Dental essentials to TCM: This S’pore startup builds vending machines that dispense medicine

SmartRx is a groundbreaking healthcare solution that aims to bring greater convenience and efficiency to patients by reducing the need for travel and waiting time during medical consultations.

Established in 2019, the company is co-founded by Tong Ping Heng and Bennet Lee, who recognised the potential of digital technology to transform the healthcare industry.

Ping Heng, the managing director and co-founder of SmartRx, brings over 30 years of experience in the life science and medical technology industry across Asia. His extensive background includes starting up renowned multinational companies such as Bio-Rad Laboratories, Gambro Inc, and The Laryngeal Mask Company, building up legal entities and the team.

Ping Heng’s entrepreneurial journey began in 2010 when he started Aeras Medical, focusing on diabetes monitoring and using technology to simplify data recording for patients and their healthcare teams.

Meanwhile, Bennet, the CTO of SmartRx, has a diverse professional background. After graduating from the National University of Singapore (NUS)’s Computer Science, he worked as a software engineer and consultant before transitioning to roles in pre-sales consulting, system analysis, solution architecture, project management, and associate director positions.

The co-founders first became acquainted during a remote vital-signs monitoring project. Bennet, working as a Project Lead, collaborated with Ping Heng, who was the vendor for the project.

During their conversations, Ping Heng shared his vision for a digital solution that would enhance convenience for patients by reducing travel and waiting time for consultations and medication collection. Inspired by Ping Heng’s vision, Bennet decided to partner with him and embark on a new venture together.

Making access to healthcare more convenient

The primary goal of SmartRx is to bring quality healthcare closer to the community by reducing the need for patients to travel to healthcare facilities.

This comes from personal experiences of having to support elderly parents with multiple chronic illnesses, that require multiple trips for consultations for different disease specialities, laboratory tests, diagnostic imaging requirements, and then waiting for medicine in the always-crowded pharmacies, whether in hospitals or GP clinics.

– Tong Ping Heng, co-founder of SmartRx

He explained that the idea of SmartRx is to build upon the vital signs solutions that Aeras Medical established, and integrate it with telemedicine with real-time doctor’s consultations.

Patients can then conveniently collect their prescribed medication through SmartRx’s automated pharmacy machines (APMs) without stepping into a hospital or clinic.

The company’s modular system also allows customers to select and customise the functionalities they require, be it retailing medicine, teleconsultation, or both.

What sets SmartRx apart from its competitors is its ownership and development of intellectual property (IP) and technology for both hardware and software.

“Currently, no other company has the technology and experience to provide telemedicine and automated drug dispensing solutions within the same machine,” said Ping Heng. This integrated approach resolves challenges faced by healthcare providers who offer pharmacy and general physician clinical services.

COVID-19 accelerated adoption of digital healthcare

During the initial stages, SmartRx considered utilising existing vending machines available in Japan and China for its pharmaceutical needs. However, after experiencing limitations in meeting stringent pharmaceutical requirements, the founders decided to build a customised solution from scratch.

Collaborating with a Chinese company, SmartRx developed a machine that met the safety and flexibility standards necessary for handling pharmacy-only medication (P-Med) and prescription-only medication (POM).

This decision laid the foundation for SmartRx’s unique offering in the market, but the COVID-19 pandemic soon hit Singapore shores.

The onset of the pandemic presented both opportunities and obstacles for SmartRx. As healthcare facilities discouraged physical visits, teleconsultations and home drug delivery became the new norm.

Regulatory bodies quickly adapted to support digital health solutions through the creation of sandboxes and guidelines. These developments allowed healthcare providers to embrace innovative approaches to healthcare delivery, aligning with SmartRx’s vision.

Unfortunately, travel restrictions and economic downturns posed challenges in manufacturing the APMs.

The [original] factory could not produce the prototype in time, and the quality was sub-standard. As the first prototype was not meeting the specifications required, we needed to rebuild one more prototype.

Compounding the issues, the original factory went bust and we had to move to a few other companies to build our first three prototypes. What a nightmare for a startup!

– Bennet Lee, co-founder of SmartRx

To add fuel to the fire, supply chain disruptions caused by the inflation and geopolitical tensions impacted production timelines and costs. Despite these setbacks, SmartRx remained resilient and sought solutions by localising production to mitigate risks and improve time-to-market.

The regulatory environment in Singapore posed hurdles for SmartRx, with distinct requirements under the Drug Act governed by the Health Science Authority (HSA) and the Private Hospital and Medical Clinics Act (PHMC) by the Ministry of Health (MOH).

Existing guidelines supported the sale of General Sales List (GSL) or Over-The-Counter (OTC) items via vending machines, but no provisions existed for the sale and dispensing of P-med and POM.

“Similarly, there were no PHMC guidelines for GP clinics to operate drug dispensing outside of their premises. This meant that we needed to work with the various pharmacies, along with HSA and MOH, to create new guidelines that allow our APM and technology to operate,” said Bennet.

These efforts culminated in the recent issuance of guidelines by HSA in April 2023, marking a significant milestone in transforming healthcare delivery.

However, financial constraints remained a constant challenge. Although they received a funding grant from Enterprise Singapore, the grant disbursement and tender revenue were contingent upon meeting milestones, which were impacted by the pandemic.

With no external funding from investors, SmartRx’s progress was funded by Ping Heng’s other company, Aeras Medical.

Preventing misuse and abuse of drug dispensing

The latest collaboration between SmartRx and Essentials Pharmacy was born out of the shared vision to revolutionise healthcare delivery in the community.

