That a doctor is just a click away is no longer a dream but a reality. Daktari Africa, an online medical provider, has made it possible for Kenyan patients with smartphones and internet connection to consult a doctor at the comfort of their homes.
The e-health firm has a team of 512 doctors who serve more than 10,000 patients across the country.
“We work closely with health players in the rural areas,” says Dr Charles Kamotho who is also the chief executive of Daktari Africa, which introduced telemedicine in the country in June 2015.
This innovation has been particularly critical during the coronavirus period, with Dr Kamotho saying an increasing number of patients with chronic diseases such as cancer, asthma, diabetes, and hypertension, have been using the online platform.
The system has an interface that allows patients to post their medical data. And once patients indicate their location, a new page comes up allowing them to choose a doctor from an online list.
When a patient chooses a doctor, a video connection is automatically set up, and the two proceed to engage.
The patient shares his or her medical data on the screen, enabling the doctor to carry out diagnosis and render prescription, which is seamlessly sent via email.
Patients using the platform can also buy medicine on MyDawa digital platform, whose prices are 20 percent cheaper than regular chemists, and get it delivered to their homes.
In Kenya, there are 41 registered e-Health providers, according to the Kenya Healthcare Federation.
The providers offer a wide range of services including diagnostics, prescription, surgery pre-assessments, ultrasound, and pharmaceutical e-commerce.
Other services are health insurance, doctor-to-doctor consultation, and medicine e-Learning through audiovisual communication.
The Kenyatta National Hospital (KNH) was supposed to spearhead efforts to roll out telemedicine through a USD100,000 project in May 2015, but it is yet to take off.
The planaimed to link KNH physicians to Machakos Level Five Hospital, located in the eastern part of the country, via videoconferencing.
The Machakos hospital was to be the base from where patients would be linked to doctors in Nairobi. But five years later, the project remains a dream.
A surgeon opined that the plan was not actualised because it was not ingeniously thought-out. However, he added, the move set the stage for tech-savvy individuals in the medical field who came up with startups “that are helping reduce the doctor –to-patient ratio in the country.”
Other players in the telemedicine ecosystem are MyDawa, M-Tiba, Acess Afya, Penda Health, Sasa Doctor, AskADoc, Nadia, Unumed, MyOwnDoctor, Daktari Online and Afya Pap among others.
Emanuel Kombo has been using Sasa Doctor and is enthusiastic about the system. “It saves my time, I don’t have to go to hospital. There are also chances of contracting infections at the hospital,” he says, adding that the online health services are affordable as well.
“Compared to doctor consultations in hospitals that can cost USD50 I have never paid above USD10 for the online services. I have used Daktari Online with my family since May, 2019. It is has helped us a lot,” he reveals.
Eunice Adhiambo,who uses the platform in Kisumu County, located in the western part of the country, says e-Health apps come in handy not only for individuals but for the whole family.
“If I have any health concern for my family when I travel, I always login to the system. The doctors keep calling to follow up on your progress,” she said.
A number of patients say video calls with doctors give them comfort and convenience, noting that telemedicine can greatly help in controlling diseases such as diabetes, obesity and hypertension.
“You get your glucose, blood pressure and cholesterol tested and that is fed into your online patient account. Your online doctor can use that to determine your case,” says a user of Livia, one of the online platforms.
Francis Osiemo, the chief operating officer of Sasa Doctor, says e-health will be instrumental in fostering universal health coverage while bringing down the cutting costs.
This will be achieved as the innovations will push up uptake of health insurance by reducing the cost of premiums for individuals and corporates.
“We aim to assist in universal health coverage where patients can use a medical app to decongest public health facilities. I believe 60 percent of patient we have can use telemedicine without moving an inch,” he notes.
The platform’s Tabibu Sasa mobile wallet allows low income households to save between USD 0.2 and USD 0.5 a day for their healthcare needs.
