Having enjoyed a measure of success in emerging markets across the Middle East including Egypt, Saudi Arabia, Lebanon and Jordan, Dubai-based digital healthcare booking platform Vezeeta, founded in 2012, is now looking to scale up operations and activities at a pivotal time for telemedicine.
Nana Frimpong, the startup’s Vice President for Africa, explained more to Omnia Health Insights on Vezeeta’s ambitions in sub-Saharan Africa.
Earlier in 2020, the company soft-launched in Kenya and Nigeria, with initially varying results. It was a strategic move, allowing it to understand better the similarities and differences of both sides of the continent, with the two markets possessing unique characteristics and strengths.
Vezeeta will evaluate how to scale its numbers in the “coming months”, ahead of any planned further expansion into sub-Saharan Africa. It’s also evaluating how to deliver services without establishing a physical footprint or presence in a target market, since its technology can be accessed anywhere.
Tech-savvy Kenya, populous Nigeria
Kenya, a nation of 50 million people, stands out as one of the most tech-forward countries in sub-Saharan Africa today, and especially dominant in the fintech space (Frimpong cited mobile money transfer service M-Pesa as an example).
As such it was favoured by Vezeeta from the outset for factors that included internet availability and smartphone penetration. But it also appealed for its accessibility to doctors and, relatedly, affordability of doctors, and doctor patient ratio.
These conditions presented the startup with the ideal opportunity to identify how to augment or enhance existing processes through technology that is using the phone to find and book a physician without having first to drive to the clinic in the hope of meeting the doctor.
Frimpong added another benefit: innovations that begin in Kenya proliferate throughout the East Africa region.
Nigeria was a decision based on commercial considerations. “One of the most important countries on the continent,” Frimpong explained, owing to the sheer size of the market and population, Nigeria offered an unique opportunity: how to use technology to leapfrog infrastructural challenges that come with such a large territory.
Integrated model succeeds in COVID-hit Kenya
In Kenya a proliferation of telehealth services emerged during the COVID-19 crisis. Yet Vezeeta stood out in the market. Rather than offering technology alone it provided an integrated service including in-person consultations as well as telehealth.
In other words, technology is used to support the continuum of care, rather than supplanting it altogether.
This was ideally suited to Kenya, as while the nation’s doctors are tech-savvy and tech-ready, they also have reservations about prescribing drugs via a teleconsultation and would therefore expect the patient to physically come into the clinic.
If it’s a simple follow-up conversation or an initial consultation to determine what happens next, then the telehealth format “makes a lot of sense,” Frimpong explained.
In Nigeria the nation’s relatively severe lockdown impeded Vezeeta’s ability to get into the market quickly, get its physicians on board and bring them together with patients.
Since the country eased lockdown measures, however, Vezeeta has seen adoption pick up – both of its platform and suggestions.
Young patients seek mental care - and care for parents
In terms of how patients have been using Vezeeta’s platform to date, Frimpong revealed that “psychiatry”, while not a mainstream subject in Africa, is a popular category of teleconsultation as patients seek mental health support.
Medical specialities too, that include gynaecology and dermatology - demand is seen coming in from patients in the East Africa region for teleconsultations with Kenyan doctors on skin issues that they are facing.
In Nigeria, where there remains a disposition towards in-person consultations still, patients are recognising that they can see a doctor in Lagos from Abuja without having to travel (a distance of approximately 700km), or alternatively they can book ahead of their visit, as opposed to turning up and hoping for the best.
Most teleconsultation patients are young, in the 24-35 bracket (Gen-Z and young Millennials). Surprisingly, many are booking appointments on behalf of their parents - the analytics show that people are booking from Australia, Florida, Canada and the UK, for example, for a parent or loved one living in Nigeria or Kenya.
A telehealth policy framework could unleash a healthcare revolution
Highlighting that many doctors in both markets are raising questions around legal issues, data security and protection, Frimpong said that for Vezeeta is was “incredibly important” that patients are given the security they need, as well as the company adhering to general ethical practices around data management.
But there remain important questions – for instance what happens in the event of medical malpractice lawsuit. This underlines the need for a clear and robust policy framework to guide how telehealth interactions take place moving forward.
This is especially pertinent, Frimpong believes, in consideration of how telehealth appears to be accelerating more quickly than anticipated.
A well-designed framework would see greater and faster adoption of telehealth solutions - so long as policies and legislation are in favour of expanding access.
He noted how Australia developed a framework bringing together payers, patients and providers in a way that everyone benefits, while the US lifted restrictions during COVID-19 that allowed people to access care across state lines.
A similar framework that allows patients to safely access doctors across Africa, provided they are licensed and held to the same standards, could prove “revolutionary” for healthcare in sub-Saharan Africa, where there remains a shortage of doctors.
In some rural areas there are few specialists for certain diseases compared to North Africa, where there are physicians across multiple specialties.
A new model could therefore emerge that, through telehealth, integrates local doctors with physicians in other countries who have particular expertise in a given area. Under such a scenario, Frimpong said, patients are able to select medical care that suits themselves and their families in accordance with their needs and price point – rather like consumers.
On this last point, he elaborated further by saying that uptake surges when patients feel the price point is right, and that it was important to understand how patients price the value proposition of teleconsultations versus in-person consultations.
But physicians too have a different perspective on this, in how they get compensated.
How the two may be reconciled was an area of discussion at Omnia Health Live Africa that Frimpong looked forward to. The Vezeeta executive spoke at a session on Policies and regulations shaping telemedicine in Africa: Challenges and opportunities in COVID times when he was joined by panelists from Lagoon Hospitals; Board of Healthcare Funders of Southern Africa; Discovery; and Homeplus Medical Care Services.