Key takeaways
- Hidden operational waste: Vietnam’s healthcare system spends nearly 2,000 billion VND (~$80 million USD ) per year on medical imaging film. A compliance-ready PACS system can reduce imaging operating costs by around 50%, with breakeven typically reached by the second year.
- The “double cost” trap: Many hospitals invest in digital systems but still maintain paper records to satisfy insurance and regulatory requirements – resulting in duplicated material costs and administrative labor.
- A smarter investment strategy: A modular architecture approach – securing revenue first (HIS), eliminating structural costs next (PACS/LIS), and enhancing patient experience later – helps hospitals modernize without overextending capital.
- Performance-proven results: Real-world implementations show that fully connected, performance-led systems can deliver up to a 70% improvement in operational efficiency and a 90% reduction in medical incidents.
Caught in the middle: Why mid-sized hospitals struggle to transform
Vietnam’s healthcare sector is entering a period of accelerated change. Government regulations are pushing hospitals toward full digitalization, while foreign-invested hospitals with modern infrastructure are rapidly entering the market and raising expectations for efficiency and patient experience.
Caught between these two forces are mid-sized and Tier-2 private hospitals, typically operating between 300 and 700 beds. These institutions face a structural challenge that neither large healthcare conglomerates nor small clinics encounter.
They are too large to operate efficiently with basic clinic software, yet too constrained to invest in enterprise platforms designed for healthcare giants. Systems such as SAP or Oracle are often financially and operationally out of reach, while low-cost solutions lack the depth required to manage complex workflows, high patient volumes, and advanced medical equipment.
As a result, many hospitals invest in digital systems but remain digitized without being truly transformed.
When policy meets reality: The compliance gap
From a regulatory standpoint, the direction is clear. Circular No. 46/2018/TT-BYT sets the long-term objective for hospitals to eliminate paper medical records and move toward digital workflows.
In practice, progress has been slow. By the end of 2024, only around 100 out of 1,500 hospitals nationwide had officially announced paperless operations, according to the Ministry of Health. This gap highlights a critical reality: technology adoption does not equal operational readiness.
For hospital leadership, compliance is not merely legal. It directly affects insurance reimbursement, revenue stability, and audit risk. When digital systems are not fully aligned with regulatory and insurance requirements, hospitals are forced to maintain paper-based processes alongside digital ones, compounding inefficiency.
Rising competitive pressure from foreign investment
At the same time, competitive pressure is intensifying. In the first nine months of the year, Vietnam attracted nearly USD 25 billion in FDI, with investors from Singapore and Japan building modern, digitally enabled hospitals.
These facilities set new benchmarks for speed and experience. For local private hospitals, the implication is immediate: without modernization, patients will migrate to faster, more advanced providers.
The problem: Stuck in the middle
This combination of regulatory pressure, rising competition, and limited investment flexibility creates the “Middle Trap.”
Hospitals invest in digital systems to keep pace, but because those systems are not fully integrated or compliance-ready, paper workflows remain. Instead of simplifying operations, complexity increases. Instead of reducing costs, expenses multiply.
This is the context in which the “Double Cost” trap emerges and why technology decisions for mid-sized hospitals require far greater strategic discipline.
Financial paradox: Where is capital leaking?
For financial directors, the most damaging costs are not always visible ones. In many hospitals, the real issue lies in hidden operational waste embedded in daily workflows.
In Vietnam’s healthcare sector, this capital leakage is driven primarily by material consumables and duplicated processes.
Material waste: The 2 trillion VND burden
Hospitals across Vietnam spend an estimated 2,000 billion VND per year – approximately USD 80 million – on medical imaging film for X-rays, CT scans, and MRIs. To put this into perspective, major institutions such as Bach Mai Hospital report annual costs of nearly 70 billion VND for printing films and clinical paperwork alone.
From a financial perspective, this is capital that is permanently consumed, repeating year after year with no long-term return.
When digital investment fails to deliver savings
Picture Archiving and Communication Systems (PACS) offer a clear alternative by eliminating physical films. While the initial investment is significant, operational data shows that ongoing PACS costs are typically around 50% of annual film expenses, with breakeven commonly reached by Year 2.
However, many mid-sized hospitals hesitate to fully transition due to the “Double Cost” mechanism.
In certain localities, misalignment in Health Insurance (BHYT) reimbursement policies for digital versus physical records forces hospitals to maintain both systems simultaneously:
- Digital costs: servers, software licenses, maintenance, and electricity
- Analog costs: printing films, paper records, and physical storage
The burden extends to labor. A single medical record can include 50-60 pages of A4 paper, requiring staff to enter data twice – once digitally and once manually. This results in double the labor hours for the same administrative output, directly compressing operational margins.
This is how digital investment, when not aligned with compliance and workflow realities, turns into a financial paradox rather than a cost-saving solution.
The technology strategy: Why “off-the-shelf” fails at scale
To avoid high upfront investment, many mid-sized hospitals (300+ beds) default to off-the-shelf SaaS platforms. On paper, these solutions appear fast and cost-effective. In practice, they often fail to support the operational depth and regulatory sensitivity of a growing hospital.
At this scale, the “Buy” strategy introduces two structural liabilities.
Integration risk: When systems stop talking
A hospital is not a simple workplace. It is a connected clinical ecosystem. Daily operations depend on seamless data exchange across dozens of systems, including LIS, PACS, HIS, medical devices, kiosks, and even service robots.
