As some sectors of the economy such as education and finance move to digitize their services improving remote access and relevance, the healthcare sector is yet to make similar strides. While Rwandans can increasingly access a number of services including government services remotely, trips to healthcare centres and hospitals by those seeking medical services have been maintained. What would it take to scale up digitized healthcare services? Digitization of healthcare services would among other things allow patients to have remote interaction with medical services providers without necessarily visiting healthcare facilities. This could among other things increase the size of the population access healthcare as well as curb trends such as over the counter self-medication. Digitization of healthcare services has been said by experts as one of the paths to scale up healthcare access at the same time keeping costs minimal. Locally, there is only one firm rolling out the services, Babylon Health which has so far served delivered over 1 million consultations and registered about 2M users since its debut in 2016. Babylon Health (operating as Babyl in Rwanda) early this year signed a 10-year partnership agreement with the government which among other things allows patients to use community-based health insurance scheme, Mutuelle de Sante for consultation as well as lays out a partnership with health centres for services such as laboratory tests and issuing prescriptions. Medical practitioners, however, say that over the years, there has been progress such as universal health coverage, broadband coverage, increased mobile phone penetration which is ground for rapid uptake and growth of digitized healthcare. Dr Emmanuel Rudakemwa of King Faisal Hospital told The New Times that much of the foundation necessary for digitized healthcare is already in place. “This is the right time to build on some of the achievements over the years such as access to health insurance and technology investments. We have a lot to build on, it is the right time. The government has shown intentional efforts to go digital to allow service delivery,” Dr Rudakemwa who is an Associate Clinical Professor of Imaging and Radiation sciences said that in regard to whether the country is ready to adopt the model, there are aspects that can be rolled out such as primary healthcare as well as promotional services. This he said would see patients seeking diagnosis for basic ailments virtually by talking to practitioners virtually (either video or audio), without needing to physically visit hospitals. Digitization of healthcare with relevant platforms would also allow patients to have tests taken at laboratories and doctors reviewing the results before making prescriptions further reducing physical trips to hospitals. The success of digitization of healthcare among other things relies on the confidence of patients on the platforms and systems. The confidence, Rudakemwa said can be achieved by having clear set standards and monitoring of the standards. “For instance, security and privacy of patient records should be treated with confidentiality and there should never be any doubt that one’s records could be leaked,” he said. Rudakemwa said that adoption of digitized healthcare will also improve the referral process allowing patients with complex cases such as cancer to receive urgent medical attention and specialists. Among the potential models of rollout in the country, experts say is public-private partnership where the government plays a role of setting up a conducive ecosystem and monitoring quality while the private sector works on innovation. Shivon Byamukama the Managing Director of Babyl Rwanda said that their recent integration with Rwandan healthcare stakeholders such as the Ministry of Health Rwanda Social Security Board will have much impact on easing access and increasing relevance to users consequently driving uptake. Digitization of healthcare could also help efficiency amid a relatively low doctor-patient ratio which in 2015 was estimated at around 1:15,000. Experts say that through a triage system, cases are referred to doctors following assignment of degrees of urgency ensuring complex cases have specialist attention. A 2019 study dubbed “The Future of Healthcare: The Impact of Digitalization on Healthcare Services Performance” noted that increasingly healthcare systems are facing many challenges, ranging from growing population to demand more services necessitating design of digitized services and changes in the paradigm of healthcare delivery. The study noted that while it will reduce direct costs and there may be savings from fewer visits and there could be indirect costs such as training or through increased demand induced by the greater accessibility facilitated by the technologies. Other aspects that could improve relevance of digitization of healthcare include Electronic Medical Records (EMRs) of Rwandans enabling coordinated care for patients through efficient digital referrals and patient information transfer. Babyl is in the process of setting up such a system. Earlier this year commenting on the importance of digitization of healthcare, Dr Daniel Ngamije, the Minister of Health had said that innovative digital healthcare service will among other things increase access to doctors reducing self-diagnosis and self-medication which lead to longer-term complications. With the reduced burden on health centres and other medical institutions, he said medical professionals can also spend more time and resources on serious medical cases.
