IR 4 0 OPPORTUNITIES FOR HEALTHCARE SECTOR IN VIET NAM

MINISTRY OF EDUCATION AND TRAINING FOREIGN TRADE UNIVERSITY MASTER THESIS IR 4.0: OPPORTUNITIES FOR HEALTHCARE SECTOR IN VIET NAM Specialization: Master of Research in International Economics DINH THI HONG HANH Hanoi – 2020 MINISTRY OF EDUCATION AND TRAINING FOREIGN TRADE UNIVERSITY MASTER THESIS IR 4.0: OPPORTUNITIES FOR HEALTHCARE SECTOR IN VIET NAM Major: International Economics Specialization: Master of Research in International Economics Code: 1806410005 Full name: Dinh Thi Hong Hanh Supervisor: Prof Dr Tu Thuy Anh Hanoi – 2020 i TABLE OF CONTENTS ACRONYMS AND ABBREVIATIONS iv LIST OF FIGURE AND TABLE vi ABSTRACT…………………………………… ………………………………… INTRODUCTION CHAPTER 1- APPLICATIONS OF INDUSTRY 4.0 IN HEALTHCARE 1.1 The fourth industrial revolution 1.2 Healthcare 4.0 12 1.2.1 Robot 12 1.2.2 Three-dimensional model 12 1.2.3 Internet of things 12 1.2.4 Big data 13 1.2.5 Artificial intelligence 13 1.3 Overview of healthcare system in Vietnam 22 CHAPTER 2- OPPORTUNITIES OF INDUSTRY 4.O FOR HEALTHCARE SECTOR IN VIETNAM 24 2.1 Vietnam under Industry 4.0 24 2.2 Healthcare digital technology in Vietnam 28 2.2.1 Vietnam proposes the route of making hospitals intelligent 28 2.2.2 Health ID issued to citizens 29 2.2.3 Digitalisation of healthcare feild, double-edged sword 30 2.2.4 Affairs on high-teach healthcare complex beginning in Hanoi 32 2.3 Hospital digitalization 34 2.3.1 Medical examination treatment management 34 2.3.1.1 Increase of healthcare on demand 35 2.3.1.2 Mobile application technology is personalized 36 2.3.1.2.1 Searching by voice 36 2.3.1.2.2 Development of wearable medical devices 37 2.2.1.3 Artificial Intelligence 37 2.2.1.3.1 AI and forecast analytics 37 ii 2.3.1.3.2 Wonders of Artificial Iintelligence 38 2.3.1.4 Blockchain 39 2.3.1.4.1 Blockchain and promise of better electronic health record 39 2.3.1.4.2 Healthcare 40 Blockchain in 2.3.1.4.3 Blockchain integration 41 2.3.1.5 Virtual Reality 42 2.3.1.5.1 Interaction environment 42 2.3.1.5.2 Patient treatment by virtual reality 43 2.3.2 Hospital Digitalization in Viet Nam 44 2.3.2.1 Hospital going digital 44 2.3.2.2 Government support for digitalisation in healthcare 48 2.4 Opportunity of utilizing big data in healthcare 50 2.4.1 Benefits of Cloud computing for healthcare 51 2.4.1.1 Unlimited capacity 52 2.4.1.2 Reliable broadening capacity 52 2.4.1.3 Seamless cooperation…………………………………………………… 52 2.4.1.4 System security increase 53 2.4.1.5.Accessing AI and Machine Learning 53 2.4.1.6 Remote care opportunity 53 2.4.1.7 Advantages of data orientation for medical insurance 54 2.5 Strengthening healthcare sociallization 55 2.5.1 Vision 58 2.5.2 Implementation 60 CHAPTER – EXPERRIENCES OF APPLYING INDUSTRY 4.0 IN HEALTHCARE IN SELECTED COUNTRIES 68 3.1 Hospital digitalization in US 3.1.1 IoT concept involves digitalization of medical products and related care processes 70 3.1.2 Mobile devices and applications into helthcare 71 3.1.3 Big data in medical system management 73 3.1.4 New digital health consultant generation 76 iii 3.2 Integrated care model based on capacities of IR 4.0 in Weston european 78 3.2.1 Care 4.0 78 3.2 Healthcare policies 79 3.2.2.1 Academic merging co-design in Scotland 81 3.2.2.2 Building faith in systems and in the whole population 83 3.2.2.3 Activating renovation culture 83 3.3 Socializing healthcare China 99 in 3.4 Digitalisation of healthcare: digital health enablers in Vietnam 106 CHAPTER 4INVESTMENT OPPORTUNITIES HEALTHCARE IN VIETNAM'S DIGITAL 114 4.1 Policy and management: Adjusting our society to change fast in the medical and healthcare ecosystem 114 4.2 Incresasing many investments into Information technology 115 4.3 Policy and technology renovation challenges in healthcare 4.0 117 CONCLUSION 121 REFERRENCES 122 iv ACRONYMS AND ABBREVIATIONS TERM DEFINITION AI Artificial Intelligence IoT Internet of Things ILO International Labour Organization STEM Science, Technology, Engineering and Mathematics VR Virtual Reality CPS Cyber Physical System IOS Internet of Services SERP Smart Enterprise Resource Planning IR Industrial Revolution GSO General Statistics Office ICT Information and Communications Technology ASEAN Association of South East Asian Nations MOH The Ministry of Health CRM Customer Relationship Management DHI Digital Health and Care Institute HMO Health Maintenance Organization MIP Ministry of Planning and Investment CIEM Central Institute for Economic Management VHEA Viet Nam Health Economics Association EHR Electronic Health Record CMS Medicare and Medical Services BMI Business Monitor International CDC Centers for Disease Control GIS Geographic Information Coalition CHCs Commune Health Centers TCF Textiles, Clothing and Footwear E&E Electronic and Electric v MOOCs Massive Online Open Course AIC Asia Internet Coalition AWS Amazon Web Services DA Doctor Anywhere’s VR Virtual Reality CAGR Compound Annual Growth Rate mIoT Medical Internet of Things NLP Natural Language Processing LOINC Logical Observation Identifiers Names and Codes US United States UK United Kingdom vi LIST OF FIGURE AND TABLE Figure 1.1: Capabilities of Industry 4.0 in the medical field IoT, Internet of things……………………………………………………………………………… …….14 Table 3.1: The 4.0 toolset applied across care organization…………………….90 ABSTRACT The fourth industrial revolution is currently proceeding and is expected