The Importance of Technology in Healthcare

Lessons Learned From Thailand During the COVID-19 Pandemic


By Chanyaporn Aroonnetthong and Chihiro Toya


“The Importance of Technology in Healthcare: Lessons learned from Thailand during the COVID-19 pandemic” seminar was co-hosted by the Graduate Program on Human Security Program (HSP), the Research Center for Sustainable Peace (RCSP) and International Law Training and Research Hub at the University of Tokyo on 12nd June 2022.


Project Findings

Through an online seminar on the importance of technology in healthcare, the findings from Thailand were extracted from an experienced start-up initiative that helped people during the height of COVID-19 restrictions. It is worth mentioning that these findings from Thailand can provide lessons for other countries that are tackling the pandemic and other emergency situations. The findings are as follows:


  1. To prevent the spread of COVID-19, the use of technology has become vital. The Thai government has encouraged both public and private actors to utilize technology in various sectors like as healthcare, work, school, etc.

  2. With the emergence of the Delta variant, which caused more serious illness and fatalities, the best way to respond is to set a target and act fast. Bureaucratic processes and delayed decisions can delay responses to emergency situations fast enough to save people’s lives.

  3. The start-up, which uses technology to deal with massive amounts of information in real time, responded to the situation rapidly and efficiently. Such a response by a private actor is deemed more suitable in offering solutions to such urgent situation.

  4. With the public data provided by the government, and the start-up’s quick response and scalable system, it was possible to provide responses relevant to the healthcare sector. Hence, the government and public actors must proactively seek partnerships to take advantage of rapidly available and easily adaptable technology. Their cooperation in information management contributed to the protection of people from the impact of pandemic.

  5. In Thailand’s countryside, a strong culture of collectivism is apparent in communities, allowing them to adopt a system called “Village Health Volunteer” which ensures that every household has access to proper COVID-19 treatment. The local volunteer system was effective because of the strong sense of community, despite the lack in technological development in such areas.

  6. Thailand is likely to continue using medical consultation through telemedicine. This aims to address the decreasing medical human resources – a trend that contrasts with the high demand in treatment in an aging society.


Seminar Report


Opening

Professor Ai Kihara-Hunt opened the seminar by introducing the “Mutual Learning and Network Formation on Human Rights Best Practices by Non-State Actors in COVID Responses” Research Project (the Toyota Research Project) which is funded by the Toyota Foundation. This research project follows the previous research project on the collection of best practices in Asia, the Crowdsourcing Database Project in partnership with the UN Office of the High Commissioner for Human Rights (UN-OHCHR). While the previous project collected data on non-state actors' initiatives protecting human rights of particular groups during the pandemic, the Toyota Research Project aims to create opportunities for non-state actors from six Southeast Asian countries to learn from each other and build a network to address complex human rights issues in various sectors. In this project, there are four sub-groups on four key areas: student-led initiatives education, migration, and resilience in disaster response. Each group has developed research agenda on human rights-responsive responses and has conducted regular meetings. In addition to these subgroups, an independent group, the Thai team has explored the power of technology in helping uphold the right to access health and relevant information. The research project aims to publish a final report and host a symposium jointly organized with the UN-OHCHR to share lessons learned from our partners.



Introduction

Chihiro Toya, a member of the Toyota Research Project and a PhD Student at the University of Tokyo, provided a brief introduction of the COVID-19 situation in Thailand. Since the confirmation of the first case in Bangkok on the 13th of January 2020, the number of positive cases have fluctuated. Although Thailand was able to manage the numbers in the beginning through restrictions, the number of new infections rapidly increased in 2021. Hospitals were overwhelmed and the entire healthcare system became stretched beyond capacity, exacerbating the vulnerability of certain groups and communities. Health workers, for instance, had to deal with a severe shortage of masks and other personal protective equipment that are crucial to reducing viral transmission.


Mask Map Thailand is a crowdsourcing project created by Mr. Eggyothin Pila, a project partner from the Crowdsourcing Database Project. The Map provides timely information on the location of sellers, prices, and stocks of masks in all regions of Thailand and some places in neighboring countries, helping individuals deal with the shortage of masks at the height of the pandemic. This is a remarkable example of harnessing technology to create online spaces for the participation of different segments of Thai society, from consumers to small businesses, with companies providing the server and donors assisting through financial aid, making it possible for the developer to maintain the website and accessible to people with online access.


Technology has played an important role in responding to the spread of COVID-19. It is necessary for the government to collaborate with multiple stakeholders including technology companies to supplement and improve the healthcare system.