Most packaged SaaS solutions function as closed systems. They offer limited support for critical medical standards such as HL7 and DICOM, and API access for third-party integration is often restricted or priced at a premium.
The result is data silos. Clinical information becomes fragmented across disconnected platforms, forcing manual reconciliation and slowing diagnosis, treatment, and reporting. Instead of improving efficiency, technology becomes another bottleneck.
Regulatory lag: The hidden compliance risk
Vietnam’s healthcare regulations evolve continuously. The Ministry of Health and Vietnam Social Security (BHXH) regularly update reporting requirements, data formats, and insurance payment gateways.
Global SaaS vendors, whose roadmaps are optimized for larger markets like the US or EU, tend to respond slowly to these local changes. Updates can take months to be localized and deployed. During this gap, hospitals face rejected insurance claims, delayed reimbursements, and audit exposure.
This is where off-the-shelf systems quietly become a revenue risk.
The alternative: Agile compliance by design
A custom-built system, developed with a specialized domestic partner such as Synodus, follows a different logic. Instead of waiting for global releases, the platform is designed for Agile Compliance – able to adapt immediately to local regulatory changes.
For hospital leadership, this is not a technical preference. It is a safeguard for operational continuity, compliance certainty, and predictable cash flow as the institution scales.
Synodus solution: A “modular & connected” strategy
As a strategic partner in Vietnam’s National Digital Transformation, we approach digital health investment with a simple principle: Modernization should protect cash flow, not strain it.
Instead of large, one-time capital expenditures, we help hospitals modernize through a modular architecture, implemented in phases that support each other.
Each phase is designed to fund the next.
| Phase | Name | Detail |
|---|---|---|
| Phase 1 | Protect Revenue and Patient Flow | The priority is stability. Deploying a robust hospital information system (HIS) and self-service kiosks improves patient intake, reduces waiting time, and secures billing accuracy. |
| Phase 2 | Eliminate Structural Costs (LIS/PACS & EMR) | Once revenue is stable, hospitals can confidently invest in LIS, PACS, and EMR to remove recurring costs related to film, paper storage, and manual reconciliation. |
| Phase 3 | Patient Experience (Apps & AI) | With operations streamlined and costs under control, hospitals can then focus on patient-facing innovation: mobile apps, AI-driven tools, and personalized care experiences. |
Cost savings only materialize when digital systems are fully accepted for insurance reimbursement.
Synodus designs filmless PACS systems that align with BHYT reimbursement requirements, referencing Circular 39/2024/TT-BYT. This allows hospitals to receive full reimbursement for digital imaging services without printing physical film.
Beyond technology, we also support hospitals with procedural guidance, helping teams align workflows, documentation, and reporting with regulatory expectations.
At reception, integration with VNeID and chip-based citizen ID (CCCD) enables automated patient intake, reducing manual data entry and lowering administrative staffing costs.
Real-world performance: A case study in scale
The value of a digital strategy is measured not in features, but in live operational outcomes. A large-scale deployment by Synodus for a major general hospital provides a clear benchmark for what “Performance-led” engineering achieves in a live medical environment.
Project overview
The hospital operates on a significant scale: 700 beds, 2,500 outpatient visits per day, and a workforce of 800 medical staff. As patient volumes increased, manual and semi-digital workflows could no longer keep pace, resulting in administrative overload, fragmented data, and rising operational risk.
Solution provided
Instead of layering disconnected tools, Synodus delivered a fully integrated digital ecosystem built on the HL7 international standard. The solution included:
- Hospital Information System (HIS)
- Electronic Medical Records (EMR)
- Quality Management Dashboards
- Mobile applications for patients and staff
All components were designed to operate as a single synchronized system, not independent modules.
Key outcomes
The transition to a connected digital infrastructure produced results across four critical dimensions:
- Operational efficiency: Overall efficiency increased by 70%, enabling higher patient throughput without increasing staff headcount.
- Administrative load: Time spent on complex administrative tasks, such as annual inventory analysis, dropped by 60%.
- Risk management (patient safety): Medical incidents across related facilities declined by 90%, materially reducing liability exposure and strengthening patient trust.
- Interoperability: The system achieved 100% connectivity between LIS and PACS, demonstrating that data silos are an architectural choice, not an inevitability.
On this scale, performance is not accidental. It is the result of standards-based architecture, deep integration, and systems designed for clinical reality, not demo environments.
Conclusion: From cost avoidance to operational advantage
The case study above illustrates a critical point for mid-sized hospitals: digital transformation is not a capital race, but an operational one. When systems are designed for scale, compliance, and interoperability from the outset, technology shifts from a cost burden to a structural advantage.
As Vietnam’s healthcare market opens further to international competition, digital capability is no longer discretionary. It becomes a license to operate. Hospitals that delay modernization risk not only inefficiency, but declining patient trust, reimbursement friction, and long-term irrelevance.
The financial path forward therefore demands discipline. Leadership must look beyond the lowest upfront bid – a choice that frequently leads to fragmented systems and the costly “double cost” trap. The more resilient strategy is to work with a technology partner capable of tailor-made architecture, built on deep understanding of Vietnam’s regulatory environment, insurance frameworks, and hospital workflows.
The performance outcomes demonstrated at scale – higher efficiency, lower risk, and full interoperability – are not exceptional cases. They are the result of correct strategic decisions.
By 2026, the hospitals that succeed will not be those that spent the least on technology, but those that integrated it best.
