Another idea (M-health) that need to pick up steam

[Kim Jong-Un's Pajama Pants]

Windy,
Your friend Moonki is just obnoxiously conceited smart alec hijacking every debate with tangential issues. If this debate is about Call a Doctor then we should confine it there..otherwise like I previously said we can spawn as many problems,challenges and solutions as we can imagine in broad topic like health & medicine.

Nobody has claimed this thing that I am praising is panacea to all our problems; a silver bullet; hell no I have just said this is  start ; a great example of private sector innovation into a difficult area and we shoud all laud and wish them well.

Well apparently not everyone is that "patriotic".

I see the application as an added value.  It is not a bad thing.  Especially if one can get in a one-on-one chat with a healthcare professional, anywhere on earth, in a place where the only option might be a witch-doctor.  It could offer someone a level of access into a modern health system. 

But it has its limits.  For instance a healthcare professional in Chicago might be totally unprepared to give useful answers to a patient in a  bilharzia prone region.  But I guess you could build intelligence in the system to connect to people who are specialists in something like tropical diseases.  But I see that potential of creating channels to healthcare intelligence.

To me, the whole topic is interesting, including MOON-Ki's probing questions.  I feel like I come away more informed one way or another.  Patriotism comes in different flavors I think.  I am not patriotic to any country because it's meaningless to me; one homo sapien deserves as much as the next all things even in my book.  But I think one can be patriotic by constructive and even persistent criticism.

[Kim Jong-Un's Pajama Pants]

Windy

I guess it would be the e- health system like RVP said. This is a new thing in Australia. It's a medical records web interface which allows pts and health providers access to your medical records. That way you and your doctor can keep abreast with treatment schedules and your medical history. I did case studies of this- medical records getting lost in back room file drawers, different doctors not knowing your medical history, negligence and wrong diagnoses. My lecturer was actively advocating this initiative in the early phases- she had no support because doctors her age could barely type and people branded her a nut. She's now spearheading this govt backed initiative.

With EMR (Electronic Medical Records) you can access your medical records anywhere like your mobile phone and you can page your doctor during emergencies, schedule an appointment online, request a phone appointment call etc. the problem in Australia at the moment is consent. Some are trying to make this mandatory while others cite privacy. In Kenya it could be a godsend revolution in delivering more accessible, convenient, seamless healthcare- so long as it has govt backing and support from health providers.

We've had that electronic record for sometime in the US.  A lot of information about many things that are totally intimidating and meaningless if you are not a health professional.  But I see this particular one as a webMD kind of thing with added element of interactivity.

[MOON Ki]

What  Hello (Sema) Doctor, which started this thread and has been vigorously promoted by some, has to offer will be found on their webpage.    Here, for the South African version:

https://www.hellodoctor.co.za/

and here, for the Kenyan version:

https://www.hellodoctor.co.ke/

The Kenyan version has some information on their 15 doctors and explains that:

What is Sema Doc?

It's hard to see where people are getting some of this other stuff.

[Kim Jong-Un's Pajama Pants]

What  Hello (Sema) Doctor, which started this thread and has been vigorously promoted by some, has to offer will be found on their webpage.    Here, for the South African version:

https://www.hellodoctor.co.za/

and here, for the Kenyan version:

https://www.hellodoctor.co.ke/

The Kenyan version has some information on their 15 doctors and explains that:

What is Sema Doc?

It's hard to see where people are getting some of this other stuff.

It looks like you can chat with one of the doctors.  So they have co-opted doctors they can work with.   If it is profitable, it might be one way to keep doctors inside the country.  Given that they are providing insurance, you might think they might want to move it beyond chat and phone on recommendation - it might be in the details, I am not sure.

It also has cash benefits for admission to the listed hospitals.  Collaboration with pharmacies might be an area one might be able to exploit.

[MOON Ki]

Given that they are providing insurance  ... you might think they might want to move it beyond chat and phone on recommendation... It also has cash benefits for admission to the listed hospitals.