Chihiro concluded her introduction by sharing the objectives of the seminar: 1) to learn from non-state actors’ initiatives that utilize their skills and networking to quickly and effectively respond to health emergency and fill gaps in the state's response, and 2) to discuss the power of technology in healthcare to better prepare the world for the next health emergency.


QueQ Application

Mr. Rungsun Promprasith (Founder of QueQ Application)


QueQ is a start-up company founded in 2015 aiming to free people from long queues in public places. QueQ created a mobile application which allows people to book restaurants and receive notifications when their turn comes so they do not have to stay in the queue, thereby enabling them to use their waiting time for other tasks. They have been working with various stakeholders including the government to address human rights concerns, including those relevant to the right to health and access to information, which are especially crucial during the pandemic. QueQ is a remarkable example of how a business actor can use technology swiftly to offer critical physical protection in contexts where social distancing is mandated to prevent the spread of infection.


In 2020, the Thai Royal Embassy in London, the UK saw a surge in people lining up to secure documents needed for return to Thailand. Since the coronavirus is transmitted via airborne particles and droplets, the crowd was at risk of causing a cluster of outbreaks. Mr. Rungsun and his team were asked by their friend in the Embassy to create a new system to address this issue. The system allowed people to book their appointment with the embassy remotely and wait for a notification for a scheduled visit. This new system not only reduced the crowd but also protected people from the risk of infection. The Thai government recognized their work and asked them to create a similar system to be used in Thailand.



In 2021, the virus spread rapidly, and more people started to take the PCR test to get negative results for work and school purposes. Free testing centers in Thailand faced the same situation as the embassy in London. QueQ tested their system for the COVID-19 testing lab at Chulalongkorn University in Bangkok and worked with the then Vice Director of Pra Kanong district to implement their system in the district. Since the system worked well, they gained trust from government officials and managed to implement their system in all provinces after a short period.


They, then, expanded the use of their booking system to vaccination. Mr. Rungsun said that although a collaboration between the government and start-up companies rarely happened in the past, their example signals a path towards more cooperation to adopt new technologies from start-up companies, helping the government find solutions to the country’s problems. QueQ will continue to develop new systems such as the eTicket system for the entrance of national parks to reduce long lines by cooperating with governmental actors.


PedThaiSuPai Project by Panachit Kittipanya-ngam, (Ph.D.),

Former president of Thai Startup Trade Association (formerly known as Thailand Tech Startup Association)



The Thai Startup Trade Association (founded as Thailand Tech Startup Association) created an ecosystem for initiatives and adopted policies, on behalf of Thai start-up companies, by working with many corporations and the government. The association played an important role in initiating the “PedThaiSuPai” (meaning Thai Duck Fighting with Disaster) project. The project included the following services:

  1. News Duck – the Facebook fan page for “PedThaiSuPai” that helped correct online misinformation and communicated with people regarding COVID-19, in cooperation with the Department of Disease Control, Ministry of Public Health.

  2. Triage Duck - the Chatbot that arranges a survey on symptoms. After checking with the bot, it will show if an individual needs be tested for COVID-19 or not. The start-up cooperated with Chulalongkorn Hospital and Rajavithi Hospital for COVID-19 test reception.

  3. Follow Duck – the Chatbot for high-risk groups. An assessment of symptoms will be conducted for 14 days after a person has been deemed to belong to a high-risk group.

  4. Delivery Duck – collaboration with a start-up named “Bellugg”, which provides baggage delivery for tourists in Thailand, as well as “SmartTaxi”, a ride hailing application. The service not only transported people who are at high risk for infection to the test site but also delivered medicine to them so that the patient’s symptoms will be alleviated.

  5. Resident Duck – the project cooperated with hotel businesses in Thailand to take in high-risk individuals for quarantine, thereby lowering the risk of spreading infection.


In February 2020, when COVID-19 started to hit Thailand. The Association discussed what tech start-ups can do to help. Even though the Association had little healthcare and medical expertise, they did not want to sit back and do nothing. They decided to initiate the project called “PedThaiSuPai” to help address the situation.


The unprecedented COVID-19 pandemic called for a quick response from various actors. The start-up approach fits well in pandemic response because of its ability to utilize and organize and sort massive and disorganized information. It involves testing systems, measuring performance, and rebuilding scalable operation to adapt to a given situation. The challenge of PedThaiSuPai was to quickly and efficiently distribute limited medical resources such as vaccines, masks, and medicine among others, to those in need.


