Digital health in emerging markets
February 2017

The Digital
Healthcare Leap
In this paper3	The digital healthcare
dilemma in emerging
markets6	Do traditional digital healthbusiness models have a rolein emerging markets?
10	The leap forward

www.pwc.com/global-healthwww.pwc.com/gmc

Foreword

David McKeering
PwC Global Healthcare Markets Leader
PwC South East Asia Consulting

Whether we like it or not, technology has become part of ourlives. It has arguably helped us as individuals become more
informed and more connected. The use of technology isembedded in the industries of banking, automotive, insurance
and retail. Today the health sector faces a daunting new digitalchallenge: unleashing the power of technology to fundamentally
reinvent how care is delivered. On top of their existing technology
needs and priorities, today’s health providers need to address thedigital requirements demanded by health policy or by consumers
and other stakeholders.
Digital Health initiatives rely heavily on having the rightinformation in the right place at the right time for use by the rightclinician. To really use technology effectively in health, we needsystems to interact with one another to provide the data required
to make informed decisions about the delivery of care. ‘Digital
healthcare’ is not about the technologies, it’s about new ways ofsolving healthcare problems, creating unique experiences forpatients and accelerating healthcare providers’ growth. Over the
longer term, digital healthcare will help system-wide operations
and organisations to deliver more powerful healthcare.
Yet these challenging financial times discourage all but the mostprudent, high-return investments. Advanced, enterprise-wide digital
health solutions should head many emerging healthcare providers’lists of ‘must have’ capabilities; however, traditional digital
healthcare models often come with high costs. Our experience isthat digital health can dramatically improve an organisation’s
productivity and, in turn, provide benefits in both patient outcomes
and the bottom line. This means that if the costs of digital healthcare
solutions can be made affordable, digital health could be an answer
to the emerging markets’ challenge to achieve sustainable growthand leapfrog the developed nations to provide quality, affordable,
universal and patient-centric care.

PwC | The Digital Healthcare Leap | 1

Characteristics ofhealthcare in
emerging markets

Healthcare demand in emerging markets is growing, driven by a number of factors
such as a growing population as well as an ageing population. With the growing
middle class and rising incomes, people are spending more on healthcare. Noncommunicable diseases such as diabetes are no longer ‘rich country’ diseases andtheir prevalence is increasing in emerging markets. In these countries most of thehealthcare infrastructure is concentrated in urban areas, while more than 50% of
the population lives in rural areas.

Ageing population

Growing population• Emerging markets will account for
80% of the world’s elderly by 20501

21%

Many emerging markets in the Asia-Pacific region
are yet to reach their ‘peak’ population3• Some emerging markets should
7%
expect a significant increase in the
portion of their population aged 65+
Vietnambetween 2015 – 20502
30%

Projected population growth (2015-2050)

10%
2015

8%
increase

Thailand

2050

China

Population in 2050
108%

46%
increase• 68% of total deaths globally occur due to NCDs; emerging
markets account for 75% of these deaths7

India

Population in 2050
146%
40%
increase• Almost 200 million of the world’s 370 million people
diagnosed with diabetes live in Asia8

50%
Malaysia
Population in 2050 increase
150%

Indonesia
Population in 2050
140%

Indonesia

Prevalence of diabetes
as % of population8

3.4
2012

Growing middle class

8.6
2030

Malaysia

Thailand

2.3

3.2

8.5

2012

2030

4.1

2012

of the global
middle classwill be in
Asia-Pacificby 20304

2/3

2030

Philippines

2012

65%
Population in 2050 increase
165%

Philippines

Increased prevalence of non-communicablediseases (NCDs)

2.9

Japan

Population in 2050
93%

rds

Vietnam

8.1
2030

0.9

2.6

2012

2030

Urban-rural divide

Percentage of population in rural areas (2015)5• Over 50% of the emerging market in
Asia-Pacific live in rural areas6

