Taiwan’s healthcare system has been highly regarded on the world stage, especially in recent years. The Bloomberg Health-Efficiency Index, tracking life expectancy and medical spending across 58 major economies, saw Taiwan clinching third spot in 2020; meanwhile, the CEOWORLD’s Health Care Index ranks Taiwan’s healthcare system as second in the world for the quality of its infrastructure, professional competency, cost and other related factors.
What is Taiwan healthcare’s winning formula? One key factor would be its universal health insurance policy, which ensures a good level of medical care for the majority of the population, said Dr Wayne Shihwei Huang, Superintendent of Chang Bing Show Chwan Memorial Hospital in Taiwan.
However, this system does have an inherent weakness. As the main source of income for hospitals come from the government, it can be difficult for hospitals to expand or provide new services. This also means that “the introduction of new medicines, new technologies from foreign international pharmaceutical companies is hindered and restricted; therefore, the most advanced therapies are harder to establish in Taiwan as compared to some other countries,” noted Dr Huang.
The role of medical R&D
For Show Chwan though, efforts to encourage innovation and global partnerships have been implemented to ensure its services stay on par with its peers globally.
As a private healthcare provider running a network of some 10 hospitals in Taiwan, it is also operating a regional training centre for minimally invasive surgery, IRCAD Taiwan. Over the past 13 years, it has trained over 13,000 doctors, through 90 to 100 workshops that are held annually. Over half of these doctors are from outside of Taiwan.
“It’s a really unique network of training centres that we collaborate with,” said Dr Huang, referring to tie-ups with other IRCAD centres in Brazil and Africa. “We share our expertise, our networks, to provide the best training platform to efficiently train surgeons and doctors, so that patients can enjoy the best, highest level of service.”
The training centre has also acted as a unique platform for local medical start-ups to showcase and test their new ideas and technologies to an audience of doctors from across the region. Dr Huang revealed that through partnership with a medtech accelerator, a hospital-backed venture capital fund has been set up, with investments made in more than 10 companies thus far.
“We are able to really get to know the technology and see that it has meaningful impact on care outcomes, and we want to help it move forward. And the support we provide is not just money; we hope to connect them with larger companies that would provide them with more resources,” said Dr Huang.
This focus on innovative technology extends beyond looking at external companies. Show Chwan also carries out its own research work into new medical innovations – Dr Huang pointed to a new hospital department set up to focus on IP license application, which has so far incubated three companies from the hospital.
Driving future growth
The ability to embrace up and coming technologies is crucial to driving hospitals’ growth and development, said Dr Huang.
Hospitals should keep abreast of the latest in devices, pharmaceuticals, precision medicine and so on, and be able to pivot quickly and set up partnerships with different players in the market. Various systems need to be in place to allow this to happen.
“You have to have a system in place for doctors in different specialties who can be contact persons of these innovative treatment modalities. You also have to have a system of management that can navigate a rapid change of technology in the healthcare industry; for example, to quickly adapt and design a new payment system for patients, using QR codes, while considering the threat of cybersecurity,” Dr Huang pointed out.
Other than hardware, innovations in “heartware” – or service quality – is another key area of focus.
This involves constantly looking at every detail of patient service, to ensure patients are treated well with their needs being taken care of, such that they feel they are in a safe, comfortable environment.
“This is a never-ending journey of looking at your guidelines, your protocols, how the patient goes through the hospital, and how the different specialties come together and serve the patient as an individual,” noted Dr Huang.
The goal of improving healthcare accessibility
The Show Chwan network of hospitals are located in initially underserved areas, with the goal of providing the best level of service to patients, irrespective of location.
Though the rise of telehealth has helped to extend the reach of hospital services further from its physical location, the issue of defining the payer for such services remains to be solved in Taiwan.
The government has allowed insurance reimbursement for telehealth services during the pandemic period. However, the policy remains unclear as to what will happen once the pandemic is over.
There is also the need to define specific protocols and workflows for telehealth, that are vastly different from physical services.
“Telehealth is about integrating video conferences with the workflow or patient journey within the hospital, and it is very disease specific. We need to have a specific protocol for diabetes patients, and another for dementia or major depression patients,” said Dr Huang.
“So every telehealth treatment protocol needs to be redesigned, and the technology incorporated with how the doctors and the different specialties work within your hospital, because what works at another hospital doesn’t necessarily work with your hospital system.”
However, he acknowledged that the trend of telehealth is here to stay – accelerated by the pandemic and enabled by new technologies such as 5G.
“So the technology is here, but the healthcare industry needs to embrace these technologies and be able to implement the technology in a meaningful way into their DNA,” he said.
“Having a platform for clinical trials to prove that the service can and will improve patient outcomes will in turn persuade the local authorities to cater budget for telehealth services.”
In the meantime, Show Chwan has partnered with an insurance company to provide telehealth services to their clients, in a new three-way relationship. It is hoped that the collaboration can lead to lowered health expenditures of their clients, pushing the case for insurance companies to pay for telehealth.
On future plans for its physical facilities, Dr Huang revealed Show Chwan’s plans to expand its presence into Southeast Asia, with healthcare being a strictly controlled business in Taiwan. Malaysia is the first country it is targeting.
“We are looking at Southeast Asia where the regulation is not as strict, and where we can provide a high level of service with our networks in Taiwan as a base. Though we will be hiring doctors and nurses from the local region, the overseas facility will be supported by technology and training from the Taiwan hospitals.”