Dr. Somsak Akksilp is a Bangkokian through and through. Growing up, access to healthcare services wouldn’t have been a worry. But after 22 years working at a tuberculosis centre in northeastern Ubon Ratchathani city, he saw the clear need to make healthcare more accessible to poor and remote communities.

This marked his mission when he became Director-General of the Department of Medical Services three and a half years ago. He pushed to bring healthcare services out of the hospital and closer to where the patients were.

GovInsider spoke with Akksilp to learn his vision for remote healthcare, his strategy for managing Thailand’s current hospital bed shortage and how tech has supported the country’s fight against the pandemic.

Raising healthcare’s quality and equality

Akksilp’s department is piloting a telemedicine tool for dementia patients in remote areas. The nation’s population is ageing, and dementia will soon be a big issue, he notes. The condition is “difficult to take care of if you have no experts”.

This tool connects patients with doctors through their mobile phones. Doctors can analyse how serious the condition is and give advice on the level of care they need. The department is piloting the tool across more than 10 provinces.

The coming 5G revolution will be a “game changer” for telemedicine, believes Akksilp. Even with just 4G or 3G, wider network coverage can make a huge difference for rural areas, he adds.

Akksilp has a second reason behind his telemedicine push. “If you do it right, it should reduce the burden in the hospital,” he says. Doctors will have more time to care for critical patients, raising the quality of care.

Thailand has built a Doctor Knows You telemedicine app to help with this. It groups patients with non-communicable diseases into three levels – green, yellow, red – to indicate how often they should visit the hospital.

Patients in the red group may have to visit regularly, while yellow patients may come around twice a year. Green patients don’t have to make a trip down at all. They can consult doctors virtually, then pick up their medicine at a nearby pharmacy or have it delivered from the hospital.

Other types of tech can support at-home care. Akksilp’s team is working on a medical device for patients to measure their own blood pressure, he shares.

The app also allows doctors to consult their peers for particularly complicated conditions.

Managing the outbreak

With Thailand’s recent spike in Covid cases, hospital beds are filling up fast. Akksilp’s team is working to bring all healthcare providers and authorities together to ensure there are enough beds to go around.

Private hospitals in particular play a crucial role in this fight. “More than 40 per cent of patient beds in Bangkok are in private hospitals,” he points out.

It won’t be easy to convince private organisations to disregard profit. That’s why Akksilp is looking elsewhere for support.

His department started an initiative to turn other healthcare facilities into Covid wards. The National Cancer Institute, for instance, can now house 60 Covid patients and will expand to 100 beds, Akksilp shares.

These “hospitels”, as Akksilp calls them, are fully paid for by the government. They operate separately from the luxury quarantine wards run by private organisations, which have drawn flak for charging over-the-top fees. A two-week stay can cost more than a year’s wages, according to The South China Morning Post.

LINE vaccine app

Another key part of the country’s pandemic response is its vaccination campaign. The government has partnered with popular messaging app LINE to allow citizens to register online for their jab.

The “Doctor Ready” service will tell citizens whether they are suitable for the vaccine, and the date and time of their appointment. Registrations open in May, and the first slots are scheduled for June, Akksilp says.

The tool will also check in for adverse side effects after each dose. It will prompt citizens after 24 hours, 7 days and 30 days to report any pain or fever, he shares.

Thailand aims to vaccinate 30 to 40 million people, and Akksilp expects half of these to use this app for their appointments. It will be most helpful for city-dwellers, but those living in remote areas may have to register manually in health centres, he adds.

Tech experimentations for Covid

Thailand has experimented with new digital tools to cope with the coronavirus. For instance, hospitals used robots to deliver food and medicine to Covid patients. They also collect vital signs and symptom information to limit healthcare workers’ exposure to risk, says Akksilp.

His department has introduced a service that tells doctors the number of each type of bed available in the hospital. It links data from Covid test labs to hospitals, so they know how many patients to expect and how to plan for the resources needed.

This tool is still a work in progress, however. Doctors and nurses need to update the number of beds manually, and many of them are too busy to keep up, Akksilp notes. He plans to expand it to all public and private hospitals in Thailand in time.

Outside of the hospital, the country set up a Covid hotspot app to show the risk level of different regions. There’s also a mobile screening app that tells citizens whether they are at risk of contracting Covid-19, and whether they should be tested.

Akksilp is determined to bring healthcare services outside of the confines of the hospital, and into patient homes. Tech such as telemedicine could not only make healthcare more accessible, it could also help the nation through the coronavirus crisis.

Featured image by juicyraiCC BY-NC-ND 2.0.

Images of Dr Somsak Akksilp and the Doctor Ready app by the Department of Medical Services, Thailand.