No. 749/QD-TTg:                                                   growing population, with rising
four main areas: Health Information Technology,                                                                           Healthcare is amongst                                                      healthcare awareness and
Telemedicine, Consumer Health Electronics, and                                                                            prioritised sectors for digital                                            greater prevalence of chronic
Healthcare Big Data & AI-based products and                                                                               transformation.                                                            diseases.
services. Currently, these areas are in the early                                                                 •   Government’s master plan for                                               •   Increasing demand for premium
stages of development. Specifically, most of the                                                                      EHRs promotion (Decision No.                                                   and high quality healthcare
healthcare facilities in Vietnam still use paper-based                                                                5349/QD-BYT) and digitising                                                    services
                                                                                                                      patients’ records at hospitals                                             •   Untapped customer pools in tier
                                                                                                                                                                        Vietnam’s
                                                                                                                      and setting up smart hospitals                                                 II, and III cities
                                                                                                                                                                      digital health
                                                                                                                      (Decision 4888)
                                                                                                                                                                         market

18   Market Intelligence Report                                                                                                                                                                         Market Intelligence Report   19
Local digital health ecosystems                                                                                                                                            Key players:

                                                                          POLICY MAKERS                                                                                    Top 5 Central Hospitals:
                                                                           The Ministry of Health has set out targets to digitise the
                                                   Ministry of Health      healthcare sector from 2019-2025, including gradually
                                                                                                                                                                            Hospital name                      Type of hospital                   Number of beds
                                                                           build a smart health-care and prevention system, using
                                                                           electronic medical records and electronic payments, and
                                                                                                                                                                            Bach Mai Hospital                  General                            1,900 beds
                                                    Electronic Health      strengthening the application of information technology in
                                                     Administration        health management
                                                                                                                                                                            Cho Ray Hospital                   General                            1,800 beds
                                                                                                                                                                            K Hospital                         Oncology                           1,800 beds

 HEALTHCARE SOLUTION PROVIDERS                                                                                                                                              Huu Nghi Viet Duc Hospital         General                            1,200 beds
                                                                                                                                 FUNDERS/ SPONSORS
         Representative            Representative
                                                                          A PATIENT-CENTRIC,
                                                                                                                                                                            University Medical Center Ho       General                            1,000 beds
        local companies          foreign companies                                                                       Vietnam Social      Bao Viet       Bao Minh
                                                                          INNOVATIVE DIGITAL                                 Security       Insurance      Insurance        Chi Minh City
          FPT                    IBM          Doctor
      Information   Buymed*
                              Corporation   Anyw here*
                                                                        HEALTHCARE ECOSYSTEM
        System
                                                                                                                                                                           Top 3 conglomerates in Digital Health:
                                                                                                                         VSS is also planning to replace paper
                                                                                                                         insurance cards with digital ones to reduce        Digital heath conglomerate         Digital health services            Key partners
     Both local and foreign companies have                                                                               errors in processing information and reduce
     responded to rising demand for digital health by                                                                    time for administrative procedures                 FPT                                Health information tech and AI &   200 hospitals including Bach Mai
     offering solutions such as teleconsultation                                                                         Meanwhile, private insurers are partnering with
     application, clinical decision-support systems,                                                                     digital solution providers to encourage                                               Big Data                           hospital and Cho Ray hospital
     online appointment-booking systems etc.                                                                             adoption of digital health services in Vietnam
                                                                                                                                                                            VNPT                               AI & Big Data and Telemedicine     168 hospitals including Bach Mai
     Note: *Start-ups                                                                                                                                                                                                                             hospital and Huu Nghi Viet Duc
                                                                        HEALTHCARE PROVIDERS
                                                                                                                                                                                                                                                  hospital

