Telemedicine platforms evolve beyond virtual consultations

TELEMEDICINE startups in South-east Asia are expanding beyond virtual consultations, with some companies buying physical assets or partnering other healthcare players.

Telemedicine platforms emerged about six years ago as an easy way for patients with straightforward ailments to consult general practitioners through video call.

Many startups were slow to gain traction, until the Covid-19 pandemic forced consumers to adopt digital ways of accessing healthcare.

Now that demand has normalised, companies are seeking ways to differentiate themselves and capture more parts of the value chain. Their diversification comes amid growing pressure for startups to build a long-term sustainable business.

“The real question (after Covid-19) was, ‘What’s next for us?’” said Lim Wai Mun, the founder and chief executive of Singapore-based Doctor Anywhere.

“Telehealth is a mainstream product now… It’s just one of the things to be adopted into practice for a doctor,” said Lim. “So, what does that mean for us and what we are trying to build?”

Doctor Anywhere decided it wanted to break out of the telemedicine mould. In December 2022, it acquired Singapore-listed Asian Healthcare Specialists (AHS) in a privatisation deal that valued the AHS at S$109 million.

The acquisition added 12 specialist clinics to Doctor Anywhere’s network, spanning orthopaedics, dermatology, urology and more. It also gave the loss-making company a profitable, cash-generating business – Asian Healthcare Specialists recorded a net profit of S$4.5 million for the year ended September 2021.

Doctor Anywhere has continued investing in assets. In February this year, it launched an upscale 12,000 square foot health-screening centre in Orchard Road, offering packages priced from S$519 to S$14,169.

Lim told The Business Times that there are plans to open more screening centres. The company has bet big on brick-and-mortar investments because it aims to become a healthcare player targeting several aspects of the patient journey, made more efficient by technology, he added.

Other companies have preferred to stick to the asset-light route. WhiteCoat is similarly expanding beyond primary care to go downstream, but plans to do so only through partnerships.

WhiteCoat and Doctor Anywhere were part of the Ministry of Health’s (MOH) regulatory sandbox initiative, launched in 2018 to understand the risks and benefits of telemedicine. In the years since, WhiteCoat has gained a steady stream of users via its partners, including insurer AIA, said CEO Bryan Koh.

Koh said wellness and chronic disease management will be a key focus for the company this year. WhiteCoat is working on services to help patients manage their long-term health issues, diets and mental wellness.

“That’s where we notice insurers and corporates gravitating towards. They want that holistic solution for the patients,” said Koh.

Holistic healthcare

Indonesia’s Halodoc has also seen a shift in the healthcare industry, from focusing on curing diseases to tackling issues earlier through preventative healthcare and wellness programmes.

The company, which said it has 20 million monthly active users, rolled out a service for patients to access lab tests, vaccinations or vitamin injections remotely. Medical personnel collect samples from patients’ homes to take to Halodoc’s laboratory partners, and the results are displayed in the app.

The company said it has partnered more than 20,000 doctors and 3,300 health facilities.

Indonesia, the world’s fourth-most populous nation, has one of the lowest physician health penetration rates in South-east Asia. It has 0.6 physician for every 1,000 residents, falling short of the 2.5 per 1,000 residents recommended by the World Health Organization.

The uneven access to healthcare is a pain point that many local startups are aiming to tackle through technology.

The usage of Halodoc is increasing outside of the main Indonesian island of Java, to other parts of the archipelago such as Maluku, Riau Islands, Kalimantan, Bangka Belitung, East Nusa Tenggara and Papua, said Halodoc’s chief operating officer Veronica Utami.

Singapore’s residents have easier access to healthcare, but the nation is grappling with a rapidly ageing population. It has prompted companies such as Speedoc, which was also part of MOH’s sandbox, to build innovative solutions to tackle the capacity crunch in hospitals.

Speedoc worked with public hospitals to create a service where patients can receive care at home, instead of being warded – what is known as a “virtual bed”. The service relies on Speedoc’s network of care professionals who make home visits, telemedicine technology, and a remote monitoring system built by Speedoc.

Speedoc CEO Shravan Verma said: “When we looked at the price and compared it to the publicly available data by MOH for managing these conditions in (various classes of public wards), you’ll notice that we’re almost 30 or 40 per cent lower each time.”

The company is operating about 50 virtual beds, and aiming for that to become 100 to 150 by this year.

Sustainability

Digital health startups have expanded significantly in the last five years, yet many remain loss-making.

Doctor Anywhere’s losses widened to S$43.3 million in 2022, from S$16.2 million the year before, driven by a 170 per cent jump in operating expenses. Revenue rose to S$51.6 million from S$31.9 million, regulatory filings showed.

The company narrowly missed its target of doubling revenue in 2023 after evaluating some of its business-to-business services and discontinuing them, said Lim. He did not specify the services, but said overall margins have improved.

WhiteCoat has not filed financials for 2022, but Koh said the company has broken even in its core market of Singapore. In 2023, it nearly doubled the previous year’s revenue of US$7.7 million, and facilitated close to half a million consultations – twice that of 2022.

Koh expects more consolidation in the industry as smaller companies buckle under pressure, which could throw up opportunities for acquisitions.

But he said WhiteCoat will stay asset-light for now and focus on regional expansion in markets such as Indonesia and Thailand.

“Sometimes when you acquire networks such as specialists and go into the medical centre setup, the key worry is always whether you’re confident about steering users into that segment,” Koh told BT.

“If not, to me, it becomes almost like a white elephant of sorts. The move makes sense for some of my peers, but I would say for us, we don’t see it as the right approach for now.”