Man in a lab coat attending a patient holding a tablet.

Telemedicine

By National Cancer Institute

Telemedicine

Country
Sector
Most major industry classification systems use sources of revenue as their basis for classifying companies into specific sectors, subsectors and industries. In order to group like companies based on their sustainability-related risks and opportunities, SASB created the Sustainable Industry Classification System® (SICS®) and the classification of sectors, subsectors and industries in the SDG Investor Platform is based on SICS.
Health Care
Sub Sector
Most major industry classification systems use sources of revenue as their basis for classifying companies into specific sectors, subsectors and industries. In order to group like companies based on their sustainability-related risks and opportunities, SASB created the Sustainable Industry Classification System® (SICS®) and the classification of sectors, subsectors and industries in the SDG Investor Platform is based on SICS.
Health Care Providers
Indicative Return
Describes the rate of growth an investment is expected to generate within the IOA. The indicative return is identified for the IOA by establishing its Internal Rate of Return (IRR), Return of Investment (ROI) or Gross Profit Margin (GPM).
15% - 20% (in ROI)
Investment Timeframe
Describes the time period in which the IOA will pay-back the invested resources. The estimate is based on asset expected lifetime as the IOA will start generating accumulated positive cash-flows.
Medium Term (5–10 years)
Market Size
Describes the value of potential addressable market of the IOA. The market size is identified for the IOA by establishing the value in USD, identifying the Compound Annual Growth Rate (CAGR) or providing a numeric unit critical to the IOA.
USD 100 million - USD 1 billion
Average Ticket Size (USD)
Describes the USD amount for a typical investment required in the IOA.
Depending on the stage of investment in the business model, start up cost range between a few hundred-thousand dollars to a few millions at Series A or B stage of investment.
Direct Impact
Describes the primary SDG(s) the IOA addresses.
Good health and well-being (SDG 3)
Indirect Impact
Describes the secondary SDG(s) the IOA addresses.
Decent Work and Economic Growth (SDG 8) Reduced Inequalities (SDG 10)

Business Model Description

B2C models to provide medical consultations, diagnosis, and prescription via digital platforms to patients. The business model may also combine online and offline (traditional in-person) services. Examples of companies active in this space are:

Doctor Anywhere: a Singapore-based start-up operating in Vietnam since the end of 2019, serving more than one million users in Vietnam, Singapore, and Thailand, offering teleconsultation services in internal medicine and pediatrics through a smartphone application. Successful deal of Series C of USD 8m in 2021 (4)

Med247: New generation medical start-up, combining traditional model and technology. It is the first family medical service in Vietnam to provide a full cycle of medical examination and treatment from In-person (Offline) to Online (Online), targeting not only big cities but also remote areas. It has raised $4.5 million in a round of funding led by Altara Ventures on March 31, 2022

Expected Impact

Improving access to healthcare services for the population that cannot visit physical healthcare clinics, and for reducing patient overload at large hospitals.

How is this information gathered?

Investment opportunities with potential to contribute to sustainable development are based on country-level SDG Investor Maps.

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Country & Regions

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Country
Region
  • Vietnam: Red River Delta
  • Vietnam: Mekong Delta Region
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Sector Classification

Situate the investment opportunity within sustainability focused sector, subsector and industry classifications.
Sector

Health Care

Development needs
Regional disparities exist in access to quality and affordable healthcare services between rural and urban areas (1); Increased non-communicable diseases (NCDs) due to unhealthy habits, like excessive smoking and drinking; NCDs were the cause of 77% of deaths in 2016, as opposed to 68% in 2010 (1); Slow reduction of under-5 mortality rate, i.e. 23 in 2013 and 20.6 in 2020. (13)

Policy priority
Specified in Decision 531/QĐ-TTg: Increase healthcare service quality, improve the healthcare system efficiency towards accommodating the aging population, international integration, and digital application; diversify medical services, encourage private sector participation, and increase healthcare access for the population (6, 23)

Gender inequalities and marginalization issues
Limited access to healthcare for ethnic minorities and mountainous areas where maternal mortality is 3 times higher than the national average of 2019 (11). The adolescent birth rate in the 15-19 age group strongly increased in the past 10 years, from 24‰ in 2009 to 35% in 2019. The adolescents in the 15-19 age group in rural areas have a higher fertility rate than in urban areas, 45% vs 16% (16)