                                                          Bach Mai
                                                                                                                                                                            Viettel                            Telemedicine                       200 hospitals including K hospital
                                                          Hospital
                                                                           Central-tier hospitals have made great progress in
                                                                                                                                                                                                                                                  and Bach Mai hospital
                                                                           integrating digital solutions into their daily procedures,
                                                        Huu Nghi Viet      such as giving teleconsultations for satellite hospitals to
                                                        Duc Hospital       save time and cost, or applied online booking systems to
                                                                           prevent overcrowding
                                                                                                                                                                           Top 5 Start-ups:
                                                          Gia Dinh
                                                          Hospital
                                                                                                                                                                            Start-up                           Digital health service             Key partners
                                                                                                                                                                            Doctor Anywhere                    Telehealth/ telemedicine           Saigon Eye Hospital, DoLife
Source: Tradepress, Ministry of Health, Hospital websites                                                                                                                                                                                         Hospital, Thu Cuc Hospital
                                                                                                                                                                            JioHealth                          Telehealth/ telemedicine           Bao Viet Insurance
Besides the government and associated                                                   also partnered with Bao Minh Insurance and Bao Viet
                                                                                                                                                                            Mydoc                              Telehealth/ telemedicine           Bao Viet Insurance
organisations, private entities in various sectors                                      Insurance respectively to further encourage digital
like telecommunications, IT, and insurance are also                                     adoption in Vietnam. Notable local start-ups include:                               VieVie Healthcare                  Telehealth/ telemedicine           Medicare, Hoan My Hospital
participating in the digital health space. This creates a                               VieVie Healthcare, an online platform that enables                                  BuyMed                             Telehealth/ telemedicine           7,000 pharmacies and clinics
cooperative ecosystem between the government and                                        patients to book appointments and post their concerns
private players that will drive innovation and develop                                  or questions in-app, which will be answered by
the sector.                                                                             qualified doctors; and BuyMed, which offers a secure
                                                                                        wholesale channel for pharmacies in Vietnam.
Even though digital health remains in its early stages
in Vietnam, it has attracted the participation of both                                  Digital health solutions have also been well-received
local and foreign start-ups, and conglomerates. Notable                                 by hospitals through improved operations management
local conglomerates include FPT, VNPT, and Viettel,                                     and data storage. Healthcare digitalisation continues
which are leading telecommunications firms in the                                       to facilitate the enhancement of operational efficiency
country. These firms offer end-to-end solutions in                                      and medical outcomes in public hospitals. Notably,
Vietnam, aiming to support hospitals in managing                                        more than 92% of public hospitals have outsourced to
daily operations with real-time data, digital signature                                 local IT companies such as FPT, Link Toan Cau, Dang
integration, and digital medical records solutions.                                     Quang and OneNet to develop digital solutions for their
Foreign players are also present in the sector. For                                     facilities.
instance, Microsoft and its cloud services are used
by hospitals and modern pharmacy chains, and IBM’s                                      Compared to public hospitals, private facilities in
Watson is used for Oncology by some domestic                                            Vietnam have relatively more advanced health
institutions.                                                                           management systems. Large hospital chains such
                                                                                        as Hoan My, and Vinmec Hospital have upgraded
Start-ups in Vietnam are operating at a smaller                                         their digital infrastructure to manage their branches.
scale. Doctor Anywhere, JioHealth, and Mydoc are                                        Furthermore, in order to provide the best services,
international start-ups that offer digital consultations                                many foreign-invested hospitals are focusing on
and scheduling systems for in-clinic appointments or                                    investing in digital platforms.
at-home visits. Doctor Anywhere and Mydoc have

20     Market Intelligence Report                                                                                                                                                                                                                              Market Intelligence Report   21
Key areas in
digital health                                                                                                   Case study analysis

                                                                                                                 FPT.eHospital. The solution consists of 22 functional modules and
                                                                                                                 is divided into five main groups:

                                                                                                                 01 management of medical examination and treatment;
Health information technology
                                                                                                                 02 administration and office management;

Key development milestones            Opportunities                                                              03 laboratory management;

