Part I – Telemedicine
Guest: Dr. Alexander Börve – Founder of iDoc24
This is a mini-series about technologies that are radically changing healthcare. In each part I preview how a technology came about, how it is being used and how it will evolve, illustrated by my conversations with some of the health care entrepreneurs bringing this technology to life.
History Repeats Itself
“The Doctor” is a painting done by Sir Luk Filde in 1877. The painting shows a doctor focused intently on a patient, in what used to be the cornerstone of healthcare: The home visit.
Over the past few decades, health delivery has shifted away from the home and mainly into the hospital because of its technological readiness. Ironically, it is also the progression of technology that is now bringing health care back to patient’s homes.
Telemedicine or TeleHealth already provides 10 Million US citizens with home-based care from doctors that are mostly from other states. This is rapidly becoming a global phenomenon propelled by the power of mobile technology.
iDoc24’s flagship product, First Derm, provides users in 160 different countries access to American board-certified dermatologists on the same day, with a process that is as easy as SnapChat. First Derm has over 100,000 downloads on the app store.
“In the US, it takes around 30 days to see a dermatologist, while First Derm provides medical information within 24 hours.” Explained Dr. Alexandre Börve, founder of iDoc24. “Our studies have shown a 40% reduction in costs related to unnecessary visits and wasted physician time”.
The service costs $40 per case as opposed to the dermatologist visit, which averages $120.
Trends and Usability
I have created this data visualization based on a survey done by Health Intelligence Network interviewing 129 Organizations that use Telemedicine. Click on the drop down menu to see the different trends in the industry.
Current Bottlenecks
“Have you ever seen a doctor virtually, Omar?” Alexander asked me to which I almost felt ashamed to reply with a blank “No”.
“See that’s the problem, even a die-hard digital health enthusiast such as yourself hasn’t adopted it. I think the best way to solve this adoption issue is by incentivizing doctors to recommend it to their patients. There isn’t enough doctor compensation yet.”
Another obstacle in the US is the long and tedious task of new state licensures that is required by doctors who treat and prescribe medications to patients living in other states. Doctors also require lab tests and biopsies, which aren’t readily available to them through current virtual health modalities.
Furthermore, there are significant financial and technical barriers when it comes to syncing with legacy EMRs. I cringed when Dr. Börve told me that it costs money to use EPIC’s API and that the images are uploaded as scanned documents rather than as real time integrated data.
Dr. Börve reassured me that all these limitations could be solved with the right partners though. “As long as you have someone who wants to use your service and you have a good relationship with them, that is really all that matters.”
The Future
“Technology isn’t the problem anymore, but what is likely to change in the upcoming years is the adoption problem.” said Dr. Börve.
“As data starts becoming seamless, we can start relying on algorithms to tell us what our health problem could possibly be, get a feeling of where to start managing it, or even know about a disease spreading in the area we live in” Stated the orthopedic surgeon and dermatology researcher.
Perhaps what excites me the most about Telemedicine is its obvious power to break boundaries set by national borders and deliver a global meaning to the world ‘universal’ care.
Imagine a patient in Tanzania using an X-Prize Challenge- like tricorder device to send accurate information and receive care from a top-notch doctor in the US or Europe without having to pay thousands of dollars he doesn’t have for travel. Perhaps he would even pay for the consultation in Bitcoin!
The irony of Sir Luke FIlde’s ‘The Doctor” is that the physician actually hardly knew anything about a patient’s biometrics in the 19th century, no matter how hard he stared. Nowadays, doctors know way more without even being in the room.
Omar Shaker completed medical school in Egypt, followed by internships in the US. He soon left primary care for the world of digital health, moving to San Francisco to work on his own projects. These posts represent his reflections on a series of interviews he conducted with some of the more exciting entrepreneurs working in digital health today. Omar can be reached at shaker118@gmail.com.