Digital technology is an invaluable tool to support healthy ageing. — 123rf
MALAYSIA’s growing ageing population is expected to put a strain on the healthcare sector as it attempts to meet the complex needs of the elderly.
More digital health services in both the private and public sectors have been rolled out to meet this rising need, as senior citizens are the most frequent users of healthcare services.
But a low uptake of these services by the targeted group could put more pressure on the healthcare system, even though the Health Ministry received a 13.5% raise, or an increase of RM4.9bil from 2023, to a RM41.2bil allocation under Budget 2024. This comprises RM35.2bil for operating expenditure and RM6.1bil for development expenses.
Malaysia was already regarded as an ageing society when the population aged 65 years or older crossed 7% in 2021. The number rose to 7.4% in 2023 and is projected to double to 14% by 2044, based on World Bank estimates.
The Employees Provident Fund (EPF) has attributed the nation’s ageing status to increased life expectancy and declining birth rates. These demographic shifts will challenge Malaysian society, especially in healthcare, aged-care facilities, and retirement income security.
Digital technology is proving to be a viable solution to this meet some of these challenges. However, new research by Universiti Tunku Abdul Rahman, with support from the Malaysian Communications and Multimedia Commission (MCMC), shows that senior citizens’ acceptance of digital health services remains low.
Tech solution
Digital healthcare services allow for fewer hospital visits, better medication adherence, improved treatment management, and strengthened patient empowerment,among others. — Agencies
Digital healthcare services allow for fewer hospital visits, better medication adherence, improved treatment management, strengthened patient empowerment, and faster medical diagnosis and treatment.
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In some instances, digital health services could also reduce costs.
“While direct costs to patients should be marginally lesser compared with in-person services, we often fail to consider the savings in indirect costs of transportation and opportunity cost,” says Dr Khor Swee Kheng, cofounder of the Malaysian Health Coalition, and also Angsana Health chief executive officer.
“For example, a senior person who previously could only attend in-person physio sessions on weekends, can now do it digitally on any day of the week.”
However, Dr Khor says costs can go up when the elderly patient requires more varied professional care.
Seniors, particularly those with noncommunicable diseases (NCDs), often require closer health monitoring and complex treatments due to their increased vulnerability and a higher chance of having two or more long-term illnesses.
“Seniors face issues that the general population doesn’t, such as instability, hence they have different health needs. To provide for the seniors adequately, the general practitioners (GPs) need to provide a holistic team, and therefore require a larger team such as physiotherapists and nutritionists,” says Dr Khor, adding that this is where digital health services and companies can come in.
As he explains, GPs might be reluctant to change their fundamental business model, hence digital health services – which are sometimes offered by specific digital health companies – will allow GPs to keep their business model while still offering extra services digitally that cater to their elderly patients’ needs.
“Many do see digital health as a viable solution to address the increasing healthcare needs of seniors,” concurs Dr Chang Jing Jing, who heads UTAR's Department of Computer and Communication Technology.
However, UTAR’s survey of 404 senior citizens showed a low adoption of these digital health services.
Low awareness
Dr Chang: A lack of awareness of digital healthcare facilities and resources remains in the elderly community.“Lack of awareness is the main reason for the low adoption rate,” says Dr Chang, who is the principal researcher of the project to investigate issues arising from digital healthcare for seniors.
Funded by MCMC’s Digital Society Research Grant, the research findings will be presented at the MCMC Research Symposium next month.
As Dr Chang highlights, the survey showed that while 85% of the respondents were comfortable with using instant messaging applications such as WhatsApp and Messenger, and 62% were able to search for information online, more than half of the respondents did not use any digital healthcare services at the time of the survey.
The most used digital healthcare services are online appointment bookings (25%), followed by instant messaging with healthcare providers (23%), and wellness monitoring applications (20%).
Just under 7% do not own any smartphone or mobile devices.
“Some seniors are not ready for digital health. And we certainly can’t expect those who are not digitally literate to adopt digital health without external support. They need real assistance to guide them through the transition,” says Dr Chang.
These include the most basic tasks like getting them a new mobile device, installing mobile applications, changing the size of SIM cards, initiating home Wi-Fi installation, and upgrading mobile plans.
“Once the gadget is ready, you may be surprised at how eager they are to learn to use it. How-ever, if their family members can’t carry out these tasks, someone else must take them up,” says Dr Chang.
Digital health has much to offer seniors, especially in arranging medical services, preventive healthcare, and disease management, he stresses.
For example, digital health interventions have shown promising results for the management of NCDs such as diabetes, hypertension, and mental healthcare. The main challenge lies in encouraging seniors to begin and continue using digital health platforms.
Dr Chang points out that Malaysia is not short of seniors who are digitally literate and ready for digital health.
“(But) many just don’t know it exists and don’t see the need to change; there is little or no reward for them to adopt digital health.”
Change with support
Digital illiteracy among the elderly is a growing concern but a problem that is likely to ebb in the future, notes gerontologist Lily Fu. She believes strongly that such a problem will not persist in the years to come since the country has been educating its young on digital technology.
Fu: There are already younger senior citizens or those in the post-retirement age group, that remain adept at using digital devices and facilities. — YAP CHEE HONG/The Star
“Our children are already exposed to using digital devices in schools and at home through the use of tablets and smartphones for communication.
“By the time they grow old, they will be used to new technology.
“This is different for senior citizens who grew up without computers at home or with no exposure to digital technology.”
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As of now, Fu says there are already younger senior citizens or those in the post-retirement age group who are adept at using digital devices and facilities.
“There are three categories of senior citizens. Those who have just retired, those aged between 60 and 70, and those beyond 70. Their skills in adaptability vary.”
And most importantly, the idea that senior citizens today cannot learn anything new is simply not true, she says.
Dr Khor points to a lack of awareness among caretakers and healthcare professionals about digital health services for seniors as a possible issue: “Caretakers and healthcare professionals should first be aware, then trust, and finally advocate for digital services,” he says.
Dr Khor: The government should build a more robust and flexible regulatory framework to support digital health services.
Seniors feel more in control when communicating physically with healthcare professionals. Similarly, most healthcare workers also feel more confident treating seniors physically, at least until remote monitoring devices become more accepted.
Dr Khor adds that the government should build a more robust and flexible regulatory framework to support digital health services.
“Without such a framework, digital health companies are limited to only telemedicine platforms and are restricted in some ways, and under-regulated in others. Once that is done, much work should be done to encourage the digitalisation of health services to cater to not just seniors, but all categories of patients.”
Caretakers and healthcare professionals need more awareness of the digital health services available for seniors. — Agencies