to significantly affect the way individuals live and in result change the society in various aspects The ICT-based convergence industries of the fourth industrial revolution contain various fields This thesis examines the researches done in fourth industrial revolution in medical field This study also suggests necessary contents in the fourth industrial revolution to be focused on for further research in this field INTRODUCTION The importance of the study Vietnam’s healthcare landscape is changing The country’s strong economic and population growth is creating a new middle class which is demanding higher quality medical treatment These affluent, digitally-literate consumers are spending more on their healthcare, leading to a rise in demand for private providers and digital health services The population of Vietnam is not just becoming richer It is also growing older This is resulting in a shift in the burden of disease from communicable to non-communicable conditions like diabetes and cancer These non-communicable conditions require coordinated, long-term care solutions Meanwhile, Vietnam is embracing the Fourth Industrial Revolution Internet access is widespread and the country has seen rapid development in 4G and 5G mobile communication technologies Building on these foundations, the government of Vietnam is driving a digitalisation agenda in hospitals and clinics across the country Smart solutions are being strongly encouraged that utilise big data, artificial intelligence (AI), cloud computing and mobile technology to help alleviate Vietnam’s overcrowded public hospitals and increase quality of care Together, these factors are opening up new opportunities for companies in Vietnam’s digital healthcare space We looks at the enablers for the adoption of digital healthcare solutions in the country, as well as some of the difficulties that face new market entrants The report gives an overview of Vietnam’s healthcare landscape – including its challenges and opportunities – and describes the main domestic and international players already operating in the market It also includes key commercial opportunities available for companies as well as some tips on doing business in Vietnam’s emerging digital health sector In area-wise research on Industry 4.0 in medical, we observed that the computer science area provides the maximum contribution of 31% in total research publications However, the overall engineering field contributes 25%; decision sciences and mathematics contributing 11% each; business, management and ac counting 6%; materials science 4%; biochemistry, genetics and molecular biology 2% and other fields 10%, which includes energy, health professions, pharmacology, toxicology and pharmaceutics, physics and astronomy, psychology and social sciences Industry4.0 in the medical field is increasing and research and development are progressing towards providing commercially viable and acceptable solutions for the medical field Industry4.0 in the medical field is increasing and research and development are progressing towards providing commercially viable and acceptable solutions for the medical field Industry 4.0 focuses on the design and manufacturing and helps perform different cases precisely Industry 4.0 provides extensive contributions in the medical field with the help of innovative designing and smart manufacturing system Industry 4.0 provides excellent flexibility to create smart industrial and medical models which help to improve communication between doctors and patients In future, Industry 4.0 will move towards mass production systems and adapt to the world-class manufacturing system It enables to create smarter medical products in lesser time and cost This revolution will change all management and treatment system of the patient With the help of smart manufacturing technologies, medical students can be well trained to detect problems and correlate them to take future action In the medical field,it can help to increase overall performance by providing a digitally controlled management system to the patients It provides precise surgery to the patient by the applications of additive manufacturing, sensors, holography, robots, AI, big data and IoT devices Industry 4.0 bringing upon innovation with the help of holography and visual reality Doctors and surgeons can take advantages of this revolution for research, development and excellent service to the patient In the upcoming years, it will provide disruptive innovations to the medical field Research question and Objectives of the study The study has two main objectives: - Firstly, Fourth Industrial Revolution - Secondly, opportunities of Industry 4.0 for healthcare in Vietnam To get above objectives, the study addresses issues: - Development of Industry 4.0 in Vietnam - Experience of countries: US, China - How does Industry 4.0 bring opportunities and solutions in medical field in Vietnam? Subjects, scope and data of the study Subject of the study: Vietnam is embracing the Fourth Industrial Revolution Health and healthcare solutions in the Fourth Industrial in Vietnam Scope of the study: US, China, Europe, Vietnam By using secondary data from reliable sources such as Ministry of Health, Ministry Science and Technology from government and enterprise Methodology To reach the objectives, the author uses combination of research methodologies: - Researching