Digital Health

in Vietnam
Market Intelligence Report

Department for International Trade

report prepared by KPMG and Oxford
University Clinical Research Unit
—
December, 2020
Table of Contents
04 06 18
Foreword Overview of Digital health
Vietnam’s economy ecosystem

Macroeconomic Overview of digital health

indicators market in Vietnam
Vietnam’s healthcare Local digital health
sector overview ecosystems
Telecom Infrastructure:
Connectivity
22 32 36
Key areas in Digital health Market access
digital health regulation strategies for
UK companies
Health information Decision 4888/QD-BYT -
technology National agenda for
e-health adoption
Telehealth / Telemedicine
Cyber Security Law
Consumer health and Regulation
electronics
Big Data / AI-based
AI and Big Data in medical devices
digital health
Potential hurdles
Opportunities for for UK companies:
UK companies legal perspectives on
procurement process
W elcome to the Digital health in Vietnam – Market intelligence report!

In an age of growing challenges from non-communicable diseases, and emerging threats from infectious diseases
such as COVID-19, digital health has the potential to offer new solutions and alleviate pressure on overstretched
health systems. Digital health technology can empower patients to actively participate in their care, improve clinical
outcomes and enhance operational efficiency.

Innovation and technology have touched many aspects of life in Vietnam and healthcare is no exception. In a
concerted effort to embrace Industry 4.0, the Vietnamese government has committed to a national agenda that
seeks to harness the potential of digital solutions across the health system. This has set a solid foundation for digital
transformation in Vietnam.

Vietnam and the UK share many of the same aspirations. We seek to utilise digital innovation to expand equitable
access to quality care, in line with United Nations Sustainable Development Goal 3, on good health and wellbeing. At
the early stage of digital transformation, Vietnam has plenty of opportunities for innovative solutions from the UK. In
this comprehensive guide, we provide insight into current market opportunities across health informatics technology,
telemedicine, AI and Big Data. The report also explores the future direction of digital healthcare transformation in
Vietnam and potential challenges facing new entrants to the market.

The UK and Vietnam have a rich history of collaboration, and this year we celebrate 10 years of strategic partnership. I
am delighted to support UK organisations interested in entering the Vietnamese market and I wish you every success
in exploring long-term partnerships in Vietnam that will further strengthen our bilateral healthcare ties.

For more information on these opportunities and how we can help you do business in Vietnam, please reach out to
our team.

Emily Hamblin
Department for International Trade in Vietnam
December, 2020

4 Market Intelligence Report

Foreword
O ver the past two decades, Vietnam has achieved laudable improvements in key quality of life metrics such
as life expectancy, infant mortality, and access to affordable medicines. This success is the result of the
government’s concerted effort to modernise the health system and expand access to affordable care. At the time
of writing, Vietnam has extended Universal Health Coverage (UHC) to 90% of the population, and targets to reach
95% by 2025. This coverage ratio leads its regional peer markets. The country nevertheless still has a relatively
high out-of-pocket expense ratio while spending the highest amount of GDP on healthcare. It is therefore likely
that if Vietnam hopes to continue to expand access to quality care and maintain sustainable health financing, the
health system will need to find a way to provide more services, while expending fewer resources per patient.

Digital health is one answer to achieving scale of access while improving clinical outcomes and maintaining costs.
To do this, the government needs to expand market access and encourage international business and clinical
partnerships.

UK companies have many of the missing digital pieces Vietnam needs to accelerate progress towards its
healthcare development goals. At the same time, digital health companies that understand Vietnam’s unique
population health challenges and can provide collaborative solutions will gain access to one of Asia’s fastest
growing healthcare markets. Through this market access, companies can achieve early-entrant advantage and
meaningfully help Vietnam’s financial and physical burden of disease.

This document is intended as an introductory guide to Vietnam’s digital health market. Please do not hesitate to
reach out to its authors or Department for International Trade as you begin your exploration.

Enjoy the read

Luke Treloar Guy Thwaites Louise Thwaites

Managing Director – Director Senior Clinical Research Fellow
KPMG Global Strategy Group Oxford University Clinical Oxford University Clinical
National Head – Research Unit Research Unit
Healthcare and Life Sciences
Vietnam and Cambodia

Contributors

Vo Thi Kim Ngan Du Vu Hoang Tuan Le Hang Nga

Associate Director Manager Assistant
KPMG Global Strategy Group KPMG Global Strategy Group KPMG Global Strategy Group
Vietnam and Cambodia Vietnam and Cambodia Vietnam and Cambodia

Market Intelligence Report 5

Overview of
Vietnam’s economy
Macroeconomic indicators

Population

Population overview Implications to digital health

At the time of writing, Vietnam has Indicator Issue Implication
a population of 96.5 million, making Golden Among the working-age Vietnam is well positioned to
it the 15th most populous country population population, nearly half are adopt digital health solutions.
in the world, 8 th in Asia and 3rd in structure under 34 years of age, For instance, there will be a
Southeast Asia (behind Indonesia and which is favourable for potentially large addressable
Philippines)1. Despite the addition of the adoption of innovative market for consumer health
around 1 million people per annum, science and technology. electronics in the country.
the rate of Vietnam’s population
growth has slowed gradually, from Ageing The golden population The application of Big Data
approximately 2% per annum in the population structure is also and AI can bring geriatric care
early 1990s to around 1.1% throughout associated with an ageing solutions. Vietnam can apply
the 2010s. By 2024, the county’s population. The faster passive sensors and other near-
population growth rate is expected to growth rate of the people patient monitoring technologies
slow to 0.8% per annum, reaching a aged 65 years and above to enable remote care solutions
total population of 101.1 million2. will create a burden on that link an individuals’ behaviour
healthcare facilities and to treatment.
As Vietnam’s birth-rate declines, its demand for care services. At the same time, electronic
average population age will continue This will be particularly health records will pave the
to rise. Currently, Vietnam is enjoying acute for elderly-care in way for more efficient medical
a so-called “golden structure” in its the country. information management.
age demographics, with 70% of the Governments and policymakers
population aged 15 to 64 years. This can utilise relevant population-
age structure has been a key driver based data to initiate preventative
in the country’s recent economic programs and make decisions
development and will continue to at a health-system level.
push its transition from a largely Health workers will be able
agrarian economy to one led by to deliver healthcare services
export manufacturing and domestic more effectively, thanks to the
consumption. After 2030, Vietnam will availability of historical health
however begin to age rapidly, with the records and related training
over-65 years of age cohort growing programs.
at an anticipated 5.3% per annum. The adoption of remote
This could drive the growth of the monitoring and telemedicine
current “retirement age” population of elderly patients will lessen
distribution 300% by 2050, potentially hospital overcrowding by allowing
straining health and related resources. doctors to monitor patients from
their homes, and thus freeing
hospital resources such as beds
1. World Population Prospects, the 2019 Revision and saving administrative costs .
2. Fitch Solutions

6 Market Intelligence Report

Economic development
Over the last several decades, Implications to digital health
Vietnam has achieved rapid
economic and social development, Indicator Issue Implication
which has driven the demand for Increased An increase in living Some of the most notable
more advanced healthcare services. living standards and healthcare examples include consumer
Beginning in 1986, the Doi Moi standard expenditures will likely health electronics (e.g. hi-
reforms initiated a broad-based expand Vietnam’s access tech wearables) and telehealth
economic transformation, which to digital health, which (e.g. remote health diagnostics,
opened a largely closed economy can be provided at a monitoring, intervention, and
to international markets and trade lower incremental cost education). The application
and began a series of ‘pro-business’ than traditional models of telehealth will play an
reforms. As a result of these of care. important role in supporting
policies, Vietnam achieved high the diagnosis and treatment of
economic growth rates that lifted non-communicable diseases
the country to Emerging Market across the population. However,
economic status. This strong this poses a challenge for the
economic expansion will likely lower income groups with
continue to benefit the country by less access to technological
creating an attractive growth story advances, particularly those in
that will further attract Foreign remote, underdeveloped, or
Direct Investment (FDI) (growing rural areas. To attain universal
by 13.5% per annum from 2014 health coverage for the entire
to 2019 in terms of registered population, further government
capital), which in turn will bring support and policy incentives will
much needed technology and be required.
knowledge transfer 3. Vietnam has
signed 13 Free Trade Agreements Vietnam’s GDP per capita and real GDP growth from 2017 to 2025f
(FTAs) further accelerating inbound
FDI. Most notably of which are
the ASEAN Free Trade Agreement
Vietnam’s GDP per capita and real GDP growth (2017 to 2025f)
(AFTA), the Comprehensive
and Progressive Agreement of 5,000 8.2 9.0
4,303
Transpacific Partnership (CPTPP), 7.1 3,964 8.0
6.8 7.0 3,656
and more recently the EU Vietnam 4,000 7.0
FTA (EVFTA). These trade 3,120
2,828 6.0
3,000 2,567 2,715 6.4 6.4 6.4
agreements are lowering tariffs 2,366 6.0 5.0
on many goods including medical 4.0
2,000
equipment and will help position 3.0
Vietnam as an attractive investment 1,000 3.0 2.0
and trade destination. At time of 1.0
writing, Vietnam is in discussions 0 0.0
with the UK on a possible bilateral 2017 2018 2019 2020e 2021f 2022f 2023f 2024f 2025f
agreement. Such an agreement
GDP per capita (USD) GDP Growth, % y-o-y
would extend similar market access
benefits to UK-based organisations.
GDP Growth & Healthcare expenditure per capita in 2019
Growth in FDI is driving GDP per
capita and the rapid expansion of GDP Healthcare expenditure
Country
an urban middle class. This middle Growth (%) per capita (% of GDP)
class is expected to account for
Vietnam 7.1% 6.0%
up to half of the total population
by 2035 4 and will, according to the Philippines 6.2% 4.6%
World Bank, drive growth in per
capita healthcare expenditures. Malaysia 4.7% 4.0%
This expansion in healthcare
expenditures will be more apparent Indonesia 5.2% 3.7%
in higher-end care and in urban
areas, which could expand rural Thailand 4.1% 3.7%
healthcare access inequalities.