50%

50%

56%

44%

66%

34%

67%

33%

Urban
Rural

2 | The Digital Healthcare Leap | PwC

ThailandPhilippines

VietnamIndia

7%decrease

The digital healthcare dilemma inemerging markets
There is a clear burning platform andopportunity to address the growing burdenof healthcare costs and corresponding impact
on economic productivity due to ill health(the impact of non-communicable diseases
like cardiovascular, cancer and diabetes is
estimated at 4-6% of GDP across the APAC
region). Solutions will require robust analysis
and foresight, leadership and multi-stakeholder
public-private partnerships.
Sarah Butler
PwC Australia National Healthcare Leader

The healthcare gap
Expenditure on healthcare is increasing exponentially inemerging markets (see Figure 1). As incomes are rising and the
middle class is growing in emerging markets, people are
spending more on healthcare and demanding better healthcare
services. With changing lifestyles and people living longer, there
is a tectonic epidemiological shift from communicable to chronic
disease such as diabetes, cardiovascular diseases and cancer.
While developed economies also have their challenges withaffordability of care, their fundamental infrastructure is in place,for the most part, and their population growth remains relatively
steady. Improving healthcare access and quality is becoming apriority in emerging markets. However, these countries havesignificant strain on their health systems. Digitisation of healthservices, if done in a different model, can help to improve thequality of and access to care while reducing costs.

Figure 1: Healthcare expenditure is increasing exponentially in emerging markets
Healthcare expenditure developed vs. emerging markets (%)
15%

22%

26%

29%

35%
Emerging

85%

78%

74%

71%

65%

2005

2010

2015

2020

2025

Developed

9%

CAGR between
2015 and 2020 inemerging markets

Source: Business Monitor International (BMI)

On the demand side, the patients/consumers in emerging
markets are becoming more discerning around their own healthand customer experience has become a key motivator forproviders. Healthcare providers that fail to adapt to thisconsumer shift will risk consumers turning elsewhere to havetheir health needs met. For example, in Indonesia, patients are
increasingly travelling to neighbouring countries such as
Malaysia and Thailand to access better healthcare services.
On the supply side, the healthcare system in the emerging
markets is characterised by underdeveloped infrastructure andfaces an acute shortage of resources (see Figure 2). Governments
are looking to improve healthcare access and affordability. They
are implementing universal healthcare coverage and increasing
national budget allocated to healthcare to upgrade the existing

facilities as well as to add new facilities. However, considering
the gap and what is needed to bridge it, the traditional model for
growth would not be sustainable.
For example, Indonesia is looking to expand its national
insurance programme to all its citizens by 2019. In 2015, it
allocated 5% of its national budget to healthcare.9 However, it isalready facing a funding gap and has an acute shortage ofhealthcare resources. It would need an additional ~900k hospitalbeds and ~700k physicians to provide healthcare services
comparable to those available in OECD (Organisation for
Economic Cooperation and Development) nations. To ensure thelong-term sustainability of its national healthcare program,Indonesia needs to look at innovative technology and disruptive
business models.

PwC | The Digital Healthcare Leap | 3

Figure 2: Emerging markets are characterised by underdeveloped infrastructure and face an acute talent gap

OECD average
4.7
3.3

Japan
12.3
2.5

S. Korea
8.8
2.3

China
3.3
1.8

India
0.8
0.8

Thailand
2.2
0.4

Philippines
1.1
1.2

Vietnam
2.9
0.8

Malaysia
2.0
1.6
Singapore
2.0
2.3

Hospital beds

PhysiciansIndonesia
1.0
0.4

Infrastructure and Talent Gap

Low
Gap

Moderate
Gap

High
Gap

Australia
3.9
4.4

Source: Business Monitor International, 2015; OECD Data, 2014

By 2035 the global shortage ofhealthcare professionals willreach 13 million from

7 million today10

4 | The Digital Healthcare Leap | PwC

Over 1/3 of countries
suffering from this shortage
are emerging markets11

Weak tertiary and continuing
medical educational system limits
quality of knowledge distributedin emerging markets

