CEO and Co-Founder of Get Health, Trevor Brewer, explains how his healthcare start-up is helping to alleviate the burden on public health services by providing access to affordable, quality primary healthcare.

While pursuing my MBA at Gordon Institute of Business Science (GIBS) I conducted my thesis into developing a service quality framework for the delivery of patient-centric care to the uninsured in South Africa, which is about 80% of the population. SA has a shortage of healthcare workers, this coupled with the overburden of demand for public health services has resulted in the providers being forced to see hundreds of patients a day, leading to low quality services and extremely long patient waiting times. As part of my research I interviewed patients, CEOs of public and private hospitals and everyone in between, and I was inspired to do something that could make a tangible difference.

Developing a solution

At the beginning of 2015 I decided to try and address this healthcare issue facing the lower income patient. I discussed options with Gary Hill, who has a logistical background and is now the Co-Founder and COO of Get Health. We went about researching best practice healthcare models from around the world. We identified, contacted and then visited organisations in the US, India and Kenya to learn from their experiences and what we found was that they all had the same goal: to improve the lives of as many people as possible. They were all incredibly open with us and shared their mistakes and success stories, which gave us a great starting place for what we wanted to achieve.

Essentially, we wanted to provide an alternative service to the public and private healthcare options; a patient-centric primary healthcare option that was cheaper than private healthcare but which didn’t have the service delivery challenges of the public sector.

Adapting for the South African context

The next step was adapting the different models we’d seen into a model that was suitable for South Africa. At the core of our model is the use of health coaches, which are the facilitators of the healthcare experience. They’re important in the delivery of care because they understand the social context that the patient is coming from and can also speak the same language. Through my thesis I realised that patients are very intimidated by doctors, especially doctors that come from a western background and don’t really understand the socio-economic context that their patient comes from.

It was therefore very important for the care process to be facilitated by these health coaches. The health coaches are there to answer any questions the patients may have and explain to the patient why they’ve got, for example, high blood pressure and what it means and how it can be treated. This relationship ensures that the patient is empowered and educated around their condition. The health coach is also responsible for triaging the patients so that the healthcare professionals can focus on treating the patient by: diagnosing, developing a treatment plant, prescribing and dispensing medicine.

Through this approach we’re hoping to improve patient satisfaction because the patient is receiving compassionate care from a health coach who’s devoting valuable time with them, which will lead to improved health outcomes.

Turning the idea into reality

Our company, Get Health, was formed at the beginning of 2015, and in September we opened our first clinic in Johannesburg CBD. Currently, the clinic uses clinical associates but we plan to implement a multidisciplinary approach to include oral hygienists for example, to provide a complete offering of primary and preventative care.

We are currently partnering with Wits Pathology to run the clinics’ tests, but within six months to a year we’ll have our own in-house lab, which will not only make it more affordable for the patients but will also ensure a quality service.

The clinic operates on a fee-for-service model, and patients are charged R150 per consultation which is well below private rates but allows us to ensure the sustainability of the service and enable future growth. Further down the line, we want to implement a membership model similar to what we’ve seen in India and Kenya. Also, once we scale up to four clinics we hope to implement a telehealth service allowing one centralised doctor to use Google Hangouts to ensure clinical oversite over the clinical associates enabling the delivery of high technical quality healthcare to all.

Harnessing eHealth for sustainability

We’ve recently collaborated with AAT to develop a USSD platform that integrates into Google Calendar, enabling patients to book an appointment using a basic feature phone. By allowing patients to schedule appointments in the easiest and cheapest way possible the barrier to accessing healthcare should diminish.

We’ve also put a lot of energy into developing our Clinical Management System because we require efficiency in the way that we deliver care. We’re volume focused and not margin focused, so we need to make sure that patients can visit the clinic, be seen and treated with an adequate level of care, at an adequate level of patient satisfaction.

Initially we tried to find the best eHealth solution that encapsulated all of our requirements, but that didn’t seem to exist in a single solution. After extensive research we chose to implement a scheduling system from New Zealand and an EHR system from the US that are interoperable with each other. From this process we have a better handle on what we need and don’t need, so in the future we’ll develop our own eHealth system that is also interoperable with third party systems – especially in light of the roll-out of NHI.

Developing partnerships for the future

We at Get Health believe that the answer is in working together to answer each of the individual questions that make up this complex system. We’re actively looking for innovative individuals and organisations in the healthcare space to partner with whose values and goals align with ours and we can work together to offer a much-needed middle ground between the private and public sector. Ultimately, we believe that keeping patients at the centre of our business helps us to maintain quality standards of care and we hope to inspire other private sector stakeholders to enter the space and harness the competition for patients that will improve quality and decrease costs even more.

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