3. The Ministry of Planning and Investment

4. Fitch Solutions Source: Fitch Solutions

Market Intelligence Report 7

Vietnam’s healthcare sector overview

Health status in Vietnam

The World Health Organization (WHO) recently estimated that non-communicable diseases now account for 77%
of all death and disability in Vietnam. Of these, cardiovascular disease and cancer are the two most common
contributors to premature death and loss in disability-adjusted life years (DALYs), followed by diabetes/chronic kidney
disease as the 3rd most common cause of death and 4th cause of DALYs. Many of these deaths can be prevented
with improved diagnosis, monitoring, and tech-enabled early-stage interventions.

There is increasing recognition of the important interactions between non-communicable diseases co-existing with
infectious diseases, particularly cardiovascular diseases. For example, hepatitis C Virus infection is associated with
an increased risk of cardiovascular disease and represents a global burden of the loss of 1.5 million DALYs. This
tragic burden falls disproportionately on low-income and middle-income countries. Risk of type 2 diabetes mellitus
is increased by almost 70% in Hepatitis-C infected patients. Similarly, in people living with HIV, increased risk of
cardiovascular disease has been noted. Whilst there is limited data on co-existing cardiovascular and infectious
diseases in Vietnam, the high rates of both means that improving diagnosis and management of these is likely to have
a particularly significant impact in Vietnam.

Implications to digital health

Indicator Issue Implication
NCD impact on The nature of ill health in Vietnam is Telehealth can promote a healthy lifestyle
health changing from communicable to non- and encourage preventative measures through
communicable diseases. This trend is patient risk-factor monitoring in pre-disease
expected to continue, which will create a stages. The utilisation of Big Data and AI in
greater need for long-term and coordinated digital health allows for real-time, population-
healthcare services that cater to chronic based, forward-looking data that can help avoid
diseases. Digital health is well-positioned to or mitigate non-communicable diseases while
help address these challenges. enhancing care delivery.

Top causes of death in 2019 & percentage change from 2009 - 2019
% change from 2009-2019

31% 18% 52% 45% 25% 32% 28% 63% 30%

107,659

86,130

38,005
26,191 24,002
22,489 19,758
17,118 18,227
13,825 11,387
9,391 11,044 14,367
2,0452,614 1,2572,054
Lung cancer Tuberculosis LRI* Ischemic heart Stroke COPD Cirrhosis Alzheimer’s Diabetes
disease disease
Source: World Health Organization

8 Market Intelligence Report

 Healthcare structure in Vietnam

Healthcare system
ORGANISATIONAL STRUCTURE OF HEALTHCARE
HEALTHCARE SYSTEM INSTITUTIONS

Administration Levels Hospitals Health centres Academic institutions

Ministry of Health (MOH)

  
MOH is a government al agency responsible for
TERTIARY

national management and regulation development, Central general and Central Medical and
management of national hospitals, research and specialty hospitals (Class I preventative health pharmaceutical
Pasteur institutes, universities and colleges. & II) centres universities and colleges

Other ministries Public Private Public Private

NATIONAL
Other ministries including MOD, MOT, MOIT, and
MARD run healthcare network of hospitals and clinics

Department of Health
  
Department of Health is an agency under the Provincial general and Provincial
Provincial secondary
Provincial People’s Committee, supporting provincial specialty hospitals (Class I preventative health
medical schools
healthcare management and preparing decisions, & II) centres
PROVINCIAL directives, plans, etc. across all aspects of the
(63 provinces) healthcare sector on the provincial level.
SECONDARY

Public Private Public Private

District Health Bureau  

District Health Bureau is an agency under the District District general hospitals District preventative
People’s Committee, supporting districts’ healthcare (Class II, III & IV) health centres
management and preparing decisions, directives,
DISTRICT plans, etc. across all aspects of the healthcare sector
(645 districts) Public Private Public Private
on the district level.

Commune Health Centre


PRIMARY

Commune health
Commune Health Centre is an agency under the centres
Commune People’s Committee, supporting communes’
COMMUNE healthcare management (providing primary health care
(11,162 services, most basic care and health education). Public Private
communes)

Availability of public / Non-availability of public /

private sector private sector

Source: The Ministry of Health, World Health Organization

Market Intelligence Report 9

Hospital capacity
Hospital numbers

Vietnam’s public sector has a decentralised hospital system classified into four groups
corresponding to four administrative levels. At the central level, specialised and general
hospitals provide secondary and tertiary care, and are active in research, and function as
teaching hospitals. At the provincial or city level, hospitals and medical centres mostly provide
secondary and tertiary care, combined with outpatient services. Each province is divided
into roughly 20 districts. District health centres offer primary and some secondary care
services. Finally, at the communal level, Communal Health Centres (CHCs) offer primary and
preventative health services. Communal healthcare centres are generally the first point of
contact for much of the population, especially in rural areas.

The Vietnamese private healthcare sector has started to play an important role as a provider of
care in major cities. The percentage of private hospitals is projected to increase rapidly in the
coming years as domestic corporations develop hospital groups and clinic chains across the
country. Some of the examples include Hoan My Medical Corporation, and Vinmec Hospital
Network of Vingroup. Main drivers behind growth are:

01 Many public hospitals lack needed infrastructure investment;

Rising personal income allows patients to increase out-of-pocket payments for

02
private sector and/or premium healthcare services and

FDI encouragement policies allows foreign investors to build wholly

03
foreign-owned hospitals.

Number of hospitals in Vietnam (2013-2018)

1,069 1,063 1,071 1,077 1,085 1,094

CAGR ’13-19

Total hospital numbers 1.3%

Public hospitals 1.2%

165 165 169 171 185 193

Private hospitals 1.6%

2013 2014 2015 2016 2017 2018

Public hospitals Private hospitals

Source: Fitch Solutions, World Health Organization, General Statistics Office of Vietnam

Hospital beds

Over the past five years, according to Fitch Solutions and the General Statistics Office of
Vietnam, approximately 6,000 hospital beds per annum have been added to the healthcare
system, corresponding to a CAGR of 2.5% (from 2013 to 2018). Of these additional hospital beds,
nearly 16% are at national level, while 43% and 41% are added to provincial and district levels,
respectively. This demonstrates the effort of the government in alleviating the overloaded capacity
of hospitals across Vietnam.

However, the proportion of private hospital beds remains low (5%), mainly due to the marginal
volume of private hospitals. Nevertheless, the government has indicated its intent to grow the
ratio of private hospital beds to 20% of total hospital beds through public and private partnerships.

In terms of the number of hospital beds per capita, there are large regional variations. More
specifically, Vietnam’s North Central and Central Highlands have far fewer hospital beds per capita
compared to other regions. Recently, the shortage of hospital beds has increased: bed to patient
occupancy rates has reached 120-160% in some public hospitals. This increase is often most
pronounced in central hospitals in major cities.

10 Market Intelligence Report

Healthcare professionals

Vietnam ranks on the lower end of countries with regards to trained Healthcare
Practitioners (HCPs) per capita. This shortage is particularly acute in
specialised care, such as cancer, palliative care, geriatrics, and mental health.
The distribution of health workers between urban and remote areas is also a
challenge, with higher concentrations in urban areas.

When compared with regional peer markets, one can see Vietnam’s shortages
are particularly acute in trained nurses. As of 2018, there are 77,995 physicians
and 128,386 nurses in the country, which is relatively low compared to the
total population (around 1 physician and 1.3 nurses per 1,000 residents).

