Eliminating Health Inequality in Taiwan

Mythili Mamidanna

The glaring rural-urban medical gap seems to get more accentuated across the world and Taiwan is no exception.

Taiwan’s National Health Insurance (NHI) system is one of the best in the world. It provides universal social insurance coverage for all citizens, giving everyone equal and affordable medical services. Yet, the services are still not accessible for more than 5 million people who live in rural areas, especially on country’s eastern coast.

iHealth Express links technology and professionals to eliminate health inequity in ageing populations, disabled groups, and remote communities. Their solution begins with transporting medication to client’s houses directly by pharmacists. After receiving a patient’s chronic prescription, pharmacists dispense, check and deliver the medicine.

Through the delivery, face-to-face counseling, medication reminders and health related education are also provided by professional pharmacists. In addition, they provide comprehensive care through a 24-hour toll-free number where their health professionals immediately answer questions about health, diseases, or side effects of drugs.

iHealth Express’ innovative solution of a mobile medical service system to achieve health equity in Taiwan bagged them a coveted top spot in DBS-NUS Social Venture Challenge Asia 2015.

A conversation with Johnny Wang, founder of iHealth helped us understand the motivations and the vision for this enterprise.

Tell us a about your journey on iHealth Express and what triggered the start of this social enterprise?

There are three main reasons that triggered me to start iHealth Express. I was keen on creating a neutral, trustworthy, and professional medical consulting platform. Founding the best working environment to health professionals was also important for this to happen. Most importantly, coordinating with government on health promotion, patient education and community health development was vital to bridge the health inequality existing in the country.  Let me explain more about this.

I had been running a community pharmacy for 8 years. A community pharmacy can only serve people who live with a 1 km radius in cities. The market is very competitive so pharmacists have to push sell supplements and other products to survive.  At this point, customers are confused with pharmacist’s role, if he/she is a professional or a businessman. As a pharmacist, it’s was really sad to see people suspect my suggestion even though they did not have a better solution to solving the health problem on hand.  I wanted to rebuild the trust and bridge the patient-provider health information gap.  In iHealth business model, we not only refill and deliver the medicine to the patients for free, but also provide health consultation and education.  We do not sell any products to patients.  The reimbursement for the medicine is claimed from the National Health Insurance. Hence a neutral, trustworthy and professional medical consulting platform got created.

Health professionals are not protected under labor law in Taiwan.  Work overloaded and overtime is very common for health professionals here.  I used to work long hours - more than 300 hours a month on an average.  Since my first daughter was born, balance between work and family became very important to me, especially family time during weekends.  Unfortunately for most of pharmacists, they need to take turns to work on night shift and weekends.  In iHealth, the working hour is from 9 am to 5 pm, Monday to Friday.  We also have longer annual vacations than others but we serve so many deserving patients in our working hours turning in very meaningful work. Hence iHealth helped in creating a very conducive working environment for health professionals.

I have been involved in international affairs and public affairs since 2002 and had the opportunities to learn from other countries and see how they face aging population trend.  The aging population in Taiwan is currently at 12% and will increase to 20% & 30% in 2025 and 2035 respectively. Healthcare and long term care issues are two of the most important policies for Taiwanese government.  Private sector also plays a very important role in public health.  I wanted to provide a trustworthy platform and also build strong relationships with people. iHealth will be more capable to coordinate with the Government on health promotion, patient counseling and community health development programmes.

Where do you and the professionals at iHealth draw inspiration from?

To see the satisfying smiles from the customers is the most fulfilling moment.  It is really interesting to undertake home-visitations because we can explore different ways to help patients and bring in the value of being a pharmacist. On the other hand, customers don’t know what we can do for them. Through conversation and observation, we try to understand their health condition and medication history.  This is very helpful for patient counselling. It is really inspiring to us when they understand that we pharmacists can do a lot more than they expected.

Did you ever feel like giving up? What challenges did you face?

Yes, to be honest, it happens all the time. In different stages, new challenges never stop coming, including organisation reform, financial issue, HR issues. Fortunately, the give up feeling goes away in one second from my mind. In these years, I realised that all the problems and challenges are not from external sources or from other people. I tell myself that I am the one who created the problems and challenges and only I can solve and conquer them, nobody else! I am a very optimistic person.  Challenges are very important nutrient for me to grow stronger and tougher.  I have learnt many new lessons, experienced new things, met new friends, and came up with new ideas, explored possibilities and came up with new thoughts.  I always like to pick the hard way to do the right thing instead of easy way to make something right.  I believe that if by doing the right thing I may fail, I rather fail as early as possible.

Did winning the DBS-NUS SVC Asia help you apart from the prize money?  

Yes, it certainly did. The win created more alliance opportunities with private sectors and helped co-work with public sectors.  This competition is the largest social venture challenge in the world.  There were more than 683 teams from 30 countries, including 50 teams from Taiwan.  We are recognized as the top social enterprise after winning this prize.  People have paid more attention to iHealth after we won the prize, especially Taiwanese Government and the companies who seriously care about CSR.  The social enterprise concept is very new in Taiwan and this prize is very encouraging to all other social ventures in Taiwan.  Taiwanese are very innovative and philanthropic and social entrepreneurship perfectly matches our values and thinking.  Our Government declared 2014 as the first year of social enterprise and aggregated lots of resources to help social ventures in these two years.  iHealth proves Taiwanese social enterprise can soon catch up with best international standards.

What next for iHealth?

For the next few years, iHealth is planning to expand the service to more rural areas and alliance with other strategic partners to reach more end users. The long term care insurance is scheduled for launch in 2018 by Taiwanese Government. We will closely observe the market needs to seek opportunities for providing new medical and long term care services. Moreover, we will also look for opportunities overseas. We believe decentralized mobile medical service model can be duplicated to other countries which we hope to start in 2017. We are more than happy to share our concept and experience with other countries.

Interested to find out more about iHealth? Please visit their website or write to Johnny on johnny@ihealth.com.tw


 If you want to find more about socially conscious living in Asia, check out Asia For Good's social enterprise directory.


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