Digital adoption in emerging markets
Over the next decade, developing countries
will need to spend billions on healthcare
infrastructure and services. Advancements
in technology must be considered with theseinvestments. Where urgent needs prevailin emerging markets with limited access tohealthcare, the learnings from costly EHR
implementations in development markets must
be considered to determine a more affordable
path forward. Similarly to how wirelesssolutions have allowed developing countries toleapfrog fixed line infrastructure investments
for broadband access, emerging markets need toconsider innovative EHR solutions that will allow
them to leap towards improved healthcare that ismore affordable.
Vaughn Kauffman
PwC Global Healthcare New Entrants Leader

Adoption of traditional Electronic Health Records (EHR) is still
low in emerging markets (see Figure 3). These markets mostly
use paper-based solutions and outdated IT equipment.
The traditional EHR solutions have mostly been implemented indeveloped markets and represent a monumental changetransformation which can be measured in decades, rather thanmonths or years. There is a significant up-front cost required topurchase and install EHR as well as training costs and ongoing
maintenance costs. The USA Congressional Budget Office (CBO)
reported that, on average, EHR implementation costs for
hospitals amount to approximately US$14,500 per bed withannual operating costs of US$2,700 per bed per year.12 For
example, USA based healthcare provider, Lifespan, announcedplans to implement Epic’s EHR in March 2013, and the healthsystem went live in April 2015. The implementation is estimatedto have cost US$100 million.13 Healthcare providers in emerging
markets are unlikely to be in a position to afford suchprohibitively expensive operating costs from major EHR vendors.
However, the adoption of digital healthcare solutions including
EHRs in emerging markets could change dramatically in the next
few years. With the internet and smartphone penetration growing
and the technology infrastructure moving to cloud-based services,
this presents the opportunity to develop innovative and costeffective solutions to deliver healthcare services. These new
digital healthcare models involve rapid prototyping, design andimplementation which presents a great opportunity for emerging
markets to leapfrog the developed markets.
Also it will be easier to implement innovative solutions inemerging markets because of fewer sunk costs, given existing
infrastructure and equipment, lower fixed costs from building
overcapacity, weaker vested interests and less divided public
opinion than is typical in established markets.

Figure 3: Digital adoption is still low in emerging markets
Netherlands

US

GermanyJapan

S. Korea

MediumCanadaEmerging
markets

ThailandUK

Malaysia

Philippines

Indonesia<25%

Australia

China

India

Low

EHR Adoption*

High

Singapore

Denmark

Vietnam
25%-70%Internet Penetration (2015)>70%
Population size

Source: Statista, HIMMS Analytics Electronic Medical Record Adoption Model, PwC Analysis*Note: EHR Adoption includes usage of medical records, health records, and other digital solutions by hospitals and physicians to deliver healthcare service.
PwC | The Digital Healthcare Leap | 5

Do traditional digital health businessmodels have a role in emerging markets?
Emerging markets will reset the delivery model for
EMRs and EHRs in the next few years. The lack oflegacy infrastructure can liberate health systems(both public and private) from the financiallydaunting capital costs which have led togovernment-sponsored initiatives such as
Meaningful Use in the United States. Cloud-based
technology, mobile enablement and fees for service
models will lead to faster deployment andincreased benefits for patients. Perhaps then theemerging markets will instead become the leaders,with the followers quickly shedding their ‘onpremises’ technology.
John Forsythe
PwC Australia, Southeast Asia,
New Zealand Digital Healthcare Leader