UK 2.12
6.38
Thailand 0.47
2.6
Vietnam 0.82
1.34
Philippines 1.25
8.54
Malaysia 1.99
4.31
Indonesia 0.36
1.29
Singapore 2.39
5.84
0 2 4 6 8 10

Physicians per 1,000 of total population Nurses per 1,000 of total population

Source: Fitch Solutions

Indicator Issue Implication

Hospital Congested and Digital health can help address capacity
capacity overcrowded constraints faced by public hospitals By
and hospitals remain a introducing solutions such as telehealth
professional challenging issue and electronic health records, more
staffing in Vietnam. This patients, even in rural settings, can
strains resources gain access to needed healthcare, thus
in central and also improving hospital efficiency and
provincial reducing patient crowds. From a health-
hospitals economics viewpoint, telehealth and
and creates electronic health records can also help
inefficiencies at healthcare providers cut cost by reducing
the district and paperwork, improving safety, eliminating
community levels. duplicative tests, and improving health
outcomes. The latter drives economic
benefit by lowering readmittance
through long-term remote monitoring.
AI and wearable tech have the potential
to improve quality of care while reducing
cost of care in Vietnam. By extending
patient access to AI-enabled wearable
devices, healthcare professionals
can gain a real-time view of patient
conditions and make more accurate and
faster diagnoses. Layering AI and Big
Data into the monitoring and diagnosis
process will give clinicians the ability
to analyse multiple patient data sets
simultaneously to identify irregularities
and take early-stage preventative action
when interventions are more effective
and cheaper.

Market Intelligence Report 11

Healthcare insurance system in Vietnam

Vietnam has made great strides in expanding health insurance coverage. After introducing compulsory insurance in
2015, Vietnam now aims to grow the coverage rate of health insurance, setting the goal of reaching 95% in 2025.
Nevertheless, out-of-pocket expense ratios in Vietnam are some of the highest in ASEAN, which puts considerable
financial pressure on lower income households.

It should be noted however, Vietnam has made substantial progress in lowering out-of-pocket expense from 61% in
1999 to 45% as of 2019.

Healthcare expenditure 19.5 CAGR ’14-19 ’19-24

13.8 14.4 Total

13.1 4.3% 6.3%
11.7 11.8 12.2 59.6% expenditure

53.3% 54.4% 55.5% Public

51.5% 50.2% 51.7% 5.9% 7.8%
expenditure

49.8% 48.3% 46.7% 45.6% 44.5% 40.4% Private

48.5% 2.5% 4.3%
expenditure
2014 2015 2016 2017 2018 2019 2024

Private (USDbn) Public (USDbn)

Source: Fitch Solutions, World Health Organization, General Statistics Office of Vietnam

Public healthcare insurance

Person working in the agriculture, 88% Population

forestry, aquaculture and salt
Coverage (2018)
industry; household members

Children under age six, near poor individuals,

and students

Employees in non-state enterprises with more than 1

employee, other organisations, war veterans, and the poor

National Assembly Representative, People’s Council member,

preschool teachers, social welfare groups, dependents of police and
armed forces staff

Civil servants, employees in state enterprises, employee in private enterprises with

more than 10 employees, pensioners, and people on subsistence for the elderly 2% Population
Coverage (1992)
1992 1998 2005 2008 2018

Private healthcare insurance

In 2018, 33 million people (35% of total population) However, after the increase in healthcare fees at
were covered by some forms of private health large public hospitals brought about by the so-called
insurance. This coverage, however, only represents 2% ‘autonomy mechanism’, more people are expected to
of total health expenditures5. Low coverage rates are join private health insurance policies to gain access to
largely due to higher reimbursement rates and more comprehensive
coverage. Furthermore, continued growth in private
strict regulations imposed for non-life insurance
01 sector employment will likely expand employee-benefit
companies operating in the market;
insurance packages as a share of total private insurance.
high insurance premiums compared to public
02 Compared to peer market countries, insurance
options; and
penetration rates (calculated by total premium over total
low brand awareness of private insurance GDP) for Vietnam remains on the low range, accounting
03
packages. for only 2.4% of total GDP in 2018. This indicates
room for further growth6. According to the Insurance
5. News articles Association of Vietnam, the insurance penetration rate
6. Fitch Solutions is expected to reach 3-4% in the near term.

12 Market Intelligence Report

Healthcare quality and access

Patient journey Medical tourism

Inpatient and outpatient care Inbound medical tourism

In Vietnam, outpatient visits outpace inpatient Medical tourism has flourished globally over the past
admissions by two orders of magnitude. Overall, both decades and is now valued at over USD53 billion. This
inpatient admissions and outpatient visits remained value is expected to grow at 12.9% through 2025 8.
consistent from 2014 to 2019, with 5,600,000 cases Asia Pacific is a top source of, and destination for,
admitted to hospitals and approximately 156,000,000 medical tourism patients. This, however, is still in the
outpatient visits served per year respectively7. early stages in Vietnam. While competitively priced, the
Overcrowding remains prevalent, given the fact that number of foreign patients in Vietnam is still relatively
small compared to Singapore, Thailand, and Malaysia.
hospitals often run inpatient care at over- Most of Vietnam’s inbound medical tourists come from
capacity levels, meaning more than one Laos and Cambodia. For now, Vietnam is not considered
patient is assigned to the same hospital as a top destination for medical treatment due to a lack
bed, and of health infrastructure investment and regional brand
healthcare facilities will often see between recognition.
5,000-8,500 outpatients visit per day,
Outbound medical tourism
particularly at central hospitals.
As the local healthcare sector continues to experience
capacity constraints, a significant number of upper-
Vietnam’s efforts to reduce the average inpatient stays middle to high income patients have chosen to receive
have not yet seen success. Average stays remain at or healthcare services abroad from regional countries such
above a week since 2013. While this is comparable to as Singapore, Thailand, Malaysia, or even further afield
levels seen in the Philippines and Indonesia, Singapore, in the United States. The total amount paid for these
Malaysia and Thailand have managed to shorten this services abroad is estimated to be USD2 billion yearly 9.
indicator to less than 5 days. For patients, a lengthier
stay means higher costs and risk of nosocomial Critical factors for why patients prefer overseas
(“healthcare-acquired”) infections from other patients treatment to local care can include,
at the hospital. At the same time, for hospitals, higher
length of stay results in lower patient capacities.
reputation of foreign facilities,

qualifications and experience of

foreign doctors,

availability of medicines, and

better service and overall quality of care.

As well, inconsistency in diagnosis between local

healthcare facilities can also play a role in the decision
of patients to seek second opinions abroad.

7. Fitch Solutions
8. KPMG Analysis, PR Newswire
9. KPMG Analysis, PR Newswire

Market Intelligence Report 13

Implications to digital health
Indicator Issue Implication
Healthcare access The relatively low ranking of healthcare Increasing demand for ageing infrastructure and
and quality access and quality index reflects some human resource shortages are driving hospital
current challenging issues for Vietnam’s executives and government officials to leverage
healthcare system. More specifically, digital to optimise the patient experience and
overcrowded hospitals need the most create a health system without walls.
infrastructure investment. Digital health technology and the medical
tourism industry are converging to enhance
patient experience and trust in the process. This
Patient journey Even though Vietnam’s total number of
effort will shrink the perceived quality of care
hospital beds and ratio of doctors per capita
difference between Vietnam and other markets,
have reached national objective levels,
which will help to stem the USD2bn in outbound
hospital capacity is still overcrowded. This
medical tourism and strengthen Vietnam’s brand
indicates that availability of professionals and
as a medical tourism destination.
facilities still does not meet the country’s
needs. Digital tools are increasing patient engagement
through direct patient-provider communication,
Medical tourism Vietnam possesses many of the necessary instant messaging apps, telemedicine, and
qualities needed to develop inbound medical encrypted electronic records. AI-enabled
tourism, such as highly skilled professionals, technologies are just a few examples of digital
yet the industry remains in its early days. integration in the medical tourism supply chain.
Vietnam has rapidly developed its private Telemedicine over online video calls in pre-
hospital networks, some of which achieved treatment diagnosis and assessment and post-
international standards such as Joint treatment can be beneficial in that it lessens
Commission International (JCI) accreditation. the strain on physical medical infrastructure and
Nevertheless, building trust with patients will empowers patients to have consultations on a
take more time. schedule and location of their choosing.
The adoption of digital health will help Bringing patient consultations into a digital
accelerate the development of patient trust setting can improve clinical outcomes and
by increasing transparency and converging lower costs for Vietnamese patients. Clinicians
domestic care standards with the best will have access to powerful new tools to
international practices. longitudinally track health outcomes and make
more personalised recommendations.