Through the recommendation of Pauline Ong, the founder of Guardian, Ping Heng reached out to Simone of Essentials Pharmacy, who embraced the concept of APMs and the opportunity to bring transformative change to the industry.

This partnership allowed SmartRx to deploy APMs at HDB void decks, bringing easy access to a wide variety of medicines — such as for cough, flu, sore throat, diarrhoea, and even supplements for sleep disorder — for the local residents.

According to Ping Heng, the specific medicines available in the vending machines are determined by clinical partners, such as Essentials Pharmacy.

To ensure that the selection meets the needs and demands of the residents, SmartRx regularly updates the offerings based on residents’ feedback, changing healthcare situations, and emerging health concerns like the waves of the COVID-19 pandemic.

The teleconsultation feature integrated into SmartRx’s vending machine serves a vital purpose in meeting regulatory requirements for the dispensing of P-Med and POM via APMs.

It also enables real-time interaction between users and pharmacists or doctors. Teleconsultation helps ensure responsible dispensing and allows healthcare professionals to provide appropriate guidance and prescriptions to patients.

SmartRx understands the importance of safety when it comes to dispensing medicines through vending machines. While the control for GSL and OTC medicines is similar to current market practices, SmartRx has implemented additional measures to prevent misuse or abuse of dispensed medicines.

For P-Med and POM, where a pharmacist or doctor consultation is necessary before dispensing, the risk of abuse or misuse is inherently limited. SmartRx’s technology assists healthcare professionals by providing the patient’s purchase history, enabling them to exercise caution during teleconsultations.

The APM system also includes inventory management with traceability capabilities to track the movement of medication packs dispensed.

To prevent minors from accessing medicines through the vending machines, age restrictions and verification processes are also in place for P-Med and POM, in accordance with HSA policies.

However, for GSL/OTC medicines, the purchasing process through the vending machines is similar to what is available in the market. SmartRx follows existing regulations and does not impose additional restrictions on the quantity of OTC medicines a user can purchase.

Ultimately, responsible usage and adherence to recommended dosage guidelines remain the responsibility of the user.

From dental supplies to TCM

SmartRx has expanded its product range beyond traditional pharmacy offerings, recognising the need for specialised vending machines in various healthcare domains.

The dental APM, for example, emerged from a need for dental supplies. Unable to find interested suppliers, SmartRx decided to operate the retailing services themselves.

They collaborated with healthcare institutions like the National Dental Centre and purchased dental supplies such as interdental brushes, special toothbrushes and toothpaste, dental floss, and mouth gargle for both adults and children.

Meanwhile, the Traditional Chinese Medicine (TCM) APM was a breakthrough for SmartRx, targeting a market often perceived as traditional due to its association with elderly patients.

Through a partnership with Chung Hwa Medical Institution, SmartRx successfully transformed the digital landscape of TCM in the heartland. The TCM APM offers a unique range of medicines, including herbs in large plastic bags, flat plasters, and tools used in TCM treatments like guasha. To cater to the elderly Chinese population, the APM also incorporates a multilingual user experience/user interface (UX/UI).

Another significant achievement for SmartRx is the partnership with Minmed Group, where a telemedicine clinic comprising an APM and a pod was established at the Singapore University of Technology and Design (SUTD), serving their community of staff, students, and nearby residents.

Patients can register through the Minmed app, visit the telemedicine clinic for consultation, and utilise vital signs devices like thermometers, blood pressure monitors, and pulse oximeters during the consultation. Following the consultation, patients can collect their prescribed medicine from the APM immediately.

All the partnerships we had thus far are invaluable to us as a startup in this very new drug delivery system directly to the consumer/patient. The experience and exposure certainly helped the people to understand what we are trying to do where no one has threaded before.

… We have APMs in a foreign worker dormitory with a GP group, hospital and polyclinic retailing, dental centre, TCM, military triaging booth and local housing estate retailing. All these use cases laid the foundation for us and the experiences are invaluable and applicable in any country, whether large or small.

– Bennet Lee, co-founder of SmartRx

Currently, SmartRx has deployed five APMs in various configurations across Singapore. However, the company plans to ramp up this figure significantly by rolling out an additional 20 to 50 units islandwide by the end of 2023.

SmartRx is also exploring opportunities to expand its solution overseas by working with countries in the region to assess the suitability of their local environments.

In fact, feasibility studies are already underway to bring SmartRx’s technology platform to regional countries.

“Based on our business plan including regional countries, our path to breakeven and profitability is about 12 to 24 months from now, depending on the business models for the expansion into the region,” said Bennet.

He added that SmartRx has experienced steady sales revenue growth over the past three years. Their revenue streams include direct retailing, APM leasing, and project-based initiatives.

Furthermore, SmartRx recently received a large order from a customer, highlighting their leadership role in providing hyper-local and convenient access to medicine through 24/7 services.

Additionally, SmartRx’s patent application was recently granted, solidifying their innovative solutions and establishing them as leaders in this pioneering industry. The company further expressed its commitment to expand their portfolio of patents to safeguard their innovations and maintain their leadership position.

Looking ahead, SmartRx has ambitious plans for the future. They are currently in the process of applying for the CE marking, a conformity mark for products sold in the European Economic Area, to prepare for their expansion plans and ensure product quality.

SmartRx is also investing in developing their AI capabilities to support various processes in medicine inventory management.

Besides that, they are exploring the implementation of blockchain technology to ensure the integrity and authenticity of the medicine supply chain, particularly in regions where counterfeit medicines are prevalent.

As part of their growth strategy, SmartRx is also actively seeking strategic investors who can help accelerate their business plan and overall growth trajectory.

Featured Image Credit: SmartRX