In a 2017 episode of the TV show The Good Wife, a doctor in Chicago is seen using Skype to advise a dental surgery in Syria. Such remote operations, part of an emerging sector known as telemedicine, are not only the stuff of televised fiction, but a real technology that is attracting increasing attention from business and government.
Singapore, where advances in medical research and development already are rippling across borders, has introduced telemedicine legislation as part of its upcoming Healthcare Services Act 2020.
These services already "have become increasingly popular and are poised to become a key feature of Singapore's health care system," said Marian Ho, a senior partner in the corporate division of Dentons Rodyk Singapore, a law firm.
She said in a legal briefing that what makes the new law significant is that Singapore will focus on the types of medical services provided, rather than on the premises where they're provided. For instance, if a patient needs to refill a painkiller prescription, it is less important that he is on the premises of a hospital, and more important that he is receiving consultation services from a doctor, even if it is over Skype.
Singaporeans already use smartphone apps for simple check-ins with their doctors, using text messages and video calls. The apps range from Doctor Anywhere to MaNaDr. However, the new law will be the overarching framework that the island nation uses to regulate this business, including to authorize the Ministry of Health to issue licenses for new services.
As businesses develop new ways to provide health services over the internet, the impacts are likely to spread beyond Singapore. The rich micro-state is already a world leader in biomedical science, manufacturing four out of the world's top 10 drugs, according to a 2019 report from consulting firm TMF Group and Singapore's Economic Development Board.
However, the new technology also comes with risks, such as a doctor's accuracy rate over a video call versus in person, whether personal data will be protected as it is handed over to apps, and insurance and liability questions in case of malpractice.
"My understanding is that out of 10 startups, maybe one survives," gastroenterologist Desmond Wai told Singapore's Business Times. "When the rest close down, who will be keeping the patient records?"
The Healthcare Services Act, approved by parliament this month, will regulate one of Singapore's biggest sectors. National manufacturing decreased overall from December to January, yet biomedical production increased 10.3% annualized, including a 20% increase in medical technology production, according to research from Singapore's OCBC Bank.
That makes medtech a significant part of the Southeast Asian economy — one that will see even more telemedicine in the future.
"Singapore's strong digital capabilities and vibrant research ecosystem aided by close collaboration between the public, private and academic sectors make it the region's leading center for biomedical sciences," the TMF-EDB report said. "Over 30 of the world's major biomedical science and pharmaceutical companies have established their regional clinical trial centers in Singapore."