From a quick look---I'll have to take a closer look at the details---it looks like the insurance covers the "cash benefits" (to hospitals) to an amount of 5000 shillings per visit, maximum 3 times in one year (but not for the same condition!)***.    That's hardly serious money; so "moving it" could be tricky.

If it gets to serious money, then any insurance company (including theirs) will take a close look at some of the statements included in their legal agreements.   For example:

Important Disclaimer:  Notwithstanding the high level of skills, training, professional qualifications and expertise, the Subscription Services are not intended nor suited to be a replacement or substitute for professional medical advice, diagnosis or treatment relative to a specific medical question or condition.

and

Hello Doctor and the attending doctor:

do not guarantee that a conversation with a doctor via the telephone and/or text message is the appropriate course of action for your particular health care problem.

You add that:

If it is profitable, it might be one way to keep doctors inside the country.

That would depend on the number of Kenyans who (a) have ailments that are on the list the doctors may chat about and (b) consider it worthwhile to chat to a doctor about it.   Looking at the list, I don't see much demand on things like jetlag, travel sickness, stop smoking, ...


***

- On insurance: once you have made a claim on a hospital visit for a given condition and got your Sh. 5000, you may not, ever again, make another claim on that condition.  (And any claim may be rejected.)   

- The Sh 300 is just for the "app" etc.   

Fee for the doctor access service: Each time you request access to a doctor, there is a small fee of KSh60 to talk to a doctor and KSh20 to text a doctor.

These are the initial fees, which may increase from time to time.

[veritas]

Windy

You're starting to sound like MK- hint of misogyny and condescension. I get you defend him but just don't spiral down with him.

The US doesn't have EMR- the proper one. The US has an appalling healthcare system. At least in Kenya it's a British hybrid health system with a transparent subsidiary scheme for pt billing.

Kenya has a health system similar to UK and Oz. In US they charge the pt the full cost of healthcare or the insurance company the full cost. Doctors and hospitals charge whatever they want. I've written a paper about this and I'll post it up if I can find it. EMR - the  legit one isn't possible in the US until they adopt a fully fledged public health system divorced from Big Pharma.

[MOON Ki]

Windy

You're starting to sound like MK- hint of misogyny and condescension. I get you defend him but just  don't spiral down with him.

The old last-resort trick of "it's because I am a woman!"  ?!?  Come on.   Surely, you can do better than that.  Stop seeing non-existent "hints", and let's stick to facts and logic. As it is, some folks have already been carried away with emotion, and we need to try and reduce that.

[veritas]

I find you offensive for many reasons not limited to misogyny. It's not my last resort because there was no malevolent motive there to begin with. You present distorted facts for the sake of in your head "logic" when this is about a grassroots initiative that could benefit wananchi. You don't seem to care about that. It's disturbing. I don't wish to throw my pearls to detractors. You and I don't share the same vision. I don't see the point.

[MOON Ki]

I find you offensive for many reasons not limited to misogyny. It's not my last resort because there was no malevolent motive there to begin with. You present distorted facts for the sake of in your head "logic" when this is about a grassroots initiative that could benefit wananchi. You don't seem to care about that. It's disturbing. I don't wish to throw my pearls to detractors.

What you then need to do is this:

(a) List what you claim are "distorted facts".

(b) Explain clearly the basis on which you consider them distorted.

We can then have a go at an objective discussion of those.

I have no issue with anything that would "could benefit wananchi"; I'm all for such.   I have simply asked how Hello Doctor (aka MPESA Telemedicine) will do that.  And that question seems especially important given the hyperbole that has accompanied this "Kenyan launch".

As for finding me offensive, please don't let it bother you; I can live with it.   The charge of misogyny has no basis, so this is my last word on it: if that's a card you feel you've got to play, then run with it; just don't expect it to change anything from my end.