Mr. Panachit noted that after framing the problem, the project started work on data flow with many partners, including the government, hospitals and volunteers. The Start-up came up with the following strategy

  1. Rapidly finding new cases and giving medicine to the infected

  2. Giving vaccines to high-risk groups as soon as possible

Through this strategy, the Start-up handled a field hospital with Chulalongkorn Hospital especially for low-risk patients within a week after discussion. The group utilized an automated chatbot support from ‘AIYA’, a patient case management system from ‘Wisible,’ and a dashboard system for social monitoring from ‘YDM’. This was done in order to reduce physical interaction between low-risk patients and medical personnel. Moreover, the Association coordinated with an e-commerce Start-up to access patients’ data, and then deliver Antigen Test Kits and medicines. Through rapid response, the Start-up screened more than 600,000 patients using an automated system and arranged one-day medicine delivery to more than 5,000 cases in July 2021.


Research Summary Ms. Aroonnetthong Chanyaporn provided an assessment on how technology from non-state actors filled human rights protection in the health context in Thailand.


Thailand has ratified the 1966 International Covenant on Economic, Social and Cultural Rights, obligating the Thai State to provide proper medical care to people without discrimination. The COVID-19 situation posed unprecedented challenges in upholding this obligation.


Thailand issued a regulation under Section 9 of the Emergency Decree on Public Administration in Emergency Situations. The importance of technology, and the role of private actors in providing it, was emphasized by the government. Through this regulation the government encouraged the use of technology to reduce physical. Moreover, the Ministry of Public Health issued guidelines for telemedicine providers. It can be argued, then, that COVID-19 accelerated the digital trend and the use of technology in transactions and communication.


In response to an invitation by the government, many private sector initiatives were called upon to help prevent the spread of infection. The examples cited in this seminar exemplified the ability of non-state actors to contribute to emergency response through the use of technology.



Q&A Session

Questions from participants are answered by the two guest speakers (hereinafter referred to as: the Start-up Initiatives).


1. How can you deal with an aging society with your technology?

After the pandemic, Thailand will continue to utilize advanced technology in healthcare services, especially to serve the elderly. Since the elderly are groups that need extensive healthcare, we believe that telemedicine services will become more popular. Thailand also uses electronic prescription to conduct treatment and checkup processes more smoothly.

The Start-up initiatives in Thailand learned from the pandemic that they cannot afford to mobilize people due to the risk of infection. Because of this, telemedicine may become more prevalent. We learned through the patient-triage process that not every patient needs to go to the hospital; only some people need urgent treatment. Start-up initiatives can be utilized in the triage system to address the needs of the aging segment of society better. Before COVID-19, doctors treat patients on a one-by-one manner, but when the pandemic came and resources were lacking, consultations and the triage system became indispensable in order to reserve resources (i.e. doctors, nurses) only for those most in need of them.


2. How can you cooperate with different sectors?

The end-to-end customer experience is what the Start-up initiatives learned during the pandemic. The patients, regarded as customers in the system, will need to know if they got sick or infected. As a service provider, the Start-up initiatives must think through the process, from the infection, treatment at a hospital, to safely coming back home from hospital. The Start-up initiatives must break down this process and cooperate with other stakeholders. The advantage of the Start-up approach is availability of data and the ease of coordination and cooperation. It can be concluded that “best practice” doesn’t come from thinking, but from acting fast, getting feedback, and quickly improving the system.

In the future, the Start-up initiatives are trying to pass the lessons they learned from PedThaiSuPai to Bangkok Metropolitan Administration (BMA). Hopefully, they can work on publicizing data about government procurement and contracts to create transparency.


3. What is your opinion about fake news?

The issue should not be approached through regulation, but through community management. The problem that Start-up initiatives found in relation to communication during the pandemic was that the government sent out formal communication with too many technical terms, resulting in ordinary people not understanding what to do. The Start-up initiatives, then, established the PedThaiSuPai project to make fact-checked information reachable and understandable for ordinary people. The Start-up initiatives believe that clear and easily understandable communication is better than harsh punishment alone.


4. How could your technology help with the Human Rights aspect?

What Start-up initiatives learned from COVID-19 was that everyone in the world is connected. The spread of infection is very likely. Since COVID-19 restricted physical interaction, people are increasingly compelled to engage in the digital world. The Start-up initiatives made an observation that with the increasing amount of digital access in Thailand, marginalized groups (i.e. the disabled) can also use technology to gain equal and equitable access to healthcare services.

For people who do not know how to use the technology, the model used by “Village Health Volunteers” (in Thailand called Aor. Sor. Mor.) is particularly helpful. These volunteers are local people who are subsidized by the government, visiting each household to ensure that each person can get access to medical services. With this model, people without much knowledge and access to technology-driven services may be taught by the volunteers on how to access and use such services. The kind of localized approach in the Village Health Volunteers model might not work well in individualistic cultures or urban societies, but it has worked well in the collectivistic cultures in provincial Thailand and other Asian countries. In conclusion, culture might play an important role in such kind of volunteering.


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