on primary and secondary documents to have the theoretical basis, such as curriculums, research papers, science reports and so on - Descriptive statistics method: After collecting data from reliable sources, the author proceeds to arrange, analyze and compare data as well as other documents to have a particular and a concision Structure of the study - Chapter 1: Applications of industry 4.0 in healthcare - Chapter 2: Opportunity of Industry 4.0 for healthcare in Vietnam - Chapter 3: Experiences of applying Industry 4.0 in healthcare in selected countries - Chapter 4: Investment opportunities in Vietnam’s digital healthcare CHAPTER 1- APPLICATIONS OF INDUSTRY 4.0 IN incidence of chronic diseases will undoubtedly lead Vietnam toward an unhealthy and extremely costly, if not unaffordable, future Action is required to create change and try to address these negative health trends before our problems grow larger Healthy Vietnam is a collective response to the risks that threaten Vietnam’s future health and wellbeing, as well as its economic recovery It is a new national Framework for action to improve the health and wellbeing of the population of Vietnam over the coming generation It sets out four central goals for improved health and wellbeing, and outlines clear routes and strategies to achieve these goals, in which all people and all parts of society can participate The Healthy Vietnam Framework draws on existing policies but proposes new arrangements to ensure effective co-operation and collaboration and to implement evidence-based policies at government, sectoral, community and local levels It is about each individual sector helping to improve health and wellbeing, multiplying all efforts and delivering better results 2.5.1 Vision A Healthy Vietnam, where everyone can enjoy physical and mental health and wellbeing to their full potential, where wellbeing is valued and supported at every level of society and is everyone’s responsibility Healthy Vietnam is designed to bring about real, measurable change and is based on an understanding of the determinants of health Health and wellbeing are affected by all aspects of a person’s life; economic status, education, housing, the physical environment in which people live and work Health and wellbeing are also affected by policy decisions taken by Government, the individual choices people make about how they live, and the participation of people in their communities This understanding calls 59 for a partnership approach in all of the actions set out in the Framework Healthy Vietnam is designed to harness the energy, creativity and expertise of everyone whose work promotes health and wellbeing, and encourages all sectors of society to get involved in making Vietnam a healthier place to live, work and play participation of people in their communities This understanding calls for a partnership approach in all of the actions set out in the Framework Healthy Vietnam is designed to harness the energy, creativity and expertise of everyone whose work promotes health and wellbeing, and encourages all sectors of society to get involved in making Vietnam a healthier place to live, work and play Goal 1: Increase the proportion of people who are healthy at all stages of life This means addressing risk factors and promoting protective factors at every stage of life – from pre-natal, through early childhood, adolescence, adulthood and into old age, to support lifelong health and wellbeing Goal 2: Reduce health inequalities Health and wellbeing are not evenly distributed across Vietnam society This goal requires not only interventions to target particular health risks, but also a broad focus on addressing the wider social determinants of health – the circumstances in which people are born, grow, live, work and age – to create economic, social, cultural and physical environments that foster healthy living Goal 3: Protect the public from threats to health and wellbeing Healthy Vietnam is designed to ensure effective strategies and interventions to protect the public from new and emerging threats to health and wellbeing are implemented Being prepared to prevent, respond to, and rapidly recover from public health threats through collaborative working is critical for protecting and securing the nation’s health Goal 4: Create an environment where every individual and sector of society can play their part in achieving a healthy Vietnam It is beyond the capability of any one Government Department or organization to promote society wide health and wellbeing This can only be done through society-wide involvement in and engagement with health and wellbeing promotion 60 and improvement activities - from individuals making positive lifestyle choices and projects run by community and local groups, to policy and legislative changes at the highest level of government 2.5.2 Implementation Healthy Vietnam, whilst guided by a clear vision, is very much outcomes driven, with targeted actions grouped under six broad themes: • Governance and Policy • Partnerships and Cross-Sectoral Work • Empowering People and Communities • Health and Health Reform • Research and Evidence • Monitoring, Reporting and Evaluation The Cabinet Committee on Social Policy will oversee the delivery of this Framework The Health and Wellbeing Programme in the Department of Health has responsibility for strategic planning and co-ordination