The previous article on Thailand’s Telemedicine Success: Innovative Contactless Healthcare That Touches Many Lives has shown how this apparent utopia of healthcare have played an important role in COVID-19 response, bridge the urban-rural healthcare access and quality gap, as well as promote conversations about mental health. Now it’s time to find out the secret of its success!

A quick reminder - What is Telemedicine?

Telemedicine is a modality of healthcare delivery that uses technology for the exchange of medical information. With internet connectivity and electronic devices like smartphones or computers, anyone can consult a doctor in real-time regardless of their geographical location.

It generally contains four components: 1) The provision of clinical support, 2) The intention to overcome geographical barriers, connecting users who are not in the same physical location, 3) The usage of various types of ICT, and 4) The improvement of health outcomes.

How to Set Up Telemedicine Platforms In Resource-Limited Countries?

Establishing a telemedicine platform requires resources, even ones beyond your control. What to do if you are an entrepreneur in a resource-limited country? If there is anything the two founders of Thailand’s top telemedicine platforms have proven, it is that entrepreneurs can still succeed if they have a vision, and apply these tips:

1. Convincing and choosing doctors for the platform - Telemedicine platforms cannot exist without medical practitioners (providers). When Doctor Raksa first started, its co-founder contacted almost a hundred doctors before one agreed to enter their platform. Ooca also experienced a similar hurdle. From this experience, they shared strategies for doctor recruitment:

a) Find doctors who share the same vision and are willing to try new ways of doing things with your organisation b) Choose doctors who are well-established in their field or professors in medical schools. Their reputation will help boost buy-in from their medical network. c) Start with services that are familiar and friendly to the feelings of providers. In the case of psychiatrists, it is counselling. d) The doctor chosen into the platform should be able to adapt the current practice to acquire critical information from patients, given the physical limits of telemedicine. If the doctors are not fully committed, they will end up giving patients bad experiences.

Additionally, entrepreneurs should carefully communicate with doctors about the trade-off between a full-fledged service versus patients’ needs. In the beginning, Ooca faced difficulties recruiting psychiatrists because some were concerned about not being able to observe and react to patients’ expressions.

“Since Ooca’s mode of delivery is video calling, psychiatrists’ tools of the trade such as observing the patients’ physical expression as they walk in or handing out tissues when they cry will be missing. As an entrepreneur, you have to urge them to think about the net benefit of the patient. What do you think the patient needs most, a tissue when they cry or professional help at their most vulnerable moment?” said the founder of Ooca.

2. Map localised user journey - Gather perspectives from both the providers and users to map a holistic ‘User Journey’. The entrepreneur has to understand the doctor’s work schedule in their platform - does it match with patients’ demand? This practice will help entrepreneurs understand the unmet needs of all stakeholders in the platform. Keep in mind that the user journey needs to be localised. For example, if internet connection is poor within the operational area, the video call will not be the most effective mode of communication.

3. Appointment-based versus an On-demand system - In the appointment system, patients have to book an appointment with doctors based on the doctors’ schedule, whereas in the on-demand system, doctors will be the one waiting for patients to select them.

“In the beginning, we debate whether to go for the appointment or on-demand system. While other players in the market choose to cater to the doctors in the form of an appointment system, we decided to take the harder route. In our on-demand model, the doctor waits for the patient, which is much more patient-friendly. This strategy is why we won the majority of the market share.” COO of Doctor Raksa.

4. Rally multi-disciplinary efforts - To propel the healthtech industry forward, all concerning sectors - public health, educational institutions, government, private donors, technologists - need to adjust their mindset on innovation and safety. Technologists’ role is then to act as enablers and negotiate with other actors to achieve a shared goal of a healthier and more equal nation.

“Telemedicine is going to happen whether it is now or in the next few years. So, the question really is ‘Do you want to be a part of it or just want to see it happening and miss this opportunity.’” remarked Doctor Raksa. As the healthcare landscape is being disrupted everywhere, it is high time now for entrepreneurs to make waves in this sea of change in lieu of simply riding one.

The author would like to thank Anisha H. for her valuable mentorship, Anna C.M. for her meticulous proofreading work, Joy A. for introducing the author to the interviewees, and all of the interviewees including Doctor Raksa and Ooca founders who contributed their insights on telemedicine.