Discovery’s Adrian Gore: ALL South Africans get access to doctors – free, online #Covid19

South Africa’s wealthiest, smartest business players have wasted no time in putting their teams to work on ways to contribute to fighting the Covid-19 pandemic and limiting its damage to the economy. Discovery’s Adrian Gore and colleagues, and their partners at Vodacom are the latest to step forward, in this case with a simple, powerful plan to create easy access to doctors for any South African who fears he or she might have contracted the deadly coronavirus. The move follows announcements by the families of billionaires Patrice Motsepe, Johann Rupert and Nicky Oppenheimer to contribute R1bn to efforts to assist businesses. Companies like Naspers have also committed funds to various prongs of the Covid-19 national strategy, offering R500m to the Solidarity Fund and about R1bn to pay for protective equipment for medical personnel and medical supplies. In this podcast with BizNews editor-in-chief Alec Hogg, Gore sets out the details of how the plan to create fast, cost-effective access to doctors will work. – Jackie Cameron

Discovery CEO Adrian Gore is with us, on a day you where have announced a very interesting and nation building partnership with Vodacom today. Why did you select them?

We worked with them on a few issues and wanted to work with them again. The vision here is about providing access to a doctor online for free. We needed a telco partner where we could get the data for free. Vodacom and us have worked together  on this very powerful idea and partnership, to get access to a doctor for Covid-19 entirely for free. They bring all the technology and we bring the doctor framework and the chassis we built. It’s taken us time to build a chassis but it’s a very simple powerful idea, to bring online access for all South Africans to a doctor for Covid-19.

It’s got enormous potential, even for after Covid-19 which we can explore in a moment. Where did the whole idea come from, for the two of you get together?

We’ve had this platform we’ve built over a number of years called DrConnect. If you look overseas, best practice is about tele-medicine, right in the front line just as the first point of contact, it makes healthcare accessible. The issue here in South Africa. The guideline has been that a doctor can’t consult and a patient can consult a doctor online unless they’ve seen him physically first, this has been a restriction. On the back of that we haven’t actually rolled out DrConnect very aggressively, we’ve almost kept it on ice. With the Covid-19 issue it is imperative you get care to all South Africans, we have this idea, could we do this at scale?  It’s taken years to build the DrConnect platform and chassis, but over weeks because of Vodacom, we have managed to scale it.

Has that blockage then been removed, that you don’t have to first go and consult with a doctor physically?

No, it hasn’t, the HPCSA guidelines remain. That’s why this service is limited only to Covid-19. It is about treating Covid-19. We continue to be in consultation and discussion with HPCSA, the Health Professions Council.

But you’ve pushed ahead anyway.

We feel the imperative is just too great, we’re rolling it out in the process.

Is any mobile phone able to access it?

Any mobile phone and most people have access to smartphones. The power is you can go on our site by web or on mobile and use it via video or text you, or you can phone Vodacom *111#  line. It’s very accessible.

How many doctors are on the other end of the line?

There are two sides to this is, patients across the country have access to it for free. The others, doctors consulting with existing patients, are concerned about patient contact if the patient is positive. We see the other applications as doctors using the existing base. This is rolling out now and we have a pretty substantial training regime. Doctors can sign up and be trained quickly and get online. We have a core of about 150 to 200 doctors initially and I heard this morning that 5000 doctor’s potential are going to join. We’re moving quite quickly and we’ll see in the next couple of days how we do.

How would the doctors get paid for their time?

With the partnership of Vodacom collectively we funded the first 100,000 consultations. We have committed R20m between ourselves and Vodacom to essentially buying 100,000 consultations. If we go through that we will have to think about how to continue the funding and have a look at other sources of funding, but doctors are paid to consult that’s the intention.

What do they get paid per consult on this platform?

It’s about R200 or so. It’s a standard fee and hopefully worthwhile for a doctor.

Is it for any South African, anywhere in the country with access to a smartphone, if they’re having some of the symptoms they can then pick up the phone call Vodacom even if they aren’t a Vodacom client?

If you’re not a Vodacom client, the data then will not be zero-rated so there is a cost to it. Our research has shown that many people use multiple SIM cards, so people have the ability to get on to the Vodacom network, that is the hope. They simply go on, if you’re not a discovery member you have to put your ID in and then do a verification through the Home Affairs system. The system then asks a set of questions about symptoms of Covid-19 and you can access a doctor via video.