of the implementation of the Framework actions Detailed and more specific implementation plans for priority policy areas will also be developed Implementation plans will be subjected to high levels of consultation across Government, health and other sectors Specifying direct responsible individuals for each action will be an important characteristic of Healthy Vietnam implementation plans Research and Evaluation An important feature of Healthy Vietnam is its focus on research, to ensure that goals, programmes and funding decisions are based on robust evidence about the determinants of health and best practice approaches in addressing them A Healthy Vietnam research plan will be developed to build the knowledge base and ensure that the highest quality and most up-to-date data, scientific knowledge and evaluation tools are available to support the implementation and monitoring of the Framework’s actions and guide the development of new policies into the future Basing Vietnam’s health promotion policies and programmes on robust evidence 61 means that interventions will be in line with international best practice, cost effective, integrated with service delivery and more likely to make an impact Healthy Vietnam will be subject to rigorous monitoring and evaluation An Outcomes Framework will be developed that will specify key indicators to underpin each of the four high-level goals Targets for quantifiable improvements will be set, where appropriate Regular measurement of these indicators will allow progress to be assessed over time Participation Healthy Vietnam has been informed by feedback from an extensive consultation process within Government, the health sector and wider public and private society It reflects international experience and evidence of what determines health and reflects best practice in how to prioritise and invest for health and invest for long-term sustainable health benefits It proposes a necessary shift towards a broader, more inclusive approach to governance for health, moving beyond the health service, across national and local authorities, involving all sectors of society, and the people themselves It will be about focusing and redirecting existing resources, accelerating progress on existing initiatives, and creating new and innovative programmes Healthy Vietnam describes supportive mechanisms to ensure effective co-operation between the health sector and other areas of Government and public services concerned with social protection, children, industry, food safety, education, transport, housing, agriculture and the environment It invites the private and voluntary sector to participate through well supported and mutually beneficial partnerships It provides an outcomes driven approach to implementation to ensure existing resources are used to better effect, with better evidence and better monitoring and evaluation Moving towards a healthier future will take senior government and societal commitment, time, planning and strong leadership to ensure consistent implementation It will result in people living in Vietnam being supported to make healthier choices in their day-to day lives, in health-promoting and sustainable environments Why is a healthy Vietnam framework needed? 62 Vietnam is facing serious challenges within the economy, society and the health system The current health status of people living in Vietnam and their lifestyle trends are leading us toward a costly and unhealthy future A review of the literature relating to health trends and the wider determinants of health Defining Health and Wellbeing Health means everyone achieving his or her potential to enjoy complete physical, mental and social wellbeing Healthy people contribute to the health and quality of the society in which they live, work and play Health is much more than an absence of disease or disability, and individual health, and that of the country, affects the quality of everyone’s lived experience Health is an essential resource for everyday life, a public good, and an asset for health and human development Wellbeing is an integral part of this definition of health It reflects the quality of life and the various factors which can influence it over the course of a person’s life Wellbeing also reflects the concept of positive mental health, in which a person can realise his or her own abilities, cope with the normal stresses of life, work productively and fruitfully, and be able to make a contribution to his or her community Consideration of health and wellbeing requires a shift in focus from what can go wrong in people’s lives, to focusing on what makes their lives go well Is Vietnam Healthy? Many people living in Vietnam and their families are affected by chronic diseases and disabilities related to poor diet, smoking, alcohol misuse and physical inactivity Enjoyment of health is not evenly distributed in society, with prevalence of chronic conditions and accompanying lifestyle behaviours being strongly influenced by socio-economic status, levels of education, employment and housing Chronic conditions are responsible for a significant proportion of premature deaths The prevalence of conditions such as hypertension, coronary heart disease, stroke and type-2 diabetes increases dramatically with age, is greater in lower socio economic groups and generally higher in males By 2020, the number of adults with chronic