1 September 2016

Ugandan Start-Up Medical Concierge Group Delivers Health Care Online to 50,000 Users Monthly, Will Expand to Kenya Next Year

The Medical Concierge Group was borne out of the frustrations of young Ugandan medical professionals with the shortcomings of the existing health sector, particularly the public sector. Russell Southwood spoke to its co-founder Dr Davis Musinguzi about how he's planning to change healthcare in Africa.

Musunguzi's company started from a very simple proposition:"How can we deliver personalized healthcare to people?... It's simple things like not having to queue at a hospital that will make everyone's experience better."

The Medical Concierge Group launched in August 2013:"We first started as a call centre that was free to the general public and then we had to find ways of making it financially sustainable." The co-founders were four doctors who were drawn from the private sector, development work and Government health services. They wanted to create a fremium model that allowed its main public services to be free at the point of delivery.

It now has 50,000 monthly users online via voice, SMS, WhatsApp and social media:"They are mainly 18-35 years old, the mobile savvy generation. They are very comfortable speaking to the doctor in this way. 70% of the calls are for primary health care consultations and picking stuff up from the pharmacy. 20-25% need to see a specialist like a cardiologist or an obstetrician. 1-5% need to go directly to a health facility."

The service is most used by those living in urban and peri urban neighbourhoods: 70% of them come from these areas and 30% from rural areas. Extending the service's reach is limited by the marketing costs of getting to rural areas:"Most of the rural users come through partnerships we have with development and clinical research organisations."

The organization has "bootstrapped" itself into existence from savings and the salaries of the co-founders. It cost US$50,000 to set up the call centre at the heart of the operation:"The company is still completely owned by the founders of the company. We've had no VC or angel funding. But there are new areas we want to get into and we want to raise (funding) within the next 12 months."

It has started testing different revenue models and is already breaking even. The start of the search for revenue models included advertising and renting out seats in its call centre but both of these failed. So it then looked at organisations in the health space that it might be useful to: development and research organisations; health insurers and private health care providers:"We're making it possible for people to pay us as a business."

It was able to collect data around different types of patient research and remind those being studied (by phone) to go to their next study visit. Development organisations were interested in having long-term clinical care for conditions like TB, HIV/AIDS and diabetes. It was able to help them reduce the number of people failing to take their medicines, ensure a steady supply of medicines, make sure they turned up for appointments and gave patients help with side-effects. It is also working on offering private medical insurance holders or those paying national health insurance, a doctor consultation at any time of the day. It hopes to create four revenue streams and is integrating mobile payment.

Government employees pay a national health insurance that their employer matches. Others pay privately for healthcare or have to rely on services subsidized by development organisations:"There is the equivalent of the UK's national health service but it is not in full effect."

So can he see a time when they might deliver health services for the Government?:"If we gather sufficient evidence to show the cost benefits of this type of service, the Government can put this into context. I hope we can rope in Government intervention and funding if we can provide evidence. But it's very much a long-term activity for us."

In the next 12 months, it's also looking to roll-out remote medical monitoring with wireless diagnostic devices:"So for example, we can have blood pressure results sent to us." Other possibilities include a weighing scale and a pulse oximeter:"The results can be communicated to a dashboard at the call centre and we can adjust treatment or make lifestyle changes. Treatment becomes immediate. I think in three years time you'll see a very mature and integrated telehealth service."

Does Medical Concierge have competitors?:"We haven't seen players in this space so far. There have been a few development initiatives but they lasted as long as they were funded. They were not staffed by medical personnel. In Kenya, Safaricom's Sema Doc is very much like us. They charge a monthly subscription and you can get loans to carry out a lab test. However, it's important to us to reduce the barrier to access by offering a free service and focus on getting revenues at the back-end."

And what of future plans over the next 12 months?:"We will roll-out in Kenya next year and we're looking at Nigeria."

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