Traditional digital health models
Most developed countries have moved away from paper-based
healthcare solutions and have adopted or are in the process ofadopting ‘traditional’ digital healthcare models (see Figure 4). These
traditional models require the purchase or lease of hardware andsoftware as well as dedicated space to house servers/data centres.
These systems are coded, siloed, fully customised and require
highly skilled programmers and IT professionals to develop andmanage solutions. The developed markets are now moving to a new
digital health model with increasing adoption of cloud and mobilebased technology in the healthcare system. But integration andinteroperability challenges of existing traditional models will makethis progress slower.
For example, in Singapore, the National Electronic Health Record(NEHR) system was rolled out in 2011. It allows patient healthcare
records to be shared across the entire healthcare system. Currently,
all community hospitals, 56 community healthcare providers andclose to 40% of GP clinics have access to NEHR.14 The Singaporean
government aims to get the remaining private players on board as
well. It invested US$128 million to develop Phase 1 of the NEHR,
and is paying about US$15 million each year in maintenance costs.15
Singapore is now transitioning to a new digital health model. It islooking to move health information to the cloud. Named as hCloud,the project will cost US$37 million for the first ten years.16 However,it will help to bring down the cost of running the Healthcare IT
system. Future developments will also include the use of data
analytics to support both decision making at the point of care andnational planning for the Ministry of Health (MOH).

Improved health outcomes

Figure 4: Emerging economies will leapfrog developed markets and adopt the new digital health model

Em

m
ng
i
g
er

New digital
health model

ts
ke
ar

Traditional digital
health model

Paper based healthsolutions

All paper records

Digital version ofpatient information
Coded
Data centred
SiloedTime

6 | The Digital Healthcare Leap | PwC

Cloud based
Open source
Integrated
SocialMobileEmerging economies are unlikely to adopt the traditional digital
health models. There is a significant gap in most of theparameters required for successful adoption of the traditional
digital healthcare model, including affordability. Figure 5
compares emerging economies in Southeast Asia to Singapore on
the ten parameters required to leverage information andcommunications technologies (ICTs) for social and economic
impact. An emerging market such as Indonesia lags behind
Singapore in terms of the political and business environment,
infrastructure, affordability, skills and stakeholder readiness
required to adopt the traditional digital health model.

Figure 5: Fundamental gaps in every aspect of Information Communication Technology
1. Political and regulatoryenvironment
8
6
4
2
0

10. Social impacts

2. Business and innovation
environment

9. Economic impacts

3. Infrastructure

8. Government usage

4. A ffordability

Singapore

7. Business usage

5. Skills
6. Individual usage

Malaysia
Indonesia
ThailandSource: World Economic Forum ‘Network Readiness Index’ 2015

Philippines

New digital health models
In emerging markets the new digital health model will play apivotal role in overcoming many of the challenges impeding
healthcare delivery. It will help improve healthcare access,affordability, quality and safety. Emerging markets will leapfrog
developed markets to move to the new digital health model(see Figure 4).
Emerging markets are increasingly digitising health information.
Affordable EHR solutions are coming to market, such as cloudbased EHR or open-source EHR, which can help emerging markets
digitise at a fraction of the cost and in a fraction of the time.
The Philippines has implemented an open source electronic
medical record system for government health facilities
called CHITS (the Community Health Information Tracking
system). CHITS is managed by the UP Manila – National
Telehealth Centre. The program has been able to improve healthcare delivery in government health centres. Nurses and midwives
who usually record health data on paper were trained to use thesystem to generate timely reports for DOH national vertical
health programs. Through the program implementation, delaysin accessing health data were minimised, giving more time forhealth workers to give care to patients at the health centre.17
Many private sector providers in emerging markets have also
opted for cloud-based solutions. There is strong support for
healthcare cloud systems from both public and private hospitals
in Malaysia and the Philippines. Mary Johnston Hospital in
Manila, in the Philippines, implemented a cloud-based EHR
solution called HarmoniMD. This solution is built from theground up using the latest cloud technologies and helps leapfrog
over legacy server-based applications.18 Similarly, the Philippinesbased company Lifedata offers a web-based electronic medical
records system. It has also signed an agreement with thePhilippine Medical Association (PMA) for the ‘standardisationand computerisation of clinical practices in the Philippines’.19
Digitising the health information lays the foundation of thedigital health model in emerging markets. For best outcomes,
other healthcare innovations such as telemedicine, mHealthapplications and e-prescriptions will be built around the digitised
health information.