[veritas]

I don't need to do that at all you misogynist. You're not my logics instructor or husband. Live in Kenya or just real life for a while then we can debate logically on the same playing field. I feel like you're belittling this laudable grassroots initiative into some undergraduate debate because you have no tangible real world experience. Try experiencing things in the real world and you'll see what a pretentious ass you sound like.

[Kim Jong-Un's Pajama Pants]

Windy

You're starting to sound like MK- hint of misogyny and condescension. I get you defend him but just don't spiral down with him.

The US doesn't have EMR- the proper one. The US has an appalling healthcare system. At least in Kenya it's a British hybrid health system with a transparent subsidiary scheme for pt billing.

Kenya has a health system similar to UK and Oz. In US they charge the pt the full cost of healthcare or the insurance company the full cost. Doctors and hospitals charge whatever they want. I've written a paper about this and I'll post it up if I can find it. EMR - the  legit one isn't possible in the US until they adopt a fully fledged public health system divorced from Big Pharma.

veritas,

I have no issues with your gender.  What's condescending in what I said?  Can you quote it?

The way I understand EMR is that it's an electronic medical record.  That is available in the US as far as I can tell. 

I assume that to be case because a specialist, say a dermatologist, is able to pull up your medical history.  On your first visit.

I am not sure how extensive it is or the levels of integration.  The devolved nature of the country certainly imposes major constraints. 

Is it different from Ozzy?  I wouldn't be surprised. 

[MOON Ki]

I don't need to do that at all you misogynist. You're not my logics instructor or husband. Live in Kenya or just real life for a while then we can debate logically on the same playing field. I feel like you're belittling this laudable grassroots initiative into some undergraduate debate because you have no tangible real world experience. Try experiencing things in the real world and you'll see what a pretentious ass you sound like.

See, right there is a fine example of what I mean by excessive and unhelpful emotion.   As the forum owner and admin, I hoped you would be aiming to set a positive example.    Please try to calm down.

[veritas]

Point taken.

[mya88]

[mya88]

I don't need to do that at all you misogynist. You're not my logics instructor or husband. Live in Kenya or just real life for a while then we can debate logically on the same playing field. I feel like you're belittling this laudable grassroots initiative into some undergraduate debate because you have no tangible real world experience. Try experiencing things in the real world and you'll see what a pretentious ass you sound like.

See, right there is a fine example of what I mean by excessive and unhelpful emotion.   As the forum owner and admin, I hoped you would be aiming to set a positive example.    Please try to calm down.

I agree, we set the standards, lets abide by them.

[mya88]

Windy

You're starting to sound like MK- hint of misogyny and condescension. I get you defend him but just don't spiral down with him.

The US doesn't have EMR- the proper one. The US has an appalling healthcare system. At least in Kenya it's a British hybrid health system with a transparent subsidiary scheme for pt billing.

Kenya has a health system similar to UK and Oz. In US they charge the pt the full cost of healthcare or the insurance company the full cost. Doctors and hospitals charge whatever they want. I've written a paper about this and I'll post it up if I can find it. EMR - the  legit one isn't possible in the US until they adopt a fully fledged public health system divorced from Big Pharma.

veritas,

I have no issues with your gender.  What's condescending in what I said?  Can you quote it?

The way I understand EMR is that it's an electronic medical record.  That is available in the US as far as I can tell. 

I assume that to be case because a specialist, say a dermatologist, is able to pull up your medical history.  On your first visit.

I am not sure how extensive it is or the levels of integration.  The devolved nature of the country certainly imposes major constraints. 

Is it different from Ozzy?  I wouldn't be surprised. 

The US healthcare has EMR,

It has always had EMR, but was optional in some corners.

Starting with the affordablecare ACT, all entities are required to implement EMR

If the dont implement it by a certain grace period, they will be fined large fees

For those smaller healthcare facilities, the goverment is willing to offer subsidies in revamping the whole thing.

Just like if you did not buy into Obamacare by the deadline, you will be charged in your taxes.

Doctors cannot just make up fees and charge patienst what they want unless it is a private practice.