The healthcare market size was USD 17.3b in 2018, with the spending per capita projected to increase from USD 170 per capita in 2017 to USD 400 in 2027; the Pharmaceutical market is the second largest in Southeast Asia, i.e. USD 5.9b in 2018, and is projected to grow at 14% CAGR by 2025 (18); Medical equipment is estimated at USD 1.6b (2021), growing at a CAGR of 10% for 2017-2021. (19)

Key bottlenecks introduction
Some constraints exist on registration for licensing for medical devices, pharmaceuticals, and patents, regulations on divestment, coverage of healthcare insurance for private health facilities. The form of public-private partnership involves the problem of state assets, lack of human resources, and limited financial affordability for patients in certain areas.

Sub Sector

Health Care Providers

Development needs
Hospitals in large cities are overloaded, with two to three patients sharing a bed. Bed occupancy rates have reached 120–160%, especially in the central hospitals of some large cities (9). Healthcare service is understaffed (3): only 8 doctors for every 10,000 population, compared to 15 doctors in Malaysia and 23 in Singapore (14)

Policy priority
Ministry of Health's Decision 2628/QĐ-BYT/2020: Develop a hospital system with distant medical consultation capacity at the provincial and district level, and provide affordable quality healthcare for the population in rural areas (17), Ministry of Health Decision 5316/QĐ-BYT: digital transformation is promoted across all sectors, including healthcare (10).

Gender inequalities and marginalization issues
Under-performing healthcare services for ethnic minorities, for example, in 2020 more than 30% of Mang, Mong, and Cong (13) have births not attended by skilled medical staff, and the percentage of ethnic minority women accessing antenatal care services (at least 4 antenatal care visits) is 58 percentage points lower than the national rate (16% versus 74% in 2017) (15). Limited availability of old-age care services.

Investment opportunities introduction
Digital solutions for telehealthcare like medicinal teleconsultation or teleprescription; Revenue in the digital health market is projected to reach US$607.10m in 2021 (5)

Key bottlenecks introduction
Regulatory framework is still in the development stage for distant medical consultation; underdeveloped digital skills of healthcare staff and limited access to online services for certain population groups. Traditional habits of patients to visit clinics limit the growth of telemedicine.

Industry

Health Care Delivery

Pipeline Opportunity

Discover the investment opportunity and its corresponding business model.
Investment Opportunity Area

Telemedicine

Business Model

B2C models to provide medical consultations, diagnosis, and prescription via digital platforms to patients. The business model may also combine online and offline (traditional in-person) services. Examples of companies active in this space are:

Doctor Anywhere: a Singapore-based start-up operating in Vietnam since the end of 2019, serving more than one million users in Vietnam, Singapore, and Thailand, offering teleconsultation services in internal medicine and pediatrics through a smartphone application. Successful deal of Series C of USD 8m in 2021 (4)

Med247: New generation medical start-up, combining traditional model and technology. It is the first family medical service in Vietnam to provide a full cycle of medical examination and treatment from In-person (Offline) to Online (Online), targeting not only big cities but also remote areas. It has raised $4.5 million in a round of funding led by Altara Ventures on March 31, 2022

Business Case

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Market Size and Environment

Market Size (USD)
Describes the value in USD of a potential addressable market of the IOA.

USD 100 million - USD 1 billion

CAGR
Describes the historical or expected annual growth of revenues in the IOA market.

15% - 20%

Critical IOA Unit
Describes a complementary market sizing measure exemplifying the opportunities with the IOA.

Over 60 million people living in rural areas generally have limited access to healthcare services.

"Health care expenditure in Vietnam is estimated at 6% of GDP, more than 17b in 2018 (12) 66% of the population with internet access, 94% of the population have daily use of the internet (6)"

Indicative Return

ROI
Describes an expected return from the IOA investment over its lifetime.

15% - 20%

The return generated from digital healthcare solution providers depends on multiple factors including products, leadership, and business management. Venture capitalists expect the value of investment to be at least 3-4 times the initial investment.

