Around the world, health service providers struggle to keep up with the pace of change.

In response, most healthcare providers have focused on back-office efficiency and improving simple transactions, while leaving the majority of patient-facing activities unchanged.

Digital technology has a vital role in the healthcare industry, especially for senior and aftercare programmes, according to a report by KPMG.

“A combination of advanced technology can be used in multiple angles of healthcare through real-time data collection from IoT and wearable devices. Advanced analytic tools such as AI, precision medicine and Robotic Process Automation can certainly help hospitals and healthcare providers deliver healthy and quality living to the elderly.”

Navigating this new landscape is challenging for organisations and their leaders as they try to increase productivity and quality through digital technology. There is no doubt, however, that technological transformation will be one of the major differentiators between successful and unsuccessful providers over the next decade. The competing pressures of cost and expectations of quality mean that doing nothing is not a sustainable option.

However, a pattern has emerged as past technological initiatives raised high expectations of the potential from new technology, which then encountered an initial period featuring frustration and reduced productivity. Benefits of the technological shift have generally eventually materialised – often after two or more years – but weathering this “digital dip” has proved an important hurdle and many transformation strategies have been scaled back or even abandoned.

Examining both successful and unsuccessful technological implementation in healthcare, it is clear that success isn’t achieved by replacing analogue processes with digital ones. It’s about rethinking the purpose of services, re-engineering how they are delivered, and capitalising on opportunities afforded by data to adapt and learn.

In its “Digital Health: Heaven or Hell?’ report, KPMG identified seven key lessons from those that have successfully realised benefits and overcome setbacks.

1. Transformation first. Transformation comes from new ways of working, not the technology itself. You need a transformation programme supported by technology – not the other way round. This is the fundamental lesson that underpins everything else.

2. People problems not technology problems. The majority of the issues faced along the transformation journey are people problems, not technology problems. These require sophisticated leadership and change management capabilities.

3. Systems design. There has been insufficient attention to the design of systems. Technologies need to solve problems recognised by the people who are going to use them, be they patients or professionals. This requires a deep understanding of the work, as well as the needs of the worker.

4. Invest in analytics. Far too often providers make significant investments in digital systems but overlook the capabilities to use the data collected – hence the payback is never seen.

5. Multiple iterations and continuous learning. Even with careful design there may need to be a number of iterations in the design of systems. This is a continuous process and there may be several cycles – some quite painful – before systems reach a tipping point where all of this investment starts to pay off.

6. Support interoperability. The inability to share and combine data between different systems is a major hindrance to realising the full benefit of technology in healthcare. A coordinated approach to minimum interoperability standards would help accelerate healthcare providers’ digital journey.

7. Sound information governance and data security procedures. Data sharing requires strong information governance and security, particularly in the face of a growing threat from cyberattacks. Action is required at a national and local level to help organisations hold and share data safely.

Written by Natasak Rodjanapiches, advisory director, KPMG in Thailand.

The number of corporate defaults globally fell to 82, its lowest level since 2014.

“By many measures, 2018 showed improved performance for S&P Global Ratings’ corporate credit globally,” said Diane Vazza, head of S&P Global Fixed Income Research. “Many of S&P Global Ratings’ measures for rating performance and rating stability, as well as the proportion of upgrades, rose to their highest levels since 2014.”

More companies were upgraded than downgraded in 2018, and 73 per cent of companies retained the same ratings by year-end. All companies that defaulted in 2018 that were rated at the start of the year were speculative grade (rated ‘BB+’ or lower), and 74 per cent of these were in the ‘CCC’/’C’ rating category. As a result, the one-year global Gini ratio (a measure of the rank-ordering power of ratings over a given time horizon) rose to 93 per cent in 2018 from 92.7 per cent in 2017, reaching its highest since 2014.

Kukkong Ruckphaopunt, executive vice president of Bangkok Bank cited BOT governor Veerathai Santiprabhob as saying that a taskforce had been set up to guide the establishment of the system – based on QR codes – for use in all 10 Asean countries.

Veerathai had been attending a meeting to advance the goal of payment connectivity in the region.

Commercial banks would be invited to join the taskforce later, Kukkong quoted Veerathai as saying.

The BOT is expected to call in commercial banks for discussions on the project later. If the arrangements are finalised quickly, the QR code payment system would likely be launched late this year, Kukkong said.

