Hospital-at-home startup seeks to disrupt traditional healthcare in South Africa

Dr Vuyane Mhlomi, CEO of Quro Medical

Quro Medical, a South Africa-based digital health startup that uses technology to offer home-based medical care, has just raised $1.1 million in a seed funding round. Founded in 2018, Quro combines hardware, software and the expertise of traditional doctors to manage acutely ill patients in the comfort of their homes. Jeanette Clark speaks to co-founder and CEO, Dr Vuyane Mhlomi, to understand the difference between the company’s services and existing telemedicine offerings.

Explain how Quro Medical’s hospital-at-home offering works.

Quro Medical currently offers two key services.

The first is our remote patient monitoring service, which effectively allows us to provide real-time monitoring of patients’ vital signs from the comfort of their homes by using our technology. Covid patients who have been asked to isolate at home, is an example of where this can be applied. In the past, these patients would have had to do this “blindly”. Enter Quro Medical, where we leverage our technology to achieve continuous 24-hour monitoring wirelessly through biosensors attached to the patient. All of this information is streamed to our Quro Medical 24-hour command centre, operated by clinical professionals. This means that at the earliest sign of clinical deterioration, we are then able to mobilise the necessary intervention for that patient. Along with this we also offer virtual oversight or ward rounds and consultations for these patients by doctors and nurses; this ranges from telephonic to video-enabled check-ins.

Secondly, we have the hospital-at-home offering which is a care option in lieu of a general ward admission. Here, the patient would be physically visited by a member of our clinical team after being referred into our care by their doctor. Our team member would go and see the patient once a day for about an hour to physically check on their status and administer any medicine that is required. This is coupled with the continuous monitoring as already described and all information is entered onto our proprietary platform for the doctor to be able to visualise in real-time.

One of our core technologies is a chest biosensor that communicates via Bluetooth to a relay device, which is a customised mobile phone. We have recently partnered with MTN to ensure that patients don’t need to use their own data or have wifi access. If there is decent network coverage, we can provide the remote patient monitoring. It is a simple device that we send to where it is required for our own team or contracted service providers to install.

How would a patient be admitted into Quro Medical care?

How it usually works is that a patient would go and see their doctor where a clinical assessment would be done and a clear care plan developed by that doctor. He or she will then complete the Quro Medical referral form and the patient is then admitted into our care. This referral process is not much different than if the patient would have been admitted into the hospital environment.

The referring doctor remains the originator of the process for two reasons. One is to provide safe care. We believe that every patient requires a proper clinical assessment and referral before admission. Secondly, it is to manage supply-induced demand. Taking Covid-19 again as an example, you could have a situation where patients prefer to be admitted into a model where they can remain in the comfort of their homes. This could lead to the overutilisation of our service if an independent intermediary layer does not exist where a doctor assesses the clinical needs of the patient.

Can patients request their doctors to consider your services as part of their treatment options?

Yes, patients need to be empowered with information around their symptoms and diagnosis, but also in terms of the treatment options available to them and where care can be provided. There is an overwhelming body of evidence that suggests that patients recover faster at home and the risk of impairments and infections are lower than what you would get in the context of a hospital. The home is really a fantastic place for care for most patients and can yield better clinical outcomes.

How does a doctor join the platform?

Any doctor can refer patients to Quro Medical, provided that they have signed up to our platform and accepted our terms of use. They can go onto our website, read the terms of use, submit the application and we then cross-check in terms of their registration with the Health Professions Council of South Africa (HSPCA). Once that is done they receive access details to our proprietary software platform. It is a seamless and quick process.

If you have a doctor that is, for some reason, uncomfortable to refer, we do have a list of Quro-friendly doctors that have used our platform before if the patient wants a second opinion.

Can you offer your services anywhere in South Africa?

We have looked after patients in remote areas of Limpopo right through to the Eastern Cape. That was based on demand and interest just after launch. However, we now have a more targeted strategy in terms of where we make our services available and indicate that this has to be in a radius of 30km from our main catchment areas – Pretoria, Johannesburg, Cape Town and Gqeberha (formerly Port Elizabeth). As our catchment areas expand we are then able to provide a reliable and sustainable service to more patients.

While we can offer the service in remote areas, another consideration is that we want to ensure we have the right contracted emergency services. We need to be able dispatch an ambulance pretty quickly if we do detect that one is needed.

But, we can be operational in an area quite quickly. In December, at the peak of the second wave of Covid-19 in South Africa, the medical schemes that we are partnering with in Gauteng reached out to us and told us about the hospital bed crisis in Gqeberha. We were able to set up operations there within four days.

Are your services covered by medical aids and how does the cost compare to admission to a general ward in hospital?

At the moment it is covered by some medical schemes, and we are in conversation with the others. There hasn’t been a single medical aid that we have engaged with that did not come on board, with those administered by Medscheme being the first to sign up.

Depending on the services required, patients will have a saving of up to 75% compared to private hospital costs.

How does your service compare with existing telemedicine offerings?

Telemedicine right now usually involves the doctor consulting with the patient, sometimes asking them if they have a blood pressure machine available for example and then making a diagnosis. Our offering is really a lot more nuanced. In addition to the ability to connect with the patient virtually, we also introduce the remote patient monitoring component that allows us to continue gaining insights into how the patient is doing. Doctors can log on to our platform, where they can visualise how the patient is doing.