diseases will increase by around 40%, with relatively more of the conditions affecting those in the older age groups 63 Rising Costs to Health Systems and Society Health comprises the largest component of public expenditure after social protection Recovering Vietnam’s Health and Prosperity There is an overwhelming economic argument for action: national and international evidence shows that health is an economic good in its own right and is a key factor in employment, earnings, productivity, economic development and growth Better health can lead to economic growth, not only through an increase in total GDP as the population increases, but also, more importantly, through long term gains in human and physical capital that raise productivity and per capita GDP Protecting health and putting in place targeted, cross-sectoral and costeffective prevention programmes and policies will play a central and supportive role in Vietnam’s short and longer-term economic recovery programme, as well as reducing the prospect of unaffordable future health costs, which will certainly arise if current health trends are not addressed The creation of healthy generations of children, who can enjoy their lives to the full and reach their full potential as they develop into adults, is critical to the country’s future A healthy society and workforce benefits all sectors, so responsibility for prevention programmes cannot rest solely with the health system but must be shared across Government Departments; departments that will benefit in terms of less expenditure on sickness benefits as well as greater productivity and contributions to the exchequer Wider participation from the private and voluntary sectors will produce even more effective results Ireland’s economic recovery will be defined as much by the health and wellbeing profile of the population as by core economic trends or growth The rationale for taking on this significant programme of work is clear – both in terms of health costs and potential health benefits Proven economic benefits flow from having a healthy society Prevention at the population level results in better value, increased productivity and improved quality of life Unless we change course, healthcare will become unaffordable for society and for the country The characteristics of an effective response 64 The development of the Healthy Vietnam Framework placed a strong emphasis on ensuring the measures proposed were based on robust evidence and reflected national and international best-practice This was achieved through an extensive national consultation process Detailed analyses were undertaken to examine and understand health and wellbeing trends and systems in Ireland and in other countries This commitment to evidence- based action means that the goals, strategies, structures and principles of Healthy Vietnam are based on international and national evidence and experience about what works in improving health and wellbeing Key principles and approaches that have proven to be effective have emerged from the research evidence and have been adopted in drafting this Framework Leadership and Accountability Effective health and wellbeing improvement calls for new ways of working and requires a mandate and formal commitment from central Government Successful programmes also use advocacy and networking to bring partners together and mobilize broad-based political and cultural support for equitable, sustainable and accountable approaches to improving health The health sector must assume both a stewardship and advocacy role to support other sectors in pursuing health and wellbeing goals The Healthy Vietnam Framework has the support of all Government Departments, and puts in place structures to ensure that clear direction, accountability, good governance and support for collaborative working underpin all its actions This governance structure will allow objectives set by Government to be subject to rigorous monitoring and continuous evaluation All partners will be engaged in planning, to establish the right participants for each action, to identify common indicators and benchmark progress over time, and relative to other countries Intersectoral Approach – a whole-system response Whole-system approaches shift the emphasis slightly from individual lifestyles and single diseases to societal factors and actions that shape our everyday living environments Broad-based policy approaches are therefore needed, to ensure 65 that health is an integral part of all relevant policy areas, including environment, social and economic policies For example, the Environmental Protection Agency in its draft strategic plan commits to “the development of stronger and more robust approaches and promoting the essential role that protecting the environment plays in improving the health of the population” To this successfully a whole-system approach is needed Intersectoral working is a politically challenging strategy that requires deliberate efforts to be promoted Healthy Vietnam acknowledges and seeks to address these challenges through its vision, goals, structures and actions Partnerships and Reaching Beyond Government Effective partnerships with citizens and communities, supported by a wide network of public and private stakeholders, are essential to gain insights into health and wellbeing at the local level Building partnerships wins support for action