Telecom Infrastructure: Connectivity

Telecom infrastructure
Mobile development
Device and service affordability
72.11
Maximum score: 100

Mobile network infrastructure Consumer readiness index

49.15 74.10
Maximum score: 100 Maximum score: 100
Mobile
connectivity

Mobile connectivity index Content and service availability

63.03 60.11
Maximum score: 100 Maximum score: 100

14 Market Intelligence Report

Smart phones

Smart phone sales volume (million) Smart phone sales value (USD billion)

CAGR (14-19) 31.6% CAGR (19-24) 2.4% CAGR (14-19) 15.5% CAGR (19-24) 5.5%

32.4 4.9
29.6 28.6
27.0 3.8 4.0 3.8
21.7 3.4
2.7
15.1
1.8
7.2

2014 2015 2016 2017 2018 2019 2024 2014 2015 2016 2017 2018 2019 2024

Key observations

Overall, the market of smart phones has experienced rapid growth over the past five years (nearly 32% per annum),
and is on track to reaching a saturated status in the next five years. While growth is expected to slow down, the
demand for new products will continue to drive the market.

Mobile-cellular telephone subscriptions

Mobile-cellular subscriptions (million) 3G and 4G subscriptions (million)

CAGR (14-19) -1.0% CAGR (19-24) 2.3% CAGR (14-19) 667.0% CAGR (19-24) 11.9%

CAGR (14-19) -9.5% CAGR (19-24) -22.5%

141.5
132.5

130.4
128.8

126.2

79.2
123.9

120.0

28.7

0.1 4.9

2014 2015 2016 2017 2018 2019 2024 2014 2016 2018 2020 2022 2024

3G 4G
Key observations

Along with the rise of smart phones, the number of mobile-cellular subscriptions is expected to increase steadily in
the next five years. This is driven by the surge of 4G since 2016 and 5G (estimated to launch in 2020), both of which
will replace the older generations 2G and 3G.

Source: Ministry of Information and Communications, Fitch Solutions

Market Intelligence Report 15

Internet and broadband infrastructure
Internet development

Internet users (% of population) Internet bandwidth (Mbps)

CAGR (14-19) 71.2% CAGR (14-19) 41.4%

78% 13,632.8
67% 66%
53% 58%
41% 45%
4,083.6
927.7
722.2

2014 2015 2016 2017 2018 2019 2024 2014 2015 2016 2017 2018 2019

Domestic International
Key observations

The internet has become an integral part of Vietnamese people’s life, reflected upon its increase in the internet
penetration rate (66% of the total population as of 2019). Combined with the expansion of internet bandwidth (both
domestically and internationally), this lays the groundwork for digital development across all sectors in the country’s
socio-economy.

Broadband subscriptions

Broadband subscriptions (million) Fixed broadband breakdown (%)

CAGR (14-19) 19.8% CAGR (14-19) 16.1% 2% 1%

7%
19%
61.0 44%
52.8
44.9 78%
36.2 83% 92% 93%
31.8 71%
29.0
47%
13.0 14.8
9.3 11.3
6.0 7.7 13%
8% 9% 10% 9% 6% 6%
2014 2015 2016 2017 2018 2019 2014 2015 2016 2017 2018 2019

Fixed broadband Mobile broadband xDSL FTTx Others

Key observations

Broadband infrastructure in Vietnam has seen rapid changes since 2014, with a significant increase in both fixed
and mobile broadband. In terms of fixed broadband, the more modern FTTx has started to take over the traditionally
dominant role of xDSL technology since 2015. This will further enhance the adoption of digitalisation in Vietnam in
forthcoming years.

Source: Ministry of Information and Communications, Fitch Solutions

Implications to digital health

Indicator Issue Implication

Telecom Telecommunication infrastructure has grown The continuous improvement of Vietnam’s
infrastructure significantly over the past five years across telecommunication infrastructure enables the
both internet and mobile sectors. country to become better positioned to adopt
digital health solutions. Telehealth, consumer
health electronics, and electronic health records
will have a solid foundation to continue to grow
in the future.

16 Market Intelligence Report

Internet usage trends in Vietnam

Overview of internet usage and mobile

Internet penetration
rate

Internet
penetration rate
66%
Daily use of internet
(% population)
66%
Daily use of internet
(% population)
94% Average time spent
on daily internet use
94%
Average time spent
on daily internet use
6H 42Min
Social media
penetration
6H 42Min
Social media
penetration
64%
Average time spent on
64% daily social media use

Average time spent on

daily social media use
2H 32Min
2H 32Min
Source: We Are Social, Hoosuite

Implications to digital health

Indicator Issue Implication

Internet usage Daily usage of internet in Vietnam has The widespread popularity of internet and
become increasingly prevalent. On average, social media, combined with the relatively
an individual spends nearly 7 hours on the young population, will foster a rapid adoption
internet every day, nearly half of which are of new communication technologies. In the
on social media. context of digital health, this will open up more
opportunities for telehealth, consumer health
electronics, as well as healthcare Big Data and
AI applications in Vietnam.

Market Intelligence Report 17

Digital health
ecosystem

Overview of digital health market in Vietnam

Vietnam is now laying the foundation for a smart medical records for patients and disease tracking.
healthcare industry that includes disease prevention, Since June 2018, Vietnam has set a clear target
medical examinations and treatment, and health that, by 2025, 95% of Vietnamese population will
management. Under Decision 4888 issued on have Electronic Medical Records. Meanwhile,
18 October 2019, the MOH set out a roadmap to telemedicine solutions remain under a “pilot
digitise patient records at hospitals and establish phase”, and the application of AI and Big Data in the
smart hospitals. This is the beginning of an ambitious healthcare sector remains limited.
multidisciplinary journey that will benefit from access
to the global industry’s best practices.

Vietnam’s digital health market can be divided into

four main areas: Health Information Technology,
Telemedicine, Consumer Health Electronics, and
Healthcare Big Data & AI-based products and
services. Currently, these areas are in the early
stages of development. Specifically, most of the
healthcare facilities in Vietnam still use paper-based

18 Market Intelligence Report

Key drivers impacting the digital health market in Vietnam:

Industry
• Overloading and
understaffing issues at
existing healthcare public
facilities
• Pressures from hospital
financial autonomy policies
• Increasing competition
Government amongst public and private Patient
medical service providers in
• Government’s initiatives terms of cost and efficiency • Rising demand for affordable
to promote national digital both locally and regionally access to healthcare services
transformation program is driven by an ageing,
• Decision No. 749/QD-TTg: growing population, with rising
Healthcare is amongst healthcare awareness and
prioritised sectors for digital greater prevalence of chronic
transformation. diseases.
• Government’s master plan for • Increasing demand for premium
EHRs promotion (Decision No. and high quality healthcare
5349/QD-BYT) and digitising services
patients’ records at hospitals • Untapped customer pools in tier
Vietnam’s
and setting up smart hospitals II, and III cities
digital health
(Decision 4888)
market

Market Intelligence Report 19

Local digital health ecosystems

POLICY MAKERS
The Ministry of Health has set out targets to digitise the
Ministry of Health healthcare sector from 2019-2025, including gradually
build a smart health-care and prevention system, using
electronic medical records and electronic payments, and
Electronic Health strengthening the application of information technology in
Administration health management

HEALTHCARE SOLUTION PROVIDERS

FUNDERS/ SPONSORS
Representative Representative
local companies foreign companies
A PATIENT-CENTRIC, Vietnam Social Bao Viet Bao Minh
FPT
INNOVATIVE DIGITAL Security Insurance Insurance
IBM Doctor
Information Buymed*
Corporation Anyw here*
HEALTHCARE ECOSYSTEM
System

VSS is also planning to replace paper

insurance cards with digital ones to reduce
Both local and foreign companies have errors in processing information and reduce
responded to rising demand for digital health by time for administrative procedures
offering solutions such as teleconsultation Meanwhile, private insurers are partnering with
application, clinical decision-support systems, digital solution providers to encourage
online appointment-booking systems etc. adoption of digital health services in Vietnam

Note: *Start-ups

HEALTHCARE PROVIDERS
Bach Mai
Hospital
Central-tier hospitals have made great progress in
integrating digital solutions into their daily procedures,
Huu Nghi Viet such as giving teleconsultations for satellite hospitals to
Duc Hospital save time and cost, or applied online booking systems to
prevent overcrowding
Gia Dinh
Hospital