PwC | The Digital Healthcare Leap | 7

Making the transition to the new digital health model
The new digital health model is focused on four key elements –disruption, engagement, integration and trust (see Figure 6).

Integration – Providing seamless access to health information
across systems and devices.

Disruption – Transforming businesses through innovativemodels that don’t exist in the market today.

Trust – Ensuring secure information in a digital age to inspire
trust in the providers by the customers.

Engagement – Enabling digital interactions between clients andcustomers in a more engaging and patient-centred way.

Figure 6: New digital health model is focused on four key elements – disruption, engagement, integration and trust

Paper-based/Traditional
digital health model

New digital health model

Paper-based Digitisation

Digitisation

Disruption

Physician-centric

Patient-centric(Engagement)

Independent

Integrated

Security

Trust

From digitisation to disruption
New entrants are disrupting the traditional health model by offering
digital healthcare services in new and unique ways. They are
exploiting the cost-quality curve to deliver healthcare services in analternative setting. The new care delivery models introduced bythese new stakeholders will partially fill the healthcare gap.
The new entrants are increasingly collaborating with healthcare
providers and combining the use of EHRs and mHealthapplications. There will be an increasing influx of wearable
solutions in emerging markets that will support consumer andhealthcare desire for monitoring and tracking to be integrated into
daily life.
With fewer sunk costs and regulatory hurdles, emerging markets
will be able to transition quickly to these disruptive solutions.

8 | The Digital Healthcare Leap | PwC

A small start-up founded in 2009 in Myanmar offers web-based
and mobile application solutions related to healthcare. Its main
solution is offered in conjunction with the leading telecom
provider. The mobile application (app) helps users scheduletelemedicine consultation or appointments with doctors. Users
can also order medicine and seek health-related information
through the app. The app had a user base of around 7,000 in 2015
and the telecom partner has agreed to pre-load the app in 600,000
mobile phones in 2016, and 1 million phones the year after.
The start-up is further seeking partnerships with hospitals togive the app to their patients. It has also developed a healthinformation system aimed at helping healthcare providers to
track patient data. It is also currently creating a humanresource information system to help healthcare providers keep
track of doctor entry and retirement.20

From physician-centric to patient-centric(Engagement)

From security to trust

Consumers are demanding better quality and customer service
through social, mobile analytics and cloud technologies. With
democratisation of data and increased usage of social media andmobile, patients will play a more active role in clinical decision
making. The new digital model will focus on customer experienceand understanding patients in their everyday lives. The solution
will use customer relationship management technology to deliverpatient-centric care.

Cybersecurity is a growing concern in healthcare, especially given
recent disruptive ransomware incidents, and the increasing cost of
breaches. Data breaches happen for both malicious and benign
reasons, enabled by greater digital adoption. Health records are an
attractive target for criminals due to the breadth and depth of theirdata, and healthcare organisations’ relatively low degree of focus
on security issues.

The digital solution will also act as a hub by sharing information
across a broad community to provide support, coaching,recommendations and other forms of assistance. It will enable
patient involvement and the provision of ubiquitous and instantfeedback in order to realise new behaviours and/or sustain
desired performance.21

From independent to integrated
Consumers increasingly expect seamless management of theirinformation across their healthcare providers. Currently,
traditional healthcare models rely on disparate systems, multiple
sources of truth and silos of solutions that don’t support theprovider. The new digital healthcare model will transition towards
an inherent capability to ensure seamless information exchange
across system(s) of record.

