Providing healthcare via video in remote communities

Lindsay James
Lindsay James
By Lindsay James on 20 February 2017
Providing healthcare via video in remote communities

Pakistan’s healthcare system places it close to the bottom of the rankings in the Human Development Index, with less than one doctor per 1,000 people. Women, in particular, often lack vital care. Research has shown that female health is sorely under-prioritised in Pakistani society. Cultural taboos hold many women back from seeking out healthcare services, and general medical awareness and education is often so poor in rural areas that treatment comes too late. For many women, their first and only visit to the hospital is to die.

The team at RingMD is bringing healthcare resources to Pakistanis in remote rural villages, by facilitating virtual consultations using internet-enabled vehicles.

This vehicle fleet is equipped with basic medical equipment, and in some cases, doctors from various specialties are on hand to assist. The virtual consultation services conducted from the vehicles connect villagers to doctors thousands of miles away in major cities like Islamabad, Lahore and Karachi. In an uncertain political and economic climate, this type of critical service is providing invaluable healthcare relief in poverty and conflict-stricken areas. The virtual care services have already proven to be critical for both patients and doctors alike in Pakistan.

Dr. Vidya Neelkant offers her services on the platform and raves about the good work she’s been able to do. She spends most of her time helping women with health matters they might otherwise never have gotten checked out due to cultural taboos and patriarchy.

“Women in India don’t like to see male doctors, and they often live so far away from a hospital that they don’t get the care they need, especially when they’re pregnant,” Neelkant said. “It’s so good that I can help them have healthier pregnancies now and advise them on things like diet, hygiene and how much to work. A mother’s health is very important for her baby, yet not everyone is getting this care, especially in the rural areas.”

“We’ve helped thousands of people in Pakistan and elsewhere speak to a doctor for the first time in their lives,” said Justin Fulcher,RingMD’s founder. “We’re working in many areas that are conflict-stricken and in poverty. Based on the number of people we’ve helped, we’re bigger than many hospital groups, and yet we’re helping governments deliver health care at a tenth of the cost, through digital solutions.”

The company partnered with the government of India to provide health care services through 250,000 Common Service Centres, or CSCs, in villages around the country. Implemented with the “Digital India” project, RingMD provides a gateway to health care for India’s 880 million rural residents, Fulcher said.

RingMD offers tailored solutions to each market it works in, and it developed a separate platform for Digital India to provide in-country servers and additional payment options, such as bank transfers. RingMD’s platform is hosted in the Microsoft Cloud, so it can scale quickly without the additional cost or infrastructure challenges faced by traditional health care systems that would need to build clinics and move staff in order to expand.

Priyanka Bali, who operates a CSC that covers five villages in the foothills of the Himalayas, said the people in her rural area used to rely on a local pharmacist to give them medications, even though he wasn’t qualified to diagnose their ailments. That was easier than spending a half day traveling to and from the nearest hospital by bus, but it often resulted in misdiagnoses, she said.

Since November, villagers there have had immediate access to doctors and specialists through RingMD’s platform. Bali’s centre offers patients some privacy for their appointments, providing a computer in a curtained-off area in the back. Bali said she tried it herself first. She set up an appointment for a rash that she was able to show to a doctor through the webcam and then provide close-up photos of in a message over the app. The consultation and treatment went so well that she sought out a paediatrician on RingMD soon afterward, to ask about her daughter’s fever.

The service is gaining the same acceptance among villagers, Bali said, who are not only spreading the word but are coming back for more medical advice themselves.

“Even people who hadn’t used computers before responded well to it, because it’s so easy,” Bali said. “The beauty was that the doctors were able to communicate in the local, regional language. So a connection was formed between the doctor and the patient, because they’re both speaking Hindi.”

RingMD’s app detects each user’s location based on the IP address of their smartphone, tablet or computer and then shows which doctors are closest. The sister platform, RingWell, connects users to non-medical providers, such as mental health professionals, counsellors and nutritionists.

Payment can be made electronically through the app or in-person at centres, for those who don’t have credit cards. Doctors and wellness professionals using the RingMD marketplace set their own prices, so fees vary. Medical consultations in lower-income countries such as the Philippines and India cost less than US$10, whereas the global average for an appointment with a counsellor or therapist on the platform is about US$100.

RingMD is also working with big data to develop predictive analytics for health care, Fulcher said, using machine learning, artificial intelligence (AI) and complex algorithms to provide patients with tailored health recommendations. AI and chatbot technologies are being developed to help doctors improve the speed and accuracy of diagnoses. And the company is working on ways to help people avoid getting sick or needing a doctor altogether, by better monitoring their health symptoms.

RingMD’s accessibility enhances the continuity of care for both rural and urban patients, Fulcher said, because people are more willing to hop on a video chat for a follow-up appointment that doesn’t require physical touch or tests than to bother going in for a clinic visit.

“We’re doing a lot in elderly care, mental health support and helping pregnant women get more regular advice and checkups from their doctors,” he said. “In rural areas, we’re connecting the unconnected, and for urban populations, we offer time savings, cost savings and convenience.”


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