You’ve got a big operation in the UK where the National Health Service has got something similar, have you modeled DrConnect and this new Covid-19 a risk tool on anything that they’re producing?

Absolutely. In the UK, there Isn’t a restriction on doctors in the frontline, we have a virtual consultation service through vitality health in the UK they do close to 5,000 consults a week. We have used a lot of lessons we’ve learned from it. It’s successful in markets like the UK, and we’ll really see how this plays out in this market. As I have said, it’s narrow to Covid-19 but I’m sure through the process we’ll learn a lot about what’s possible with it.

Adrian, you’re an actuary do numbers mean a lot to you if you are putting aside R20m for 100,000 consults. That’s a long way from South Africa’s current infection level of around 2,000. Where do you see this going?

It’s hard to tell. It’s the early phases of the pandemic. 1,200 to 1,300 cases reported, it’s growing at 30% today. The government and the president have acted remarkably swiftly and rigorously with the lockdown and hopefully we can flatten the curve quicker than other countries. But we’ve got a large population of people who live in close quarters, people who immunes are compromised with HIV and TB. We’ve got some unique challenges here. We have modelled a number of scenarios on the stuff coming out of the different countries, especially Imperial College predictions, and tried to understand where those numbers get to. The difficulty is the range of projections is incredibly wide, from kind of low to medium to high with where deaths can be hundreds of thousands. I don’t believe that will happen, I certainly hope it doesn’t, but we are preparing both in our health businesses and in our life mortality structures to understand what we can and we can do what we need to for society and all of these projections. We’ve modelled every single bit of data, we’ve looked at our client base to understand people that are vulnerable and have learned that particular ages and comorbidities are more vulnerable than others. We’re reaching out to those vulnerable sectors of our client base to warn them to try and get them isolated and give advice to them.  We are working 24 hours a day to use the data to try to keep people out of harm’s way, but the projections are very wide.

I had the opportunity to talk with your colleague and partner Alain Peddle who’s the deputy CEO of Ping An, it was fascinating to get his insights from what happened in China. It appears as though we’re drawing on those experiences.

We are, the Chinese lockdown was pretty substantial, the ability to flatten the curve is very much a function of how successful these processes are. It’s hard to draw conclusions. Germany, the mortality rates are quite low, then in Spain and Italy the mortality is incredibly high. The riddle is trying to understand the denominator, how many people are really infected and trying to understand the age factors. You can draw a lot of lessons from each of these countries but I think we’re learning more about the best practice of flattening the curve, massive testing regimes, track and trace, which you’re not doing enough of, and hopefully start doing. We are trying our best to learn from all errors, the Chinese did a good job once they got going. The Germans have done a very good job, and I think Singapore and South Korea did a great job of containing things. We’ve got the opportunity if we act swiftly.

All the countries that you mentioned, China, Singapore and South Korea have used digital tools aggressively. We heard from the president, Cyril Ramaphosa that those tools are now starting to be used. Is this a game changer potentially?

I think it is, you’ve got to test a large number of people. You’ve got to track and trace those people that are positive, that is a key in this battle. We have acted swiftly on the issue of lockdown, but we haven’t done enough tests because of capacity issues. People are working around the clock, labs, business and the ICD and all the rest. It will be a game changer, we have got to move quicker on the testing and tracking your tracing, it is crucial.

Through this tool that people can access online before they even go to a consultation with a doctor, is this disease or is this virus specific enough for them to quickly understand whether they’ve got it or not or if they’re at risk or not?

The tool that we roll out primarily now is about telling us your symptoms and getting you to a doctor virtually. The doctor then decides one or three things, leave it if your fine or referring you to a pathology structure for a test, or having you come back for a second consultation. It is the front line to a triage process that will happen after that. It’s trying to make the process into the health care system more informed, it’s not trying to replace it, it’s trying to make sure that right at the front line you get educated doctors helping people navigate the system.

One of our colleagues in the UK, Linda van Tilburg was saying that there, if you have symptoms, the National Health Service (NHS) will tell you to self-isolate for a week and thereafter to engage with them again to see how serious it is, whether you need a hospital bed or not. Is that a similar line that will be followed here?