Ensuring secure information in a digital age to inspire trust in
consumers by their providers is critical. Security in the traditional
sense rested on a patient’s level of comfort about the protection of
the privacy of health related information and threats ofcybersecurity breaches. In the new digital health model where
measures have been established to ensure the security of this typeof information, the patient’s focus has shifted to how to establish atrust based relationship with their healthcare provider who may or
may not be physically present.
Healthcare providers and governments are rethinking strategies
for avoiding these attacks. Employee education is a key tactic for
avoiding attacks. The players are also looking at innovative
solutions such as cloud-based initiatives, Big Data analytics andadvanced authentication to improve security and build trust.22

Leading products must integrate data collected from disparate
devices and apps into external health ecosystems. It should be
integrated into existing activities and workflows of providers andpatients to provide the support needed for new behaviours.
As health data becomes more integrated and analytics and
Big Data becomes more prevalent, healthcare providers will
increasingly gain insight into real-time customer needs and pain
points. Analytics will help in early diagnosis, better treatment andimproved clinical decision making.

PwC | The Digital Healthcare Leap | 9

The leap forward for the emerging markets
The benefits of digital healthcare can be felt
beyond patients. By assisting the prevention ofillness and supporting the provision of carethrough alternative locations such as clinics,
fewer new doctors and nurses will need to be
trained and fewer additional beds and hospitals
created, which can help to reduce the overall
financial healthcare burden on governments inemerging markets, enabling them to fund otherkey areas of the economy. A whole nation benefits
from digital healthcare.

Benefits of moving to the new digital
health model
There are substantial potential benefits of digital healthcare
solutions in addressing business challenges caused by the current
systems and processes associated with paper medical records. The
benefits are not unlike those that could be achieved in a developed
market; however, with a much lower cost base, and much broader
diversity of solutions that cross the continuum of care, they could
be significantly enhanced (see Figure 7).

David Wijeratne
PwC Growth Markets Centre Leader

Figure 7: Summary of benefits of digitising healthcare for patients, providers and payers
Patients

Providers

Payers

EMR

Easier to read and understandEasy storage and retrieval; improved efficiency
and productivity

EHR

Better diagnosis and treatment

Coordination and informed decision-making

Faster reimbursements

Personal Health
Records

Personal wellness management

Consistency of information

Links to healthcare plans
and lower claims

Remote Diagnostics

Reduces duplicated tests and referrals

Easy accessLower cost

Remote Monitoring

Patient-centric integrated care

Reduce emergency and re-admissions

Lower cost

TelecareAccess to specialist care

Improves productivity and reduces burden ofhealthcare resources

Lower costmHealthapplications

Greater patient engagement andsaves time

Proactive and targeted care

Big Data/Analytics

Accurate diagnosis, better treatment

Improves diagnostics and accuracy of treatment

Lower cost

* EMR – Electronic Medical Records; EHR – Electronic Health Records

Key considerations in moving to the new digital health model
Technology can bridge the growing gap between workforce
supply and consumer demand and clinicians are beginning to see
how care can be amplified through mobile technology. In a recent
PwC Health Research Institute survey, 85% of clinicians said theywould use data from apps and wearables in future treatments.23
However, it is well documented that 80% of large organisationalchange initiatives fail to achieve their intended objectives,
particularly in technology-related programs.
Digital health initiatives offer the opportunity to have afundamental impact on the business model of the implementing
organisation. With the introduction of new ways of solving
business problems, creating unique experiences for the customer
and engaging people through digital mechanisms, many tasks
may also become automated or be eliminated, and result in newworkflows to complement digital solutions. As a result, any
company looking at digital healthcare needs to provide
substantial support to the business in order to manage people
through this change process. Attempting to implement a digitalchange in a healthcare environment requires the active
involvement of clinical leaders and sponsors who are committed
to the change process and can help lead the organisation throughthe change. These individuals or groups are sponsors andchampions who play a key role in driving the change.
10 | The Digital Healthcare Leap | PwC

