Digital Strategies and their Relevance for Health Insurers

It is sensible to work on a digital health strategy that takes the health insurance side into account.

Digital Strategies and their Relevance for Health Insurers

Many developing countries look into Europe, the Republic of Korea, or Japan to learn from their experience in formulating a strategy to use technology as an opportunity for expanding their existing health insurance schemes. While it is useful to look beyond borders to see what has worked well in more developed countries and where their challenges lie, the context needs to be taken into consideration as well.

It is important to stress that any innovative technological solution needs to be continuously assessed to ensure that the outcomes of introducing the solution continue to contribute to the long-term goals stated in the national digital health strategy. 

It is observed that countries that have a clear vision, mission, and strategy for the goals to be achieved in the health sector are also faster in defining digital strategies. A clear goal, defined in a digital strategy, is the basis for assessing the reliability, sustainability, and cost-effectiveness of a potential digital intervention for a health insurance operator. 

Especially in the health insurance arena, there is a tendency to compare country contexts incorrectly. An example of this would be smaller European countries such as Finland, Denmark, and Sweden. These are far ahead in using digital technologies for their citizens, but not only in the health sector.

However, this is due to specific factors such as:
  • The countries are relatively “rich,” and the government can afford a large portion of the budget for investments in digital health and/or on e-governance interventions.
  • The government is centralized, and ministerial representatives are working closely together.
  • The government formulated precise roadmaps and defined medium- and long-term goals before discussing potential digital solutions.
  • The government invested in infrastructure development and IT literacy of the entire population.
  • The government put effort into setting up “registries” and assigning a National Identifier to each citizen, which helps link to various programs and their digital tools. 
Image Attribute: India's Ayushman Bharat Digital Mission Health ID 

The aforementioned characteristics are not present in many LMICs. An important difference is the comparatively high number of inhabitants, and thus, the number of potential health insurance beneficiaries differs significantly. 

It is sensible to work on a digital health strategy that takes the health insurance side into account. However, “copying” digital health strategies from other country contexts does not work in practice.

While the need for better connected digital solutions for health insurance operators has already been recognized, it has also been recognized that this cannot work without a clear digital strategy that considers the country context and includes aspects outside the health sector (e.g., identification and biometrics4). 

In the Lao People’s Democratic Republic and Cambodia, where consolidation, merging, or linkages of existing health insurance schemes are currently under discussion, these countries have decided to develop their country-specific strategies that consider lessons learned from other countries. In Box 1, the ideal case of Estonia is presented, where a high level of digital maturity has been reached thanks to clear digital strategies. 


BOX 1 

A good example that shows how these factors contributed to the successful implementations of digital health strategies is Estonia. Indeed, Estonia took its first steps toward e-health in 2004. In 2005, the government adopted the first e-health roadmap, and in 2008, the national health information system was launched. Since then, several additional services have been introduced. For example, e-prescribing began in 2010, and in 2018, all prescriptions were digital. E-consultations, which allow family doctors to consult virtually with specialists, were introduced in 2012. In 2015, their ambulances went digital, and in 2016, they introduced decision support systems to notify doctors about drug interactions. In 2018, the government continued its work by focusing on personalized medicine, enhanced analytics and research, and cross-border services. 

Introducing e-health in Estonia was mainly based on good governance, committed stakeholders, a clear policy and strategy, and clear benefit(s) for its citizens. The relatively small size of the country, with a population of 1.3 million, was undoubtedly an advantage for technical implementers.

Source: Metsallik, J. et al. 2019. Ten Years of the e-Health System in Estonia. Department of Health Technologies, Tallinn University of Technology. 

Takeaways for Digital Strategies

  • The complexity of the insurance landscape has generally increased.
  • Government-supported health insurers in Asia have very different levels of maturity in terms of digitalization. Some are still at the early stages of digital development, and there are not yet many examples of fully mature health insurers that are, for example, fully interconnected with healthcare providers.
  • The formulation of a digital health strategy can help governments stay on track and introduce digital solutions in a coherent manner.
  • Digital strategy needs to be updated regularly.
  • Ideally, the digital health strategy should contribute to the objectives of the overall health strategy of the country.
  • There is a risk that too many different strategies with narrow focus are developed and not linked: it needs to be examined whether a digital strategy only for health insurance makes sense (if there are no existing broader ICT strategies) or if it should be integrated into another (especially when there is a broader framework).
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Declaration: This article is an excerpt taken from a report authored by Michael Stahl, Siddharth Srivastava, and Daniella Majakar; published by Asian Development Bank under the title – “Digital Technologies for Government-Supported Health Insurance Systems in Asia and the Pacific” and it is licensed under a Creative Commons Attribution 3.0 IGO License provided by the original publisher.

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IndraStra Global: Digital Strategies and their Relevance for Health Insurers
Digital Strategies and their Relevance for Health Insurers
It is sensible to work on a digital health strategy that takes the health insurance side into account.
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