Vietnam’s health information          The Vietnamese government has acted swiftly to embrace Industry            04 image transfer, processing, and storage;
system is making initial              4.0, extending this to the digitisation of healthcare. The MOH has
progress: Most medical                encouraged hospitals to apply technology to their operation in order       05 and secure data storage.
institutes in Vietnam still use       to enhance efficiency. As former Minister of Health Nguyen Thi Kim
                                                                                                                 The medical management solutions have helped reduce
paper-based medical records           Tien states:
                                                                                                                 information errors, while integrating patient information into a
for patients and diseases. Since
                                                                                                                 system that is readily accessible to medical professionals. The
June 2018, Vietnam has set
                                              Together with the achievements made over recent years,             administrative management solutions in FPT.eHospital have also
the goal to promote Electronic
                                              Vietnam continues the reform of the healthcare system.             begun transforming old hospital management systems. As an
Health Records (EHRs). Under
                                              We want to learn from countries in the development of the          example, instead of using separate applications, hospitals can
the governmental plan for the
                                              healthcare sector and encourage private investment into            now utilise vertical management applications integrated in to
deployment of EHRs (Decision
                                              this path,                                                         FPT.eHospital, which manages the administration processes
No. 5349/QD-BYT), at least
                                                                                                                 from front-office patient care to back-office
80% of people in provinces and
                                                                                                                 resource management.
central-affiliated cities will have
EHRs in the near-term, reaching       Additionally, as Vietnamese hospitals transfer to a more digital
a target of 95% of population         system, there is an opportunity for UK digital service providers to help
nationwide by 2025. Currently,        manage the complexity of data that this transformation creates.
there are 24 provinces
                                      Challenges
implementing EHRs in
Vietnam, six of which officially      Several challenges slow the process of hospitals advancing health
considered the “piloting EHR          information technology and digitisation, namely:
provinces”. Emerging EHR
providers like FPT.eHospitals
                                                 Financial pressures: Hospital management software
are quickly gaining traction in
                                                 and the broader information technology infrastructure is
Vietnam. However, Vietnam
                                                 expensive.
data localisation requirements
may create challenges for
providers that operate on a                      Lack of investment in human resource training: all
global cloud.                                    healthcare professionals will need to be trained in the use
                                                 of digital systems. This may be a significant hurdle in rural
                                                 or remote regions of the country.

                                                 Concerns over data privacy and cyber security laws
                                                 to protect patient data.

22   Market Intelligence Report                                                                                                                                                      Market Intelligence Report   23
Telehealth / Telemedicine

Key development milestones         Opportunities                                                                    Case study analysis