Healthcare providers and administrators need to set strategies
that harness technology for mutual interests and mutual gain as
they build care delivery models with patients – not patientencounters – at their centre.
The companies that will emerge as winners in this newmarketplace will be those that can articulate how technology can
add value, align incentives, strategically share and analyse data,
and redeploy, extend and expand their workforce to embrace
digital enablers. The following elements are key:
• Understanding which digital health technologies
healthcare providers and consumers value should shapedigital strategies• Generating meaningful, actionable insights
through analytics will focus investments and yield better,
faster results• Understanding what motivates both caregivers andconsumers to adopt and continue to use digital technology
will be critical for sustainability• Rethinking the workforce and informing workflows will
fuel the Digital Health return on investment.

Conclusion
After decades of slow progress, it’s time for healthcare to take theleap into the new digitally enabled healthcare era. The magnitudeof the challenge facing the health sector is considerable. Its
implications are far reaching for all aspects of society and theeconomy. It is clear that the challenge of affordable andsustainable healthcare is common across both emerging anddeveloped economies. Finding a sustainable solution to enable
better healthcare delivery is no longer the responsibility of the
public sector. There is a collective responsibility across both the
public sector and private sector to redefine traditional healthcare
business models to find new pathways to sustainability.
Innovative companies are empowering healthcare customers
with new solutions and forcing the entire industry to rethink theway it does business. With the patient/customer becoming morediscerning around their own health, customer experience has
become a key motivator for providers. Consumers are no longer
passive patients, but have become more engaged and morediscerning, wielding new tools and better information to compare

providers. The near future will be marked by how well theindustry responds to this consumer shift. Hospitals andhealthcare providers that fail to adapt will risk declining
revenues as consumers turn elsewhere to have their health needs
met. The message is clear for healthcare delivery: digital is here
and if as a provider you are not prepared, you may be left behind.
Healthcare companies should look to how they will integrate andconnect their existing systems with new digital technologies andmerge the data locked inside them to generate meaningful,actionable insights for caregivers. In the new digital health era,
digitally enabled care is no longer going to be a nice-to-have, butrather a fundamental business imperative. Industry leaders acrossproviders, insurers, medical technology and the pharmaceuticals
all see major shifts in how care is being delivered. Digitaltechnology has the potential to bridge time, distance, theaffordability of healthcare and the expectation gap between
consumers and clinicians.

PwC | The Digital Healthcare Leap | 11

About the authors

David McKeering

Christopher Norton

PwC Global Healthcare Markets Leader
PwC South East Asia Consulting

Director
T: +65 9784 6255
E: christopher.norton@au.pwc.com

T: +65 9382 5658
E: david.mckeering@sg.pwc.com

David is the South East Asia Consulting
Public Sector and Healthcare Leader andGlobal Healthcare Markets Leader. Prior to
moving to Singapore, David was the
National Healthcare Leader for PwC
Australia as well as the Consulting Site
Leader for Queensland.

Chris is a Director in the Australia, Southeast
Asia and New Zealand Healthcare Consulting
team. As senior member of PwC’s Southeast
Asia Consulting practice Chris leads thehealthcare consulting team in the region
working with private and public sector clients
to solve their most complex challenges.

He has a recognised track record in bothprivate and public sectors, and across thevalue chain of public sector and healthcare
services. David has recently led engagements
around eHealth Programs, National Health
Reform Blueprinting, Divisional Culture andChange Projects, Clinical Services Redesign
Projects, Workforce Planning and major
technology implementations.

Chris has extensive experience in Health IT,
productivity and efficiency, health service
planning, project management and change
management. Chris has over 16 years’
experience in the healthcare sector and is aqualified registered Nurse. Prior to working
with PwC Chris worked in frontline clinicaldelivery and hospital executive roles.

