After more than 3 months of mandated lockdown, the Chinese city of Wuhan, the epicentre of the viral contagion, was lifted. Neighbouring cities and countries were also under quarantine as an extreme (but necessary) measure in social distancing. Countries that were reluctant or were late to adopt such preventive care methods suffered greatly in terms of infections and deaths.
This pandemic phenomena was a direct measure (or acid-test) on the capacity of a country’s health system and also the level of governance of their public bodies. It has been argued that stringent central bureaucracies of East Asia were perhaps better at healthsector policy execution (lockdown, testing, nationalising private healthcare facilities, civil protection etc) compared to European and North American ministries.
However a better measure of controlling the viral spread, was the efficacy of mass incorporation of digital health innovations. Healthcare startups have been pivotal in creating novel inventions, graciously supported by much needed public funds, in supporting the entire health sector of various countries. IoT devices have been instrumental in rolling out point-of-care diagnostic tests and Big Data analytic software with cutting edge AI-mainframes assisted in health informatics, to guide resources deployment.
In China and elsewhere, mobile devices were the main tool in contact tracing, health content delivery and controversially (albeit necessary), individual users had to download a publicly-mandated app which served as a ‘health certificate’ that allowed tagged individuals to move about like an e-passport.
Regardless of the dire global situation, digital healthcare innovation was needed decades ago, with or without a global health emergency. Other industries with complex systems have rapidly adopted digital transformation; such as logistics networks, taxation, commerce and others — except healthcare.
Healthcare providers and policymakers are traditionally anti-disruptive. The reasons could be a professional culture that is deeply intertwined in hierarchical structures, low public investment in technological upskilling, strong lobbyists in collusion with other major industries, lack of data on effectiveness of existing technologies on health outcomes and other issues related to certain bottlenecks in technological adoption.
The Coronavirus outbreak was the watershed moment where global public demand for digital solutions tripled overnight. Ecommerce, food delivery apps, video conferencing and now digital healthtech innovation has finally found their opportunities to provide their real value to the people.
It is easier for startups to rapidly innovate and execute a tech-based solution for a growing need, much faster than central decision-making bodies to enact policies. In developing countries, the IT infrastructure is much more developed for the ‘last mile customer’ than basic public health services (especially universal health coverage). This is known as leapfrogging development.
I had predicted 2 years ago that digital healthcare solutions would be the dominant narrative for the emerging middle class of many developing countries in Asia. Therefore as a physician entrepreneur I had taken the initiative to develop a digital health startup — VIOS, a medical app for Doctors, made by Doctors.
The following is an excerpt from an interview for an upcoming conference in Europe.
What is the definition of digital health?
Any operational process that seeks to alter or upgrade the natural life process of the end user, using IT enabled tools.
❏ Detect life process abnormalities (blood pressure) ❏ Monitor changes to systems (muscle growth) ❏ Alter behaviours (smart watch to remind you to be active) ❏ Communicate information (Covid infection signs) ❏ Enable access to specialised services (nearest available gynecologist)
What’s your story, how did you become an innovator in healthcare?
My name is Dr. Ismail Sayeed, I am a physician entrepreneur and health tech startup founder in Dhaka, Bangladesh. I started my career as a pediatrician, graduated and trained from a medical university from UAE. I had 6.5yrs experience as a child specialist, especially in NICU setting (neonatal intensive care) in the private and public sector in UAE, Chicago, India, Egypt and in Bangladesh.
I had completed 2 Masters degrees in Global Health (Queen Mary University of London) & Masters in Pediatric Medicine (University of Sydney), and worked in an NGO as a healthcare systems consultant. Through an understanding of unmet health needs of the population, I decided to try out healthcare entrepreneurship.
Initially I just wanted to start a generic/traditional medical-related business — such as in medical events management, medical tourism and ecommerce. However they were not successful nor impactful.
Later I focused on the problems affecting my doctor comrades in Bangladesh and in other countries. After much analysis I realised that it was a problem/pain related to communication between doctors and patients i.e. branding of doctors to the right patients and lead generation of patients to doctors in an efficient way.
I was focused on sustainable healthcare optimisation, using mobile technologies as a tool.
If you want to read about my origin story, get your free copy of my autobiography here
What is the most interesting thing you’ve discovered working in the digital health space?
❏ How pro-tech business many governments are ❏ Ability to change any feature quickly and effectively without recalling any made products (app updates) ❏ Zero cost of manufacturing (app downloads) ❏ Easily measurable KPI (churn rate, subscriptions) ❏ Robust business models (SAAS) ❏ Ability to incorporate multiple revenue streams eg. saas, ecommerce, content marketing ❏ Easier to incorporate call-to-action in digital ads eg. direct downloads from FB
Why is it important for companies and governments to innovate and invest in modern technologies in digital health?
1 To be Future-proof & Quarantine-proof
Early adoption of digital solutions to provide services, whether health related or not, allows organisations to be ready for future user demands. The large pool of data on patterns of service/product consumption, feedback and possible future behaviour (extracted from data analytics) can guide strategic decisions on what to invest in and for whom.
And now the Covid-19 crisis has completely disrupted the notion of centralised work cultures, it is a lesson learned in utilising wireless communication to maintain processes, oversight, reporting and distributed responsibilities across various roles.