Telemedicine solutions             The plan to expand the use of telemedicine is expected to pave the way
                                                                                                                    Doctor Anywhere (DA)
are under “pilot phase”:           for further hospital adoption. The government is encouraging investors
Adoption of telemedicine in        to participate in the development of digital health in Vietnam, including        Doctor Anywhere is a Singapore-based start-up            Currently, BuyMed has an extended network of 700
urban and rural areas is still     telehealth.                                                                      that has operated in Vietnam since the end of            verified suppliers, distributors, and manufacturers,
on a small scale. During the                                                                                        2019. The company serves more than one million           serving over 7,000 healthcare providers. Thuocsi.vn
COVID-19 pandemic, Vietnam’s       Although the capacity of telehealth service is currently limited to basic
                                                                                                                    users in Vietnam, Singapore, and Thailand. It offers     and BuyMed have both seen significant growth as a
Ministry of Health piloted         consultations in Vietnam, it is still expected to improve health conditions
                                                                                                                    teleconsultation services in internal medicine and       result of COVID-19.
telemedicine to encourage          in underserved geographical areas. Going forward, opportunities for
                                                                                                                    paediatrics through a smartphone application. The
social distancing and reduce       telemedicine applications in Vietnam exist across numerous areas including                                                                Jio Health
                                                                                                                    patient’s records, prescriptions, and related papers
nosocomial infections.             remote patient diagnosis and prescriptions, remote patient monitoring and
                                                                                                                    will be emailed to the patient after the consultation
Specifically, on 24 April,         consultation, and even surgical care and telecardiology.                                                                                  Jio Health is a telemedicine app that enables on-
                                                                                                                    session. In addition, the prescribed medicine can
the Ministry of Information                                                                                         also be delivered to the patient upon request through    demand access to healthcare services such as
and Communications, the                    “Telemedicine consultation is accompanied by simple medical              partnered pharmacies. The company is currently           primary care and chronic disease management. By
Ministry of Health, and the                devices such as thermometers, blood pressure meters, heart rate          delivering 350 tele-consultation sessions per day        providing a comprehensive ecosystem through its
Voice of Vietnam signed a                  meters, diabetes meters, and COVID-19 tests will be developed            in Vietnam due to COVID-19, a 600% increase              mobile application, customers can talk to doctors
Memorandum of Cooperation                  soon. With technology advancements, these medical devices                comparing to 60 sessions per day before the              and nurses 24/7, and schedule appointments with
to provide a free support                  will become cheaper and will facilitate healthcare development           pandemic. With Doctors Anywhere, patients are            preferred doctors as well as monitor and download
package for online telemedicine            at home,” said the Minister of Information and Communications,           able to receive consultations from doctors currently     their own medical records such as clinical notes, test
during the COVID-19 pandemic.              Nguyen Manh Hung.                                                        working in leading hospitals in the country, such as     results, and prescriptions. In addition to this, the app
For access, people can                                                                                              Bach Mai Hospital and Cho Ray Hospital.                  can manage the records of direct family members,
download the VOV Bacsi24                   “Vietnam has advantages such as powerful telecoms and IT                                                                          stored safely in cloud. Users can access their health
app from Google Play or Apple              groups, nationwide infrastructure, and resources which can develop       Doctor Anywhere has developed partnerships with          records electronically at any place and time through
Stores, create an account,                 infrastructure to speed up digital transformation in important           nearly 100 hospitals and clinics, 50 pharmacies, and     Jio Health’s mobile application and possibly purchase
and follow instructions. In                sectors like education and healthcare,” Hung elaborated.                 100 doctors from leading hospitals to meet the rising    prescriptions on the application as well. Payment
addition, the government has               “The country needs more platforms, and so, we call on the                                                                         methods are also simplified and safe on JioHealth’s
                                                                                                                    demand of its users.
implemented a pilot program                business community to join the development.”                                                                                      application, ranging from cash to electronic wallets.
with Hanoi Medical University                                                                                       BuyMed
Hospital linking it with several   Challenges                                                                                                                                Since its launch in 2014, an estimated 200,000 people
satellite hospitals, including                                                                                      BuyMed is a medical start-up in Vietnam that seeks to    have registered on the application.
Muong Khuong General                                                                                                tackle counterfeit drug issues. The company operates
                                             Lack of clear regulation framework for telemedicine                    Thuocsi.vn, a pharmaceutical distribution marketplace,
Hospital (Lao Cai province), Ha
Tinh City General Hospital (Ha                                                                                      and aims to simplify pharmaceutical distribution
                                   MOH issued Circular 47 in 2017 regulating telemedicine in Vietnam.               system in Vietnam and the rest of Southeast Asia.
Tinh province), commune health
                                   This circular, in effect since February 2018, allows doctors to offer            The platform works by verifying suppliers and
stations, and patient homes.
                                   telemedicine services to patients, subject to certain requirements including     reducing the risk of medications making entering
This program is expected to
                                   IT infrastructure and licenses. Circular 47 also provides guidelines for a       the grey market. Since initial feedback on Thuocsi.
serve as a steppingstone to the
                                   range of telemedicine activities such as telemedicine consultation, tele-        vn have been positive, BuyMed plans to add new
wider adoption of telemedicine
                                   radiology consultation, remote consultation, remote surgery consultation,        product lines including medical devices, supplements
in Vietnam.
                                   and telemedicine technology transfer training. This is the only regulation       and medical services to become ‘one-stop shop for all
                                   governing telemedicine activities so far. In addition, there is also no          users’ healthcare needs.
                                   regulation on reimbursement schemes from Vietnam’s Social Security, or
                                   private insurance providers for telemedicine. Telemedicine is a new area, and    As there are no major multi-brand distributors in
                                   as such, the regulatory framework is catching up with business needs.            Vietnam, most pharmaceutical manufacturers
                                                                                                                    and brands end up building their own networks,
                                                                                                                    fragmenting the process of providing prescriptions
                                             Underdeveloped infrastructure, especially in rural areas               and pharmaceutical supplies to healthcare providers.
                                                                                                                    This results in distributors serving over 40,000
                                   The limitation in synchronising digital technology of many hospitals,            independent pharmacies and an estimated 5,000
                                   especially tier II and III hospitals is amongst the key challenges for the       independent clinics.
                                   implementation of telemedicine in Vietnam. Many older patients and people
                                   living in remote areas have limited access to technology, thus require certain
                                   level of additional infrastructure before they can leverage digital health.

