To meet the growing demand for healthcare facilities efforts have been made to harness digital technology to develop ways to increase the accessibility to healthcare services and disease management.
Even as early as the 19th century, the idea of telemedicine has already surfaced in the form of communicating with the doctor through the telephone, minimizing the need to visit the doctor’s office.1 It was not until decades later when other forms of telemedicine instruments begin to materialize. Some of these prominent devices include the telecardiogram, developed by Willem Einthoven (1860 – 1927) in 1906 using the string galvanometer. This allowed the transmission of cardiogram readings through wires from patients in the Leyden Hospital to the physiological laboratory, 1.5 kilometres away.2
“Radio Doctor – Maybe” a cover story by Hugo Gernsback, a science-fiction writer, was published by Radio News magazine back in 1924. The cover illustration paints a futuristic picture of a boy communicating with a doctor from home through a monitor of a device much like a radio. What seemed to be visionary at the time has become a reality with technology catching up and the increase demand for healthcare facilities to meet the needs of ageing populations.
In today’s context the terms ‘telehealth’ and ‘telemedicine’ would refer to the use of digital telecommunications to remotely have access to healthcare services such as consultation from a physician, healthcare assessments, and pharmaceutical prescriptions.
In our quest to understand current technologies in telemedicine, we had the privilege of engaging Dr. Vas Metupalle, Co – Founder and Chief Information Officer of MyDoc, a healthcare mobile application, to enlighten us about their beginnings, motivations, and challenges as a digitally – managed healthcare platform.
Starting out in 2012, MyDoc was founded by Dr. Vas Metupalle and Dr. Snehal Patel to provide for the ever-growing need for healthcare facilities in Asia. The outpatient space was one resource which caught their attention as Asian populations grow and develop a wider ageing population, they saw that current outpatient resources could not match this development. To fulfil this need, Dr. Vas and Dr. Snehal set out to provide an online service, modelled after other telemedicine companies such as Teladoc, they decided to focus on primary and outpatient care.
At that time, no one was providing clinical care online as most of their operations revolved around booking of appointments at clinics or coordination with hospitals for referrals. They were also providing a service for follow up consultations to healthcare providers, and companies.
In 2014, MyDoc found a niche in corporate healthcare, where companies who provide health screening for their employees could use their services to follow up on their medical reports. Following that they began an effort to follow up with clinical laboratories online and communicate the data through MyDoc where they will assign the laboratory report which will be followed up by a doctor. With this initiative MyDoc was able to have 60 to 70 per cent of patients follow up online which gave them a good opportunity to start collaborations with third party administrators, insurance companies, and healthcare groups.
During this time there were no regulations for primary general practitioner (GP) consultations online, resulting in grey areas in terms of operations of such services. However, on 18th April 2018, Singapore’s Ministry of Health (MOH) launched the new Licensing Experimentation and Adaptation Programme (LEAP). As the first regulatory sandbox to support the development of telemedicine and mobile medicine services,3 MyDoc along with several other telemedicine providers joined as active sandbox providers. This has since paved the way for regulations for the innovation and expansion digital healthcare options in the Singapore healthcare system.
MyDoc is now focusing on preventive health and acute consultation and has since launched its new weight loss program, LivingLiteTM, seeing that obesity is a major contributing factor for chronic disease motivated them to move on to chronic disease management.4,5
The inspiration behind the development of MyDoc was to focus purely on outpatient care, MyDoc provides a digital solution to care coordination and an outpatient space for doctors to be able to give e – referrals and e – prescriptions.
“We are in the outpatient space, trying to push the value – based care model. Purely a digital outpatient space, that does not own the clinics”, says Dr. Vas.
MyDoc provides the first ‘ask the pharmacist’ service with Guardian pharmacy where users can consult a pharmacist directly through the mobile application. They were then called up by MOH to figure out how will this affect current outpatient services as this will separate the process of GP consultation and drug fulfilment.
With all the benefits of convenience and speed in accessing primary care for the patients, Dr Vas also highlights how healthcare professionals can reap the benefits of telehealth.
Healthcare professionals can gain from the volume of business that they can manage, and another would be a secure income for them. This would especially benefit younger doctors who are more mobile and provide them with training programs that allows them to be up to date with information in terms of quality of care and evidence – based medicine. On top of this they would be able to develop the skills to adapt to the technology to be a telehealth doctor.
Dr Vas explains to us the challenges they had at the time for MyDoc were the lack of regulations as to running a healthcare service such as this. In the early stages of development there was no clear guideline, so MyDoc had to be collaborative with MOH and work with current healthcare groups and providers in order to set the ecosystem.
“There was a learning curve that we had to go through to come up with a product that is very flexible in terms of preventive and acute care”, added Dr. Vas.
It is a multi – disciplinary platform with many types of partners, MyDoc is looking to add pharmaceutical companies as potential partners in the future. With the aim for disease management especially for chronic diseases like cardiovascular disease, diabetes, and chronic obstructive pulmonary disease.
MyDoc plans to continue to develop disease management programs even for mental health issues such as depression. With the ultimate vision of having a digital polyclinic, by providing all the different types of healthcare services online from multiple groups. Just as you would experience at a government polyclinic but without the queues and long waiting time. MyDoc runs on a scalable model where they would keep their consults within 10 minutes for a patient to get in contact with a doctor or pharmacist.
As a concluding note, current digital technologies and efforts to meet the demands for healthcare facilities will allow for a paradigm shift in medical care towards convenient and accessible care for all. From traditional methods of visiting the doctor to the digitalization of consultations and medical prescriptions, we cannot help but to look to the future with encouragement to see where these technologies will take us in terms of healthcare. [APBN]
This interview was conducted by Deborah Emmanuel Seah Qing En
References
- Board on Health Care Services; Institute of Medicine. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary. Washington (DC): National Academies Press (US); 2012 Nov 20. 3, Thomas S. Nesbitt, M.D., M.P.H. The Evolution of Telehealth: Where Have We Been and Where Are We Going?
- Carl J. Wiggers, MD (1961) Willem Einthonven (1860 – 1927) Some Facets of his Lift and Work, Circulation Research, An Official Journal of the American Heart Association: 1961;9: 225 – 234
- https://www.moh.gov.sg/our-healthcare-system/licensing-experimentation-and-adaptation-programme-(leap)—a-moh-regulatory-sandbox
- https://www.hpb.gov.sg/article/1.7-million-singaporeans-already-at-risk-of-obesity-related-diseases
- https://www.moh.gov.sg/docs/librariesprovider5/resources-statistics/reports/executive-summary-nphs-2016_17.pdf
About the Interviewee
Dr Vas Metupalle
Co – founder and Chief Information Officer for MyDoc