The Impact of Health Call Centres on Patient Engagement in Uganda

For many decades before, medical doctors and other health professionals were the sole custodians of health information and expertise. Those that were afflicted by disease had to seek the services of these ‘selected few’ many miles away. To many, some doctors were some form of ‘demi-gods’ sent to restore health to the ailing and suffering.

This way of medical practice did not see much change and was the order of business for centuries.

The last three decades have seen a great advent of technology in general and indeed its adaptation within the healthcare sector. Mobile phone and internet technology has, by far, had the biggest disruptive impact on the way of life and brought new ways of healthcare delivery.

Digital and mobile health platforms have opened up new ways of extending the limited medical human resource especially in Africa, to reach as many beneficiaries as possible.

Capitalising on these new trends and opportunities is The Medical Concierge Group (TMCG), a leading digital and health IT enterprise in Africa. It is headquartered and operates in Uganda and is incorporated in Kenya and Nigeria with operations set to start in 2017.

TMCG runs a medical call centre with a team of full-time medical doctors and pharmacists providing real-time medical consultations and health information to the public.

These services are provided across seven communications platforms: Voice calls, SMS, Facebook, Twitter, WhatsApp, Email and Skype. These doctors and pharmacists are available on any of these platforms 24 hours a day, 7 days a week including holidays and regardless of your geographical location. The value of this service is far-reaching and indiscriminate of social and economic status.

One impactful testimonial is that of Tom Sabbilla, a boda-boda (Commercial motorbike) rider from the Manafwa district in Eastern Uganda located approximately five hours from the capital city, Kampala. For two days, his wife had been complaining of abdominal pain and they both were confused and distressed by this mysterious pain.

A visit to the nearest hospital would mean Sabbilla would have to sacrifice the day’s wages from his boda boda business, and spend an entire day on the round trip and in the long queues at the waiting room not to mention the 20,000 Uganda shillings ($6) doctor’s consultation fees.

Instead, Sabbilla used his basic mobile phone to dial the TMCG hotline to seek a free doctor consultation from the comfort of his home with his wife. After thorough history taking by the medical call agent on the origins and circumstances of his wife’s pain, it was discovered that the query could be resolved by getting over-the-counter
medication without any need for a hospital visit. Sabbilla was also given information on accredited drug shops in his proximity where he could purchase the medication. Sabilla and his wife later got back to us to thank us for the service since the pain had long vanished. After all, Sabilla spent only 20 percent of what he had initially expected to spend at the hospital and did not have to lose paid hours away from work.

Many young people can also relate to the story of Samantha, a 19-year-old university student in her first year. She grew up in a strict religious family and attended only-girl schools before joining university. In her sexual encounters, she did not use any protection because no one had ever talked to her about condoms in her family and at school. She contacted the TMCG call centre after seeing one of the TMCG information stickers in her university hall. She was timid and does not openly talk about her situation. The call centre doctor, however, assures her of utmost professionalism and confidentiality of their interaction.

Samantha is helped then to know more about safe sex and the practice of using protection to prevent sexually transmitted infections as well as undesired pregnancy. She was given information on where to find emergency contraception as well get screened for STIs. She is also linked up with a community-based organisation working among youths to get a supply of condoms.

In the situation of Mrs. Kasumba, she was pregnant with her fifth child after the last two were delivered by caesarian section due to complications. Her husband has not been very supportive because he says that he does not understand ‘women’s health issues’. Mrs. Kasumba was very frustrated with his indifference and she thought the stress would harm her baby. She eventually reached out to the call centre regarding her fears.

The call centre medical team provided counselling and advice regarding her pregnancy, the need for contraception and family planning options to choose from. Through the couple-counselling initiative, the husband agreed to be contacted by the medical team to educate him too about his wife’s health needs and family planning. They were both initiated in the TMCG’s targeted antenatal care SMS cycle to support the couple throughout the pregnancy. Mr and Mrs Kasumba eventually had a healthy baby after which Mr. Kasumba opted for a vasectomy as his preferred family planning method.

TMCG Doctors and Pharmacists Providing Free Medical Consultations through a Medical Call centre, Kampala, Uganda

Sabbilla, Samantha and Mrs. Kasumba are just three of the 50,000 monthly users receiving medical consultations using the various TMCG teleconsultation platforms. A large percentage of medical issues do not necessarily require a physical hospital/clinic visit and can be resolved remotely over the phone. The introduction of social messaging platforms which are widely used and affordable has increased timely patient engagement through multimedia exchange.

The privacy and confidentiality provided by this approach to seeking healthcare allows more candid expression of stigmatic issues like HIV and sexual reproductive health without fear or embarrassment. This has led to more male engagement than female, utilisation by commercial sex workers and men who have sex with men to looking for friendly healthcare services and information. This is a stark contrast from the patterns observed in the conventional healthcare service delivery systems.

TMCG has, over the last 4 years, demonstrated the value of digital and mobile health platforms for fostering equitable provision of quality healthcare to both rural and urban dwellers. As such, it has opened up new opportunities to scale up the call centre and mobile technology model for patient engagement and behavioural change communication. TMCG is now a leading digital health partner with the government, the ministry of health, development partners like USAID, UNICEF, World Vision as well as clinical research institutions, private healthcare providers and insurers.

The demonstrated value has been due to the ease-of-use, can be tailored for individual needs and also offer multifunctional adherence tools familiar to the patient. This has led to public health impact through improvement of HIV treatment adherence and more prompt linkage of patients to relevant and accurate care.

Through such partnerships, TMCG is able to meet the setup and running costs as well as scale geographically to reach beneficiaries both in Uganda and beyond.

TMCG is also launching premium services involving mobile payments for recommended healthcare services to its users as well as deploying connected diagnostic devices for remote medical monitoring of chronic patients such as hypertensives and diabetics.

With other African countries like Kenya and Nigeria facing similar healthcare challenges, TMCG is set to scale its innovative and impactful services in these markets.

The vision is to cost-effectively impact the health outcomes of Africans through innovative and patient-centred digital health services.

By Dr Davis Musinguzi, Managing Director, The Medical Concierge Group, Uganda. This post originally appeared on http://www.gsma.com

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