Doctor on call

Published April 25, 2014
— White Star Photo
— White Star Photo

Aman TeleHealth, a unique service in Pakistan, allows people to obtain a free diagnosis for their afflictions through a simple phone call made to their helpline at 111-11-3737. The service was launched in early 2012 under the Aman Foundation banner, and is part of an initiative designed to address the growing inequality the people of Pakistan face when they need reliable and quick access to medical advice.

The major aim of the program, as its head Dr Zahid Faheem explains, is to “provide reliable healthcare advice at a distance using the latest in information communication technology.” It is clear that the investment done by Aman Foundation in this particular wing has also focused on this goal. Rows of glistening computer screens staffed by employees who have been imparted six-week training on healthcare issues shows how serious the organisation is towards achieving their goal.

Dr Faheem explains that the call centre is a 24/7 service, operated in three different shifts per day. Each shift has a number of licensed doctors working in tandem with trained agents so that if there are any medical emergencies that can only be tackled by experienced doctors, there is one immediately available.

The entire system of logging and attending complaints is facilitated by a comprehensive medical algorithm, explains Dr Faheem. The algorithm has been adopted from a similar initiative - HMRI Andrapradesh - in India, which receives federal support via government budgetary allocation and therefore meets 90 per cent of its financial requirement through this support. Due to this support, the Indian telehealth service caters up to 50,000 calls a day and provides extensive relief to government services. This especially holds true in the realm of disaster management where there is a surge in the number of patients that require emergency medical support, relieving some of the load that public hospitals have to handle.

Dr Faheem explains that it is critical for the Pakistani government to step in and take ownership of this project in order for the service to become accessible to all Pakistanis, which is the primary goal of the Aman Foundation. Currently the installed facilities allow them to cater to approximately 1,000 calls per day which can be readily expanded to 5,000 calls given appropriate investment in infrastructure and human capital. The current volume of calls ranges from between 300-400 calls per day, which is well within their capacity.

Despite a number of public relations and marketing campaigns, primarily targeted at the rural populations of Punjab and Sindh, the number of calls has not taken off because of lack of government support, explains Dr Faheem. With government support comes a feeling of legitimacy, allowing the project to achieve critical mass and enabling Pakistanis to achieve free access to healthcare as and when they need it.

There are a number of impressive initiatives that the service has introduced. For example, there is always a licensed psychologist available to cater to patients suffering from mental health issues and who wish to discuss their problems with a degree of anonymity, given the stigma attached to mental health issues in our society. Furthermore, if the agent catering to a particular phone call determines that the patient in question needs a visit to their local doctor, then they will assist in recommending a specialist based on their geographical location. To assist in the decision, TeleHealth maintains a database that covers all licensed doctors in major cities of Pakistan, according to their field of specialisation.

In their quest to make TeleHealth accessible to all citizens of Pakistan, Dr Faheem and his team are currently working around the clock to help bring the cost of calling the helpline to the lowest possible level. “Initially we pitched the idea of making a call absolutely free of charge to all the major mobile telephone companies,” said Dr Faheem. “But due to inter-connectivity charges, this wasn’t possible.”

Nonetheless, the Aman TeleHealth teams remain relatively confident that the cost of a call to the helpline from a mobile phone will eventually be capped at one rupee per minute, which Dr Faheem believes is an affordable level for ”each and every Pakistani.” This will further help in relieving pressure on public hospitals which are currently overwhelmed and cannot deal with the sheer volume of patients that come to them seeking medical advice.

There is also a major misconception that most doctors and practitioners in the field of medical services have regarding TeleHealth services. Dr Faheem laments that the field of medicine has become primarily about making money as doctors demand to see a return on the investment they have made via acquiring an appropriate level of education to qualify as specialists in the field. Hence, most shy away from promoting the service and go to great lengths to belittle it in the fear that it might reduce their client base and therefore negatively affect the profitability of their respective clinic/hospital.

Dr Faheem explains that the TeleHealth service is a support service that actually promotes the spectre of healthcare. He argues that there will never be a day when all medicine will be ‘outsourced’ to call centres and also points out to his organisation’s practice of maintaining a database of doctors as indicative of his wish to promote healthcare and access to the best possible care. However, he agrees that healthcare professionals will have to play their part in promoting the service in order for it to truly succeed as the issue of legitimacy can only be overcome through expert diagnosis and a positive projection from all stakeholders.

Despite its reliance on the largesse of Aman Foundation’s board of directors, the TeleHealth service is here to stay and does not plan on reducing the scale of its operations at any point. The dedication of its head, Dr Faheem, who gave up a lucrative job with the Aga Khan Foundation shows that the team is making headway in its pursuit of the goals laid out while conceptualising the initiative. A concerted effort from civil society to promote and publicise the service would go a long way in helping this impressive team to meet these goals.

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