Doctor on call: The rise of telemedicine

Technology's meeting with health is known as telemedicine, which Kenyans are embracing with faster internet and cheaper smartphones

09 Apr 2018 . 5,648 Views

Boosted by technology, 21st century patients are slowly embracing the idea of being treated without necessarily visiting a doctor.

One such example is how James Momanyi, a Clinical Officer at Clayworks Medical Centre, received instructions from a doctor in Nairobi that enabled him operate on a fistula patient.

Last Saturday, while in Kisii County, he got an urgent call about a woman in his neighbourhood who was suffering from post-delivery complications.

“After my initial review, I could tell she was in the early stages of fistula. I also realised that she was going through post-partum depression. The family was hesitant to take her to hospital because they little understood the problem and only agreed after insisting that I treat her,” he says.

The problem was that Momanyi knew little about undertaking fistula operations. He turned to his more experienced friend and colleague, Dr Athanas Nyang’au, who agreed to help.

The other problem was, Dr Nyang’au, is based in Mbagathi Hospital in Nairobi which is more than 300 kilometers from Kisii.

The only way they could undertake the procedure was through a video link. And since the hospital had no video conferencing facilities, they turned to video chat application Skype, which allowed Dr. Nyang’au to guide Momanyi through the operation.

“Necessity is the mother of all inventions,” said Momanyi. “Believe it or not, Dr Nyang’au instructed me on what to do, where to probe and what to use all via Skype.”

Momanyi’s life-saving experience is an example of how technology is simplifying all facets of life, including healthcare, where technology’s meeting with health is known as telemedicine.

Telemedicine is the delivery of health services remotely through telecommunication infrastructure such as smartphones, tablets and computers.

The patient can communicate with a doctor, or doctors through video conferencing, text-messaging, mobile apps or voice calls – which Kenyans are embracing with the growing availability of faster internet and cheaper smartphones.

Doctors provide medical advice, diagnose, treat, prescribe and even refer you to a specialist.

Dr James Simiyu, the County Veterinary officer in Bungoma says even in animal health, they are relying on technology to solve some complex issues fast and with ease.

“I am not a human health personnel, but I cannot count the number of times I have made a phone call while treating sick animals, or taken a photo and sent it to a colleague at Kenya Agricultural Research Institute (KARI) in Nairobi asking for the next step on how to treat an animal,” he says.

“Technology now calls the shots, because of need and speed which is why we are embracing tele-vet services also,” he adds.

The concept of telemedicine can be traced back to the 1950’s. In the book ‘History of Telemedicine: Evolution, Context, and Transformation’ by Rashid Bashshur and Gary Shannon, it is argued that origin of modern telemedicine applications in Europe were by the Dutch physician, Willem Einthoven and the first clinical application was in cardiology.

Kenya launched what was the first telemedicine initiative in May 2015, when a partnership between Kenya’s Ministry of Health and Germany-headquartered Merck Group provided a pilot platform linking the Kenyatta National Hospital to the Machakos Level Five Hospital.

During the launch, Merck Group Board chairman Frank Haverkamp, indicated the need for sustainable capacity in health care. “The initiative aims to build capacity and improve access to innovative and equitable healthcare solutions to Kenyans,” he said.

While telemedicine is a relatively new concept in Kenya, not everybody is buying into the idea.

“To think that someone can treat me by placing, say my x-ray film on a computer or the internet, so they can consult another doctor is unsettling” says Alice Mwando a home based care giver in Kahawa West.

“I don’t have a problem with the use of technology but what if there is a communication breakdown and I end up being misdiagnosed?” she wonders.

However, companies too see a future in telemedicine.

Safaricom, in its 2017 sustainability report said that over 200,000 residents in Lamu would benefit from a collaboration between Safaricom, Huawei and the Government of Kenya in a project which would provide video-based health consultation.

The project so far has seen residents of the larger Lamu area benefit from improved medical services offered remotely, with doctors from the Mombasa General Hospital offering health services to the over 10,000 individuals.

Perhaps the most comprehensive attempt in Kenya at rolling out tele-powered doctors is ‘MDaktari’, an initiative launched by doctors Mellissa MCcoy, Dismus Masheti and Chris Harding.

Powered by ConnectMed, a mobile-based software application, it offers a platform where patients can consult healthcare providers via a web-cam based doctor-patient portal and get medical advice. Payments are made via mobile money and bank cards.

Dr. Mellisa McCoy, a medical technologist and founder of ConnectMed says the team of doctors on the app are vetted before serving as health consultants.

“Doctors engage patients for up to 15 minutes to create an online patient history. Doctors will be available to attend to patients from the safety of their clinics, homes or anywhere they choose,” she said. Consultation is Sh600 payable via MPESA or deducted from one’s card upfront.

At ConnectMed, lines are open daily from 8am to 11pm. Once booked, one can securely and privately have a consultation. After consultation, a patient can access the doctor’s treatment notes, download your prescription, and more through your dashboard online.

If you need a prescription, it will be instantly sent to your inbox or you can have it filled and delivered via ‘MYDAWA’, an app based pharmacy run by ConnectMed.

Charles Muhirwa, a Rwandan living in Ruaraka is a regular at the local Halton’s pharmacy. He uses MYDAWA app to order medicines to treat his persistent gastric problems.

“I was introduced to the app by my brother who lives in Belgium, and who says they do their medical consultations online. So, I googled for local examples and came across ConnectMed and tried it. It is relatively cheap, considering I paid Sh600 for 10 minutes, and they emailed me a prescription,” he said.

Growth is expected in the telemedicine sphere, but hurdles abound. Some of the issues include patient privacy and it waits to be seen how doctor –patient confidentiality will be handled in the era of telemedicine.

But in the meantime, patients are reaping the benefits of connectivity that enabling medical practitioners like James Momanyi save lives every day.



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