IR 4.0: OPPORTUNITIES FOR HEALTHCARE SECTOR IN VIET NAM

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MINISTRY OF EDUCATION AND TRAINING
FOREIGN TRADE UNIVERSITY
MASTER THESIS
IR 4.0: OPPORTUNITIES FOR HEALTHCARE
SECTOR IN VIET NAM
Specialization: Master of Research in International Economics
DINH THI HONG HANH
Hanoi – 2020

MINISTRY OF EDUCATION AND TRAINING
FOREIGN TRADE UNIVERSITY
MASTER THESIS
IR 4.0: OPPORTUNITIES FOR HEALTHCARE
SECTOR IN VIET NAM
Major: International Economics
Specialization: Master of Research in International Economics
Code: 1806410005
Full name: Dinh Thi Hong Hanh
Supervisor: Prof. Dr. Tu Thuy Anh
Hanoi – 2020

i
TABLE OF CONTENTS
ACRONYMS AND ABBREVIATIONS.............................................................................. iv
LIST OF FIGURE AND TABLE............................................................................................ vi
ABSTRACT……………………………………...…………………………………1
INTRODUCTION........................................................................................................................... 2
CHAPTER 1- APPLICATIONS OF INDUSTRY 4.0 IN HEALTHCARE ............ 5
1.1 The fourth industrial revolution ............................................................................ 5
1.2 Healthcare 4.0.................................................................................................................12
1.2.1. Robot.........................................................................................................................12
1.2.2 Three-dimensional model...............................................................................12
1.2.3. Internet of things................................................................................................ 12
1.2.4. Big data....................................................................................................................13
1.2.5. Artificial intelligence ........................................................................................13
1.3. Overview of healthcare system in Vietnam ................................................22
CHAPTER 2- OPPORTUNITIES OF INDUSTRY 4.O FOR HEALTHCARE
SECTOR IN VIETNAM.............................................................................................................24
2.1 Vietnam under Industry 4.0....................................................................................24
2.2. Healthcare digital technology in Vietnam....................................................28
2.2.1 Vietnam proposes the route of making hospitals intelligent ...28
2.2.2 Health ID issued to citizens...........................................................................29
2.2.3 Digitalisation of healthcare feild, double-edged sword...............30
2.2.4 Affairs on high-teach healthcare complex beginning in Hanoi
....................................................................................................................................................32
2.3. Hospital digitalization .............................................................................................. 34
2.3.1. Medical examination treatment management ...................................34
2.3.1.1. Increase of healthcare on demand..................................................35
2.3.1.2 Mobile application technology is personalized........................36
2.3.1.2.1 Searching by voice.............................................................................36
2.3.1.2.2 Development of wearable medical devices.........................37
2.2.1.3 Artificial Intelligence .................................................................................37
2.2.1.3.1 AI and forecast analytics............................................................... 37

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2.3.1.3.2 Wonders of Artificial Iintelligence...................................................38
2.3.1.4 Blockchain ............................................................................................................39
2.3.1.4.1 Blockchain and promise of better electronic health record.
..................................................................................................................................................39
2.3.1.4.2 Blockchain in Healthcare......................................................................40
2.3.1.4.3 Blockchain integration...........................................................................41
2.3.1.5 Virtual Reality........................................................................................................42
2.3.1.5.1 Interaction environment........................................................................42
2.3.1.5.2 Patient treatment by virtual reality..................................................43
2.3.2 Hospital Digitalization in Viet Nam ............................................................... 44
2.3.2.1 Hospital going digital..................................................................................44
2.3.2.2 Government support for digitalisation in healthcare..............48
2.4. Opportunity of utilizing big data in healthcare .............................................50
2.4.1 Benefits of Cloud computing for healthcare..........................................51
2.4.1.1 Unlimited capacity .........................................................................................52
2.4.1.2 Reliable broadening capacity ................................................................ 52
2.4.1.3. Seamless cooperation……………………………………………………. 52
2.4.1.4. System security increase........................................................................53
2.4.1.5.Accessing AI and Machine Learning.................................................53
2.4.1.6. Remote care opportunity.........................................................................53
2.4.1.7 Advantages of data orientation for medical insurance..........54
2.5. Strengthening healthcare sociallization ........................................................... 55
2.5.1 Vision................................................................................................................................ 58
2.5.2 Implementation...........................................................................................................60
CHAPTER 3 – EXPERRIENCES OF APPLYING INDUSTRY 4.0 IN
HEALTHCARE IN SELECTED COUNTRIES .............................................................. 68
3.1. Hospital digitalization in US
3.1.1 IoT concept involves digitalization of medical products and related care
processes............................................................................................................................. 70
3.1.2 Mobile devices and applications into helthcare............................... 71
3.1.3 Big data in medical system management ............................................73
3.1.4 New digital health consultant generation.............................................76

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3.2. Integrated care model based on capacities of IR 4.0 in Weston european 78
3.2.1 Care 4.0......................................................................................................................78
3.2. 2 Healthcare policies............................................................................................ 79
3.2.2.1 Academic merging co-design in Scotland....................................81
3.2.2.2 Building faith in systems and in the whole population ........83
3.2.2.3. Activating renovation culture.............................................................. 83
3.3. Socializing healthcare in China..............................................................................99
3.4 Digitalisation of healthcare: digital health enablers in Vietnam........106
CHAPTER 4- INVESTMENT OPPORTUNITIES IN VIETNAM'S DIGITAL
HEALTHCARE ..........................................................................................................................114
4.1. Policy and management: Adjusting our society to change fast in the
medical and healthcare ecosystem ........................................................................114
4.2. Incresasing many investments into Information technology........115
4.3 Policy and technology renovation challenges in healthcare 4.0 ..117
CONCLUSION ...........................................................................................................................121
REFERRENCES .......................................................................................................................122

iv
ACRONYMS AND ABBREVIATIONS
TERM
AI
IoT
ILO
STEM
VR
CPS
IOS
SERP
IR
GSO
ICT
ASEAN
MOH
CRM
DHI
HMO
MIP
CIEM
VHEA
EHR
CMS
BMI
CDC
GIS
CHCs
TCF
E&E
DEFINITION
Artificial Intelligence
Internet of Things
International Labour Organization
Science, Technology, Engineering and Mathematics
Virtual Reality
Cyber Physical System
Internet of Services
Smart Enterprise Resource Planning
Industrial Revolution
General Statistics Office
Information and Communications Technology
Association of South East Asian Nations
The Ministry of Health
Customer Relationship Management
Digital Health and Care Institute
Health Maintenance Organization
Ministry of Planning and Investment
Central Institute for Economic Management
Viet Nam Health Economics Association
Electronic Health Record
Medicare and Medical Services
Business Monitor International
Centers for Disease Control
Geographic Information Coalition
Commune Health Centers
Textiles, Clothing and Footwear
Electronic and Electric

MOOCs
AIC
AWS
DA
VR
CAGR
mIoT
NLP
LOINC
US
UK
v
Massive Online Open Course
Asia Internet Coalition
Amazon Web Services
Doctor Anywhere’s
Virtual Reality
Compound Annual Growth Rate
Medical Internet of Things
Natural Language Processing
Logical Observation Identifiers Names and Codes
United States
United Kingdom

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LIST OF FIGURE AND TABLE
Figure 1.1: Capabilities of Industry 4.0 in the medical field IoT, Internet of
things…………………………………………………………………………………….14
Table 3.1: The 4.0 toolset applied across care organization…………………….90

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ABSTRACT
The fourth industrial revolution is currently proceeding and is expected to significantly
affect the way individuals live and in result change the society in various aspects. The
ICT-based convergence industries of the fourth industrial revolution contain various
fields. This thesis examines the researches done in fourth industrial revolution in
medical field. This study also suggests necessary contents in the fourth industrial
revolution to be focused on for further research in this field.