Investment Timeframe

Timeframe
Describes the time period in which the IOA will pay-back the invested resources. The estimate is based on asset expected lifetime as the IOA will start generating accumulated positive cash-flows.

Medium Term (5–10 years)

"Investors suggest telemedicine businesses would take a minimum of 5 years to break even. Doctor Anywhere and Buy Med was established more than 3 years ago [since 2019 and 2018] (4) and have continued to call for investments to fuel the growth. Med247 successfully raised $ 4.5 million in 2022 (29)"

Ticket Size

Average Ticket Size (USD)
Describes the USD amount for a typical investment required in the IOA.

Depending on the stage of investment in the business model, start up cost range between a few hundred-thousand dollars to a few millions at Series A or B stage of investment.

Market Risks & Scale Obstacles

Business - Supply Chain Constraints

The difficulty in changing the behaviors of medical professionals and patients to use digital applications in delivering the service. Old patients and people living in remote areas have limited access to technology, thus requiring additional infrastructure to leverage digital health. If the investment involves established mortar & bricks hospitals, limitations exist in synchronizing the digital technology with the current operation;

Impact Case

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Sustainable Development Need

Tele-medicines, like teleconsultation, diagnosis, or prescription can keep patients not traveling for medical care to urban areas where the hospitals are overloaded (120 - 150% at major hospitals in cities) (8)

Tele-medicine service will contribute to meeting the demand of the increasing population of those aged 65 and over (from 7% to 21% between 2015 and 2050 (1)

The telemedicine service will help to address the demand of 65% of the Vietnamese population who live in rural areas where the access to and the quality and affordability of healthcare are not equal to that in urban areas due to the shortage of doctors (1)

Gender & Marginalisation

Tele-medicine service is needed as a solution to increase the access to healthcare services for people in remote areas - more than 30% of Mang, Mong, and Cong (13), for example, have births not attended by skilled medical staff.

Expected Development Outcome

Improve access to health care services for the population, especially for those who reside in remote areas, or cannot physically visit the brick-and-mortar clinics.

Reduce the burden on hospitals in large cities to serve more patients than the available capacity, thereby enabling them to invest in more locations, and improve the healthcare service quality.

Gender & Marginalisation

Provide opportunities for access to healthcare services for people in remote areas in the long run.

Primary SDGs addressed

Good health and well-being (SDG 3)
3 - Good Health and Well-Being

3.4.1 Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease

Current Value

NCDs are the cause of 77% of death in 2016 (1)

Target Value

2025: reduce 20% compared to 2015; 2030: reduce 25% compared to 2015 (13)

To achieve 30 hospital beds, 10 doctors, 2.8 university pharmacists, and 25 nurses per 10,000 people. The rate of private hospital beds reaches 10% (24)

Secondary SDGs addressed

8 - Decent Work and Economic Growth
10 - Reduced Inequalities

Directly impacted stakeholders

People

People with difficult conditions, limit access to brick-and-mortar health care services.

Gender inequality and/or marginalization

The technology for telediagnosis, like tele-ultrasound, can be used to help diagnose pregnant women who are in remote areas.

Planet

Reduce environmental burden as companies can leverage technology for reaching customers, thereby reducing the use of transport facilities that are significant emitters of Greenhouse gases (GHG).

Corporates

Hospitals will benefit by reducing the burden of overcrowding. Also, collaborating with telemedicine platforms can enable many existing healthcare players (pharmacists, doctors, hospitals, and the like) to capture a larger share of the market and reach patients in remote areas.

Public sector

Ease of burden of budget to improve the condition at overloaded public hospitals; reduce inequalities by improving access of constituents to good quality healthcare; fulfill commitments to ensure health care for the population.

Indirectly impacted stakeholders

People

Households and communities benefit from improved access to healthcare, improved quality of life, and lowering of negative coping mechanisms to manage healthcare emergencies.

Gender inequality and/or marginalization

Telemedicine can help in reducing the gender and regional divide by ensuring the last-mile reach of quality healthcare.

Planet

Reduction in GHG emissions because of a reduced burden on transportation services to access healthcare facilities.

Corporates

Improved access to healthcare services will lead to improved quality of life of laborers, contributing to productivity increase for businesses, especially those located in rural areas.