at grassroots level and contributes to community development Identifying partners at every, level of society, from government to business, to community and family will contribute to the implementation of mutually beneficial health and wellbeing programmes Building Community and Personal Responsibility Many health and wellbeing indicators are affected by individuals’ personal lifestyle choices For example, the World Health Organisation attributes 60% of the disease burden in Europe to seven leading risk factors: hypertension, tobacco use, alcohol misuse, high cholesterol, being overweight, low fruit and vegetable intake and physical inactivity The effects of these risk factors can be minimised if individuals can be motivated and supported to make healthier choices To be effective, action to control the determinants of health must include developing understanding and skills, and promoting informed health choices This means informing people and communities about how to improve their health and wellbeing and empowering and motivating them to so, whilst working to remove or at least minimize any legislative or practical barriers that impede their ability to make healthy choices Healthy Vietnam will help to raise awareness and promote healthy lifestyle choices among the public by understanding and acknowledging the broad 66 causes of ill-health and by devising targeted, inter- sectoral public information strategies and actions to address them Life Course Approach Patterns of health, illness and disease are influenced at different stages of a person’s life, and what happens during the early years has lifelong effects Healthy Vietnam adopts a life course perspective that approaches health as an integrated continuum rather than as disconnected and unrelated stages Supporting people to enjoy a healthy and active life, starting in the womb and continuing through childhood, adolescence, adulthood and older age, is a fundamental goal of this policy Framework Key transition points, such as entering or leaving school, starting a family or retirement, present opportunities for intervention, with healthcare services, educational institutions and employers, for example Healthy Vietnam seeks to impact positively on health indicators and contribute to closing the gap in health and wellbeing between socio economic groups Empowering people throughout their lives will help create better conditions for health Early Intervention and Healthy Ageing Investment in early intervention initiatives aimed at children and families in terms of child development, educational disadvantage and parenting has been shown to provide a greater rate of return than later intervention The most effective time to intervene in terms of reducing inequalities and improving health and wellbeing outcomes is before birth and in early childhood Age-related chronic diseases also have their origins in early life experiences The determinants of positive ageing also extend beyond health and personal social services to include socio-economic, environmental and other social policy factors A truly systematic, life course approach to healthy ageing starts at birth and therefore reinforces the need to prioritise early intervention Positive and healthy ageing also requires targeted, multi- sectoral interventions aimed at key risk groups in the population Healthy Vietnam will adopt a strategic focus on the synergies between health and wellbeing for both young and older people Measurement and Evaluation For sustainable success in improving health and wellbeing and tackling health inequalities, activity must be monitored and evaluated across the various levels of the system This 67 entails developing indicators and setting measurable targets, coupled with a formal reporting process Viet Nam needs a “revolution in its policy-making mind-set” before it can take advantage of the fourth industrial revolution Viet Nam Institute for Economic and Policy Research (VEPR), if Viet Nam can catch up with the revolution in time, the digital economy can help the country close the gap with other nations around the world.” However, this was concerned about policies to help boost digital transformation, saying: “Viet Nam still applies outdated policies in a new economic context.” “Since 2016, the country has spoken a lot about the advantages from the fourth industrial revolution but, after four years, we don’t see where it is in such a revolution.” “Viet Nam is in the initial stages of the revolution,” adding that each revolution takes between 50 to hundreds of years The fourth industrial revolution is one of digital transformation, which helps close the gaps in social relationships, ease the burden on labour and remove the role of intermediaries to develop the economy Ministry of Health on a plan to connect the medical records of more than 50 million people with their health insurance details and another plan with the Ministry of Transport to connect transport records of 1.2 million vehicles “It is the last chance for Viet Nam to take advantage of the era” The transformation will take time as the people (who make decisions) are still the same 68 CHAPTER – EXPERRIENCES OF APPLYING INDUSTRY 4.0 IN HEALTHCARE IN SELECTED COUNTRIES 3.1 Hospital digitalization in US A number of technologies can reduce overall costs for the prevention or management of chronic illnesses These include devices that