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INTRODUCTION
1. The importance of the study
Vietnam’s healthcare landscape is changing. The country’s strong economic
and population growth is creating a new middle class which is demanding higher-
quality medical treatment. These affluent, digitally-literate consumers are
spending more on their healthcare, leading to a rise in demand for private
providers and digital health services. The population of Vietnam is not just
becoming richer. It is also growing older. This is resulting in a shift in the burden
of disease from communicable to non-communicable conditions like diabetes and
cancer. These non-communicable conditions require coordinated, long-term care
solutions. Meanwhile, Vietnam is embracing the Fourth Industrial Revolution.
Internet access is widespread and the country has seen rapid development in 4G
and 5G mobile communication technologies. Building on these foundations, the
government of Vietnam is driving a digitalisation agenda in hospitals and clinics
across the country. Smart solutions are being strongly encouraged that utilise big
data, artificial intelligence (AI), cloud computing and mobile technology to help
alleviate Vietnam’s overcrowded public hospitals and increase quality of care.
Together, these factors are opening up new opportunities for companies in
Vietnam’s digital healthcare space. We looks at the enablers for the adoption of
digital healthcare solutions in the country, as well as some of the difficulties that
face new market entrants. The report gives an overview of Vietnam’s healthcare
landscape – including its challenges and opportunities – and describes the main
domestic and international players already operating in the market. It also
includes key commercial opportunities available for companies as well as some
tips on doing business in Vietnam’s emerging digital health sector.
In area-wise research on Industry 4.0 in medical, we observed that the computer
science area provides the maximum contribution of 31% in total research
publications. However, the overall engineering field contributes 25%; decision
sciences and mathematics contributing 11% each; business, management and ac-
counting 6%; materials science 4%; biochemistry, genetics and molecular biology

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2% and other fields 10%, which includes energy, health professions, pharmacology,
toxicology and pharmaceutics, physics and astronomy, psychology and social
sciences. Industry4.0 in the medical field is increasing and research and development
are progressing towards providing commercially viable and acceptable solutions for
the medical field. Industry4.0 in the medical field is increasing and research and
development are progressing towards providing commercially viable and acceptable
solutions for the medical field. Industry 4.0 focuses on the design and manufacturing
and helps perform different cases precisely. Industry 4.0 provides extensive
contributions in the medical field with the help of innovative designing and smart
manufacturing system. Industry 4.0 provides excellent flexibility to create smart
industrial and medical models which help to improve communication between doctors
and patients. In future, Industry 4.0 will move towards mass production systems and
adapt to the world-class manufacturing system. It enables to create smarter medical
products in lesser time and cost. This revolution will change all management and
treatment system of the patient. With the help of smart manufacturing technologies,
medical students can be well trained to detect problems and correlate them to take
future action. In the medical field,it can help to increase overall performance by
providing a digitally controlled management system to the patients. It provides precise
surgery to the patient by the applications of additive manufacturing, sensors,
holography, robots, AI, big data and IoT devices. Industry 4.0 bringing upon
innovation with the help of holography and visual reality. Doctors and surgeons can
take advantages of this revolution for research, development and excellent service to
the patient. In the upcoming years, it will provide disruptive innovations to the medical
field.
2. Research question and Objectives of the
study The study has two main objectives:
- Firstly, Fourth Industrial Revolution
- Secondly, opportunities of Industry 4.0 for healthcare in
Vietnam To get above objectives, the study addresses 3 issues:
- Development of Industry 4.0 in Vietnam

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- Experience of countries: US, China
- How does Industry 4.0 bring opportunities and solutions in
medical field in Vietnam?
3. Subjects, scope and data of the study
Subject of the study: Vietnam is embracing the Fourth Industrial
Revolution. Health and healthcare solutions in the Fourth Industrial in Vietnam
Scope of the study: US, China, Europe, Vietnam
By using secondary data from reliable sources such as Ministry of
Health, Ministry Science and Technology from government and enterprise.
To reach the objectives, the author uses combination of research methodologies:
- Researching on primary and secondary documents to have the theoretical
basis, such as curriculums, research papers, science reports and so on.
- Descriptive statistics method: After collecting data from reliable
sources, the author proceeds to arrange, analyze and compare data
as well as other documents to have a particular and a concision
5. Structure of the study
- Chapter 1: Applications of industry 4.0 in healthcare
- Chapter 2: Opportunity of Industry 4.0 for healthcare in Vietnam
- Chapter 3: Experiences of applying Industry 4.0 in healthcare in
selected countries
- Chapter 4: Investment opportunities in Vietnam’s digital healthcare

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CHAPTER 1- APPLICATIONS OF INDUSTRY 4.0 IN
HEALTHCARE
1.1 The fourth industrial revolution
The Fourth Industrial revolution, like the others before, was born in
manufacturing connecting everything to the internet, generating data
across the whole process, and using advanced analytics to support
completely new products and service models
Focusing first on a Smart Factory, the initial premise was to create a better
connected production line and generate decision support to workers to keep the
line running at maximum efficiency, removing waste, and minimizing costs. Over
time the quality and configuration of products could be changed more flexibly.
Connectivity then expanded outside of the factory to other factories to optimize
stock levels and ordering. Industry 4.0 now includes full value chain monitoring,
including how the product is used, delivered, and maintained, creating a feedback
loop to design and build and target products better in the future, keeping
businesses competitive in a fast-evolving marketplace. This revolution must meet
needs at a massive industrial scale and is projected to be worth $214 billion by
2023. The Industry 4.0 toolset includes :
• Cyber Physical System (CPS)—a connected, automated device,
capable of learning from and effecting the physical environment, that is
intelligent and responsive and can act independently (e.g., self-
diagnosing problems) or interdependently with humans or other CPSs
to achieve efficiencies or resolve issues.
• Internet of Things (IOT)—the network over which CPSs can
connect to the internet and to each other in a secure, auditable manner.
• Internet of Services (IOS)—when devices are networked over the IOT, new
services focusing on logistics, intelligence, automation and prediction are possible.
• Smart Factory—the combination of cyber-physical systems and humans,
connected through the internet of things with support from the internet of services,
monitor production processes, and make de-centralized decisions as part of an

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interdependent network. The factory management is orchestrated via smart
enterprise resource planning (SERP) systems and supported by human
and virtual agents to develop product that is responsive in real time to
demand, market conditions, and value chain (e.g., logistics) feedback.
The toolset applied within the context of manufacturing and provides a baseline
capability map for an overarching ‘4.0’ toolset which can be applied to different
sectors and delivery models. Subsequent sections will consider other applications of
this toolset in emerging next generation models of health and social care. For these
discussions the ‘smart factory’ has been jointly labelled a ‘virtual agent’ to allow the
concept to better cross sectors. The largely automated intelligent oversight of an
interconnected system is a ‘smart factory’ in a manufacturing context, but in a care
setting it is more likely to be a virtual assistant that translates between the system and
the people within it, wherever they are.
Since the World Economic Forum’s action on Industry 4.0, many people have
attempted to respond to the early challenge and opportunity. The concept is still
maturing, with discussion around the difficulty of defining this complex web of
technologies and principles. Contributors instead characterize Industry 4.0
through several different lenses. For example, arguing that it can only be fully
characterized by the changing the way organizations, business models and
markets work to optimize the benefits from the technology. A second
characterization looks at how the relationships between actors differs from
previous revolutions—with the first and second revolutions operating as a
centralized network, the third revolution as a decentralized network with multiple,
powerful hubs, while the fourth revolution will constitute a distributed network
made up of interconnected nodes with equal power. The implications are that
given the way the connected value chain reaches well beyond the physical
confines of a factory, these technologies will change how society organizes itself,
with power and assets redistributed (though not necessarily for societal good).

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Countries all around the world are now standing on the brink of h
technological revolution, commonly called the Industrial Revolution (IR) 4.0. Asia
& Pacific region is the case in point, and most particularly Viet Nam, where
rapid technology innovation and adoption at the workplace are diffusing faster
than ever before, with some variations across sectors. This policy briefs
introduces some of the opportunities and challenges for the world of work.
What is IR 4.0?
Previous industrial revolutions have been characterised by the adoption of
various techniques for production. “The First Industrial Revolution used water and
steam power to mechanize production. The Second used electric power to create
mass production. The Third used electronics and information technology to
automate production. Now a Fourth Industrial Revolution is building on the Third
with the digital revolution occurring since the middle of the last century. It is
characterized by a fusion of technologies that is blurring the lines between the
physical, digital, and biological spheres. In its broad definition, IR 4.0 is
characterised by rapid technological advancement through increased use of
mobile communication and interconnectivity (‘internet of things’), big data,
artificial intelligence, robotics, autonomous vehicles, 3D printing, Nano and
biotechnology, quantum computing etc. What could be the impacts of IR 4.0 in the
world of work in Viet Nam? With the transformation of entire systems of
production, management and governance, the IR 4.0 offers a wide spectrum of
opportunities and challenges in the world of work, with direct and indirect impacts
on sectors across the economy (agriculture, industry and services) as well as
categories of workers including the most vulnerable groups (youth, women etc.).
Technology as creator and transformer of jobs
Technological advances can support structural transformation of the
economy (shift away from the agriculture to the manufacturing and services
sectors) by facilitating labour mobility of workers across sectors and occupations
and/ or easing work by lifting up workers from cumbersome tasks.