“With that, USD 1 can be enough for the entire family to access telemedicine services for unlimited times every month,” he said, adding that the remaining amount in their wallets can be used for in-patient services if need be, “as we have partnered with Britam to bolster our health insurance.”
M-Tiba, which began as a mobile service that allows users to save, send, and spend funds specifically for medical treatment, boasts a client base of 4.3 million users in Africa who have transacted more than 800 million times since its launch in December 2015.
The service, funded by Safaricom, CarePay and PharmAccess Foundation, works with over 2,900 health providers, and has handled 587,000 treatment claims.
Sasa Doctor, for Instance, has 35 online doctors while 38 more are undergoing training to acquire emerging skills to serve its over 20,000 active users.
Dr Were Onyino, the medical director at Daktari Online, notes that 5,000 accredited Kenyan doctors are registered on the platform, with each doctor handling between 10 and 15 patients daily at a cost of as low as USD5.
The platform, which began as an e-learning hub for healthcare workers in 2013, now works in partnership with labs and pharmacies.
“We are cutting down the waiting time and consultation fees. But internet downtime means video calls cannot go through to rural areas. If the recenlty launched Google Loon 4G network becomes available in every village, then telemedicine could grow faster,” says Dr Onyino.
Managing director of medicine e-commerce platform My Dawa Mr Tony Wood reveals that more than 100,000 Kenyans are already registered on the platform.
My Dawa delivers medicine for free in the Nairobi Metropolitan area but charges only USD 3 to upcountry deliveries.
Mr Wood says only innovation will help address some of the most critical challenges the health sector faces
.“If telemedicine is used well, it will relieve the pressures we have on health. Gradually, people will change their attitude towards the innovation because the aim of this technology is to improve your health,” he remarks.
My Dawa buys medicines directly from manufacturers and stocks them. Within Nairobi, they are delivered within four hours but to remote areas it could take two days, with a plan to make deliveries in Mombasa, Kisumu and Nakuru free, in course.
While Kenya is making commendable progress in telemedicine, a number of challenges remain.
According to The Ministry of Health’s Kenya National e-Health Policy document 2016-2030, some of the challenges in the uptake of digital health solutions include poor infrastructure, low literacy, inadequate technical expertise, unreliable power supply, limited funding, and lack of government involvement.
The government, the document points out, is faced with legal challenges in regulating eHealth systems due to lack of laws.
“There is a need for a comprehensive legal framework that regulates adoption and use of eHealth systems and services in Kenya,” it states.
Another challenge is convincing patients to share their data. Most patients still do not trust apps with their data, unsure if the platforms will keep it private.
Doctors themselves can be a stumbling block to digital health adoption, as some of them are hesitant to register on e-Health platforms because they own clinics that provide the same services they would deal with online.
“They see going online as a threat because it will deny them the chance to extort poor Kenyans,” says Mr Osiemo, adding that online medical services are far much cheaper compared to the traditional treatment.
Although the Health Act recognises telemedicine as a mode of treatment, insurance companies find it difficult to pay doctors for digital services.
Mr Osiemo is of the view that doctors need a change of mindset as they cannot keep technology at bay forever.
While acknowledging the disruptive nature of technology to traditional models of operations, he advises doctors to learn to embrace the changes by being tech-savvy enough to serve “the millennial population that loves faster, ubiquitous services”.
Some doctors, Dr Kamotho notes, have become so possessive of their patients that they won’t let them access the cheaper, more efficient services rendered by an online doctors. “This is worrying because they are motivated by money,” he says.
Although there are a number of hurdles in the way of telemedicine adoption, experts are optimistic that digital health will expand and be a catalyst in provision of quality medical services to cross-section of Kenyans.
While developed nations began rolling out telemedicine solutions 10 years ago, it is during the last four years that the innovation has gained momentum in developing countries.
Kenya, whose population consists of over 75 percent of people aged under 35 years, is regarded as comparatively tech-savvy, and is leading Africa in adoption of eHealth and other various forms of online solutions.