Source: Tradepress, Ministry of Health, Hospital websites

Besides the government and associated also partnered with Bao Minh Insurance and Bao Viet
organisations, private entities in various sectors Insurance respectively to further encourage digital
like telecommunications, IT, and insurance are also adoption in Vietnam. Notable local start-ups include:
participating in the digital health space. This creates a VieVie Healthcare, an online platform that enables
cooperative ecosystem between the government and patients to book appointments and post their concerns
private players that will drive innovation and develop or questions in-app, which will be answered by
the sector. qualified doctors; and BuyMed, which offers a secure
wholesale channel for pharmacies in Vietnam.
Even though digital health remains in its early stages
in Vietnam, it has attracted the participation of both Digital health solutions have also been well-received
local and foreign start-ups, and conglomerates. Notable by hospitals through improved operations management
local conglomerates include FPT, VNPT, and Viettel, and data storage. Healthcare digitalisation continues
which are leading telecommunications firms in the to facilitate the enhancement of operational efficiency
country. These firms offer end-to-end solutions in and medical outcomes in public hospitals. Notably,
Vietnam, aiming to support hospitals in managing more than 92% of public hospitals have outsourced to
daily operations with real-time data, digital signature local IT companies such as FPT, Link Toan Cau, Dang
integration, and digital medical records solutions. Quang and OneNet to develop digital solutions for their
Foreign players are also present in the sector. For facilities.
instance, Microsoft and its cloud services are used
by hospitals and modern pharmacy chains, and IBM’s Compared to public hospitals, private facilities in
Watson is used for Oncology by some domestic Vietnam have relatively more advanced health
institutions. management systems. Large hospital chains such
as Hoan My, and Vinmec Hospital have upgraded
Start-ups in Vietnam are operating at a smaller their digital infrastructure to manage their branches.
scale. Doctor Anywhere, JioHealth, and Mydoc are Furthermore, in order to provide the best services,
international start-ups that offer digital consultations many foreign-invested hospitals are focusing on
and scheduling systems for in-clinic appointments or investing in digital platforms.
at-home visits. Doctor Anywhere and Mydoc have

20 Market Intelligence Report

Key players:
Top 5 Central Hospitals:

Hospital name Type of hospital Number of beds

Bach Mai Hospital General 1,900 beds
Cho Ray Hospital General 1,800 beds
K Hospital Oncology 1,800 beds
Huu Nghi Viet Duc Hospital General 1,200 beds
University Medical Center Ho General 1,000 beds
Chi Minh City

Top 3 conglomerates in Digital Health:

Digital heath conglomerate Digital health services Key partners

FPT Health information tech and AI & 200 hospitals including Bach Mai
Big Data hospital and Cho Ray hospital
VNPT AI & Big Data and Telemedicine 168 hospitals including Bach Mai
hospital and Huu Nghi Viet Duc
hospital
Viettel Telemedicine 200 hospitals including K hospital
and Bach Mai hospital

Top 5 Start-ups:

Start-up Digital health service Key partners

Doctor Anywhere Telehealth/ telemedicine Saigon Eye Hospital, DoLife
Hospital, Thu Cuc Hospital
JioHealth Telehealth/ telemedicine Bao Viet Insurance
Mydoc Telehealth/ telemedicine Bao Viet Insurance
VieVie Healthcare Telehealth/ telemedicine Medicare, Hoan My Hospital
BuyMed Telehealth/ telemedicine 7,000 pharmacies and clinics

Market Intelligence Report 21

Key areas in
digital health
Health information technology

Key development milestones Opportunities

Vietnam’s health information The Vietnamese government has acted swiftly to embrace Industry
system is making initial 4.0, extending this to the digitisation of healthcare. The MOH has
progress: Most medical encouraged hospitals to apply technology to their operation in order
institutes in Vietnam still use to enhance efficiency. As former Minister of Health Nguyen Thi Kim
paper-based medical records Tien states:
for patients and diseases. Since
June 2018, Vietnam has set
the goal to promote Electronic Together with the achievements made over recent years,
Health Records (EHRs). Under Vietnam continues the reform of the healthcare system.
the governmental plan for the We want to learn from countries in the development of the
deployment of EHRs (Decision healthcare sector and encourage private investment into
No. 5349/QD-BYT), at least this path,
80% of people in provinces and
central-affiliated cities will have
EHRs in the near-term, reaching Additionally, as Vietnamese hospitals transfer to a more digital
a target of 95% of population system, there is an opportunity for UK digital service providers to help
nationwide by 2025. Currently, manage the complexity of data that this transformation creates.
there are 24 provinces
Challenges
implementing EHRs in
Vietnam, six of which officially Several challenges slow the process of hospitals advancing health
considered the “piloting EHR information technology and digitisation, namely:
provinces”. Emerging EHR
providers like FPT.eHospitals
Financial pressures: Hospital management software
are quickly gaining traction in
and the broader information technology infrastructure is
Vietnam. However, Vietnam
expensive.
data localisation requirements
may create challenges for
providers that operate on a Lack of investment in human resource training: all
global cloud. healthcare professionals will need to be trained in the use
of digital systems. This may be a significant hurdle in rural
or remote regions of the country.

Concerns over data privacy and cyber security laws

to protect patient data.

22 Market Intelligence Report

Case study analysis

FPT.eHospital. The solution consists of 22 functional modules and

is divided into five main groups:

01 management of medical examination and treatment;

02 administration and office management;

03 laboratory management;

04 image transfer, processing, and storage;

05 and secure data storage.

The medical management solutions have helped reduce

information errors, while integrating patient information into a
system that is readily accessible to medical professionals. The
administrative management solutions in FPT.eHospital have also
begun transforming old hospital management systems. As an
example, instead of using separate applications, hospitals can
now utilise vertical management applications integrated in to
FPT.eHospital, which manages the administration processes
from front-office patient care to back-office
resource management.

Market Intelligence Report 23

Telehealth / Telemedicine

Key development milestones Opportunities

Telemedicine solutions The plan to expand the use of telemedicine is expected to pave the way
are under “pilot phase”: for further hospital adoption. The government is encouraging investors
Adoption of telemedicine in to participate in the development of digital health in Vietnam, including
urban and rural areas is still telehealth.
on a small scale. During the
COVID-19 pandemic, Vietnam’s Although the capacity of telehealth service is currently limited to basic
Ministry of Health piloted consultations in Vietnam, it is still expected to improve health conditions
telemedicine to encourage in underserved geographical areas. Going forward, opportunities for
social distancing and reduce telemedicine applications in Vietnam exist across numerous areas including
nosocomial infections. remote patient diagnosis and prescriptions, remote patient monitoring and
Specifically, on 24 April, consultation, and even surgical care and telecardiology.
the Ministry of Information
and Communications, the “Telemedicine consultation is accompanied by simple medical
Ministry of Health, and the devices such as thermometers, blood pressure meters, heart rate
Voice of Vietnam signed a meters, diabetes meters, and COVID-19 tests will be developed
Memorandum of Cooperation soon. With technology advancements, these medical devices
to provide a free support will become cheaper and will facilitate healthcare development
package for online telemedicine at home,” said the Minister of Information and Communications,
during the COVID-19 pandemic. Nguyen Manh Hung.
For access, people can
download the VOV Bacsi24 “Vietnam has advantages such as powerful telecoms and IT
app from Google Play or Apple groups, nationwide infrastructure, and resources which can develop
Stores, create an account, infrastructure to speed up digital transformation in important
and follow instructions. In sectors like education and healthcare,” Hung elaborated.
addition, the government has “The country needs more platforms, and so, we call on the
implemented a pilot program business community to join the development.”
with Hanoi Medical University
Hospital linking it with several Challenges
satellite hospitals, including
Muong Khuong General Lack of clear regulation framework for telemedicine
Hospital (Lao Cai province), Ha
Tinh City General Hospital (Ha
MOH issued Circular 47 in 2017 regulating telemedicine in Vietnam.
Tinh province), commune health
This circular, in effect since February 2018, allows doctors to offer
stations, and patient homes.
telemedicine services to patients, subject to certain requirements including
This program is expected to
IT infrastructure and licenses. Circular 47 also provides guidelines for a
serve as a steppingstone to the
range of telemedicine activities such as telemedicine consultation, tele-
wider adoption of telemedicine
radiology consultation, remote consultation, remote surgery consultation,
in Vietnam.
and telemedicine technology transfer training. This is the only regulation
governing telemedicine activities so far. In addition, there is also no
regulation on reimbursement schemes from Vietnam’s Social Security, or
private insurance providers for telemedicine. Telemedicine is a new area, and
as such, the regulatory framework is catching up with business needs.

Underdeveloped infrastructure, especially in rural areas

The limitation in synchronising digital technology of many hospitals,

especially tier II and III hospitals is amongst the key challenges for the
implementation of telemedicine in Vietnam. Many older patients and people
living in remote areas have limited access to technology, thus require certain
level of additional infrastructure before they can leverage digital health.

Challenges for changing behaviours of medical professionals

and patients

“It is not the technology but the required changes in habits of people
and medical professionals that will challenge the shift from traditional
consultation and treatment to online services”, said Mr. Nguyen Manh Ho,
CEO of Viettel Solutions.

