How does remote patient monitoring look like in South Africa and Nigeria?

Faces of Digital Health

Clinitouch, originating in the UK NHS, is expanding globally with a focus on chronic conditions and adapting to regional nuances in healthcare delivery.

In this discussion several speakers discuss telemedicine in the context of Nigeria and South Africa.

Speakers are:

Bruce Adams, Commercial Director at Clinitouch (UK)

Japie De Jongh, CEO, Synaxon (South Africa)

Dr John Adesioye, CEO, Utopian Consulting (Nigeria)

Liam van Rooyen, System Support Manager (Synaxon, South Africa)

Key points:

African Context and Healthcare from the Transcript

Role of Remote Patient Monitoring in Addressing Healthcare Gaps:

Dr. John Aade (Nigeria) emphasized that remote patient monitoring (RPM) emerged as a practical solution during the COVID-19 pandemic, addressing the need for care delivery without physical hospital visits. In Nigeria, RPM is particularly relevant for patients in remote or underserved areas, enabling data collection and transmission to healthcare providers without requiring face-to-face interactions.

Community health workers often play a crucial role, stepping in where doctors and nurses are unavailable. They collect patient data, assess needs, and escalate cases to medical professionals when necessary, highlighting RPM's potential in resource-limited settings.

The Dual Healthcare Systems in South Africa:

Jaapie de Jong (South Africa) explained the dichotomy of healthcare in South Africa: the private sector, serving insured patients with robust infrastructure, and the public sector, catering to the uninsured population through community healthcare clinics (CHCs) and basic clinics.

He noted that while the private sector is aligned with international standards, the public sector faces capacity challenges. RPM in South Africa focuses on insured patients with chronic conditions, such as hypertension and diabetes, to reduce hospital visits and improve care efficiency.

Challenges to Technology Adoption in Africa:

Both Dr. John and Jaapie highlighted several barriers to adopting RPM technology:

Device Compatibility and Connectivity: Limited access to smartphones and stable internet connectivity is a significant challenge. Many patients rely on basic phones and are hesitant to allocate resources for more advanced devices.

Trust Issues: Patients often worry about data privacy and fraud, especially in regions like South Africa, where cell phone fraud is common. Providers must build trust by ensuring data security and clarifying the purpose and safety of the technology.

Power and Infrastructure Limitations: In Nigeria, power outages and the high cost of diesel for generators disrupt patients' ability to use RPM devices consistently.

Economic Considerations and Funding Models:

Bruce Adams noted that RPM adoption heavily depends on who pays for the service. In many African countries, healthcare services involve a mix of out-of-pocket payments and insurer-funded models.

In South Africa, as explained by Jaapie, medical aid schemes (insurers) play a critical role in covering high-risk, chronic condition patients. However, integrating RPM into existing reimbursement structures and ensuring that providers are compensated for remote care remain challenging.

Localized Implementation of UK-Inspired Technology:

Bruce Adams stressed the importance of adapting Clinitouch's UK-developed RPM platform to local African contexts. Instead of directly transplanting the UK model, Clinitouch collaborates with local partners to understand specific healthcare needs and tailor the platform accordingly.

Jaapie praised the platform's flexibility and customization, noting its suitability for South African chronic disease management programs. The ability to localize the tool for hypertension, diabetes, and other chronic conditions was cited as a significant advantage in addressing Africa’s healthcare challenges.

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