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In the agriculture sector, the adoption of mechanisation is key for labour
productivity increases and the diversification of the rural economy With two thirds of
the labour force in rural areas, employment in agriculture, forestry and fishery sector
is widespread, accounting for roughly 40 percent of total employment in 2017. While
the sector’s growth has slowed down over the last decades, there is still some great
untapped. GSO potential in off-farm activities and diversification in the non-agriculture
sector in rural areas with productivity gains arising from mechanisation”. For example,
the expansion of e-agriculture5 has the potential to enhance agriculture, forestry and
fishery outputs and foster rural development through the emergence of “green jobs”6.
Within the manufacturing sector, adoption of technology advancements has the
potential to shift workers to higher skilled occupations with higher productivity. The
ILO report “ASEAN in transformation: How technology is changing jobs and
enterprises transformation” indicates that majority of total employment in the
manufacturing sector, particularly in the textiles, clothing and footwear (TCF) and
electronic and electric (E&E) sectors, will be impacted by IR 4.0. While high-tech has
not yet completely entered the industries, there are some signs of penetration in
industries. Trade, foreign direct investment and associated technology have all
contributed to productivity growth. In those industries, significant changes in the
medium to long term are most likely to occur due to disruptive technologies, for
example in 3D printing technology, industrial robots, Internet of Things (iv)
computeraid designs, and body scanners etc.7 In turn, subsectors in engineering,
transport and infrastructure will likely boost demand for jobs. The digital revolution
has the potential to shift workers to more customeroriented jobs in the service sector .
Technology advancement also leads to a rise of the “gig economy” where a number of
jobs are increasing being performed through online platforms (Uber, Grab, e-
commerce). Ultimately, the adoption of new technology innovations could improve
workplace safety, increase productivity, wages and stimulate aggregate demand,
combined with anticipated increase of FDI inflow and easier access to major export
markets arising from FTAs, particularly CPTPP and EU-Viet Nam FTA, once ratified. As
productivity increase and working

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conditions improve, this can further lead to a reduction of working hours and
creation of more leisure services and products. Ensuring workers’ protection and
decent work in the context of the IR4.0 Technology per se is neither good nor bad
as technology cannot automate all tasks that require for example perception and
manipulation, creative intelligence and social intelligence. Therefore, supporting
workers and their protection in this process of rapid changes remains crucial. In
particular, the importance of the informal economy together with the rise of
casualization and nonstandard forms of employment put concerns on workers’
protection and the quality of employment as the employment relationship
(employer/employee) becomes more blurry.
How to maximize the use of IR 4.0? Some
examples
Agriculture sector:
Technological advancement has been used in multiple ways in the
agriculture sector in developed economies through increased use of technology
and mechanisation in production to increase agricultural productivity (direct
contribution) or through the use of ICT as a tool to empower farmers to take
informed decisions (indirect contribution). Specific examples of using ICT include
the use of smartphone mobile apps in agriculture, the use of Geographic
Information Systems (GIS) for farming and fishing or satellite technologies and
other agronomy sciences that increased significantly agriculture and fishing
outputs. Consumers and producers are also increasingly aware and conscious of
ecological matters, fair trade and the importance of agricultural biological
products with their specific characteristics as opposed to chemical products and
mass production. The use of ICT to promote these biological and organic
products is often used to sale and promote quality products together with a range
of strategies including packaging, sizing and pricing.
Industries:
The use of high-tech technologies is most commonly found in industries. In
industrialised economies, technologies have been used in multiple ways in order to

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boost efficiency (both quality and quantity) and raise productivity. As examples,
successful Asian economies like Singapore, South Korea, Taiwan and Malaysia
have achieved their economic miracles with strong industrial development
policies that placed a strategic focus on specific export-oriented sectors. In all
cases, education and training policies have prepared the labour force for entry
into targeted industries, by helping to absorb the know-how and technology from
the rest of the world and to diversify into new and more sophisticated products. In
Singapore, for example, the share of high-skill and technology-intensive
manufacturing exports represents almost 50% of the workforce.
Service sectors:
The use of mobiles devices and increased widespread access to internet has
fundamentally changed the world of work. The rise of the gig economy, digital
platform, freelancing and ecommerce, bring up new forms of work that can be
performed remotely (or partly). They also significantly contributed to expand markets
beyond borders by connecting an increasing number of people. On-line learning is
increasingly used to foster skills’ development throughout the life cycle. For example,
the use of online courses such as MOOCs (Massive Online Open Course) expand
opportunities for youth to learn and share knowledge at a minimal cost on a variety of
topics. What could be the priority areas of action for Viet Nam’s labour market? The
4th Industrial Revolution is here and cannot be avoided, yet the extent to which it
penetrates different sectors of the economy varies. While the impacts on the jobs are
difficult to predict, some ingredients are critical to carefully manage the process of
transformation. In doing so, barriers to occupational, geographical and sectoral
mobility need to be removed. Moving up the skills ladder Having the right skills to
increase the ability to adapt to the need of the labour market and drive the process of
technological advancement forward is critical. A combination of both technical skills
(such as STEM) and core skills (creativity, critical thinking, communication, teamwork
etc.) are needed to best equip the labour force and foster resilience to the evolving
labour markets. Training, (multi) skilling, reskilling, lifelong learning throughout the
life cycle are all critical

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in and out of the job. Education and training systems must be prepared to develop
skills for the future. In particular, partnership between policymakers, business and
training providers are required to ensure adequate supply with demand in the
labour market. Sectoral approach to employment creation (incl. industrial policies)
As Viet Nam will increasingly witness the impact of technological change at the
workplace, the effects will vary considerably across sectors. An effective
development strategy calls for expanding sectors that generate more value-added
and employment, with large multiplier effects and upstream and downstream
linkages to the domestic economy. The importance of industrial and other sectoral
strategies for structural transformation could be reasserted in light of the national,
regional, and global developments. The new growth model would need to be, in
order to be inclusive and sustainable, built around higher technological value-
added and productive sectors that nurture quality employment and other
qualitative dimensions of the domestic economy. The importance of labour market
governance Viet Nam could increasingly compete in global markets based on
higher productivity and better working conditions. But translating productivity
growth into better wages and higher living standards requires effective labour
market institutions, which include effective legal protection of workers’ rights in
various forms of employment, representation of workers’ voice, and collective
bargaining. Effective industrial relations is a key for stability, productivity and
equity, which will ensure sustainable and inclusive development. Active labour
market policy and social protection With accelerated changes under IR.4.0,
workers who are more frequently moving from one job to another will need to be
supported. Effective ‘active labour market policies’ that help to connect people
with jobs are important to constantly help workers to develop new skills; ensure
smooth transition from one job to another; provide skill training and
unemployment insurance during the gaps between the jobs. Only with proper
social protection, including unemployment insurance, workers’ move from lower
to higher productivity sectors and jobs will be facilitated.

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1.2 Healthcare 4.0
“In a complex world that is advancing rapidly at an exponential pace
where nearly every sphere of human existence seemingly finds the internet
indispensable, therein lies profound benefits to be gained at the convergence
of virtual reality, simulations, big data analytics and Artificial Intelligence.
Healthcare is no exception. Sophysicians, health economists and healthcare
administrators of this generation and beyond ultimately have to thrive in such
a technological environment to remain relevant in the medical profession
which provides care for the population in the modern age of digitalisation.
1.2.1. Robot
Robots are used to perform surgery and provide improved performance,
movement and control. Now, surgery can be per-formed through computer
control. It reduces/eliminates tissue trauma in open heart surgery case. It can
also work in an environment that is felt dangerous for surgeons.
1.2.2 Three-dimensional model
Holography is a noncontact 3D imaging that can be seen by anaked eye. It
provides details of the human anatomy, tissue, bones and activity of an internal
organ of the body with high resolution. Doctors can now see the patient in a
holographic image without the physical presence of the patient. It is an excellent
tool for con-tactless study which is used to measure the internal and external
fracture. Holography has excellent potential to addresses the challenge of storing
the complex issue of 3D image storing of thepatient. Patient diseases/other
information can be stored digitally which can be helpful to train medical student
Sensors provide information about temperature, blood pressure
and other conditions of the patient. Different types of sensors are used
as per the requirement of the medical field.
1.2.3. Internet of things
IoT has opened up a world of possibilities in medicine. It connects the Internet
and medical devices and collects valuable in-formation to provide control over

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patients' lives and treatment. It is helpful in monitoring, treatment and
testing to provide satisfaction to the patient.
1.2.4. Big data
In health care, big data provides life-saving outcomes. By the digitisation, it
referred to vast quantities of information and analysed it. Doctors required an
understanding of patients' past for their best treatment, so this technology is helpful
to provide valuable information regarding patients such as the sign of illness. It also
provides relevant critical insights into better care and faster treatments
1.2.5. Artificial intelligence
In medical field, AI is used to analyse complex medical data. It is an essential
technology that is programmed and controlled by machines with the help of the
computer. It has the ability to gain information and well-defined output to doctors
and patients. AI provides prevention and treatment technique to improve patient
outcome. It is helpful in personalised medicine, diagnosis processes, disease
level, drug development and patient monitoring.6. Different capabilities of Industry
4.0 in the medical field . Industry 4.0 could provide exciting capabilities and new
opportunities for patient care. It individualises products with the precise
manufacturing of patient-specific devices, which creates ahigh-quality result. It
also positively impacts the hospital

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Figure 1.1: Capabilities of Industry 4.0 in the medical field IoT,
Internet of things
Source: Industry 4.0 applications in medical field: A brief review
Applications Description
1 Customisation of - The customisation is the primary requirement of
implants the medical field because data of every patient-
specific implants and devices are different
- Industry 4.0 is famous because of the
manufacturing of the customised product, so it can
quickly create highquality implants and devices in
lesser time and cost
2 Digital hospital - Industry 4.0 provides better information
management in medical by the application of IoT
- Helpful in keeping medical record, physician,
sample and laboratory identification

