ASEAN: Regional Trends in Economic Integration, Export ... - USITC

Trade Facilitation, Logistics Services, and E-Commerce
Trade Facilitation and Logistics Services
Review of current literature and interviews with industry representatives in the ASEAN
region indicate that healthcare services firms have encountered few or no trade
facilitation or logistics issues, and improvements in these two areas are unlikely to
substantially increase the competitiveness of healthcare services exports. 85 Trade
facilitation and logistics services are more frequently associated with trade in healthcare
goods, rather than provision of healthcare services.
E-commerce
Rising Internet usage in the region has expanded use of e-commerce in the healthcare
services industry, which in turn has bolstered the competitiveness of healthcare services
exports in the ASEAN region by increasing contact with patients and developing a more
skilled workforce. 86 Many healthcare facilities have used the Internet to develop
connections with patients before performing procedures or treatments, by answering
questions and making advance arrangements. 87 Additionally, in countries where the
governments are promoting healthcare exports, governments have established central
Internet portals, generally linked to the country’s tourism Web site, intended to attract
future patients and direct them to participating private facilities. An online presence is
vital for both private facilities and governments promoting a national healthcare services
industry. 88
Increased Internet access has also increased regional competitiveness by developing a
more skilled healthcare workforce. Many healthcare facilities in ASEAN have
encountered workforce shortages, as well as variation in levels of training and education.
The availability of tele-education, 89 or training provided remotely over the Internet, has
helped to improve healthcare workers’ skills, allowing them to offer higher-quality,
competitively priced healthcare services. 90 For example, in Thailand, nursing schools and
public health colleges use teleconference and tele-education technologies to connect
students with real-time lectures, conferences, and other events. 91 Tele-education has also
offered healthcare groups in the region another avenue to expand their business and use
their industry knowledge to generate revenues beyond their borders. 92 For example, a
85 Industry representative, interview by USITC staff, Singapore, industry representatives, interview by
USITC staff, Bangkok, Thailand, March 17 and 18, 2010.
86 In 2003, the number of Internet subscribers/users per 1,000 people in ASEAN was 58.7; in 2007, it was
114.9. Telemedicine is another application of e-commerce seen with increasing frequency in the global
healthcare market. However, literature reviews and interviews with regional officials indicated that currently,
telemedicine in ASEAN is predominantly used by public providers to outsource services such as radiology
and to increase domestic access (Malaysia’s Telehealth initiative is an example). As such, telemedicine
applications do not contribute to trade volumes and do not increase the export competitiveness of healthcare
services. ASEAN Secretariat, ASEAN Statistical Yearbook 2008.
87 Industry representative, interview by USITC staff, Singapore, March 9, 2010.
88 UN, ESCAP, “e-Health in Asia and the Pacific,” 2009, 14.
89 Tele-education is defined as “the use of information and communication technologies to provide
Distance Education.” International Telecommunications Union and Inter-Americana Telecommunication
Commission Organization of American States, Tele-Education in the Americas, December 2001, 9.
90 Industry representative, interview by USITC staff, Singapore, March 8, 2010.
91 UN, ESCAP, “e-Health in Asia and the Pacific,” 2009, 10.
92 Industry representative, interview by USITC staff, Singapore, March 8, 2010.
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