24 Market Intelligence Report

Case study analysis

Doctor Anywhere (DA)

Doctor Anywhere is a Singapore-based start-up Currently, BuyMed has an extended network of 700
that has operated in Vietnam since the end of verified suppliers, distributors, and manufacturers,
2019. The company serves more than one million serving over 7,000 healthcare providers. Thuocsi.vn
users in Vietnam, Singapore, and Thailand. It offers and BuyMed have both seen significant growth as a
teleconsultation services in internal medicine and result of COVID-19.
paediatrics through a smartphone application. The
patient’s records, prescriptions, and related papers Jio Health
will be emailed to the patient after the consultation
session. In addition, the prescribed medicine can Jio Health is a telemedicine app that enables on-
also be delivered to the patient upon request through demand access to healthcare services such as
partnered pharmacies. The company is currently primary care and chronic disease management. By
delivering 350 tele-consultation sessions per day providing a comprehensive ecosystem through its
in Vietnam due to COVID-19, a 600% increase mobile application, customers can talk to doctors
comparing to 60 sessions per day before the and nurses 24/7, and schedule appointments with
pandemic. With Doctors Anywhere, patients are preferred doctors as well as monitor and download
able to receive consultations from doctors currently their own medical records such as clinical notes, test
working in leading hospitals in the country, such as results, and prescriptions. In addition to this, the app
Bach Mai Hospital and Cho Ray Hospital. can manage the records of direct family members,
stored safely in cloud. Users can access their health
Doctor Anywhere has developed partnerships with records electronically at any place and time through
nearly 100 hospitals and clinics, 50 pharmacies, and Jio Health’s mobile application and possibly purchase
100 doctors from leading hospitals to meet the rising prescriptions on the application as well. Payment
demand of its users. methods are also simplified and safe on JioHealth’s
application, ranging from cash to electronic wallets.
BuyMed
Since its launch in 2014, an estimated 200,000 people
BuyMed is a medical start-up in Vietnam that seeks to have registered on the application.
tackle counterfeit drug issues. The company operates
Thuocsi.vn, a pharmaceutical distribution marketplace,
and aims to simplify pharmaceutical distribution
system in Vietnam and the rest of Southeast Asia.
The platform works by verifying suppliers and
reducing the risk of medications making entering
the grey market. Since initial feedback on Thuocsi.
vn have been positive, BuyMed plans to add new
product lines including medical devices, supplements
and medical services to become ‘one-stop shop for all
users’ healthcare needs.

As there are no major multi-brand distributors in

Vietnam, most pharmaceutical manufacturers
and brands end up building their own networks,
fragmenting the process of providing prescriptions
and pharmaceutical supplies to healthcare providers.
This results in distributors serving over 40,000
independent pharmacies and an estimated 5,000
independent clinics.

Market Intelligence Report 25

Consumer health electronics

Key development milestones Opportunities

As Vietnam develops, people, Wearables have potential to revolutionise how people monitor and
especially the country’s urban maintain their health, and act on personalised health data. Checking
youth, are integrating health one’s vitals on a regular basis for many in Vietnam requires a visit to
technology into their lives, a local hospital or clinic, which contributes to crowding and additional
driving wearable fitness and stress on already strained healthcare practitioners, especially in
activity tracking technology. remote or rural areas. Remote patient monitoring solutions from
2.3 million people in Vietnam providers such as Phillips Health and Omron HeartGuide are
now own some forms of allowing people to communicate with their doctors and track critical
wearable tech, including Fitbits, information from the comfort and convenience of their homes. This
Apple Watches, or Samsung will free-up bed space, lower the cost of care, and allow for earlier
Watches. discharge of low-risk patients.

These devices, however,

Challenges
have greater potential utility
than just fashion or fitness However, wearable teach in Vietnam is not as common as it is
accessories. According to a in other markets. According to the Rakuten Insight survey, 57%
survey conducted by Rakuten of respondents claimed that their smartphone was sufficient in
Insight, the health monitoring monitoring their health and they did not see a reason to add a paired
is the primary reason why wearable. This may limit the types of data that can gathered and
Vietnamese consumers analysed.
purchase wearable tech. As
such, many corporations It should also be noted that wearables can be expensive, ranging
like Apple & Phillips have from USD $30 to more than $300, while the average monthly salary
announced plans to focusing of a worker in Vietnam is approximately $265. This is particularly
on medical wearable tech that true for rural workers, who generally earn less but have much to gain
focus on heart rate, and sleep from better access to health monitoring.
quality.

26 Market Intelligence Report

Case study analysis

As technology becomes more integrated into daily life, the adoption rate of wearables such as remote
patient monitoring devices and smartwatches with Vietnamese consumers will increase. These tools,
among others are now utilised by clinicians as part of standard treatment regimens. This care standard
is coming to Vietnam and will help alleviate crowding and resource constraints and improve overall
treatment quality through more accurate and timely data.

Other markets in Southeast Asia are also quickly adopting wearables and remote patient monitoring
technology to improve clinical efficiency, lower costs, and drive better health outcomes. As an example,
Singapore’s IoT (Internet of Things) solutions company KaHa recently partnered with medical solutions
provider EasyCare and iDOC Clinic to launch remote patient monitoring for primary care patients. The
partnership will leverage wearables and near-patient devices to track health statistics such as sleep
quality, blood pressure, heart rate, and activity level, and provide feedback and activity modification
suggestions to users through a dashboard. As well, data collected through the devises will be available
to the patient’s attending physician, which will assist with ongoing monitoring, and help improve the
accuracy of future diagnoses.

Market Intelligence Report 27

AI and Big Data in digital health

Key development milestones Opportunities

Vietnam is in the nascent AI can be used in various ways to improve healthcare services including,
stages of its use of Artificial day-to-day tracking, early detection of diseases, diagnoses, and treatment
Intelligence (AI) and Big Data in planning. As AI and Big Data services are still underdeveloped in Vietnam,
healthcare: only a few hospitals there might be potential for UK providers of innovative solutions in almost
out of nearly 1,400 hospitals every application of AI.
currently have any form of
AI. Some notable hospitals AI and Big Data applications are receiving strong support from the central
pioneering AI applications in government. It is hoped that these applications will drive the development
diagnosis and treatment, are of digital healthcare infrastructure and enable new R&D and enhance
the People’s 115 Hospital and healthcare delivery capabilities. However, further deregulation and
Gia An 115 Hospital. Both clarification of investment incentives will help to motivate investors to bring
of which have adopted the much needed capital, technology, and know-how to Vietnam.
Stanford University “RAPID”
system to diagnose and treat
strokes. In cancer diagnosis and Challenges
treatment, three Vietnamese
hospitals are leading the way Potential barriers to wider coverage of AI & Big Data
in terms of digitisation, namely applications include:
the National Cancer Hospital,
Phu Tho General Hospital, and Accuracy of patient data interpretation/
HCMC Oncology Hospital. standardised data
These three hospitals were
selected to participate in the
“IBM Watson for Oncology” AI Availability of qualified health care professionals
application pilot. that can use AI products

Currently, there is no legislation

specifically governing Big Data Quality and accuracy of current diagnoses that
and AI health applications, AI would be based on
apart from those detailed in
the 2019 adoption of Decision Might not be cost-effective especially in smaller
4888, which is detailed in the regions
regulations section of this
report.

28 Market Intelligence Report

Case study analysis

FPT.eHospital 2.0 IBM Watson for Oncology

Following its 2018 product update, FPT.eHospital Vietnam’s Ministry of Health has approved the use of
2.0 includes patient care technology such as artificial IBM’s Watson, an Artificial Intelligence (AI) system that
intelligence (AI), Big Data analytics, cloud computing, offers cancer treatment options based on details in a
and remote patient monitoring and mobile device patient’s medical records, for oncology diagnosis and
integration. By assisting hospitals to manage their treatment.
operations with real-time data, Electronic Medical
Records (EMR), and digital signature integration, FPT. There are currently three hospitals in Vietnam that use
eHospital 2.0 aims to create paperless hospitals, and IBM Watson to assist treatment of 13 types of cancer,
drive efficient and accurate medical examinations namely: HCMC Oncology Hospital, Phu Tho General
and treatment processes. The company hopes its Hospital, and National Cancer Hospital (K Hospital).
platform will improve hospital capacity and lower the Vietnam’s Ministry of Health noted that in its medical
incremental cost of care through business process evaluation, the IBM Watson for Oncology software did
automation. improve performance in cancer treatment, encouraging
many other hospitals to adopt the technology.
Doctors benefit from FPT.eHospital 2.0 as they can
monitor patients’ health remotely, reducing risks Pulse by Prudential
and errors by automatically checking for prescription
duplications and warnings. In addition, virtual In early May 2020, Prudential Vietnam launched Pulse,
assistants like smart chatbots can assist doctors/ an AI-powered health management app, and already
nurses in completing daily tasks such as checking on has more than two million downloads. This app was
patients and referencing health profiles. developed through Prudential’s partnership with UK-
based health technology and services company Babylon:
In real-world application, FPT.eHospital 2.0’s shortens Babylon’s existing AI technology is made available
patients’ registration times. In published use cases, for current Prudential Asia customers. The app uses
the average time for medical visit registration has AI-powered self-help tools and real-time information to
been reduced from 4 minutes to 1 minute, while empower users to take control of their personal health
patients who already had a pre-arrival registration and wellness. In the app, users can check symptoms
are processed in 15 seconds. Patients can make through the Babylon-powered Symptom Check function
appointments on the hospital’s website, virtually view and consult with healthcare professionals without
their health profiles, pay hospital fees, find additional going to a medical facility. When users are ready to
information via smart chatbots, and use calendar visit a healthcare facility, the application can provide
reminders for future appointments. information and make an appointment.