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- By the applications of digital technologies
used in Industry 4.0, symptoms and cause
of diseases are easily identified
3 Smart implants - Efficient manufacturing of smart medical
components and the same can communicate with
monitoring systems and remote physicians
- It evolves in the part of the internet of service
and opens a new era of opportunities in the
medical field
- By the applications of smart material, implants
can change the shape with increase in temperature
concerning time as per requirement
4 Designing and - Industry 4.0 can play a useful role in the design
manufacturing of and production of implants, surgical tools,
surgical tools biomodels and all other medical devices and
and devices models in lesser time
- Also used for upgradation of tools and devices
by the application of additive manufacturing
- Implants manufactured by smart manufacturing
technology fit the patients comfortably
5 Management during - During unusual circumstances such as critical
a medical illness or unavailability of any family members,
emergency technologies are reliable to easily identify
previous medical history of the patient such as
name, age, blood group, etc.
- Provide more time for treatment by speedy
admission procedure
- Provides 3G video equipment in an
ambulance by which doctors can also image
the condition of the patient before admitting

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6 Provides implants in - Build a customised model in lesser
lesser time time with required mechanical
strength
- Helpful to create a conceptual model
for medical applications
- By the applications of different advance
designing and manufacturing
technologies, implants and other medical
devices are created in lesser time
7 Cost-effective for - Produces any medical devices, instruments or
the hospitals implants at a lower cost
- Digitally controls all the system in the hospital
and provides excellent service to the patient
- Highly reliable for manufacturing of a
customised product which correctly fits the patient
- A customised implant as per patient data
reduces risk and surgery time
8 Improved accuracy - Models/parts manufactured by smart
as per patient match manufacturing technology have good
accuracy and surface finish
- Using good-quality material accuracy is
improved
- Provides satisfaction to the patient
9 Multimaterial - Smart manufacturing technology uses
implants, tools and multimaterials as input material
devices with - Multimaterial-printed implants provide exact
excellent strength information such as defects in the bone of the
patient
- These multimaterial medical models help the
surgeon for a better understanding of the patient-

17
specific problem before surgery
10 Provide flexibility - Industry 4.0 provides excellent flexibility during a
complicated surgery
- Traces the cause of diseases by predicting data
of different patients
- Flexibility to create industrial parts,
medical models, cultural artefacts and also
other dental models
11 Improved research - Industry 4.0 provides essential
and development direction for the research and
development of personalised
prostheses and other implants/
devices.
- Industry 4.0 helps to efficiently manufacture a
prototype, and this prototype is to be tested and
used for research & development purposes
12 Precise for surgeons - Medical parts and components
manufactured by this process performed precise
surgery because smart manufacturing system
produces an exact fit model.
- Easy handling of different complex cases
13 Improve - Medical model manufactured by smart
communication manufacturing systems can improve the
communication between doctor/surgeon and
patient.
- Doctors and surgeons can better understand
the treatment outcomes and provide
appropriate information to the patient
14 Reduces surgery - Industry 4.0 uses sensors and
risk innovative manufacturing

18
technology which has the potential to reduce the
surgery risk
- Quickly identifies the problems for
complicated cases
- Performs surgery efficiently which
increases the success rate of operatio
15 Reduces inventory - Industry 4.0 is famous because of the
of implants customisation, which can manufacture any shape
implant
- Reduces inventory cost because implants are
produced as per the individual demand
- By the use of digitisation, it also reduces the
paperwork because patient data are stored
digitally
16 Identifies the level - By the use of different scanning process and
of diseases technique, patient data are used efficiently
- Helpful to identify different diseases and their
causes by taking data from various patients
- Also helpful to identify the level of diseases
17 Holography - Industry 4.0 uses holography to display medical
data of the whole patient in a three-dimensional
tomographic image
- Doctors can see patient data in
multiangular view without the presence of
the patient
- Holography is an emerging and powerful
tool for medical
applications used in orthopaedics,
pathology, tissue, dentistry, ophthalmology,
otology, urology and cardiology

19
18 Virtual reality - In medical, virtual reality can provide needful
information to doctors and patients
- Provides a 3D view of the patient's data
- Improves the quality of surgical planning
- Reduces planning time of
complicated surgery
- Provides surgical skills to surgeons
using simulation and investigates each
organ of the human body in a better way
19 Complete - Easily monitors the whole treatment process of the
monitoring patient by recording all data
- Helps to monitor and avoid public health
problem with the help of different medical devices
and technologies
- Increases the quality of medical
treatment with optimised management cost
Management system with the help of innovative technologies.1,11Inmedical field,
this revolution will become a new reality to create aninnovative concept and stay
competitive. It successfully changes the whole process of the medical field by the
applications of new technologies. Fig. 1 shows the different significant capabilities of
Industry 4.0 in the medical field. Industry 4.0 provides innovative services to patients
by analysing the data of the patient with the help of sensors and IoT. It provides
accurate information using upcoming medical imaging techniques and helps perform
precise surgery. It helps to easily handle different complicated cases with the help of a
digitally controlled service to the patient. This revolution will readily undertake new
research and development in the medical field. One of the excellent capabilities of this
is the recycling of medical waste in the hospital that saves our environment. The new
capabilities are well incorporated by Industry 4.0 in the medical field and help create
excellent services to patients and doctors.

20
Journals and associated academic sources have published articles on ‘Industry
4.0 in the medical field’, such as communications in computer and information science
journal and lecture notes in computer science including subseries lecture notes in AI
and lecture notes in bioinformatics published as two articles each. Rest other sources
and other journals published one article each in this field. Article source includes
Advances in Intelligent Systems and Computing; Advances in Production Engineering
and Management; Chinese Journal of Mechanical Engineering (English Edition);
Future Generation Computer Systems; IEEE Internet of Things Journal; IEEE Journal
of Biomedical and Health Informatics; IFIP Advances in Information and
Communication Technology; Journal of Industrial Infor-mation Integration; Journal of
Network and Computer Applications; Manufacturing Chemist; Technological
Forecasting and Social Change; Manufacturing Letters and Wireless Communications
and Mobile Computing. In area-wise research on Industry 4.0 in medical, we observed
that the computer science area provides the maximum contribution of 31% in total
research publications. However, the overall engineering field contributes 25%;
decision sciences and mathematics contributing 11% each; business, management
and ac-counting 6%; materials science 4%; biochemistry, genetics and molecular
biology 2% and other fields 10%, which includes energy, health professions,
pharmacology, toxicology and pharmaceutics, physics and astronomy, psychology
and social sciences. From Scopus data, we have analysed that research on
Industry4.0 in the medical field is increasing and research and development are
progressing towards providing commercially viable and acceptable solutions for the
medical field.
In the medical field, Industry 4.0 focuses on the design and manufacturing and
helps perform different cases precisely. It isused for manufacturing of customised
medical implants, tools and other devices to meet the varied requirement of the
individual patient. It can efficiently solve the problem by the application of its various
components which helps to meet the requirements of the medical field. Industry 4.0
provides extensive contributions in the medical field with the help of innovative
designing and smart manufacturing system. It efficiently manufactures

21
complex shape medical implants with a wide variety of materials that make surgeon
job easier with minimum risk. Surgeons and doctors can convert a need/idea into
reality which provides a comprehensive opportunity for the manufacturing of modified
medical implant asper requirement of the patient. To save cost and time of surgery, it
enhances the opportunities to create a new innovative medical product which can also
be helpful for research &development purposes. Industry 4.0 provides excellent
flexibility to create smart industrial and medical models which help to improve
communication between doctors and patients. It uses the innovative concept of
holography and virtual reality. It reduces risk and analyses the data of the patient to
increase the overall performance. Industry 4.0uses different innovative devices that
can quickly detect the glucose, sugar and cholesterol level of the patient.10. Future
scope. In future, Industry 4.0 will show opportunities for innovation using integrated
innovative design, manufacturing and services. During research and development, it
will play a significant role to achieve the requirement of medical. In future, Industry 4.0
will move towards mass production systems and adapt to the world-class
manufacturing system. It enables to create smarter medical products in lesser time
and cost. This revolution will change all management and treatment system of the
patient. With the help of smart manufacturing technologies, medical students can be
well trained to detect problems and correlate them to take future action. With the help
of smart technologies, data from different patients are collected and analysed.
Industry 4.0 offers new opportunities that create innovations by bringing new tools,
devices and implants as per patient match. Different challenges regarding price, speed
and complexity can be easily solved. The hospital will also change its way to purchase
different tools and devices. By the use of the different device, it can monitor calorific
intake. It can become a new path that helps to treat an illness such as diabetes,
asthma and arthritis.
Industry 4.0 strongly encourages smart manufacturing and in-formation system
by which medical field can take significant advantage of this new revolution. It
produces high-quality medical devices and components using advanced
manufacturing techniques to meet the demand of each patient. In the medical field,