That is the same in most countries even the ones with public health systems

All other healthcare facilities, most of them state owned and accept insuarances have to bill according to set rates

These rates were largely determined by medicare/medcaid which carse for almost all senior citizens

To bill you must have a diagnsos, backed up by evidence and tests done... price for the diagnosis is set

Insuarace pays, and you pay your copay which can be $ and up depending on your plan.

I dont know what Very means by what she wrore, given her relatively short stint.

Comparing the Kenyan healthcare system with the US one is laughable to say the least.

Kenya doesnt have the US kind of problems, and the US doesnt have the Kenyan kind of problems

More in this later.

[veritas]

Healthcare is complex. For health economic matters I suggest you at least read a textbook on Health Economy. I did this as a course subject. It's a tricky subject.

I can understand why you seem a bit confused on health service fees.

Kenya and Oz have a similar health model because both countries fall under the Commonwealth. For instance, medical practitioners charge a set fee and a fixed rate and these price checks are regulated by the govt. A doctor cannot take on lots of pts and can only claim a certain amount of benefits per pt per year from the govt. Specialists on the otherhand can charge whatever they want but the cap is usually at $200 per consult- anything more in Oz and Kenya a pt can seek compensation through the govt and the medical practitioner subject to a penalty/warning letter.

In Oz, the Medicare system was adopted in the 70s and is not the same as Medico in the States. Medico is an insurance company. Medicare in Oz is not an insurance company- there is no monthly/yearly fees. It is a universal healthcare system afforded to all Oz citizens. It is regulated and subsidized by the govt. For instance, they subsidize drug costs through a steering committee (PBS) who conduct cost benefit analyses on which drugs should be subsidized so that it would benefit x amount of citizens. They put together clinical practice guidelines for health practitioners based on evidence-based or systematic reviews- things not yet established in USA.

EMR in the USA is not the same as the EMR proposed in Oz. There are stimulates in the latter tethered to govt regulated healthcare checks- which is not possible in the USA. They are two completely different systems which happen to share an electronic platform. It's not actually called "EMR" in Oz. There are different parts to it not all implemented yet. The most obvious one for the pt is called "EHealth" or "PCEHR" the govt has yet to pan out all stages of the fully fledged Ehealth system.

The health system in USA is way behind the Commonwealth system. You can also tell by the medical articles the Yankees churn out- sensationalized rubbish in most instances. Also, it's not hard to do well in American universities whereas in the Commonwealth system they fail students so the govt doesn't have to pay for university fees. Korea's medical and university system is similar to America. Those with money can afford healthcare and get a top spot at university and life.

In USA, doctors can charge whatever they want. It can range from nothing, $35 to $200 to $1500. There is no PBS system. Big Pharma offer different amount of subsidized drug costs to those insured by certain insurance companies or depending on which doctor or pharmacy. One pt could pay $150 for an asthma puffer and the other could pay $10 because they happen to be a pt of a certain doctor with ties to Big Pharma. In Oz, it's the same rate for the asthma puffer regardless of who your doctor is, who your private insurance is, or whether you have medicare, a citizen or not. In actual fact one doesn't need private medical insurance in Oz because medicare covers for hospital fees so long as it's not a cosmetic/specialty related procedure.

In USA, if you were rushed to a hospital with no insurance cover, they are not going to waive that fee. You, your insurance or some charity need to pay for it. It's completely free in Oz. In Kenya, a public hospital or clinic may charge a small fee for treatment but the majority of costs is paid for by the govt.

In Kenya, each clinic from rural to hospitals send a statistical tally of every drug used, and then the county ministry subsidizes and allocates free drugs (like immunization drugs for babies) depending on demand. If something is off, like a clinic claiming a lot more than their usual stock, they investigate. The system is similar to the PBS system in Oz.

Public health uses a completely different treatment and cost model. It's not "medical" it's more army and national security.

I could go on but I won't.

