Healthcare is a huge and controversial sector. In general, trends in healthcare innovation have been focused on the manufacturing segment of the healthcare industry. Advancements in high technology research pave the way for the future of healthcare, e.g. the pharmaceutical industry, biotechnology, genomics/proteomics, medical devices and information technology. However, soft innovation or service innovation is increasingly influencing the whole healthcare system, ranging from accrediting health units to X-raying patients. It is intangible, more complicated, and individualized. Health service innovation combines and balances an interaction between the key roles of the ‘providers’ (physicians and healthcare staffs) and ‘users’ (patients and other beneficiaries) as the main sources of diffusing technological innovation in health systems.

In this issue, TRENDNOVATION Newsletter illustrates a selection of emerging issues and signals for changes in health service innovation including changes in various attributes that would affect the poor, vulnerable people and medical staff (e.g. hospitals, research, logistics, health care policy, etc.).

Driven by a regional economic transformation towards a manufacturing and service-oriented economy, more people will live or migrate into megacities or other growth poles in Southeast Asia. In this issue, the contributors envisaged and interpreted the scenarios by portraying the future of the interactions and activity within health service in Southeast Asia. There are some improvements and lots of possible events that may change the way we perceive this particular section in a contemporary modernization.

On the bright side, healthcare in Southeast Asia over the next decade will include more people being integrated into a standardizing health system; the physical infrastructure of health service will be expanded and better equipped; public welfare will become a norm for the regional government to pursue, while private healthcare will become more specialized and targeted. The individual will value a healthy life with a higher degree of application of digital healthcare innovation; and new preventive measures and treatments will be implemented with universal coverage.

Uncertainties can be seen coming from such a grand scale of urbanization, health politics and a massive expansion of physical infrastructure. Aestheticism and individualism underline an increasing degree of complexity in health services, which is a very knowledge intensive activity. System failure, threats from biohazards, emerging and reemerging diseases, digital terrorism and intrusions, and user-provider conflicts will become new challenges within the hospital system and health policy implementation.

This issue marks the first year of TRENDNOVATION Newsletter. The passage through twelve issues has been one amazing journey. I would like to thank you all: the audience, the Rockefeller Foundation, the contributors, and the team for such great support. The newsletter is entering its second year, and we commit to a futuristic goal of making this horizon scanning more robust and relevant. We won’t rest until we’ve reached that goal.