In Bach Mai Hospital of Hanoi, the use of FPT. The app launched in Malaysia in 2019 and will be rolled
eHospital 2.0 has allowed daily arrivals to reach out across 11 Asian markets. According to Prudential,
an average of 9,000 of patients, an increase of the launch of Pulse is part of the company’s region-wide
approximately 20% compared to the previous year. strategy to provide affordable and accessible healthcare
to everyone by leveraging digital health and partnerships.

Market Intelligence Report 29

Opportunities for UK companies

Thematic Area Opportunity

Health Information The Vietnamese government is already implementing the digitisation of healthcare:
Technology the MOH has encouraged hospitals to apply technology to their operation to increase
efficiency. Vietnam has witnessed progress in implementing EHR systems. As of
2019, 14 public hospitals have systems in place, and the government aims to reach
95% by 2025. The adoption will drive data and image management opportunities for
hospitals as they transition to digital.
Telemedicine The government’s plan to expand the use of telemedicine is expected to pave the way
for adoption. International investors are encouraged to participate. Currently, telehealth
services are limited to basic consultations but can be expanded to numerous areas,
including remote patient diagnosis and prescriptions, remote consultations, especially
for satellite hospitals.
Consumer Health Wearables can potentially revolutionise how people monitor and maintain their
Electronics health, and act on personalised data. For many, checking vitals require a trip to a local
hospital, leading to overcrowding. As such, through wearables’ remote tracking, it
can help decrease overcrowding of hospitals as well as reduce the amount of time a
patient spends in the hospital.

Healthcare Big Data AI and Big Data applications are receiving strong support from the central
and AI government. It is hoped that these applications will drive the development of digital
healthcare infrastructure and enable new R&D and enhanced healthcare delivery
capabilities. However, the increase of Big Data and AI adoption in healthcare could be
accelerated with investment incentives and further deregulation.

Digitisation of Vietnam’s health ecosystem is in its • Automated solutions that empower individuals
early stage of development and has significant room to access quality care on their own terms, such
to grow. There is a clear and growing need to improve as mobile health, online bookings and health
patient access to care, lower costs by automating information platforms, and AI-enabled personal
administrative procedures, and ensure quality of care health assistance will guide users through the
across the health system. Digital innovations such patient journey and direct resources. These
as blockchain, cloud-based computing, virtual health technologies can also integrate with Hospital
assistants, artificial intelligence, process automation, Management Systems (HMS) to help alleviate
and the Internet of Medical Things can empower overcrowding by guiding patients to facilities with
Vietnam to achieve its goal of quality “health for all”, lower utilisation or local clinics rather than central
while maintaining the government’s commitment to hospitals.
sustainable health financing. The realisation of these
goals will drive business opportunities, such as: • Clinical care applications include cutting-edge AI
and cloud-based diagnostic and treatment tools.
• Telemedicine has the potential to reduce Such applications will facilitate timely diagnoses
overcrowding in most public hospitals and and treatment decisions in hospitals, improving
provide healthcare access to an ageing, income- quality of care and patient outcomes. In rural areas,
diverse, and geographically dispersed population. digital systems may enable doctors to make better
Opportunities for UK organisations exist across informed triage and treatment decisions. This will
the entire spectrum of telemedicine, including lessen the need for medical related travel, which
remote patient diagnosis and prescriptions, remote will rationalise use of central hospitals to focus
patient monitoring and consultation, telemedicine in care for the sickest or most complex patients and
surgical care, and telecardiology. possibly slow the outbound medical tourism trend.

30 Market Intelligence Report

Market Intelligence Report 31
Digital health
regulation
Decision 4888/QD-BYT - National agenda for e-health adoption

Digital health in Vietnam is Current government accomplishment milestones for digital health:
guided by several key policy
and communications, namely: Increasing utilisation of IT application in
medical services
01 Circular No. 53, 2014:
Clarifies the provision of • Extend health information systems to “most” of the hospitals in
online medical services; Vietnam.

Directive No.16, 2017: • Achieved broad adoption in larger cities including Hanoi, Danang,
02 and Ho Chi Minh City for the use of electronic medical records and
Sets initial guidelines for
digital health regulation; cloud computing.
• The MOH, in coordination with Vietnam Social Security (VSS), has
Circular No. 54, linked 99.5% of the medical facilities in Vietnam under the medical
03
dated 2017: Guides IT supervision system of VSS.
applications in healthcare
facilities;
Development of Telemedicine system and
Circular No. 49, 2017: Internet of Medical Things (IoMT)
04
Describes permissible
telemedicine services; • Vietnam’s telemedicine has developed to connect central hospitals
with lower tier hospitals. The project prioritises the identification
Decision No. 4888, and tracking of patients through bar code, sensors, and RFID whilst
05
2019: Defines Smart in hospitals and clinics.
Health Information
Technology, and outlines
development goals for a Utilisation of robots in healthcare
healthcare industry 4.0.

• Robots are now being utilised in the health industry, notably the Da
Vinci robot for endoscopy, the Renaissance robot for spine surgery,
the Makoplasty robot for knee and hip joint surgery, and the Rose
robot for neurosurgery.

AI deployment

• In 2018, AI was initially deployed as part of a cancer treatment

“cognitive computing” pilot program at Phu Tho General Hospital
and Quang Ninh General Hospital. Other AI initiatives including the
application of machine learning and cognitive computing and clinical
decision making, are under review and early stage development.

32 Market Intelligence Report

(i) Government digital health development priorities

Improve legal framework relating Develop healthcare IT

to healthcare IT infrastructure
• Promulgate guiding legislation for • Centralise health data to the
health identification code for Information Technology Department
Vietnamese citizens, electronic for a national health database.
medical records deployment, safety • Establish a specialised Big Data
and privacy protection tools of center for AI’s development and
health information on the internet application
and assessing whether information
technology service fees are to be • Construct a Vietnamese DNA
database at either Ha Noi or
part of medical service fees
HCMC University of Medicine
and Pharmacy via Big Data and
AI
• Upgrade the IT systems of all
health facilities from central to
grassroot

Establish smart healthcare and Develop smart medical

disease prevention systems service systems
• Create smart medical service • Complete software for hospital
systems and smart healthcare management and digitalisation
administration systems using IT Government’s • Deploy e-medical records in all
applications. These systems can orientation for healthcare facilities according to
connect and store medical the set roadmap
activities and records the coming years
• Build and develop information
• Implement AI for clinical decision- kiosks in hospitals
making support, medical imaging • Develop AI applications for
support, and surgery support, etc. medical services

Develop smart healthcare R&D promotion and

administration & workforce International cooperation
development • Encourage stakeholders to
• Develop and improve the national conduct scientific research on
health statistics database and the smart healthcare applications
management systems of medical • Encourage international
information, equipment and health cooperation in smart healthcare
workforce research and development
• Formulate incentive policies for IT officials
and policies to attract high-quality IT
workers to the healthcare sector

(ii) Investment opportunities will emerge to accelerate and enable the government’s ambitious digital health vision.
The government has indicated support for international corporations in digital health, particularly in areas concerning:

Disease tracking and Application-based Artificial Intelligence

early warning health information in the diagnosis and
treatment

Electronic Medical Genetic

Records research

Market Intelligence Report 33

Cybersecurity Law and Regulation Big Data / AI-based medical devices

Requirements for data protection in Vietnam are Following the introduction of Decision 4888
detailed in the Law on Network Information Security framework, there is currently no additional legislation
(“LNIS”), which came into initial effect in July of 2016. governing the application of Big Data and AI in
The governing scope of the law includes network healthcare. Given the stated importance of Big
information security activities, the rights and duties Data and AI to the government in realising its digital
of agencies, organisations, and individuals to secure transformation target, further implementation
network information, protect civil cryptography, guidance is expected in the coming years.
and achieve network technical information security
standards. The law is applicable to Vietnamese
agencies, domestic organisations and individuals, as Potential hurdles for UK
well as foreign organisations and individuals directly companies: legal perspectives
involved in or related to cyber-information security on procurement process
activities in Vietnam. Overall, the LNIS and its guiding
legal instruments are drafted in broad language and
are still somewhat open to interpretation by the Despite persistent encouragement from the
relevant enforcement authority. It is also worth noting government, healthcare Public Private Partnerships
that data privacy rules are also governed by parallel (“PPP”) remains underdeveloped. Although health
sectoral laws (including the Law on E-transactions, sector PPP was introduced more than 10 years ago
Law on Protection of Consumers’ Rights and as a mechanism to distribute investment risk, raise
Interests, Law on Competition, Law on Cybersecurity, funds for needed projects, and open market access to
and applicable Penal Codes). the private sector, Vietnam has seen few large-scale
successes. At time of writing, Vietnam has about
Personal data is, broadly speaking, defined in Vietnam 73 registered PPP health projects. Of these, only 15
as any information that can identify an individual. This projects reached pre-feasibility study development
includes information such as one’s name, date of birth, stage. Of these 15, six were implemented. This high
address, telephone numbers, identification number, or project-attrition rate is likely due to the developing
even email address. nature of governing legal frameworks.

