by Ivor Abramowitz on 22/01/13 at 3:15 pm
Calling on health entrepreneurs to patch up our ailing public health system.
“Hello Mrs Khumalo, lovely to see you. Please take a seat. We have your details on record. The Doctor is running on time this morning.”
Even in private healthcare, it is rare that a patient has this type of experience. In the public health care space, the patient experience is fraught with inefficiencies, long queues, time wastage and ill- informed medical personnel. The result is a system that fails patients and creates an even greater burden on the state. Ill-treated patients results in an unhealthy workforce. A sickly, unproductive workforce misses work more often. Companies lose productive hours and produce less. As a result, the economy suffers.
It is in these inefficiencies that there exists opportunities for creative and passionate individuals to innovate. Many entrepreneurs pursue innovations that solve first world problems. Just walk into any public health clinic and an hour’s worth of observation will reveal opportunities that can have a social impact as well as bring economic benefit to the entrepreneur.
“Innovation” and “public health” usually don’t appear in the same sentence in South Africa. Some blame the system, others blame the mindset of the individuals working within the system. We see it as circular – the system is not designed around principles that facilitate innovation and the people within that system respond to what has been designed. Further, system design is continually reinforced by those who work within it.
This circular reinforcement of the current public health care system can be described by two questions. What is done? And how is it done? Health entrepreneurs need to understand both of these areas in order to deliver a solution that is inclusive, affordable and effective.
To answer the first question, “what is done”, one has to just experience the workers in the system. One is often met with apathetic, unmotivated workers in the health care space. For these workers, there is limited scope for working outside what is prescribed or going out of one’s comfort zone.
“How is it done?” speaks to the system that underlies every action. For example, medicine is taught in a very prescriptive manner. Students are neither taught nor encouraged to question methodology. Within the clinics, there is a top down approach that requires workers to work within set guidelines. Workers within clinics don’t have the space to create solutions that are site or context specific. The top down approach does not allow workers to adapt to the specific challenges of the specific site. Workers are not encouraged nor empowered to innovate. Have you ever seen doctors fill out reams of paper and not thought to yourself “there must be a better way to do that?”
To create meaningful change, health entrepreneurs must set about creating solutions that address the “what” and the “how”. To do this, solutions need to be inclusive, affordable and effective.
An inclusive solution is one that anyone can use and combines stakeholders. For example – a mobile application for diabetics that allows patients to upload what they are eating. This information can be sent to doctors who can advise on dietary changes and devise personalised medication regimes. With this type of solution, patients and doctors can work together to assist the patient. Further, this application could deliver diabetes related information that further empowers patients. Considering that cell phone penetration in South Africa is one of the highest in the developing world, there is clearly a gap here.
Producing an affordable good or service might seem quite straightforward. However, just because a good or service is cheap, does not necessarily mean people would purchase it. Basic economic principles assume that one needs to measure both ‘willingness to pay’ and ‘ability to pay’. Someone might be able to pay for a service or good, however, they might not value it enough to purchase it. The current system is designed to facilitate the perfect environment for market research – go ask people waiting in long queues. They are sitting and waiting to help you determine a valid valuation of the good or service that you are providing.
An effective solution both creates social benefit and economic benefit for the health entrepreneur. Simple. If one thinks about a classic business model, customers (patients or health care workers), suppliers, owners all benefit from the service or good being provided.
Imagine a system that allows health care workers to personalise an application that makes their own jobs easier and more efficient. Or imagine a system that incentivises patients to live in a healthier manner. The result? Mrs Khumalo would be greeted with a smile. Mrs Khumalo would be healthier and empowered to manage her illness. Dr Ndlela would be able to provide a more informed service. Scale that up and South Africa is looking healthier, both on a societal and economic level.
For health innovators and entrepreneurs, the opportunities are endless.
Ivor Abramowitz holds an MSc in Economics from the London School of Economics. He is the resident Seed Health evangelist and Programme Manager. Seed Health is a South African incubator for ideas that aim to transform the health care sector. Get in touch with Ivor on Twitter: @ivorsaurus. View more articles by Ivor Abramowitz.