constantly monitor health indicators, devices that auto-administer therapies, or devices that track real time health data when a patient self-administers a therapy Because they have increased access to high-speed Internet and smartphones, many patients have started to use mobile applications (apps) to manage various health needs These devices and mobile apps are now increasingly used and integrated with telemedicine and telehealth via the medical Internet of Things (mIoT) This paper reviews mIoT and big data in healthcare fields mIoT is a critical piece of the digital transformation of healthcare, as it allows new business models to emerge and enables changes in work processes, productivity improvements, cost containment and enhanced customer experiences Wearables and mobile apps today support fitness, health education, symptom tracking, and collaborative disease management and care coordination All those platform analytics can raise the relevancy of data interpretations, reducing the amount of time that end users spend piecing together data outputs Insights gained from big data analysis will drive the digital disruption of the healthcare world, business processes and real-time decision-making A new category of "personalised preventative health coaches" (Digital Health Advisors) will emerge These workers will possess the skills and the ability to interpret and understand health and well-being data They will help their clients avoid chronic and diet-related illness, improve cognitive function, achieve improved mental health and achieve improved lifestyles overall As the global population ages, such roles will become increasingly important The Internet of Things (IoT) is a network of physical devices and other items, embedded with electronics, software, sensors, and network connectivity, which enables these objects to collect and exchange data Its impact on medicine will be 69 perhaps the most important, and personal, effect By 2020, 40% of IoT-related technology will be health-related, more than any other category, making up a $117 billion market The convergence of medicine and information technologies, such as medical informatics, will transform healthcare as we know it, curbing costs, reducing inefficiencies, and saving lives It sounds pretty basic, but the adoption of Electronic Health Records (EHRs) is a game changer In less than a decade, an ink-and-paper system of managing records that goes back thousands of years will be digitized and replaced The advantages are obvious and many Paper records, often written in questionable penmanship, can get stuffed away in filing cabinets, out of the reach of researchers or other healthcare providers Instead, by keeping all the important information in one place, and easily sharable, EHRs will eliminate many inefficiencies, and save lives One of the major challenges to implementing the IoT has to with communication; although many devices now have sensors to collect data, they often talk with the server in their own language Manufacturers each have their own proprietary protocols, which means sensors by different makers can't necessarily speak with each other This fragmented software environment, coupled with privacy concerns and the bureaucratic tendency to hoard all collected information, frequently maroons valuable info on data islands, undermining the whole idea of the IoT Precision medicine, as it's called, is a term that will be frequently heard in coming years It begins with genomics and goes through the rest of the omics platforms, providing multiscale data for analysis and interpretation In 2015, Intel and the Oregon Health and Science University launched a joint project, the Collaborative Cancer Cloud: a high-performance analytics platform that collects and securely stores private medical data that can be used for cancer research Though the platform began with cancer, Intel intends to open up the federated cloud network to other institutions, including ones working on cures to diseases like Parkinson's 70 Engineering simulation solutions are making medicine participatory, personalized, predictive and preventive (P4 medicine) via the medical Internet of Things (mIoT) 3.1.1 IoT concept involves digitalization of medical products and related care processes Pharma companies long ago realized that just selling traditional medicines will not produce growth nor even sustain competitiveness This fundamental change, known as moving 'beyond the pill', typically arises from one or two realizations: (1) medicines alone are often not enough to achieve optimal clinical outcomes for patients, and (2) as pharmaceutical pipelines dry up, 'beyond-the-pill' businesses can be valuable new sources of revenues This has created growing interest in methods of utilizing the new technologies and business processes for development and patient care, leading to Pharma IoT The Pharma IoT concept involves digitalization of medical products and related care processes using smart connected medical devices and IT services (web, mobile, apps, etc.) during drug development, clinical trials and patient care The outcomes of Pharma IoT in development and clinical trials can employ combinations of advanced technologies and services to create totally new kinds of disease treatment possibilities (e.g., Treatment 2.0) In patient care, Pharma IoT will enable patients and healthcare professionals to use