The proliferation in smartphones and mobile devices is unlocking a new era in telemedicine and telecare. Damian Radcliffe explores how one proponent of this evolution is unlocking these benefits in the Middle East.
Last month a leading Dubai health official argued that half of the money being spent on healthcare in the Arab World was not being properly utilised.
“I don’t think we need to pump more money into the health system,” Haider Al Yousuf, head of funding at the Dubai Health Authority said. “We just need to use that money more efficiently and ensure that it goes to the right place.”
It’s a view that Raouf Khalil, Chief Executive Officer of Mobile Doctors 24/7, agrees with.
“There’s plenty of money out there,” he told us, “it’s just that there’s so much over zealous [medical] activity.”
As an example he noted how some doctors are being paid commission—or set targets—for certain types of procedures. This can create a vicious circle, whereby patients may be prescribed services or treatments that they do not need, with the result that every year their premiums go up.
“This,” Khalil says, “is not just a financial problem, it’s a clinical issue as well,” highlighting how the overuse of antibiotics has diminished their effect.
A serial health entrepreneur, Khalil established the Mobile Doctors 24/7 service to address some of these issues. Their doctors, he told nuviun, are “not affiliated to any clinic or hospitals.” “In other words,” he says, “they are not incentivized to refer any patient or do anything unless it’s based on evidence based medicine.”
How It Works
Mobile Doctors 24/7 describes itself as a “concierge service” which offers benefits for both employers and employees. For companies and insurance companies, the service aims to reduce the impact of medical conditions for chronic and acute patients by providing on-site medical visits and the delivery of medication.
For employees and their families, potential patients are encouraged to use the free “Mobile Doctors” app to manage on-going or potentially new conditions. Through the mobile application, users can also access—in one place—their medical histories, health and appointment alerts, insurance details, and medical resources—including disease specific articles and videos—as well as directions to required health facilities and special deals from health and wellness providers.
This “Care from the Cloud” service is not only designed to be convenient—by offering medical advice and guidance around the clock—but it also seeks to alleviate some of the pressure on front-line medical staff, many of whom are increasingly seeing their time being taken up by patients with non-critical conditions.
“There is analysis from Qatar,” Khalil states, “which found that 90% of the calls that are coming through to 999—which is the emergency line—are not emergencies.”
For some patients, this is because they don’t know any better, but for others Khalil argues, “that’s the one choice they have.” Because of this, he makes a compelling case to “give people another alternative.”
Mobile Doctors aims to provide that additional solution by offering 24/7 access to family medicine specialists, general practitioners, pharmacists, nurses and wellness advisors.
This type of “virtual triage service”—whereby users can speak to western trained, DHCC licensed family medicine specialists and general practitioners at any time of the day or night—is needed, Khalil argues, “there is a huge difference between emergency and non-urgent [care] and people don’t really know what that is most of the time.”
He also hopes that by offering a legitimate alternative “to the clinic or ER” patients get “what they need, not what they can afford.” This means that patients avoid being under—or over—prescribed medication; both practises which can be particularly prevalent in the Middle East.
And it’s not just patients who can benefit from this approach. “The doctors like it [too] because it’s very ethical,” Khalil adds.
In developing the Mobile Doctors service, the team has unlocked partnerships with organisations such as Ooredoo, Asiacell, smarteletec, Cisco and Cerner.
Cisco’s involvement includes deployment, for the first time in the region, of their proprietorial Cisco TelePresence® VX Clinical Assistant, which offers high-definition possibilities for remote patient care. When launching the service, Wael Abdulal, collaboration manager, Cisco UAE, noted how through this technology “Mobile Doctors will be able to deliver a fast, efficient, ‘real-life in person’ remote care experience.” This will bring “unsurpassed value to their customers without the need to travel to a health facility,” he said.
The partnership with Cerner, meanwhile, provides another part of MD 24/7's infrastructure—by giving subscribers tools to access their electronic health records, schedule appointments or communicate with a doctor. Globally, Cerner works with 14,000 medical facilities worldwide, including more than 190 in the Middle East.
Through this combination, Khalil hopes to both streamline—and improve—the patient experience.
“As a consumer I don’t want to have to go to three different providers and someone who doesn’t know me,” he says. “So the whole foundation of these [partnerships] is what I call the 3 P’s: the Patient, the Providers and the Payers. If you don’t align at least two of these three you’re not going to have a sustainable solution. So we’ve aligned the consumer and the care.”
After a successful pilot project in Dubai—Khalil told nuviun that the service currently has 40,000 members—the next step is to take this new model for healthcare to other parts of the region.
“Many UAE insurers also have footprints in other countries, so this supports organic growth in the rest of the Gulf,” he observes, noting that priority areas for future roll-out include Saudi Arabia, the wider GCC and Egypt.
In doing this, the Mobile Doctors team hopes not just to target large employers, but also to work with the big insurance companies who might embed their service as standard in their existing health insurance products. Such a service, Khalil believes, could potentially be better for everyone.
“There is a lot of wonderful technology out there,” he says, “but if it’s not attached to a doctor…” his voice trails off, perhaps thinking about the 17-hour flight to Los Angeles he was about to catch, “…well, you’re not really in healthcare if you don’t have physician.”