A company that is already accustomed to some form of digital-based communication and operations (as much as possible) are the ones most able to survive and thrive in these circumstances.
A government body that can still function and serve remotely and digitally is the most ideal form of democracy. An organisation with remote workers, paperless reporting, established telecommunications through all chains of command are, for lack of a better word, agile in its truest form.
2 To have a lean methodology
The agility of a startup is its core value because since its inception all founders are accustomed to lack of resources, unstable contractual agreements, high costs of user acquisition, volatile competition (and sometimes alliances), unknown market behaviour and the various reasons that pit them against macro-economic forces. This hostile environment forms a training ground for executing commercial activities despite the lack of a strong financial foundation.
This robustness is a valuable trait that larger organisations should incorporate into their own work cultures. Megacorporations take too long to pivot possibly due to the ability to rely on existing asset reserves or due to their longer decision-making chain of command — nonetheless the startup mentality now is more than just a mindset, it is a necessary strategy concept that can help operations to continue.
Digital Technology can actually help massive organisations to maintain communications above all else. A constant flow of feedback from a top-down approach is essential for morale, strategy and ofcourse damage control.
3 Direct link to Consumers
This point is related to the previous mentioned points. Saas platforms i.e. app-based products can be an ideal tool to engage with consumers.
Due to the cost-effective distribution of apps — organisations can quickly provide a channel of communication between individuals and the service provider (eg. emergency hotline).
As an additional benefit, this action can be monitored and at times altered (in-app content).
4 Digital Marketing capacity
Offline marketing was already on the decline before the impact of Coronavirus. Marketing budgets became more streamlined to be more budget-friendly and have clear measurable ROI (return-on-investment).
Market research proved that high value consumers were more engaging with digital platforms as directly correlated with rising income levels. Social media platforms are the ideal structures to form the basis for mass media communications, and form a direct feedback on the overall design process of the actual content provided by companies and ofcourse public awareness campaigns.
5 Modern technology allows any sized company to rapidly assemble a team, or disperse into remote specialised work instantly
Crisis management is an essential human resources tool. Immediate actionable messages using more than a mass email burst, is the perfect tool to rapidly communicate with a team to be present for a general mass meeting. But in the days of work from home, a company that has policies on how work is to be distributed and audited remotely can adjust its core processes accordingly.
More importantly, managing cash burn dictates that all industries make emergency cutbacks on the most expensive sectors in their financial structures; namely top level salaries, dividends, loan payments and office rents. Cloud-based digital products can make this transition as painless and immediate as needed.
6 Achieve economies of scale
Companies are more than revenue-generating engines of commerce, they are by nature profit-driven (or should be).
Consumers on the other hand want the best possible version of a solution to their problems, but pay the least possible amount for it (even free).
To overlap these extremes, a product that delivers value and still generates sustainable revenue must achieve perfect economies of scale. A point where the costs of producing an extra unit as per demand of a consumer is zero.
Saas (software-as-a-service) is the perfect product that does not cost anything during downloads to a mobile device (multiple times are possible as per user’s whim).
7 Tech-savvy human resources are easier to acquire and upskill
Many companies emphasise IT-based skills as a core competency in recruitment. It is shown that IT skills; like a working knowledge of coding languages, are a high demand skill set for the new digital era.
As industries are evolving, the nature of work must adapt at the same speed — fortunately various online platforms exist where such talent can be found, rated and contracted for the digital development.
A company culture that values such high value skills can also leverage even more talented work as such competencies are an upgradeable skill.
What are the benefits and risks of delivering mental health care through technology instead of face-to-face?
BENEFITS: Anonymity for patients Access Acceptance of a digital mental health platform Professional testimonial and transparency of provider before purchasing an appointment time slot Patient is in control of conversation duration i.e. can hang up the call if the session is too intense or inconvenient
RISKS: Inability of provider to assess subtle nuances during session eg. body language or partner responses (couples counselling) Cannot take action in emergency situations eg. high suicide/violence/abuse risk Cyber security issues Patient has no guarantee that the private session is not recorded nor viewed by a third party
So in your opinion, how is digital health going to look in the next 10 years?
There will be greater investment from public health departments, health insurers, VC, pharmaceutical industry and will be intensely incorporated into mainstream healthcare systems.
Number of frontline doctors will decrease since AI chatbots, IoT, app, wearables will produce the health data, robots will take the history taking, epharma apps will deliver the meds to you via drone delivery….
But actual counselling on chronic diseases, grief, mental health, social health and behaviour modification processes, will be supported by a small but highly specialised cadre of providers trained in PHD level soft skills.
If there were some key pieces of advice you would give to a client before they embark on a major digital transformation project, what would it be?
Always ask the following questions first:
What is the problem you are trying to solve?
How big of a problem is it?
Is it related to a short term event, an emerging trend or the pain has always been there in that population group?
What would an ideal solution do to that problem and what would it look like?
How would you deliver/package that solution?
Does it have to be a tech-based solution?
What is the cheapest, simplest, easily upgradeable version of that solution & can you make it quickly (but still functional)?
Why are you doing this alone? Create your A-Team who will build your solution, sell it…..and also own shares of it.
This publication was endorsed by VIOS
VIOS is a medical app for Doctors, made by Doctors
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