22
it can help to increase overall performance by providing a digitally controlled
management system to the patients. It effectively adopts mass customisation
which fulfils the primary requirements. This revolution has a better impact on the
environment by reducing wastage of material and human efforts with the help of
various advanced manufacturing facilities. It provides precise surgery to the
patient by the applications of additive manufacturing, sensors, holography,
robots, AI, big data and IoT devices. There are various unique requirements for
fulfilled Industry 4.0, such as bringing upon innovation with the help of
holography and visual reality. Doctors and surgeons can take advantages of this
revolution for research, development and excellent service to the patient. In the
upcoming years, it will provide disruptive innovations to the medical field.
1.3. Overview of healthcare system in Vietnam
Vietnam health care system comprises by four administrative levels of health
establishments: central level, provincial level, district level and commune level.
Outline of the Vietnamese health system, there have been 21health facilities in central
level including the Ministry of Health, 64 provincial departments of health, 622district
departments and 10,917 commune health centers (CHCs).The Ministry of Health of
Vietnam, the govern-mental agency and the leading organization in central level, is
responsible for the care and protection of people’s health including issuing law and
other legal documents for health care and protection. This organization also has
duties in making long-term plans and strategies for the further development of the
health sectors. Provincial, district and commune health facilities are under the
competence management of the Ministry of Health and responsible for the
implementation and development of health care services in corresponding level. In
these levels, the people’s committee is responsible for allocating finance and human
resource, while provincial or district health department is responsible for professional
the supervising and monitoring of Ministry of Health. Provincial and district health
department also have duties in supporting people’s committee in corresponding level
in term of health care and protection for people. Commune health centers provided a
range of basic services, such as: mother and child health

23
care, family planning, treatment for acute respiratory infections, immunization and
treatment of common ailments. About thirty years after the establishment oft he health
care system, an extensive network of commune health center has been structured
throughout the country, based on population distribution and geo-graphical condition.
Although mountainous and remote areas are allowed more CHCs, some areas still lack
of health care services, not only because of their difficulties in geographic issues, but
also because of their lack of attractiveness for health workers. Although public health
system in communes is well established with health workers available in100% of
health facilities most of out-patients has chosen private health sectors and self-
treatment rather than public health facilities. Result from a previous study showed that
even service quality of public health sector is better than that of private health sector
however, people more often choose private health sector because the easier
accessibility derived from the higher number of private health facilities in commune
level. Low quality of health service in private health facilities revealed that there are
needs of comprehensive and consensus management system in health care quality
monitoring, especially in private health sector, in order to assure the equality for
people who have accessed to health care services. Health management information
system, a powerful tool for managing, organizing and planning of the health care
system in multiple levels, is necessary for the development of a health care system. At
the present, reports of the health care system in Viet Nam are mostly paper-based and
manually created. There-fore, it is difficult for managers and policy makers to analyze
and receive the accurate data about the healthcare system. In such an inefficient
system, health workers in lower levels have manually created or summarized monthly
reports to higher levels; this process soften takes time and sometimes become
irrelevant. Thus
, there is a certain need of a computerized, universal and comprehensive
health management information system for all health facilities in all levels
for the better administering and planning the health care system.

24
CHAPTER 2- OPPORTUNITIES OF INDUSTRY 4.O FOR
HEALTHCARE SECTOR IN VIETNAM
2.1 Vietnam under Industry 4.0
The country’s big potential in IT and large smart phone penetration are the key
enablers for Vietnam to develop its digital economy. However, a national strategy
for 4.0 and sturdy policies in favour of the business community to apply IT
solutions is in an urgent need. Opening Viet Nam up to industry 4.0 Vietnam’s
Industry 4.0 strategy will need a completed legal framework. One of the biggest
questions raised was whether Vietnam is now lagging behind the global digital
economic waves created by Industry 4.0. “How will the country seize the vast
opportunities given by Industry 4.0 to develop its digital economy to reach into its
own immense potential?” Over the past few years there have been almost no
specific policies and actions for developing a digital economy in Vietnam. “For
example, in the public administration, programmes on e-government, e-tourism or
e-healthcare have failed to be implemented effectively. “A legal framework on
applying IT or developing smart solutions has not been implemented either. There
has been a gap between policy and action, and while the concept of 4.0 has been
widely talked about, few actions have been made – even as the country is bursting
with opportunities to develop a digital economy.” Digital economy refers to an
economy that is based on digital computing technologies.
The digital economy is surging in Vietnam, creating major changes in business
methods. Vietnam has great opportunities to develop a digital economy because it
has immense potential. Google and Singapore’s Temasek valuing Vietnam’s
digital market at $3 billion in 2015 and $9 billion in 2018, and estimated it to rise to
$30 billion by 2025. Meanwhile, a recent study by Data 61, Australia’s data
innovation network, showed that Vietnam’s GDP could rise by an additional $162
billion within 20 years if Vietnam succeeded in digital transformation. According
to the Asia Internet Coalition (AIC), with a population of nearly 100 million people,
Vietnam is among the few nations in Southeast Asia with the highest speed of
digital transformation. Currently, Vietnam has more than 136 million mobile phone

25
subscribers and 54.2 per cent of the population are connected to broad-band wire-
based Internet. Vietnam is also one of 17 nations in the world with the biggest number
of Internet users. The Vietnamese government aims to turn the country into one of the
10 largest nations in the world producing software and digital content.
We think this target will be easily reached thanks to Vietnam’s strong
telecommunications industry.
Vietnam’s online advertising market and e-commerce are also developing strongly.
According to the Vietnam E-Commerce Association, the country’s e-commerce market
is estimated to be over $5 billion now and can double over the next four years,. The
impact of the Internet on the economy is estimated to be equivalent to 2-3 per cent of
the GDP, which may increase to 40-50 per cent in the future.
At a recent workshop on unlocking the full potential of Vietnam’s digital economy
in Hanoi, Quint Simon, head of Public Policy in Southeast Asia at Amazon Web
Services (AWS), surprised hundreds of business leaders and experts by announcing
that Vietnam is one of the nations with the fastest growth of 64 per cent per annum
in spending on cloud computing. AWS is a subsidiary of Amazon.com that provides
on-demand cloud computing platforms to individuals, companies, and governments.
“I believe that in the near future Vietnam will develop a digital economy
successfully. Cloud computing is a favourite in Vietnam, with many enterprises
using it,” Simon said, explaining that with the cloud, businesses can completely
protect their information and prevent it from being stolen. “For example, Amanotes,
a fast-growing app publisher, currently has hundreds of millions of users. It is
typical of Vietnamese businesses with cloud computing,” Simon continued. “In
another case, Masan is also using cloud to manage its stores in Vietnam. It has been
a big trend that many Vietnamese agencies and enterprises are seeking our support
in cloud applications.”
National strategy for 4.0
Deputy Minister Thang said that in order for Vietnam to seize opportunities and
facilitate enterprises to benefit from Industry 4.0, the Ministry of Planning and

26
Investment (MPI) is compiling a national strategy on Industry 4.0, which will clarify
what the digital economy means, with specific tasks for ministries and agencies.
The strategy’s prime targets are to grab opportunities arising from Industry 4.0,
increase the country’s GDP and employment, and attract more high-quality foreign
direct investment. “With this strategy, Vietnam stands ready to receive new
technologies. However, the country will have to adapt many policies to Industry
4.0,” said Nguyen Thi Tue Anh, vice head of the MPI’s Central Institute for
Economic Management (CIEM) which is drafting the strategy.
Under the CIEM’s study on the draft, Industry 4.0 would likely raise Vietnam’s GDP
by $28.5-62.1 billion, equivalent to a rise of 7-16 per cent, from now to 2030. “The
benefits for Vietnam will be huge, far higher than those from the Comprehensive
and Progressive Agreement for Trans-Pacific Partnership, which will increase
Vietnam’s GDP by 1.32 per cent by 2035,” said Dang Quang Vinh, deputy chief of
the CIEM’s Department of Business Environment and Competitiveness. “Besides,
Vietnam will be able to generate 1.3-3.1 million new jobs by 2030 thanks to
Industry 4.0,” said Vinh, who is one of the drafters of the strategy. “However,
these benefits will only materialise if we have more sturdy policies in favour of the
business community.” According to the CIEM, if medium-level technologies are
applied, Vietnam’s Industry 4.0 strategy will likely enable the country to see strong
growth in many key economic sectors by 2030 such as manufacturing (16 per
cent), wholesale and retail (20 per cent or $9.5 billion), agro-forestry-fishery (12
per cent or $6 billion), supply of electricity, gas, and air conditioning (23 per cent),
and finance-banking-insurance (14 per cent or $3.5 billion). For example, the
manufacturing sector will grow by an additional $7-14 billion based on new
technology applications, while the communications and industry sector will climb
77 per cent, or an additional $2.5 billion compared to the scenario where the
country fails to follow Industry 4.0. According to the CIEM, new industries arising
from Industry 4.0 “will be the key growth propellants for Vietnam, such as the
Internet of Things and media. They will also support other