I’m not sure. Every country has to optimise the resources that it has. The ability to test every single individual instantaneous and get results is the best thing, but it’s not practical. Every country has different ways somehow, I’m not sure we would do that. I think if we look at some of the best practice, other countries are testing much more vigorously and in much greater numbers. The tests are expensive, they take a long time, 24 hours to do a PCR test, at the moment. I’m hoping we can test more people far quicker. Track and trace, if we can do that, we’ll get on top of this thing.

You have experience with DrConnect already. Are we a nation of hypochondriacs or do we go on there when we’re really sick?

I’ve been asked that often, about the extent of health claims that are going to see through the process, so we have to model these things very carefully. What’s interesting is the other claim areas are dropping, like the elective surgery. The worried are a lot less eager to get into the healthcare system now. This thing quite quickly gets rid of any fluff, people focus more on serious things, they delay elective procedures. Some of our modelling shows ironically, that health care consumption, certainly in our base is going to be fairly flat, unless you get the higher scenario of claims because the other stuff drops off.

I know it’s very early to start looking ahead, but the problem in South Africa and why national health has become such a big issue is because not all South Africans have access to proper healthcare. Surely something like this if it’s proven, would be able to open up a new avenue?

It’s a good question, I don’t know the answer to it, but there’s an interesting vortex of solutions being built. I don’t think the world will be the same after this pandemic. Not only the way we work, but certainly in healthcare. Lessons will be learned, bridges will be built. I’m hoping that this is a device that is quite the opposite of the current structures, a sustainable system that gives all South Africans access to healthcare in some way. That will be a very good outcome.

How else do you think the world’s going to change?

The way we work. We have learned a lot in a week. We have 80% of people working at home now. We are fully business as usual at Discovery, every single function is up and running. We are in meetings continuously, as I’m sure you are with Zoom and Microsoft teams. I’m learning how efficient you can be without having to travel around. The world of work is going to change. This idea of working from home which used to be an intellectual concept, which didn’t really get going as it should have, is going to accelerate. We’re going to see a lot of profound differences in the way people think about how they work. The barrier between work and home has disappeared. On one hand it’s efficient, and on the other, it’s quite disarming. You do need routine and structure. There will be profound changes. A lot of things like the national health and many social security systems came out of the Great Depression in the world war. Its in times of adversity, where you get this ‘we’,  rather than ‘I’. There’s going to be a lot of structural changes happening from Social Security to work and health care that will linger after this pandemic.

We’ve seen a lot of that has been digitally driven. In China today you have a QR code as your colleague Alain Peddle was telling us, as long as your QR code is green you can go into the shop or if it’s red you have to self-isolate and so on. Is that a prospect for South Africa?

I don’t know. It has both positive and negative consequences, if you’re not green you’re labeled as a potential danger. These things have different implications in different societies. The era of surveillance is going to be much more intense post pandemic for sure.

All South Africans now as a result of this can dial star triple one hash on a Vodacom phone or when they’re going through to Vodacom, and if they’ve got Covid- 19 they will have access to a medical professional.

That’s the intention. Absolutely.

And there are enough medical professionals, with 5,000 who are prepared to come and join the system to be able to look after everyone in South Africa?

That’s the hope. We’ll see how the experience plays out, but that is the intent. I’m very confident together with Vodacom we can achieve it.

And your models, how long will the R20m last?

We modeled a number of scenarios but we don’t know. I’m hoping, not from financial concern, but that it doesn’t last long and that we can make this really ubiquitous.

Free online Covid-19 screening and consultations available to all South Africans through Discovery and Vodacom partnership 

Discovery media release

Discovery and Vodacom have partnered to deliver a simple but powerful online healthcare platform for the benefit of all South Africans during the Covid-19 pandemic. This platform provides easy access for all South Africans to a Covid-19 risk tool, to help understand your personal risk for Covid-19 plus, where needed, to immediately schedule healthcare professional consultations and get advice.