For the system to work, Asean countries must agree on the way that payment information will be transmitted under a uniform standard, which factors in the different currencies, the range of merchants and the codes that will be used.

Officials need to decide whether the central interbank payment system will use ITMX or sponsoring banks, while rules for business also must be finalised.

Once the QR code payment system is finalised, the related parties can determine a logo and a name for the system that will apply in all Asean countries. The logo would have a technical function in enabling scans to be made for payments, in a similar way to how the PromptPay logo with its QR code can be scanned by users, with the payment process recognised by all of Thailand’s banks.

A number of Thai banks have developed international payment systems, but these are limited to bilateral payments.

If the central payment system is developed, all banks in Thailand, including Bangkok Bank, will have the capability for customers to scan the QR codes of banks in Singapore, Vietnam or Indonesia through their mobile banking platforms to enable the payments

“An Asean QR code will be based on bank accounts. When transactions are made, money will be withdrawn from accounts directly, which could prompt competition with card providers such as MasterCard, Visa, American Express and JCB,” Kukkong said.

Without cards, the system will carry no cost, similar to the QR code-based system in use on PromptPay.

To cope with an estimated rise in mobile banking transactions among Asean countries, each bank now has high capabilities and the planned Asean QR code is expected to boost transactions by about 10-20 per cent in an initial period, Kukkong said

Veerathai said that the planned payment system would draw on existing technology that is being developed for Asean payment connectivity. This means that the system will cost less than would be the case if a new system had to be started from scratch, let alone the additional time that this would entail, he said.

The QR code system will enable fund transfers that make use of blockchain technology, making an Asean-wide system more efficient, he said.

“It’s not necessary to set up new payment infrastructure for inter-payment in 10 Asean countries,” he said. “That could take two to three years to complete and such a system could be outdated by then.

“Therefore, what we are doing is to develop existing technology for the application of connectivity. Developing the payment system on the existing technology will help determine business rules and make it easier to enable agreement among the parties.”

The Thailand Development Research Institute (TDRI) said the policies recently flagged by the government are unnecessary for an economy that is growing in the range of 3 to 4 per cent a year.

The government should use its budget to build a long-term economic foundation for the country, such as through investing in public infrastructure and upskilling the workforce, the privately run body said.

TDRI Somkiat Tangkitvanich was referring to a government announcement that it had tasked the Finance Ministry with coming up with ways to stimulate growth in the economy. Healthy annual expansion in gross domestic product (GDP) of up to 4 per cent indicated that stimulatory measures were not justified, Somkiat said.

 For the goal of building a long-term economic foundation for the country, more investment was needed in investment, though he acknowledged the policies already pursued in this area.

He identified as pressing the need for the government to usher in policies to increase the skills of the workforce, saying that more funds should be directed to this goal.

“When the skills of the workforce are increased, workers’ income will also increase,” he said. “This will lessen the need for the government to push out short-term policies to stimulate the economy and instead enable it spend taxpayers’ money on other matters.”

Somkiat conceded the necessity for government welfare that helps low-income earners. “During a time when the world economy is fragile and uncertain, there will be people at the lower level of the economy that will suffer before other groups,” he said.

“When there is an economic recession, stimulating policies are necessary. However, if stimulants are used unnecessarily on an economy that is merely slowing down in growth, it may only produce short-term benefits and can be unhealthy for the economy in the long-run.”

He suggested that the government, in its remaining time, should refrain from stimulatory policies given that government funds are limited. “If the budget is excessively spent in this period, the new government will struggle to meet their promises to the people,” he said.

The permanent secretary of the Ministry of Finance, Prasong Poontaneat, said the details of the economic stimulus package under consideration will be finalised after the Songkran festival. The proposals would then be forwarded for approval at an executive meeting of the ministry to be chaired by Deputy Prime Minister Somkid Jatusripitak.

Somkid has asked the Finance Ministry to consider whether the economy needs further stimulus. His instruction comes in the wake of the private sector cutting its forecast for economic growth this year to 3.8 per cent. The Finance Ministry estimates growth will come in at 4 per cent.

A source from the Finance Ministry said exports are trending much lower than the ministry’s estimates.

The source said, given that a new government may take some time, to be formed, any stimulus measures may not take shape until the third or fourth quarters of this year. The ministry is considering measures to help prevent a further economic slowdown in the second and third quarters of this year, the source said.