By Dr Joseph Saba

Lack of access to medicines is one of the most complex – and vexing – problems that stand in the way of better health. Often it is gaps in healthcare systems, economics, and infrastructures that hamper the delivery of medicines to millions of people. While affordability is the cornerstone of access, especially for households and health budgets, many other factors determine whether people receive the necessary medicines.

Even though the agenda for improving access is exceptionally broad and access to medicines has become a central focus for health authorities and the pharmaceutical industry, the task is not easy.

The World Health Organisation (WHO) has been striving to improve access to medicines throughout its 70-year history, and rightly so. Good health is impossible without access to medicine and treatment. Universal health coverage depends on the availability of quality-assured affordable health technologies in sufficient quantities with the help of efficient healthcare systems.

Today, the healthcare systems are overwhelmed and centred around hospitals and processes. From short-term communicable diseases to long-drawn chronic ailments, patients have considered visiting hospitals or clinics as the only way to seek diagnosis and treatment for their medical conditions. In Malaysia and for many parts of Southeast Asia, access to healthcare is almost synonymous with in-person appointments with physicians in health facilities.

The dramatic increase of chronic diseases in a growing and aging world population has exacerbated issues. While modernising health facilities requires more action to manage patients needing prolonged or chronic treatment. Most patients’ treatment journey takes place outside the hospital. Therefore, there is an urgent need to close the gap between existing healthcare systems and the changing patient needs.

Addressing the gaps in the healthcare system and patient treatment journey outside the hospital or clinical settings is essential to improve adherence to treatment and diagnosis services. It will help provide equitable healthcare access to patients, especially those requiring chronic and lifelong medications.

How do we close the gap?

We must develop a system to help patients overcome barriers outside the healthcare facility, offering patients innovative and more personalised adherence and disease management support through sustainable access solutions. This can be done by retracing the patients’ journey to access data on their health-seeking behaviour and improving the learning curve, which results in better adaptability to patients’ needs.

Numerous studies have shown that higher accessibility positively impacts patients’ health-seeking behaviour. Although a diagnosis may be made at the hospital, the time from detecting symptoms to receiving a proper diagnosis and commencing treatment may take weeks and months. This is where a patient is most likely lost in the system, unsure, or unable to cope with the disease and the treatment. Therefore, patients should be sought outside the hospital environment and throughout their treatment journey.

Patients with chronic and lifelong diseases who leave hospital after treatment often stop adhering to medication for varied reasons such as affordability and accessibility and social and psychological issues which impact their health. Another reason care should not stop at the hospital is that adherence to treatment is particularly important when the treatment is taken outside the hospital. Patients should be connected through adherence solutions that are financially sustainable and practical to achieve equitable healthcare access.

COVID-19 showed us that our healthcare systems could not reach and protect the most vulnerable, chronically-ill patients. During the pandemic, many patients lost access to healthcare; they need to be connected outside the hospital setting to ensure they adhere to their treatment. Nationwide lockdowns and overwhelmed hospitals reduced patients’ access to hospitals and medications, significantly impacting the morbidity and mortality of patients with chronic diseases.

Today despite digital advancements, healthcare systems remain dated. While modern technology is utilised solely within the hospital space, digital advancements are lacking throughout the patient journey outside the hospital and in reaching them when needed.

Axios patient support programmes

However, Axios patient support programmes ensured that medications were delivered to patients at their doorsteps through a multi-stakeholder collaboration with health authorities, pharmaceutical companies, charities, and medical societies. Similar sustainable access programmes have also been developed to facilitate healthcare access through remote care and medical treatments for eligible patients while addressing potential unmet needs around diagnosis, disease education, treatment adherence, and more.

The world is connected, but healthcare systems are not. Digitalising health by connecting patients to healthcare systems beyond healthcare facilities will help address financial barriers and the shortage of health professionals and specialists. Access programmes, proper tracking of patients, real-world insights, and feedback systems will lead to a cohesive digital health ecosystem.

There has been a gradual focus on digital transformation in healthcare in Malaysia over the past few years, with the goal to improve the quality and accessibility of healthcare services. One of the key initiatives was the implementation of the Malaysian Health Data Warehouse (MyHDW) in 2017, which aimed to collect and integrate health data from various sources into a centralised platform.

The MyHDW platform allowed for improved data analysis and decision-making, and it was also integrated with other healthcare information systems such as the National Health Financing Scheme and the National Health Information System, which allowed healthcare providers to have access to comprehensive patient data and improve care delivery.

Another notable initiative was the introduction of the National Digital Healthcare Plan (NDHP) in 2016, which aimed to enhance healthcare delivery through digital technology. The plan focused on five key areas: digital health infrastructure, digital health services, digital health data, digital health workforce, and digital health ecosystem.

Under the NDHP, several digital health initiatives, such as the MyHealth portal, were launched, allowing patients to access their health records and communicate with healthcare providers online. The Telemedicine Development Group was also established to promote telemedicine and telehealth services in Malaysia.

This continuous advancement in digital technologies, the proliferation of the Internet and mobile devices, and broader acceptance of digital services will shape the future of healthcare, leading to an increase in the demand for more effective treatment, increased accessibility, and improved experience.

As the digital revolution sweeps our life, why should healthcare lag? It is time we revolutionise accessibility through digital health to reach patients within and outside healthcare facilities and strengthen our ability to confront future global health threats as one undivided world.

-- BERNAMA

Dr Joseph Saba is the CEO and Co-Founder of Axios International and the author of ‘A World Undivided: A Quest for Better Health beyond Geopolitics.’ For more information, please visit www.joseph-saba.com