It is important to note the LNIS also provides two Recent data localisation requirement may well
primary exemptions from data protection rules: firstly, further slow Vietnam’s PPP development. Most
the processing of personal data carried out by a international healthcare providers utilise some
competent authority or on the decision of a competent forms of an encrypted cloud solution to link projects
authority based on legal grounds, and secondly, the globally. Current ambiguities on compliance costs
processing of personal data to ensure national security and requirements may slow interest from investors
such as protecting national defence, maintaining public who may wait for further clarity. For foreign investors,
order, or meeting non-commercial objectives. It is there is an opportunity to close skills and finance gaps
important to seek legal clarification before undertaking within public hospitals. To date, there have been few
any business activity in Vietnam that involves the successful cases of this type of partnership.
collection or processing of information that could be
considered personal data.

In addition to the LNIS-related rules outlined above,

organisations participating in Vietnam’s digital
healthcare sector also need to be aware of and comply
with applicable data localisation rules as set out in the
2019 Law on Cybersecurity (“LCS”). This law states
that any party collecting, exploiting (using), analysing,
or processing personal data, or data generated by
users in Vietnam, must store such data in Vietnam
for a period stipulated by the government. It is still
unclear if localisation will require all data to be stored
exclusively within Vietnam, or a domestic backup
of data in an approved facility will satisfy statutory
storage requirements. It is expected that these
matters will be clarified in future government-issued
implementation guidelines. This ambiguity poses
a compliance challenge for businesses and needs
careful consideration before beginning a digital health
business venture.

34 Market Intelligence Report

Market Intelligence Report 35
Market access strategies
for UK companies
Choosing the most appropriate legal structure for UK Direct Export Model:
companies to enter the Vietnam market is an important
decision that will impact establishment procedures, Under this Direct Export Model, a UK company will
taxation, legal restrictions, and the overall business oversee Sales and Marketing activities either from
capabilities. the UK or another regional management office. The
UK Company fills purchase orders by contracting
In order to establish a foreign-invested presence in directly with a Vietnamese customer, who will then
Vietnam, companies must first carefully consider be responsible for the importation and the customs
industry and scope of services for the Vietnam clearance process. Vietnamese customers will remit
business, as well as potential company size. These the sales proceeds to the UK company through normal
considerations will have an impact on business financial means (e.g., cash in advance, letter-of-credit,
licensing process. documentary collections, and open account). However,
some disadvantages of this includes a lack of local
The target size and complexity of business operations language and time-zone differences, which poses
in Vietnam will determine if a locally registered challenges when it comes to after-sales support.
company is needed. For many Small and Medium Sized
Enterprises (SMEs), registering a Vietnam company Key advantages of this model include direct access for
may not be needed. Two popular alternatives that do UK companies without the need for intermediaries.
not require a locally registered company include direct This provides direct and central control and oversight
sales (i.e. “Direct Export Model”), and a Business of sales and distribution functions. However, given
Cooperation Contract (“BCC”) model. the lack of local presence, the company may have
difficulties in capturing broader market opportunities,
Top tips for UK companies: communicating with customers, and gaining needed
local market insights. As well, corporate governance
01 Understand the local market relative to your and procurement process requirements with some
company, and how your business model fits; organisations may restrict this type of contractional
relationship. This should be explored and clarified before
02 Understand the key regulations and restrictions,
a company begins its market entry process.
how they impact your business, how you need
to adapt your operations to be compliant, the Key considerations:
required legal structure, and required level of
registered capital; 01 What is the unique selling point?

Identify local acquisition targets, and steps How to deliver on-site installation or after-sale
03 02
necessary to confidently complete the services (under time zone differences and in local
transaction; language)?

Identify a local partner that leverages local Who is responsible for logistics and how will it be
04 03
presence, but does not expose you to done?
commercial/ operational risk;
Is the exporter willing to localise the product?
Identify how profits are repatriated to global 04
05 (e.g. incorporating Vietnamese language)
operations, and how this impacts your tax
liabilities.

36 Market Intelligence Report

Business Cooperation Contract (“BCC”)

A business cooperation contract (BCC) is between a UK

company and a local partner to distribute products. As
mentioned above, this model saves time and resources
as there is no need to set up a legal entity in the country.
The appeal behind a BCC contract is that the overseas
company can leverage the local entity’s market insights,
while the Vietnamese company can benefit from its
partners knowledge, financial resources and technology.
As well as that, investors can participate independently
to exercise rights and perform contractual obligations.

This structure is not without its limitations. One of the

main disadvantages of a BCC stems from the lack of a
local legal entity to resolve business-related issues. This
challenge is sometimes compounded by the fact that
many BCCs in Vietnam have unclear third-party contract
implementation duties. It is therefore critical for UK
companies to consider all eventualities when contracting
through BCC in Vietnam.

Key considerations when choosing a potential

partner:

Established business footprint in Vietnam

01
(North/South/Central);

Historical experience and capability in the specific

02
business areas (records of business cooperation
with other partners if any);

How partner compares to other companies in

03
this business area? (Key competitive advantages
against its peer companies in the sector or
business area);

How extensive is their network? (are they a part

04
of a bigger company? Relationship with relevant
stakeholders in the sector?);

05 What other projects have they been involved in?

Market Intelligence Report 37

Other paths to market in Vietnam

Representative Limited-liability
Offices (“RO”) company (“LLC”)

Representative Offices provide support to the parent A limited-liability company (LLC) is the most popular
company or its regional office by functioning as a legal structure form in Vietnam. It is created by one
liaison, conducting market research or promotional or more members who contribute charter capital
activities or managing domestic projects on behalf to the company and are then liable for financial
of the parent company. For many companies in obligations in proportion to their capital contribution.
their first stages of entering Vietnam, establishing As a separate legal entity, an LLC can be either
a representative office marks their presence in the completely foreign-owned (where investors are all
country. It offers a low-cost entry for companies foreign) or a foreign-invested joint-venture (where
seeking to gain a better understanding of the at least one investor is local). An LLC can be used
Vietnamese market. These representative offices can as a subsidiary or holding company of a foreign
do research about the markets, execute contracts company interested in establishing a presence in
on the behalf of its parent company, and open bank Vietnam. The advantages of an LLC include the
accounts for administrative operations. The main fact that a company’s liability is limited to capital
disadvantage of having a representative office is contribution and that there are relatively fewer
that due to their dependent nature to their parent restrictions on business scope activity. However,
company, they cannot conduct any commercial the disadvantages are that the LLC legal registration
activities or engage in any activities that generate option includes not being able to issue shares and
revenue. This includes buying/selling commercial having a member limit of 50. As such, it is often
goods, providing services that generate profit, and most suitable for smaller legal entities in Vietnam.
signing commercial agreements without the parent
company’s ad-hoc authorisation.

Public – Private Partnership Joint Stock

(“PPP”) Contracts Company (“JSC”)

A Public-Private Partnership is a contract between a Like an LLC, a joint stock company (JSC) can
private company and government authority. This is be wholly foreign-owned or a joint-venture. The
often focused on investments in public infrastructure difference between a JSC and LLC is that the
projects and services. This form of contract typically contributed charter capital will be converted to
allows for faster project completions by including shares and divided proportionality to members.
time-to-completion as a performance measure. PPPs Within a JSC, the corporate structure is made up
are nevertheless prone to lower profit levels and of a Management Board which is supervised by
oftentimes struggle to find alignment between the an Annual General Meeting and the Inspection
public and private stakeholders. Committee, a Chairman of the Management Board,
and a General Director. Within this corporate
structure, shareholders, management board
Branch members, and directors are all responsible for
office acting in the best interest of the company and can
be held accountable. JSCs have few restrictions
Branch offices are typically implemented by on business scopes, can go public and issue
companies conducting revenue-generating shares, and do not have a set maximum number of
activities in Vietnam that have direct connections members. The JSC registration option is generally
to another office or parent company. This office is most appropriate for companies that hope to grow
legally allowed to operate as the parent company, to scale and have large and diversified shareholders.
using its own company seal and having tax-paying This comes with obvious operational complexities
responsibilities. Branch offices can carry out and compliance costs but is the most appropriate
commercial activities within the parent company’s structure for a company that may eventually
scope. However, this option is exclusive to a few go public.
sectors in Vietnam such as legal services, IT
services, consulting and management services,
construction services, commercial franchising, and
financial services.

38 Market Intelligence Report

Market Intelligence Report 39
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