The diagnosis of a serious illness takes heavy emotional and financial toll on the sick and their families. Patients also have to make tough decisions on the choice of medical care. In many African countries, access to second opinion consultations can be challenging since most have a shortage of specialist doctors. And often the few available specialists are stationed in cities hence rural patients must travel long distances.
A Kenyan social enterprise is seeking to bridge these gaps by providing patients in under-served communities with affordable, high-quality second medical opinions that help them understand their illness and the choices they face. Health-E-Net has built a global network of volunteer doctors who review patient data and provide a second diagnosis.
“All patients have this desire to get the best possible treatment and it starts with a second opinion consultation. It gives patients information about their condition, about options available, and space to think and make the best decision. The demand for second opinion consultation is universal, and possibly even more in a developing country context,” says Dr Pratap Kumar, founder and CEO of Health-E-Net.
Diagnosis from a distance
Born in India, Kumar practised medicine as a resident doctor in neurology and pursued further studies in neuroscience and health economics in Europe. While working in London, he was always sought after by patients back in India seeking a second medical opinion.
“It was very difficult to do this because one needs the patient’s history, the scans, the detailed blood work investigations… which is not easy to get access to when you are in a different country. A lot of doctors in the diaspora want to help patients back at home, but the networks don’t exist to harness these skills.”
Kumar saw an opportunity to utilise the skills of diaspora doctors who want to contribute to the communities they left behind, as well as retired doctors wanting to do something meaningful with their time but without the hassle of long travels.
Through Health-E-Net, those living in urban areas and who can afford it can access top specialists from across the globe for a US$30 fee. Health-E-Net’s team of nurses and clinical officers help patients collect their medical records, which are then digitised and stored with clear guidelines for both privacy and security. The Health-E-Net team shares the patient’s data with the appropriate specialist and offers the patient counselling and other support in their journey to recovery.
In poor and rural areas, nurses at local community clinics act as intermediaries between the patient and the global pool of health specialists. These patients pay as little as $3.
Kumar initially wanted to set up the social enterprise in India, but he relocated to Kenya after his wife was posted there for work. Although India has a bigger population and many challenges in its healthcare system, he notes Kenya is appealing because of the need to innovative.
“In India you very quickly go into the numbers game. Even if your solution is not completely optimised you can scale across the country and make the numbers work for you. In Kenya and across Africa you really need a well-designed product and you must make it work for the low-cost market. The markets here won’t grow exponentially like in India or China, but your product has to be attuned to the challenges of the consumer, so innovation has to be at its best,” he says.
Learning to hustle
Although quitting medical practice to run a start-up means a big financial trade off, Kumar notes that running his business in Africa offers him an opportunity to fully utilise his varied skills as a doctor, neuroscientist and health economist.
“Africa does allow these multiple skills to be used effectively. In a developed country it is very hard to be doing multiple things at the same time.”
But there are many limitations to growing a start-up in Kenya, says Kumar, who also serves as director for the Centre for Innovation, Research and Advisory Services at the Nairobi-based Strathmore Business School.
“The most important lesson you can learn in Kenya is to hustle,” says Kumar. “It has been a hassle to get funding. It is hard to get quality developers to work for a fair pay when they are being offered jobs by large NGO-driven projects that pay quite a lot. You have to be really creative to make it here. So for instance, working at the university has given me access to a wonderful network of people, including high potential students we have ended up hiring.”
Kumar hopes to expand Health-E-Net across the continent, and globally in other markets that face healthcare challenges.
“It works in Kenya, but it is also workable in India, Papua New Guinea or Ethiopia,” says Kumar. “Any place where there is inequality in access to healthcare, [and] where there are large populations that are rural, poor and don’t have access to the next level of care, Health-E-Net will be very useful to such settings.”