medicines with advanced sensor hardware, and craft personalized care services and processes (Product 2.0) Good examples of the Pharma IoT solutions are the connected sensor wearables for Parkinson's disease and multiple sclerosis patients, which provide medication management, improving the patient outcomes and the quality of life In addition, existing medical device products such as inhalers and insulin pens can be added to the sensor and connectivity technologies to collect data for further care analytics, and even personalized therapy All this will substantially improve personal medication and care processes, because patient care data provides new sources of innovation and competitiveness 71 The transformation also involves some challenges: at the same time, pharma companies need to take into account the forthcoming European Union (EU) data protection and privacy legislation, which will give patients control of their care data For example, patients will be allowed to transfer their care and health data across multiple service providers, leading to the emergence of totally new kinds of service platforms and business models, e.g., data brokers 3.1.2 Mobile devices and applications into helthcare We are heading into the age of information, where knowledge and data will be key We are also entering the age of the customer, in which more than ever the customer is going to determine what they want MyTomorrows is one example of the changing look of business models, in this case, directly connecting customers and pharma In this new age, devices and apps will be used to create a "health selfie" For example: • The Myo, originally a motion controller for games, is now being used in orthopedics for patients who need to exercise after a fracture With the aid of the Myo, patients can monitor their progress and doctors can measure the angle of movement • The Zio Patch measures heart rate and electrocardiogram (ECG) and is the US Food and Drug Administration approved Where is pharma in all this turmoil? Interestingly, there are signs that pharma is reaching out from its traditional medicine-centric approach • Glaxo recently announced that it is investing in electroceuticals, bioelectrical drugs that work by micro-stimulation of nerves • J&J has teamed up with Google to develop robotic surgery In addition, they are collaborating with Philips on wearable devices such as blood pressure monitors • Novartis is working with Google (again) on sensor technologies, such as the smart lens, and a wearable device to measure blood glucose levels Sensors can provide a lot of information to support pharma development, but it is particularly important to recruit the right patients for the right clinical trials 72 Body sensors, once gadgets that were mainly used by athletes and runners, are now rapidly entering the general market, and consumers and pharma will soon have access to a wealth of information including not only pulse, blood pressure, ECG and respiratory rate, but also more advanced data, such as inflammation, sleep patterns, etc A number of mobile apps which support device handling have emerged, including myDario and SleepBot among others The Hacking Medicine Institute recently announced RANKED Health, a program to critically evaluate and rank health-focused applications and connected devices It has been predicted that in the near future we will look at our phone or smart watch to check health outcomes more often than we now to check our mail or WhatsApp A typical situation might involve an elderly person, recovering from a medical condition at home, linked to a combination of several connected services streaming data towards different parties, such as family members, tele-carer and physicians Recently it was announced that Medtronic will be partnering with a digital health app company named Canary Health to be a re-seller of its digital chronic disease management programs, including its CDC-recognized Diabetes Prevention Program, which is aimed at changing behaviors in prediabetic people But the partnership goes beyond just reselling Canary Health's digital tools In fact, both Canary Health and Medtronic plan to develop solutions that "leverage Medtronic's devices, services and infrastructure as well as Canary Health's suite of behavior change programs, design expertise, and deep user engagement experience," according to a Canary Health news release One reason that Medtronic must have been attracted to Canary Health is that the company's digital tools are reimbursable As digital health programs mature, payers are looking at innovative, yet proven, ways to reduce their cost burden for chronic diseases like diabetes According to the Centers for Disease Control and Prevention (CDC), people with prediabetes who take part in a structured lifestyle change program—like the ... INDUSTRY 4. O FOR HEALTHCARE SECTOR IN VIETNAM 24 2.1 Vietnam under Industry 4. 0 24 2.2 Healthcare digital technology in Vietnam 28 2.2.1 Vietnam proposes the route of making... industry 4. 0 in healthcare - Chapter 2: Opportunity of Industry 4. 0 for healthcare in Vietnam - Chapter 3: Experiences of applying Industry 4. 0 in healthcare in selected countries - Chapter 4: ... administering and planning the health care system 24 CHAPTER 2- OPPORTUNITIES OF INDUSTRY 4. O FOR HEALTHCARE SECTOR IN VIETNAM 2.1 Vietnam under Industry 4. 0 The country’s big potential in IT and