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Health and wellness

Too busy to see the doctor? There’s an app for that in India that may be the answer to its chronic health care problems

The MFine app lets users consult doctors from leading hospitals online by phone, text, or video, and ease the burden on India’s health care system. It also aims to make a doctor’s consultation more comprehensive and effective

PUBLISHED : Thursday, 09 August, 2018, 10:45am
UPDATED : Thursday, 09 August, 2018, 8:11pm

Rahul Kaushik is a busy 33-year-old engineer, who works long hours for a mobile phone company in the Indian capital, New Delhi, where the city’s permanent traffic congestion and pollution means even a 12-kilometre drive to a doctor’s clinic is difficult.

To get around the problem he used an app called MFine. It meant when his young daughter’s fever wouldn’t subside recently and his father’s lack of appetite after an asthma attack left him alarmingly underweight, Kaushik did not have to put them in the car and take them to his local family doctor.

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Using the app, he spoke instantly to a paediatrician about his daughter and then an asthma specialist about his father.

“My daughter’s fever wasn’t serious but I just wanted to be sure there wasn’t anything else I should be doing. As for my father, the doctor prescribed something that helped,” said Kaushik.

Could this instant medical care signal a brave new world for medicine in India? Kaushik believes that it does. “I have a really pressured job, so sitting at my desk getting a medical opinion was the best thing for me,” he said.

MFine is the brainchild of Prasad Kompalli and Ashutosh Lawania, technology entrepreneurs in Bangalore who had been wrestling with two striking facts about India. One is that the country has 330 million smartphone users, a figure that will shoot up to 900 million in five years owing to broadband costs coming down. The second is that India has only one doctor for every 11,000 patients (the World Health Organisation prescribes a doctor-patient ratio of 1 to 1,000) and one hospital for more than 55,000 people.

The old-fashioned way of training more doctors and building more hospitals would take decades, but mobile phones can be used to bring doctors and patients together quickly and easily.

“I realised there was a lack of technology applications for the health care sector,” said Kompalli, who was in Hong Kong recently to meet hospital administrators.

After doctors responded positively to the suggestion, Kompalli tied up with 75 doctors at 25 leading hospitals in Bangalore (and is expanding to four other cities) across specialities which include paediatrics, general medicine, fertility, gynaecology, dietetics, orthopaedics, gastroenterology, and cardiology.

MFine was launched by Kompalli and Lawania in December 2017. Users download the MFine app, create their profiles and, when they need a doctor, can access one in a few minutes. Before they talk to a hospital doctor, MFine’s team of in-house doctors collects preliminary information which helps to identify the ailment.

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Then the user is put through to the doctor they have selected, and after the consultation, a printable, digital prescription is sent to the user’s phone. An average of 3,000 people use MFine every month to consult a doctor by phone, text, or video. More than 30,000 consultations have occurred since December.

Since MFine aggregates a lot of hospital doctors who have different time slots, users rarely have to wait more than a few minutes, and Kompalli has partnered only with hospital doctors for quality control.

“It’s all about speed, access and quality. The quality of the diagnosis is better because all the patient’s X-rays, test results, past prescriptions and medical history are systematically collected and uploaded beforehand. Doctors are not starting from scratch every time. And the care starts immediately, there and then,” he said.

Within the next two years, he expects to partner with doctors in 20 cities. He also plans to include laboratories so that, within the next three months, he can offer medical tests at home.

I got a notification on my phone every morning from the in-house care team reminding me to give Dad the medicine. And after a couple of days, the doctor messaged me asking if my father was feeling better
Rahul Kaushik

For Shahwat Kumar, an investment banker in Bangalore, the app came in handy recently when he urgently needed a second opinion. The emergency doctor treating his 66-year-old mother for a fall at her home in Pune, where she fractured her humerus, said she needed immediate surgery. Kumar wanted to be sure this was the only option, so he spoke to an MFine doctor who, after seeing the X-rays and CAT scan, said surgery was not essential.

“He said healing would probably take a bit longer without surgery but why risk surgery and infection? The first doctor hadn’t given me this option. I felt better informed. We didn’t opt for surgery,” Kumar said. It was a great relief for him to be able to consult a doctor at the weekend and in the evenings.

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Clearly, the app does not work where a physical examination is needed. Eye and dental problems, where a physical examination by doctors using specialised tools, is necessary are also out.

Kompalli says he is targeting mainly urban, tech savvy, upper middle-class consumers for the moment, but the use of video will allow the app to be used by other social groups.

Dermatologist Roshan Kumar has found that most of the 1,000 patients he has treated since March via the app have been from rural and remote areas. For skin problems, he needs patients to send high resolution pictures, and says he often sees cows and buffaloes in the background.

“This app isn’t just for the affluent. It is useful to less well off people in remote areas because they don’t have to leave their work for the whole day, losing a day’s wages, and spend half a day waiting in a hospital to be seen,” said Dr Kumar.

Follow-up is also easier. Usually, people from rural areas find it difficult to have a follow-up appointment, but with MFine it is easier for Dr Kumar to keep tabs on them. Kaushik was pleasantly surprised with the follow-up by MFine’s in-house care team, after the hospital doctor had prescribed the medicine for the stomach problem that had caused his father to lose his appetite.

“I got a notification on my phone every morning from the in-house care team reminding me to give Dad the medicine. And after a couple of days, the doctor messaged me asking if my father was feeling better,” said Kaushik.

With India’s huge health care needs, it’s difficult to meet the demand for primary care by just scaling up the physical infrastructure. How many doctors can realistically be trained or clinics set up for such a vast population? But Kompalli believes that technology will help India overcome this lack of physical infrastructure by offering primary care to a large number of people through health care platforms such as MFine.

For doctors, says Kompalli, the satisfaction of the app is in providing a consultation that is better because a comprehensive case file is prepared and made available to them. Each consultation is not a fresh interaction.

More importantly, for both doctors and hospitals, the app is a way of reaching more patients without having to invest money in building more hospitals.

“It’s a new channel to reach a patient without much investment. They have influence beyond the facility. They can serve a larger population across a bigger area. They get additional business. The consumer pays us and we share the revenue with the hospital. The hospital gets the bulk of it,” said Kompalli.

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The fee for a consultation ranges between 500 and 700 Indian rupees (US$7.30 to US$10.20), about the same as what a patient pays in a hospital, depending on the speciality.

“The tipping point will be the swift spread of the internet on mobile phones [when broadband costs come down]. That’s going to trigger the transformation,” he said.