Thailand's free healthcare system is doing more than its doctors. Can AI ease the burden?

Presenting my month-old technology called “Eidy” to investors at the Echelon X conference Singapore On May 15-16, he told how his colleagues – who were in their 20s – died in road accidents after working hundreds of hours every month without a break.
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“They were really, really good people. But they died because they worked two days in a row. [without any breaks]. And they didn't sleep at all,” he said.

“I want to find a solution to how we work. People [doctors] Our health system should not shoulder all the responsibility and burden of problems,” he said. “We can do better.”

According to Navaporn, there are also some unreported cases of suicide among overworked healthcare workers in Thailand.

Thais are covered by three health insurance schemes, and the largest – the tax-funded Universal Coverage Scheme (UCS) – covers about 75 percent of the population. Thais were previously required to pay a 30 baht co-payment for a medical appointment, but this was abolished in 2006.

Now, doctor's appointments, emergency services and even high-cost specialist check-ups are free.

Former Thai neurosurgeon Navapuran Nalita created an AI-based system called “Eddie” that hospitals can use for automated screening and diagnosis. Image: Handout

Agnos Health CEO Pfonwit Chayotanodom said the problems arose because people took advantage of free medical services.

“There are many cases where people with a common fever will go to the emergency room at night. In Thailand, this is very common because health care is free,” he said.

In addition, general practitioners were not tasked with screening patients for specialist treatment. But people line up at the front doors of hospitals as early as 5 a.m. to see a doctor for five minutes or to get over-the-counter drugs, Pafonot said. He added that even a five-hour wait would not stop people from queuing up.

According to Pafonot, government doctors often work 120-hour weeks, with many seeing up to 100 patients a day.

An engineer by training, Paphonwit has developed “Agnos,” an AI-powered health screening platform that doctors in overcrowded hospitals can refer patients to. The technology helps patients understand their symptoms, provides early diagnosis and directs them to the right service, be it a pharmacy or a hospital.

In addition to tackling overcrowding in hospitals, Pafonot said the platform could help improve medical literacy and screen for diseases such as dementia and mental health.

“The problem is huge. And us [entrepreneurs] Can only teach. [a small percentage] We still have a long way to go for population,” he said.

“Right now, we're partnering with public hospitals to get self-care patients out of hospitals so that sick patients who really need medical attention can get care faster.”

An AI-enabled health screening platform developed by Thailand's Agnos Health that doctors in overcrowded hospitals can use to screen patients. Image: Handout

But there have been challenges, including patient buy-in, to using the non-human application for medical diagnosis, although the pandemic has improved public awareness of technological solutions, Pafonot said.

It also needed to ensure that users understood the disclaimers that online screening does not constitute a medical diagnosis.

What AI-powered health tech like Agnos and Eidy can do for doctors like him is early readings of radiology results, said Dr. Chai Kobketsuksukkol, a radiologist who works at various public hospitals in Thailand, in Asia this week. to prepare

While human doctors will still need to check the AI's work to prevent misdiagnosis or malpractice at this early stage of innovation, it will help ease the workload of many overwhelmed radiology departments. .

He said that AI-powered health technology can act as a vital assistant for doctors.

Asia contacted the Thai Ministry of Health about the situation in public hospitals this week but did not receive a response.

The National Health Security Office (NHSO), which administers UCS in Thailand, is aware of the healthcare workforce shortage. According to an NHSO statement released last year, Thailand had only between 0.5 and 0.8 doctors per 1,000 people, which is less than that. World Health Organization A standard of one doctor for every 1,000.

NHSO Secretary General Jadeja Thamtachari said the agency has implemented measures to ease the heavy workload, including promoting self-care among the public, to reduce unnecessary hospital visits.

Nurses administer AstraZeneca Covid-19 coronavirus vaccine doses at a hospital complex in Narathiwat province, Thailand, in June 2021. Photo: AFP

Last year, after telemedicine caught on during the pandemic, NHSO partnered with “Doctor at Home”, an online platform, to help Thais understand basic health issues, including those conditions That warrant a hospital visit.

The government plans to expand free health care to eight more provinces, stateless persons and non-Thais. While Navaporn welcomed the move, he said poor implementation could lead to further barriers and tensions between doctors and patients.

“The system keeps changing due to political instability, so no one addresses the issues seriously. When people resign, the burden falls on those who remain and the cycle continues,” he said.

In 2022, the Medical Council of Thailand mandated that doctors must work no more than 40 hours a week and must rest for four hours after a 24-hour shift.

However, few hospitals enforced the rules and a culture of overwork persisted, Navapuran said.

“If we show weakness and complain about fatigue, we will be blamed by our peers [for slacking],” she said.

“The culture of the Thai people is to sacrifice oneself for the community.”


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Meanwhile, the Thai government is supporting medical tourism and foreign investment in the growing private hospital industry, according to Jeffrey Chee, vice chairman of global venture capital firm Vickers Venture Partners.

While medical tourism may boost Thailand's economy, it will make things worse for the public system as doctors – especially younger ones – leave public hospitals for better-paying private hospitals. According to Navapurna and Paphonot.

Nevertheless, business and the private sector can work together to solve the problems of the Thai public health sector in addition to telemedicine.

Opportunities for such collaboration include developing systems to digitize medical records and apps and devices to better manage chronic diseases such as diabetes and cardiovascular disease, he added.


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