27
sectors by raising their competitiveness, revenue, and developing new products
and services.” The new industries will include e-commerce ($40 billion in revenue
by 2030), Artificial Intelligence ($420 million), data analysis ($730 million), cloud
computing ($2.2 billion), ride-hailing ($2.2 billion), and fintech ($1.5 billion).
Currently, many nations have been developing their Fourth Industrial Revolution
strategies, such as Made in China 2025; Japan Resuscitation Strategy; Malaysia’s
My-i4.0; Singapore’s 23 plans on digital transformation; India’s Smart City Mission
and Industry 4.0 Centre; Indonesia’s Making Indonesia 4.0; and Thailand 4.0.
“Industry 4.0 offers great opportunities to Vietnam without which, the country will
continue lagging behind other nations,” said the CIEM study. “Taking advantage
of Industry 4.0 is the shortest way for Vietnam to turn itself into a modern and
affluent nation, and develop into a modern industrial nation in the shortest time.
Thus, the country needs to mobilise all necessary resources to implement its
Industry 4.0 strategy.”
A proper legal framework
At the Vietnam Private Sector Economic Forum 2019 last week, CIEM deputy director
Nguyen Duc Hieu said that it would be difficult to develop a sturdy legal framework to
regulate activities related to the digital economy. “For example, if an unmanned car
causes an accident, who will be largely responsible? Is it the car, the software owner,
the car owner or even road designers? We will have to have suitable laws for such
cases,” Hieu said. According to Minister of Information and Communications Nguyen
Manh Hung, several key foundations need to be developed to create an effective
digital economy in Vietnam. “When we dare to accept new things, new technologies
and global talent will come to Vietnam and new industries will appear,” Hung said.
“Then Vietnam will be able to create digital products that can be exported.” “However,
if we dare to accept new things but only follow other nations, we will not be able to
create many added-value products,” Hung continued. According to him, the digital
economy in Vietnam must be supported by a good ICT infrastructure characterised by
5G technology and each

28
person in the country owning a smartphone. “Second, we need to have good
policies to spur digital economy and technology. Internet in Vietnam must be
globally competitive so that Vietnamese people will not go overseas to
establish their enterprises any longer and more foreign enterprises will come
to Vietnam to do business,” he said. “Third, the government needs to develop
an initial market for IT enterprises by spending more on IT products and e-
government,” Hung added. “Finally, human resources training needs a boost
in foreign languages and IT education in schools and universities.”
2.2. Healthcare digital technology in Vietnam
2.2.1 Vietnam proposes the route of making hospitals intelligent
The Ministry of Health has unveiled a roadmap for digitising patients’ records at
hospitals and setting up smart hospitals, a conference heard in HCM City on
Wednesday. Assoc Prof Dr Pham Le Tuan, a former Deputy Minister of Health, said:
“The smart hospital approach is an inevitable choice in Viet Nam to improve the
quality of healthcare to achieve customer satisfaction and ensure security, safety and
efficiency in hospital management.” The fourth industrial revolution has been
changing the face of the world and the lives of people in all fields in positive and
promising ways, he said. “Healthcare is therefore also greatly affected by the
application of new techniques and technologies such as AI, expert systems, the
internet of things, and big data to create information management systems and
powerful applications that effectively support the management in medical as well as
professional work”. Many hospitals in the country have adopted health information
technology systems such as electronic medical records, e-Health and telemedicine, he
said. A system to share data on treatment covered by health insurance between health
facilities around the country has been set up, he said. Health data is a valuable asset,
especially for medical science, with its complex characteristics and increasing
volumes, and so there is need for a plan and strategy to manage and exploit it, he
added. Nguyen The Dung, vice chairman of the Viet Nam Health Economics
Association (VHEA), said globally digitization has created great transformation in the
healthcare industry, improving its quality and efficiency. “AI,

29
internet of things, big data, block chain, cloud computing, and other digital
technologies make hospitals smarter and smarter.” According to professor Vo
Van Toi, head of the School of Biomedical Engineering at the International
University under the Viet Nam National University HCM City, telemedicine is an
appropriate way to develop smart healthcare, especially for low- and middle-
income countries. His school has developed the internet of things for healthcare
including point-of-care devices that patients can use at home or anywhere else to
measure their vital signs, websites and apps to record and notify family members
and physicians to assist the latter in monitoring and immediately taking care of
the patient if necessary, servers to stores data, and software for connecting the
above devices and persons and analysing data, he said. A clinical trial of the
system was funded by the Binh Duong Province Department of Health and a
medical centre for public servants in the province. The 1st International Health
Informatics Conference Towards Smart Hospital was held by VHEA and the
School of Industrial Management affiliated to the University of Technology, and
provided an opportunity for hospital managers to discuss how to make their
hospitals smarter 2.2.2 Health ID issued to citizens
Each person will have a unique health ID. HA NOI — Each Vietnamese citizen
will be issued with a unique health ID card, which they will be able to use throughout
their lives, according to the Ministry of Health. The ID will be automatically generated
through the general identification system of the ministry and used to identify
individuals for healthcare services. Each ID will have a series of characters, of which
the first ten are unique to the holder. The numbers are based on basic personal
information including name, year of birth and place of birth. According to the
regulation issued by the health ministry on creating, using and managing health IDs,
each healthcare facility will have an account to access the national health
identification system. If the facilities are not connected with the system, healthcare
staff must access the website of the national health identification system and search
for the details of each patient. The ID cards will be able to create and connect health
reports for patients nationwide. Healthcare facilities are

30
responsible for managing the IDs and have to ensure the security of personal
information and the national system. The health identifications are managed
through the national health identification system located at the healthcare data
centre at the Information Technology Department under the health ministry.
The database of the national health identification system will be linked with the
database of households signing up for the social security scheme.
2.2.3 Digitalisation of healthcare feild, double-edged sword
Digitisation of the healthcare sector is important to better serve patients, but
hacking by cybercriminals is a grave risk, and great efforts are needed to keep patient
information secure. HCM CITY — The development of technologies such as 4G, 5G,
internet of things and artificial intelligence has rapidly changed the healthcare sector’s
landscape globally, including in Viet Nam, with more organisations adopting
digitisation, according to experts. The goal is to have multiple affiliated organisations
sharing patients’ digitised medical records to provide more holistic healthcare. Many
healthcare institutions are also using smart equipment to carry out conventional
tasks. For example, various devices measuring vital signs today are directly
connected to the hospital’s systems. Once measurements are taken, the data is
incorporated directly in the patient’s medical records without the need for manual
intervention. New technologies have enabled the healthcare industry to carry out
remote operations. For instance, earlier this year, a surgeon in China successfully
carried out an operation remotely. Digitisation across the healthcare industry has
helped service providers improve the quality of care and accelerate medical
breakthroughs for better patient outcomes and mitigate the rising cost of healthcare.
The Vietnamese Government is also supporting the digitalisation of healthcare,
launching projects to encourage and enable digital health solutions to be adopted
around the country. According to the Ministry of Health, all healthcare establishments
will complete digitisation of medical records by 2030. According to the Australian
Trade and Investment Commission (Austrade) Viet Nam, Viet Nam’s economic growth,
health-conscious population and fast-developing 4G and 5G infrastructure provide the
perfect environment for digital

31
health solutions. There is strong interest in telemedicine and advanced technologies
and systems that can improve decision making, improve operational efficiency and
enhance patient care and experience, it said. Yeo Siang Tiong, general manager of
Kaspersky Lab Southeast Asia, said most hospitals were in the first stage of digital
transformation, digitising simple data such as patient records, personal information,
past diagnosis, and medicine. But the digitization of the healthcare industry had led to
a massive increase in the number of targeted attacks against the sector, he said. “The
healthcare sector tracks a person’s medical history, personal information, sometimes
they also track who their parents are, and genetic conditions that pass down from
parents to child. “Some of this information is actually worth more than a bank card.” In
addition, "the sector is less protected than sectors such as banking and finance," he
said. In the healthcare industry, cyber security should not be taken slightly because
any issue could be a matter of “life and death,” he warned. “What would happen when
you need to treat a patient in an emergency room, but the information is suddenly not
available. It is a life and death situation. It is actually very dangerous.” At a recent
conference on cybersecurity in the healthcare sector, experts said the consequences
of a breach could be quite detrimental since healthcare records are highly personal
and sensitive in nature. If patients’ records were stolen, their private data could be
traded on the dark web to be exploited by cybercriminals for scams and frauds, and
worse still it could cause tremendous trauma to the patients, they said. Yeo said to
protect the healthcare industry from cybercrimes, it was very important to “raise
security awareness not just among IT workers but also users of the equipment,
doctors, nurses, and healthcare workers.” "A lot of hospitals do not have chief
security information officers," he said, suggesting that they should focus on
developing human resources to ensure cyber security, he said. The healthcare sector
is a critical one, and therefore hospitals, public and private, should start drafting
regulations to address the rising threats, according to Yeo.

