SARAH ELGAZZAR, DR. JOANNE YOONG, DR. ERIC FINKELSTEIN
Introduction
As a result of both, increases in life expectancy and reductions in fertility, countries in Southeast Asia are aging rapidly (UNESCAP 2017). The relative speed of this transformation is startling: In France, an increase from 7% to 14% of the population being over age 65 took 115 years (1865-1980), while the equivalent transition occurred in Singapore in just 15 years (2000-2015) (UNESCAP 2017). Whereas innovations in public health and healthcare have been instrumental in increasing longevity, longevity itself poses new challenges for the region. Increasing population shares living with chronic disease, decreasing old-age support ratios1 and changing societal attitudes and family structures have intensified the strain on healthcare systems to meet the growing demand for care for older adults.
At the same time, there is an equally significant rise in the adoption of digital technology throughout the region. Digital technology refers to the hardware and software that can process and transmit information in a digital format (Lessard et al. 2019), such as online platforms, mobile applications, wearable devices and the Internet of Things (IoT). In 2015, the numbers of combined internet users in Malaysia, Indonesia, Singapore, Vietnam, Thailand and the Philippines was 260 million. Cambodia, Myanmar and Laos have also seen rapid growth of internet users (ASEAN 2018). There are now 360 million users connected to the internet in Southeast Asia, 90% of whom connect through mobile phones, with the value of the internet economy estimated to have surpassed $100 billion (Google, Temasek, and Bain & Company 2019).
These converging trends point to the potential for digital health technologies to become a critical enabler for meeting the challenges of aging, with the potential to increase access, expand service coverage, improve the quality of service delivery, reduce health disparities, and lower healthcare cost. Digital health technologies that are currently in use range from consumer devices designed to capture and report on individual health data, to complex systems of integrated information that monitor, analyse and sort health information for entire communities intended for use by physicians, managers or healthcare planners. For digital health technology to reach its full potential in the region, such technology not only needs to address the complex needs of aging adults but to do so in a low cost andmscalable manner given the lack of third party funding in most countries in the region.
This paper surveys the range of digital health technology currently addressing the needs of older adults in Southeast Asia, and reflects on opportunities and challenges in the next stage of its development. To accomplish this, we conducted a narrative review of select digital technologies in use the region, complemented by a series of key informant interviews. First, as background, we briefly review the context of Southeast Asia’s aging societies and the needs that are most pressing for this population, as well as the evolving digital health landscape. Second, we report where digital health technology has been deployed to meet the health care needs of older adults in the region. Third, we highlight gaps in service delivery and challenges to broader regional implementation and provide recommendations for how these challenges can be addressed.
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