                                             Challenges for changing behaviours of medical professionals
                                             and patients

                                   “It is not the technology but the required changes in habits of people
                                   and medical professionals that will challenge the shift from traditional
                                   consultation and treatment to online services”, said Mr. Nguyen Manh Ho,
                                   CEO of Viettel Solutions.

24   Market Intelligence Report                                                                                                                                                                            Market Intelligence Report   25
Consumer health electronics

Key development milestones          Opportunities                                                              Case study analysis

As Vietnam develops, people,        Wearables have potential to revolutionise how people monitor and
                                                                                                               As technology becomes more integrated into daily life, the adoption rate of wearables such as remote
especially the country’s urban      maintain their health, and act on personalised health data. Checking
                                                                                                               patient monitoring devices and smartwatches with Vietnamese consumers will increase. These tools,
youth, are integrating health       one’s vitals on a regular basis for many in Vietnam requires a visit to
                                                                                                               among others are now utilised by clinicians as part of standard treatment regimens. This care standard
technology into their lives,        a local hospital or clinic, which contributes to crowding and additional
                                                                                                               is coming to Vietnam and will help alleviate crowding and resource constraints and improve overall
driving wearable fitness and        stress on already strained healthcare practitioners, especially in
                                                                                                               treatment quality through more accurate and timely data.
activity tracking technology.       remote or rural areas. Remote patient monitoring solutions from
2.3 million people in Vietnam       providers such as Phillips Health and Omron HeartGuide are                 Other markets in Southeast Asia are also quickly adopting wearables and remote patient monitoring
now own some forms of               allowing people to communicate with their doctors and track critical       technology to improve clinical efficiency, lower costs, and drive better health outcomes. As an example,
wearable tech, including Fitbits,   information from the comfort and convenience of their homes. This          Singapore’s IoT (Internet of Things) solutions company KaHa recently partnered with medical solutions
Apple Watches, or Samsung           will free-up bed space, lower the cost of care, and allow for earlier
                                                                                                               provider EasyCare and iDOC Clinic to launch remote patient monitoring for primary care patients. The
Watches.                            discharge of low-risk patients.
                                                                                                               partnership will leverage wearables and near-patient devices to track health statistics such as sleep
                                                                                                               quality, blood pressure, heart rate, and activity level, and provide feedback and activity modification
These devices, however,
                                    Challenges                                                                 suggestions to users through a dashboard. As well, data collected through the devises will be available
have greater potential utility                                                                                 to the patient’s attending physician, which will assist with ongoing monitoring, and help improve the
than just fashion or fitness        However, wearable teach in Vietnam is not as common as it is               accuracy of future diagnoses.
accessories. According to a         in other markets. According to the Rakuten Insight survey, 57%
survey conducted by Rakuten         of respondents claimed that their smartphone was sufficient in
Insight, the health monitoring      monitoring their health and they did not see a reason to add a paired
is the primary reason why           wearable. This may limit the types of data that can gathered and
Vietnamese consumers                analysed.
purchase wearable tech. As
such, many corporations             It should also be noted that wearables can be expensive, ranging
like Apple & Phillips have          from USD $30 to more than $300, while the average monthly salary
announced plans to focusing         of a worker in Vietnam is approximately $265. This is particularly
on medical wearable tech that       true for rural workers, who generally earn less but have much to gain
focus on heart rate, and sleep      from better access to health monitoring.
quality.

26   Market Intelligence Report                                                                                                                                                                    Market Intelligence Report   27
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