32
2.2.4 Affairs on high-teach healthcare complex beginning in Hanoi
The first phase of a hi-tech healthcare complex, expected to cost more than 1
billion USD, kicked off in Hanoi’s outskirt Dong Anh district on October 14.
Hanoi (VNA) – The first phase of a hi-tech healthcare complex, expected to
cost more than 1 billion USD, kicked off in Hanoi’s outskirt Dong Anh district on
October 14. The 40ha complex, invested by TH Group, is divided into two stages
with the first slated for completion in the second quarter of 2022, providing 300
beds. The second stage is expected to be finished in 2025, raising the number of
beds to 1,000. The TH Medical complex will include five main areas that are an e-
prevention centre, an international hospital, a wellness and rehabilitation centre,
an international R&D centre and a geriatric centre and nursing home. Addressing
the groundbreaking ceremony, Chairman of the Hanoi People’s Committee
Nguyen Duc Chung highlighted the significance of the project in improving
healthcare services for local residents, pledging that the city will support the
implementation of the project. During the ceremony, the TH Group and TH Medical
signed a cooperation agreement with Keio University and Keio Hospital of Japan
on collaboration in the project’s management, operation and personnel exchange.
Statistics from the Ministry of Health revealed that healthcare spending accounts
for approximately 7 percent of the country’s annual GDP. People’s spending on
overseas medical treatment reached nearly 2 billion USD.
Doctor Anywhere partners with ViettelPay, part of Vietnam's largest
mobile network operator Viettel, to become the 1st telco and payment
gateway to provide online healthcare services
HANOI, Vietnam, Oct. 21, 2019 /PRNewswire/ -- Doctor Anywhere (DA) and
ViettelPay, part of Vietnam's largest mobile carrier Viettel, have signed a strategic
cooperation agreement to bring a full suite of online healthcare services to
ViettelPay's more than 6 million registered users throughout Vietnam. ViettelPay's
customers will be able to directly connect to Doctor Anywhere's virtual clinic and
consult a locally-registered doctor, as well as access a range of wellness services
directly on the ViettelPay App. Payment for doctor consultation, medication, and

33
other services can be made easily using the App. With this partnership with
Doctor Anywhere, ViettelPay’s users will soon be able to have direct access to
online video-consult with a locally registered doctor, and shop on the DA health
and wellness Marketplace - all payments processed through ViettelPay’s digital
payment gateway. This unprecedented agreement is set to expand ViettelPay's
reach and influence in the Vietnam market, as the first telco and payment gateway
in Vietnam to be integrated with online healthcare services. It is also a significant
boost to Vietnam's healthcare ecosystem, as this partnership is set to make
healthcare delivery even more seamless and convenient. With Viettel's extensive
network coverage throughout the country, this will mean that people who live in
remote and rural locations will be able to access high quality healthcare on their
phones, and make payment easily using ViettelPay's payment gateway.
Mr. Pham Trung Kien, General Director of ViettelPay expressed his optimism in
this partnership, "This cooperation between ViettelPay and Doctor Anywhere will
greatly improve the distribution of reliable healthcare in Vietnam. ViettelPay's users
can have direct access to a wide variety of healthcare services anytime, anywhere. All
they need is a smartphone connected to the internet." In a country of 96 million with a
smartphone penetration rate of 84%, anyone with a smartphone can easily download
the ViettelPay App and immediately access Doctor Anywhere's services. This will help
to ease the strain and improve efficiency of public healthcare in the country, and bring
about better quality of care for the Vietnamese population. This service is slated to go
live on ViettelPay App in early 2020. Mr. Lim Wai Mun, Founder and CEO of Doctor
Anywhere, stated: "We are excited to go forward with this partnership with ViettelPay
to bring digital healthcare services to more people in Vietnam. I am confident that with
this partnership, we can better achieve our vision of a more robust and sustainable
healthcare ecosystem in the country and region." About Doctor Anywhere Doctor
Anywhere is a regional tech-led healthcare company headquartered in Singapore. With
a strong network of established healthcare providers and experienced doctors, Doctor
Anywhere's digital platform enables users to manage their health easily and

34
effectively through the Doctor Anywhere mobile App. Users can consult a
doctor anytime, anywhere, and get medication delivered to them within 3
hours. On the in-App Marketplace, users can shop for a wide range of health
and wellness products and services such as nutritional supplements, beauty
treatments, physiotherapy sessions, and even book home-based healthcare
services - all in one place. In Vietnam, Doctor Anywhere operates a chain of
medical clinics and pharmacies in strategic locations to best meet the
healthcare needs of the people. About ViettelPay ViettelPay is part of a vast
digital ecosystem under Vietnam's largest mobile network operator Viettel,
that includes digital payment gateway, data services, insurance, and e-
commerce. It currently serves more than 6 million users throughout Vietnam.
2.3. Hospital digitalization
2.3.1. Medical examination treatment management
Digital Transformation in Healthcare Trends
Digital transformation in healthcare is the positive impact of technology in
healthcare. Telemedicine, artificial intelligence (AI)-enabled medical devices, and
blockchain electronic health records are just a few concrete examples of digital
transformation in healthcare. Innovation is the name of the game here, with the main
goal of streamlining physicians’ work, optimizing systems, improving patient
outcomes, reducing human error, and lowering costs through amazing web and
mobile experiences. Unfortunately, the healthcare and pharmaceutical industries have
lagged behind when it comes to implementing digital strategies. In fact, in a recent
survey, only seven percent of healthcare and pharmaceutical companies said they had
gone digital, compared to 15 percent of companies in other industries. Despite that,
the U.S. healthcare market is enormous; with the national health spending projected to
reach $5.7 trillion by 2026. There’s still time for you to get well-versed in digital
technology and use it to bring in more business. But in order to transform your
standard practice into a thriving, digital machine in 2020, you first need a
comprehensive picture of the modern healthcare landscape. Thanks to technology,
patients get better treatment with virtual reality tools, wearable medical

35
devices, telehealth, and 5G mobile technology. Doctors, on the other hand,
can streamline their workflows using artificial intelligence-powered systems.
Here’s a better look at the state of digital transformation in healthcare in 2020:
2.3.1.1. Increase of healthcare on demand
When you think of ‘on-demand,’ you think of consumers who want things at
their own convenience, on their own time, and wherever they happen to be. The
healthcare industry is entering the era of digital innovation, as patients seek on-
demand healthcare because of their busy schedules. Mobile is especially
important when considering content marketing. People have simply become far
more mobile in the past decade. Mobility is the name of the game, and recent
statistics show that more than 50% of all web browsing in the world occurs on
mobile devices as of 2018 (to be exact, 52%). One of the first rules of content
marketing is that you must identify where your targeted consumers gather and
reach them on those platforms, i.e. mobile. That’s not surprising given that 77
percent of U.S. residents own a smartphone. On top of that, the number of mobile
phone users in the world is expected to pass the five billion mark by 2019. Factor
in that more than four billion people globally are on the Internet and you can start
to see the possibilities that digital transformation in healthcare offer.
According to DMN3, consumers are going online to obtain medical
information for the following reasons:
• 47% research doctors
• 38% research hospital and medical facilities
• 77% book medical appointments
But on-demand healthcare is also driven by the growth of the ‘gig’ economy, in
which freelance professionals in various industries hire themselves out per job or
‘gig,’ instead of tethering themselves to one company. Companies such as Nomad
Health – an online marketplace that links doctors directly with medical facilities for
short-term work – are making it easier for physicians to provide on-demand healthcare
to clients in specific circumstances that match their talents, expertise, and schedule.
In other words, doctors themselves become on-demand healthcare

36
providers to better meet the changing needs of their patients, another
benefit of digital transformation in the healthcare industry.
2.3.1.2 Mobile application technology is personalized
A dull and monotonous waiting hall, the long queues, desperation to get
inside the doctor’s chamber, gloomy faces of ailing patients; this is the picture
one would imagine maybe a decade ago while paying a visit to a hospital.
Now with the help of mobile apps, doctors or healthcare professionals are able
to speedily cater to medical emergencies and offer enhanced patient services. This
way mobile apps have successfully brought in a digital revolution in the healthcare
industry. They are rapidly becoming an integral part of doctor’s practices. Like,
starting from medical prescriptions and viewing blood reports and x-ray to track and
monitor symptoms and patient recovery, these e-prescription apps allow doctors to
diagnose patients, treat & monitor them for many common diseases while being on
the move. Consumers have become accustomed to accessing their data through the
use of various digital tools, where the use of mobile and tablet health apps has tripled
from 13% in 2014 to 48% today. Catering to this growing market, British based start-up
Babylon Health is making waves on a global scale. Partnering with the National Health
Service (NHS) and private health provider, Bupa, it has also cemented its presence
across the flourishing Chinese market, with a membership base exceeding 1.4mn
citizens across Europe, Asia and Africa. By partnering with global juggernaut Tencent,
Babylon’s artificial intelligence system has enabled both parties to interact directly
with users, identify specific illnesses, deliver health status assessments, and triage
necessary actions. The mobile app is available to over a billion users and linked to
more than 38,000 medical facilities in China alone.
2.3.1.2.1 Searching by voice
Voice is a huge healthcare marketing technique that’s been on the rise since
smartphone and smart speaker were first released (with Amazon’s Echo first hitting
the market back in 2014.) And, more importantly, it can be an effective tool in the
industry. Voice search has become incredibly popular around the world and with 1 in 6
Americans now owning a smart speaker and 40% of adults using voice search