Aastha Gulati

PwC Growth Markets Centre
Healthcare Lead
T: +65 9861 7515
E: aastha.gulati@sg.pwc.com

Aastha leads the Healthcare sector within
PwC’s Growth Markets Centre. She
specialises in supporting organisations toenter and expand into the emerging markets.
She has international experience inleading and delivering strategy andoperations projects including go to market
strategies, operating model assessment
and design, business model transformationand program management.

Spotlight authors

David Wijeratne

PwC Growth Markets Centre
LeaderJohn Forsythe

PwC Australia, Southeast
Asia, New Zealand Digital
Healthcare Leader

Sarah Butler

PwC Australia National
Healthcare Leader

Acknowledgements

Kelly Barnes

PwC Global Health Industries
Consulting Leader

Benjamin Isgur

Health Research Institute(HRI) Leader

12 | The Digital Healthcare Leap | PwC

Rachel Caoili

PwC Growth Markets Centre
Asia Pacific Lead

Vaughn Kauffman
PwC Global Healthcare
New Entrants Leader

References

1.

World Economic Forum, ‘Why ageing is an issue for emerging markets’, 12 Feb 2014

2.

Business Monitor International (BMI) Database3.

United Nations, 2015 World Population Prospects (High fertility variant, 2015 – 2100)

4.

PwC, Changing demographics demand healthcare reforms, 20155.

The United Nations Development Program's Human Development Report 2013, ‘The Rise of the South: Human Progress in a
Diverse World’

6.

United Nations Department of Economic and Social Affairs, ‘Population Facts – Our urbanising world’, Aug 2014

7.

World Health Organisation, ‘Global status of NCDs’, 2014

8.

MDDI online literature review, 2014

9.

Indonesia Ministry of Finance, 2016

10. WHO, ‘Global health workforce shortage to reach 12.9 million in coming decades’, 11 Nov 2013
11. Oxford Journal, ‘Health professionals' migration in emerging market economies: patterns, causes and possible solutions’, 2013
12. Congress of the Unites States – Congressional Budget Office, ‘Evidence on the Costs and Benefits of Health Information
Technology’, May 2008
13. Becker’s health IT and CIO Review, ‘8 Epic EHR implementations with the biggest price tags in 2015’, July 201514. Singapore Ministry of Health Website, ‘Future phase of NEHR’
15. Singapore Worker’s Party, ‘Easing the cost of healthcare for Singaporeans’, 2013. Cost data converted from SGD to USD based on
exchange rate of 1SGD = 0.75USD
16. Integrated Health Information Systems (IHIS), ‘IT boost to keep health care humming’, October 2014. Cost data converted from
SGD to USD based on exchange rate of 1SGD = 0.75USD
17. CHITS Philippines Website (https://chits.ph/)18. Healthcare IT News, ‘Manila hospital implements cloud-based EHR’, 18 Apr 2012
19. LifeData System Inc. Company Website (http://lifedata.ph/?page_id=16)
20. KoeKoe Tech Compnay Website (http://www.koekoetech.com/)
21. PwC ‘Emerging mHealth: Paths for growth’, 2012
22. PwC ‘Cybersecurity in Health Services’, 201623. PwC Health Research Institute (HRI) Clinician Workforce Survey, 2014 and 2015

PwC | The Digital Healthcare Leap | 13

This publication has been prepared for general guidance on matters of interest only, and does not constitute professional advice. You should not act upon theinformation contained in this publication without obtaining specific professional advice. No representation or warranty (express or implied) is given as to the accuracy orcompleteness of the information contained in this publication, and, to the extent permitted by law, PricewaterhouseCoopers LLP, its members, employees and agents
do not accept or assume any liability, responsibility or duty of care for any consequences of you or anyone else acting, or refraining to act, in reliance on the information
contained in this publication or for any decision based on it.
© 2017 PricewaterhouseCoopers LLP. All rights reserved. In this document, “PwC” refers to the UK member firm, and may sometimes refer to the PwC network. Eachmember firm is a separate legal entity. Please see www.pwc.com/structure for further details.
170215-231110-SS-OS