The rise of telemedicine

Technology is taking over many areas of our lives, and this looks set to spread into the medical services sector. Moneybags journalist Jessica Anne Wood looks at the rise of telemedicine and how this is changing the medical landscape.

Dr Jonathan Broomberg, CEO of Discovery Health, notes that the explosion in digital healthcare innovation will, in the coming years, reduce doctors’ workloads and overall healthcare costs five-fold, as well as speed up diagnoses. This will see a complete reinvention of the way that medicine is practiced and potentially save billions of Rand.

“New technology could empower patients to take responsibility for their health and enable doctors and caregivers to intervene almost instantly via individual wearable (or ingestible) automatic devices that monitored and transmitted in real time anything from the gut biome, heartrate, stress and insulin levels, to the amount of movement or its absence,” explains Broomberg.

Telemedicine in Africa

Henrik Thrane is the managing director and co-founder of MyDoctor24, a platform which allows people instant access to medical professionals, limiting the need to visit a doctor’s room. MyDoctor24 was developed in partnership with Claus Jakobsen, with the aim of addressing the need for better and easier access to healthcare, both for those living in rural areas with limited access, as well as busy professionals who may not have the time to visit the doctor’s rooms.

“We thought that was a pretty awesome idea and we then started the company, MyDoctor24, only to find out shockingly enough that it was not allowed in South Africa for a doctor to interact with a patient, unless there is a pre-existing relationship between the doctor and the patient,” says Thrane.

Thrane reveals that the HPCSA guidelines do not allow a doctor to consult or offer a diagnosis to a patient via the phone or other digital platforms, if they do not already know the patient. Thrane notes that this in itself does not make sense, as a person can contact a doctor they saw six years ago, and because they saw that doctor once regardless of the amount of time that has lapsed, the doctor will be able to offer a consultation over the phone or other digital platform. However, during this time the patient may have suffered any number of ailments or conditions that the doctor is not aware of, meaning that even having a pre-existing relationship does not guarantee that the doctor is aware of all the patient’s health issues.

As a result of the HPCSA’s regulations, Thrane and Jakobsen launched their service in other countries in Africa, where they felt there was a need to access to doctors virtually. However, they still want to bring MyDoctor24 to South Africa, and with the continuous changes brought about by technology, the HPCSA may soon have to change its stance on digital/virtual consultations.

As telemedicine advances the health industry will change. Thrane points out that telemedicine will have an impact on the doctor/patient relationship, especially with regards to the accessibility of doctor’s after traditional office hours.

Not only will the availability of professional medical advice change, but so will the cost of a consultation. According to Thrane, as telemedicine becomes more common place, the cost of a consultation will likely decrease.

A hint of things to come

Hello Doctor is a digital platform that allows people to interact with doctors regarding health related queries they may have. However, as the HPCSA does not allow for diagnoses to be handed out over the phone, the doctors at Hello Doctor can only offer advice.

Dr Michael Mol, the head of Hello Doctor, explains: “The HSPCA does not allow for telephonic consultations, despite the WHO’s recommendations on the value of mobile health in solving the healthcare crisis facing our country and our continent. We have consistently been complicit with their regulations, and as such only offer appropriate health advice, without making a diagnosis or treatment recommendations or providing prescriptions, all the elements that make up a formal consultation.”

Hello Doctor is able to provide expert advice on a range of medical issues. These include contraception, fertility, pregnancy, child health and mental health. “Our resolution rate on engagements with users is around 70%, with the remaining 30% who are appropriately referred.”

While the likes of Hello Doctor cannot at present offer a diagnosis over the phone, they can help to steer a person in the right direction and advice which type of doctor could assist, whether a GP or a specialist, services such as Hello Doctor do provide better information than a simple Google search would offer.

“Compare the advice of a qualified medical doctor (a human being) on the phone to that of online self-diagnosis based on the vast amount of health information available online. It’s quite simply leading to false self-diagnosis and hypochondria. There’s even a name for it: “cyberchondria”,” says Mol.

Looking forward

While at present HPCSA guidelines do not allow for virtual or tele-consultations, this will most likely change in the future as technology continues to disrupt the health industry.

Mol highlights: “The global trends in mobile health indicate that telemedicine is becoming, and will soon become commonplace across the world and a core component of the public and private Healthcare Ecosystems. So the question is not whether it will happen, but when, and which countries will be among the first to effectively, and efficiently lead the way – South Africa is primed to lead the way on the continent, we just need to get past outdated policy.”

Thrane adds: “I think the HPCSA will have to change their guidelines, because the pressure is going to be [tougher] further down the road.”

Telemedicine will not be reserved solely for use by GPs. Thrane notes that specialists will also utilise these facilities. For example, even today gynaecologists are able to remote monitor foetal heart rates. There are almost endless opportunities for the use of telemedicine is all areas of the health sector.

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