One of the hottest buzzwords in healthcare space since Feb 2020 has been “Telemedicine”. Globally reports after reports ascribe 100%-500% growth in Tele-consultations taken during this pandemic period. Consulting Firms are going gaga over this and are setting huge practices to advise Hospitals and Governments in this space, investors are showing never seen before interests to invest in startups, combined with AI, thought leaders are writing huge thought leadership articles that this is the next big thing. Sure, being myself in that space with our new startup Axon Smarthealth™, I do relate to lot of this but amidst of all thus euphoria, I tried to ask some fundamental questions about this space and assessed whether this hockey stick growth is a flash in the pan or a change that will sustain for ever. This post is to share my personal views and I welcome thoughts and comments
Before I deep dive in to my observations, let me table some interesting questions to all the readers
- Is Telemedicine a brand-new concept? Nope it has been existing for the past 20+ years in various forms and shapes. So it is clearly not a breakthrough technology or concept
- Has Telemedicine been rapidly growing over the past 10 years with a strong fundamental value proposition and spiked up during this Pandemic? Actually not. Except a handful of countries/governments across globe, Telemedicine has been one of those concepts that always had a lot of future potential but never realised anywhere close to that in the present
- Why did Telemedicine not take off for a long time then? Is Telemedicine as a concept infeasible then? Has the concept not been implemented well on the ground? Is the commercial model not ok? Is the Doctors’ experience not good? Is the Patients’ experience not good? Etc.. etc..
All these questions are good enough to raise a very key question; Is Telemedicine fundamentally a strong value proposition or it is just that simply umbrellas get sold more during a rainy season?
Let me share my thoughts on this through 4 key aspects and then draw out my inferences. Right upfront I would concede that I will be viewing this through the prism of Primary Care as 85%+ of people’s visit to a Doctor (by sheer numbers) is for Primary Care.
- A pot of rice is more valuable for the hungry
In whichever country you look at almost 70%+ of qualified physicians live in cities where only 25-30% of that countries’ population lives. The reasons are obvious. This presents a problem of plenty for people who live in big cities and consequently presents a severe shortage of qualified and good Physicians in small towns and rural parts of the Country. As we all know, Telemedicine is a concept where a Doctor can provide a consultation to a Patient who is located remotely. With this simple value proposition, it doesn’t take much for anyone to understand that the real value of such concepts lie in smaller towns and rural parts of a country (where 60-70% of the population live), as they can take consultations from good Physicians who may physically be living in big cities and hence not easily accessible. But here is the paradox, most of the Telemedicine start-ups or Hospitals focus on providing such services to their core constituents in big cities because of a simple logic that there is appetite and affordability in major cities towards “experimenting” with something like this. After all, basic business intelligence would tell you that any model is more sustainable and more valuable when your cater to the “Core” who are in need
- Is buying an uber ride same as buying a primary care consult?
This is a fundamental aspect that needs to be looked at. Before the Pandemic, many many App based Telemedicine companies started to replicate a Uber like model for providing Telemedicine services. Concept is the same; Build an App — Onboard Doctors on one side—— Provide some ratings —– Onboard People on the Other Side—- Give a few consults free (through the investors money)—- see if some stickiness develops. Sounds exactly similar to that of an Uber or Ola or Grab right? But here is the catch; I am ok to spend 30 minutes for a ride in Singapore or in Delhi or In Kuala Lumpur or in SFO with the “any” cab driver to travel from Point A to Point B; but will I be ok for my child or my wife or my Parent to take “any’ online consult with a Doctor through an App when they are running a very high temperature and vomiting for the past 4 hours? Perhaps not.. May be I would dump my convenience, even if its required to drive 45 minutes or 1 hour, wait in the Queue for 45 minutes (even if there is a risk of catching secondary infections from other sick Patients in the clinic) and perhaps get them to see a Doctor that I know or I am familiar with? I believe more people would have to do the latter. So this is not about a great technology or Doctors feeling comfortable with the tool. Its all about giving confidence to the “Core” constituents that this model is an extremely credible model and the quality of clinical outcomes would be at par with the conventional model that they are used to
This is Part 1 of the 2 Part series. Will cover two more points (as mentioned below) in Part 2 along with my concluding remarks
- Carpenter coming to your home without his toolkit to build your table!
- How can I cross the last mile without a road to connect?
Would love to get your feedback
Authored by Sivakumar Thulasidoss
Co-founder, Axon Smarthealth Pte Ltd