Public sector

Healthier population results in a more productive workforce and improved quality of human capital contributing to economic gains for the country.

Outcome Risks

The investment fails to attract a sufficient number of users due to operational reasons (e.g. lack of qualified doctors or inefficient marketing).

Users in rural/ remote areas may not get used to using telemedicine services, especially due to the availability of efficient internet infrastructure.

Low-cost services to improve access for the underserved population can impact the quality of healthcare staff available for providing consultations, thereby impacting the health of patients.

Gender inequality and/or marginalization risk: digital illiteracy may prevent women/disadvantaged groups (e.g. ethnic minorities) from using the service.

Impact Risks

The lack of improved regulation for reimbursement schemes from Vietnam’s Social Security or private insurance providers for telemedicine undermines the potential growth of the investment.

A fragmented healthcare value chain may result in ineffective health management if online consultation is not followed by expert care services.

Gender inequality and/or marginalization risk: Pregnant women may require real-time access to healthcare facilities that may not be readily available in remote areas without internet connectivity.

Impact Classification

C—Contribute to Solutions

What

Provide online access to quality healthcare services with time and cost savings for the population.

Risk

Service quality, affordability, and digital connection may limit many patients from using the platforms.

Contribution

The Ministry of Health's Decision 2628/QĐ-BYT/2020 approved a scheme for developing telehealthcare capacity for public hospitals, of the fund is mobilized from various sources (31)

Impact Thesis

Improving access to healthcare services for the population that cannot visit physical healthcare clinics, and for reducing patient overload at large hospitals.

Enabling Environment

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Policy Environment

GoV, Decision 531/QĐ-TTg: National Strategy on development of services, including healthcare (23)

GoV, Decision 749/QD-TTg: Developing a platform for remote medical examination and treatment to support people to receive medical examination and treatment remotely; 100% of medical facilities have remote medical examination and treatment departments (22)

GoV, Decision No. 5316/QD-BYT issued by the Minister of Health on December 22, 2021: Approval of the medical digital transformation program to 2025, with orientation to 2030

Financial Environment

Fiscal incentives: Investors are guaranteed by the local Credit Guarantee Fund to borrow capital at credit institutions Decree No. 34/2018/ND-CP dated March 8, 2018; preferential interest rates - Section 2, Article 13 of Circular No. 39/2016/TT-NHNN dated December 30, 2016 (7)

Health care service is allowed for preferential income tax rate (10% versus 20% of normal businesses) (21)

Regulatory Environment

GoV, Circular 49 in 2017 by MOH for telemedicine in Vietnam: Doctors are allowed to offer telemedicine services to patients, subject to certain requirements including IT infrastructure and licenses (25)

GoV, Circular No. 53/ 2014/TT- BYT: prescribes conditions for medical operation in the network environment in terms of information technology technical infrastructure, assurance of information safety and security, human resources, and information technology application. (26)

GoV, Circular No. 49, 2017: Describes permissible telemedicine services (27)

GoV, Circular No. 54, dated 2017: Guides IT applications in healthcare facilities (28)

Marketplace Participants

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Private Sector

Current digital healthcare businesses, including Med247, Doctor Anywhere, Medigo, Jio Health, and other local businesses - local hospitals, pharmacies, and advertisement agencies.

Government

Ministry of Health (MOH) at the national level or Department of Health (DOH) at the provincial level, municipal authorities.

Multilaterals

World Health Organization (WHO), United Nations Development Programme (UNDP), UN Women, United Nations Children's Fund (UNICEF), Asian Development Bank (ADB), World Bank (WB), GIZ, United Nations Population Fund (UNFPA):

Non-Profit

Private Hospital Association, Vietnam Public Health Association, Vietnam Medical Device Association, National Center for Health Communication and Education.

Target Locations

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country static map
urban

Vietnam: Red River Delta

The investment could start with urban areas, especially in Hanoi to establish an initial customer base and attract medical talent. Expansion into semi-urban area is advised where customers are more familiar with the use of smartphones and apps
urban

Vietnam: Mekong Delta Region

The investment could start with urban areas, especially in Ho Chi Minh to establish an initial customer base and attract medical talent. Expansion into semi-urban area is advised where customers are more familiar with the use of smartphones and apps.

References

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