37
once a day. So how does voice search apply to the industry? Healthcare
access is predominantly local. In other words, most Americans look for
healthcare options within the proximity of their place of employment or their
residence. Since 20% of Google searches are voice searches in 2018, voice
has become one of the main health technologies healthcare marketers must
invest in come 2019. If 1 in 5 are using voice to find out about healthcare
options, it’s imperative that you’re not missing out on the potential customers.
Bottomline: optimize your marketing campaigns & landing pages for voice.
With the rise in popularity of smart speakers and native voice search as a
whole (Siri, Google Now, Cortana etc), voice presents some of the most
amazing opportunities for healthcare executives in 2019 and beyond.
2.3.1.2.2 Development of wearable medical devices
Another trend of the digital transformation in healthcare is companies
collecting their own health data from medical devices, including wearable
technology. In the past, most patients were satisfied with undergoing a
physical once a year, and only checking in with their doctors when something
went wrong. But in the digital age, patients’ are focusing on prevention and
maintenance, and demanding information about their health more frequently.
As a result, healthcare companies are being proactive by investing in wearable
technology devices that can provide up-to-date monitoring of high-risk
patients to determine the likelihood of a major health event.
Some of the most common of these devices include:
• Heart rate sensors
• Exercise trackers
• Sweat meters – used for diabetics
2.2.1.3 Artificial Intelligence
2.2.1.3.1 AI and forecast analytics
In 2018, a major breakthrough study showed that AI could detect skin cancer better
than doctors. This study, published in Annals of Oncology, acknowledged that the
testing was not being done on actual patients, but instead dermoscopic images

38
which could skew the physicians’ work. However, the study is just the tipping point of
how AI can help detect, and prevent, life threatening diseases. AI engines can reduce
and mitigate risk of preventable medical scenarios in three critical ways:
• Automate reminders – Great for helping patients take medication
within a specific timeframe.
• Identify people at high risk – Discovering those in need of medical
intervention and trigger medical staff alerts to create custom care plans.
IBM Watson currently testing this with opioid addiction issues.
• Deliver personalized dosage recommendations – Based on each
patient’s unique body chemistry and associated environmental factors.
The European Union is set to invest $24 into artificial intelligence (AI) by
2020 in a bid to catch up with Asia and the US, who have invested heavily in AI and
cloud services. This year, Google revealed its plans to harness AI and machine
learning across a multitude of consumer technologies, particularly in healthcare. “If AI
can shape healthcare, it has to work through the regulations of healthcare. In fact, I
see that as one of the biggest areas where the benefits will play out for the next 10-20
years,” Google CEO Sundar Pichai has previously stated. The bottomline is simple:
keep AI on the radar and utilize the concept as one of the main health technologies for
you in 2019. There’s no signs of slowing down.
2.3.1.3.2 Wonders of Artificial Iintelligence
Artificial intelligence (AI) is more than just a digital transformation trend in
healthcare. AI represents the epitome of medical innovation and industry players are
eager to invest millions in it. For most patients, AI in medicine brings to mind
Japanese nurse robots. But now, there are plenty of American versions too, like Moxi,
a friendly hospital droid designed to assist human nurses with routine tasks such as
fetching and restocking supplies. Chatbots and virtual health assistants are another
AI-based technology that patients are becoming familiar with. Chatbots can fill a
multitude of roles from customer service representatives to diagnostic tools and even
therapists. Their versatility is being translated in heavy investments. But the real
power of AI can be best observed in areas like precision medicine, medical

39
imaging, drug discovery, and genomics. For instance, cancer patients used to
receive cookie-cutter treatments with high failure rates. Now, thanks to AI’s
sophisticated pattern recognition, these patients have access to personalized
therapies tailored to their genetic makeup and lifestyle. What AI-powered
computer programs do for oncology, in a nutshell, is analyze thousands of
pathology images of various cancers to provide highly accurate diagnoses and
predict the best possible anti-cancer drug combinations. And, in medical imaging
diagnostics, this technology helps radiologists spot details that escape the human
eye. What’s more, top pharmaceutical and biotechnology companies are using
machine learning algorithms to shorten the drug development cycle. In fact,
recent findings show that AI can slash early drug discovery timelines by four
years against the industry average, and generate cost savings of 60 percent.
2.3.1.4 Blockchain
Blockchain in healthcare isn’t just useful for the hype it’s ramped up with bitcoin
and other cryptocurrencies. Instead, what’s exciting about blockchain is the digital
record-keeping that creates the ledger of transactions that isn’t only transparent, but
impossible to tamper with. As healthcare organizations further embrace digital, and
specifically blockchain, there are many areas of opportunity, including claims
processing from a payer perspective and improving the exchange of patient
information and data from a provider view. Blockchain is a definite way of the future
when it comes to increasing productivity and operative ability across healthcare
organizations. Blockchain is here to stay with a variety of experts, some of whom are
skeptical of bitcoin, claiming that the technology could fundamentally change the way
that huge sectors operate – including digital healthcare marketing.
2.3.1.4.1 Blockchain and promise of better electronic health record.
Blockchain has recently developed a bad reputation due to the burst of
thecrypto currency bubble. Now, the average person thinks of blockchain
as of this vague, puzzling concept that doesn't have much of an impact on
their life. In reality, this technology will soon play an instrumental role in
keeping their electronic health records accurate and safe.

40
Blockchain is a digital ledger or a computerized database of transactions.
Shared across a network of computers, it allows customers to safely exchange
financial information with suppliers, without the need of a third party such as a bank.
In healthcare, blockchain is proven to be an effective tool in preventing data breaches,
improving the accuracy of medical records, and cutting costs. For years, health
officials and experts have been trying to come up with doable solutions to the problem
of fragmented medical records. An electronic health record (EHR) is basically the
digital version of a medical chart and includes everything from a patient’s medical
history and diagnoses, to treatment plans, immunization dates, and test results. It also
contains their home address, previous workplaces, as well as financial information
like credit card numbers. Yet, for as valuable as they are, hospitals are falling short in
managing their EHRs. Medical data is currently being recorded in unstructured
formats and stretched across multiple EHR systems. Already short-staffed doctors
and nurses struggle to manually log in every piece of information. This leads to huge
errors such as duplicate medical records, misdiagnoses, delayed treatments, and even
deaths. Some countries like Australia and UK have started to experiment with
blockchain technology to manage medical records and transactions among patients,
healthcare providers, and insurance companies. Thanks to a decentralised network of
computers that handle the blockchain and simultaneously register every transaction,
conflicting information is automatically detected. Records are not only 100% accurate,
but also harder to hack. In the U.S., regulations make it harder for companies to create
blockchain-based EHRs. Some startups like Medicalchain, however, are making big
strides towards a future where patients will control their EHRs from an app, where
doctors, pharmacists, or health insurers will be requesting permission to access their
data and where all transactions will be recorded on the distributed ledger.
2.3.1.4.2 Blockchain in Healthcare
Remember the time you visited a different in-network doctor to your regular
doctor, and they didn’t know your entire history, despite your being with the same
health system for decades? This is a major challenge for doctors, resulting in

41
regulatory non-compliance, poor referral management to specialists, longer in-patient
stays when hospitalized, and preventable hospital readmissions – all because the care
team did not have access to your entire medical history (items such as allergies to
specific medications, for instance). Add to this the fact that patients would also like to
have access to their treatment recommendations, in case they forget all of the
instructions (which almost always happens). Almost 50% of all patients fail to
understand treatment plans and do not adhere to care management guidelines, which
are complex to interpret and not easily accessible. Contrast this with the fact that
almost 70% of next-generation healthcare consumers prefer to have access on-the-go
to the latest clinical information. This has required payers, providers and pharma to
team up and offer personalized medical insight via omni-channel media platforms
including EHRs and patient portals. Yet this has not been enough to work across all
health systems for the entire patient population in a given region. The Solution:
Improving Access to Medical Records The Centers for Medicare and Medicaid
Services (CMS) have decided to replace the existing EHR incentive program with the
'Promoting Interoperability' program. This incentivizes meaningful effort from
hospitals to enable clinical and financial data interoperability for their patient
population. CMS also has launched specific provisions to sponsor Chronic Condition
Management (Non Face to Face). This mandates seamless data accessibility between
native and third-party health IT workflows, powered by advanced technologies such as
AI and blockchain. This essentially means that active incentives and policies are
pushing hospitals to develop solutions that allow for patient records to be accessible
across different hospitals, and not just within a single hospital or health system.
2.3.1.4.3 Blockchain integration
Inter Systems, a healthcare information systems vendor, recently enabled
Northwell Health to integrate its entire provider network comprising 23 hospitals, 655
outpatient facilities, and 18,500 affiliated physicians. Following this integration,
Northwell was able to create a unified patient registry, offering a billion data points,
and can practice centralized risk assessment, patient engagement and

IR 4.0: OPPORTUNITIES FOR HEALTHCARE SECTOR IN VIET NAM

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