[mya88]

In US they charge the pt the full cost of healthcare or the insurance company the full cost. Doctors and hospitals charge whatever they want

3. In the US specialized medicine is expensive and can cost quite a bit, that is the same in most of those other countries, (but not quite as expensive as the US) but the basic fundamental internal medicine or family practice is relatively the same. Hospitals depend on the governments Medicare/Medicaid programs and cannot just charge patients' just what they want. Fees are set in collaboration with the government and private insurance companies.

4.   In the US if you are rushed to the hospital sick, they must treat you no matter what, whether you have health insurance or not. They will have to sort out who pays what later and it can be quite costly if you do not have health insurance. The government however reimburses most of the costs incurred by the uninsured. All hospitals have to abide by this rule otherwise they will not get federal money, which to a large extent they depend on.

5.   The argument can be made, about whether the US healthcare system is better or worse that other Westernized nations, but you cannot make the argument that the US does not have a system in place, a functioning one for that matter.

6.   The idea that common wealth countries fail students just so that the government does not pay fees is the most ridiculous I have ever heard. I think they call it socialism

They put together clinical practice guidelines for health practitioners based on evidence-based or systematic reviews- things not yet established in USA

7. This assertion is not true. Healthcare in the US is large evidence based and there practice guidelines of all forms to guide practitioners on their treatment methodologies. This are very extensive studies with level I type of evidence and meta-analysis. You just need to know where to go to find them.
8.   The argument here is based on  two opposing schools of thought between the US and these other countries. see below

The central arguments in the socialism vs. capitalism debate are about economic equality and the role of government. Socialists believe economic inequality is bad for society, and the government is responsible for reducing it via programs that benefit the poor (e.g., free public education, free or subsidized healthcare, social security for the elderly, higher taxes on the rich).
On the other hand, capitalists believe that the government does not use economic resources as efficiently as private enterprises do, and therefore society is better off with the free market determining economic winners and losers.

The U.S. is widely considered the bastion of capitalism, and large parts of Scandinavia and Western Europe are considered socialist democracies. However, the truth is every developed country has some programs that are socialist.

This sums it up pretty well.

[RV Pundit]

You're conflating and compounding issues not related to the scope of this private initiative. Nobody said this was a silver bullet. But I see lots of use of these kind of medical care that is leveraging on the m-pesa, m-shwari and mobile telephony. It pretty self-evident. Not everyone in Kenya can google. Nor have heard of Google.

But I understands. It akin to M-pesa debate we had.....it hard for some of your to really grasp this...because you're used to systems that function.

Where options exist (including working 911), doctors, insurances, name...then you go for the "best system".

Where options do not exist....like in most of kenya...you go for "any system". Should we shut down M-health because somebody will be misdiagnosed and end up dead? Of course not! Many more are dying because they never get to any doctor..including to those on the phone or on the internet..they either pray or take herbs.

M-pesa may look sophisticated now...but it is based on very simple technology..a blow back maybe to telegram or morse code...but it works in it's unique way because there is pent up demand for modern banking in kenya.

The same can be said of M-shwari which built on that...and now M-health is trying to build on that.

[mya88]

You're conflating and compounding issues not related to the scope of this private initiative. Nobody said this was a silver bullet. But I see lots of use of these kind of medical care that is leveraging on the m-pesa, m-shwari and mobile telephony. It pretty self-evident. Not everyone in Kenya can google. Nor have heard of Google.

But I understands. It akin to M-pesa debate we had.....it hard for some of your to really grasp this...because you're used to systems that function.

Where options exist (including working 911), doctors, insurances, name...then you go for the "best system".

Where options do not exist....like in most of kenya...you go for "any system". Should we shut down M-health because somebody will be misdiagnosed and end up dead? Of course not! Many more are dying because they never get to any doctor..including to those on the phone or on the internet..they either pray or take herbs.

M-pesa may look sophisticated now...but it is based on very simple technology..a blow back maybe to telegram or morse code...but it works in it's unique way because there is pent up demand for modern banking in kenya.

The same can be said of M-shwari which built on that...and now M-health is trying to build on that.