Globally, telemedicine has proved invaluable in the management of this disease, with many governments and healthcare systems advocating for digital healthcare tools and virtual consults to be the first step and primary means of healthcare support during the Covid-19 outbreak. The Covid-19 risk assessment and virtual healthcare tools can help to identify people who need health professional engagement and potentially referral for testing or to hospital. This reduces overcrowding at clinics and doctors’ rooms where there is greater risk of the virus spreading, and also protects healthcare professionals from potential repeated exposure to Covid-19. The online doctor consultations platform makes it possible for South Africans to access a healthcare professional without them having to travel to a healthcare facility. It is a simple, free to use and available on any web or mobile phone facilitating a full consultation with a doctor either through a video call or by text. The service can be accessed by visiting either the Discovery or Vodacom websites, and Vodacom customers will soon be able to access the service via USSD by dialling *111#.

With this partnership, Discovery and Vodacom are focused on applying global learnings around effectively managing the Covid-19 pandemic through digital healthcare tools including virtual care. Through this partnership, Discovery’s existing DrConnect platform, which was previously available only to Discovery clients, is now accessible to all South Africans. Together, Vodacom and Discovery have also jointly created a fund to pay doctors for 100,000 consultations, making them free to any South African.

Adrian Gore, Chief Executive Discovery Group, says: “We are proud to be partnering with Vodacom on this important and powerful initiative – bringing free online doctor consultations to all South Africans who need it for Covid-19. Discovery has been built on a very simple but powerful core purpose: making people healthier. In the context of the Covid-19 pandemic that purpose is very simple – we need to keep South Africans out of harm’s way. We are very hopeful that this initiative will make a huge impact on the fight against the Covid-19 pandemic in South Africa – for the good of all our citizens.”

Vodacom Group Chief Executive Officer, Shameel Joosub comments: “As South Africa unites to contain the spread of COVID-19, we remain committed to supporting society and our government during this unprecedented time. Our partnership with Discovery can go a long way in alleviating any increased pressure on healthcare practitioners while at the same time empowering citizens by connecting them to doctors. As a leading technology company, we are optimistic about the capabilities of digital connectivity to transform the lives of our communities. Through the online doctor consultation platform, anyone looking for COVID-19 related information will be connected to a network of doctors who will be readily available to answer their questions.”

Adrian Gore, Chief Executive Discovery Group; Shameel Joosub, Chief Executive Officer of Vodacom Group; Dr Ryan Noach, CEO of Discovery Health and Mariam Cassim, Chief Officer of Vodacom Financial Services, explain the importance of this partnership and how the platform works in this video.

As South Africa continues to closely monitor the incidence of COVID-19, this virtual healthcare platform will work alongside other initiatives to give all South Africans free access to reliable information, risk screening and, when necessary, free online medical consultations. This partnered platform is dedicated to Covid-19-specific screening and consultations. All doctors are invited to download the Discovery HealthID and DrConnect apps from relevant app stores to join the virtual healthcare platform. Doctors will receive guidance on how to consult and how to receive payment from the dedicated fund that Discovery and Vodacom have set up for these specific consultations.

There are seven easy steps to use an online doctor consultation:

  1. Start the process by visiting Discovery’s Covid-19 information hub or Vodacom’s website. Members of Discovery Health Medical Scheme can access the service through the Discovery app. Vodacom customers will soon be able to access the service via USSD by dialling *111#.
  2. Utilise the Covid-19 self-screening risk assessment tool, by answering a number of easy questions.
  3. If you are confirmed at high risk of having Covid-19, a short registration and consent process on the DrConnect app will follow. 
  4. Book a virtual consultation with a doctor who is available to assess the need for Covid-19 testing. 
  5. If the doctor recommends testing, a photo of the completed pathology form will be sent to the patient by SMS, WhatsApp or email. The same process will apply to scripts for medicine. 
  6. Testing and collecting of medicine will be facilitated by the relevant essential healthcare service providers that patients have to visit.  
  7. Doctors will receive test results electronically and can then advise if the patient should schedule follow-up appointments to discuss results and next steps.

Mariam Cassim, Chief Officer of Vodacom Financial Services adds: “It’s always been part of the Vodacom Financial Services strategy to deliver innovative and disruptive health solutions to our customers and the current COVID-19 crisis has called for us to move quicker than we had anticipated. Partnering with Discovery on this initiative is a great example of how two large corporates can use their core capabilities to make a real difference in the lives of all South Africans during this time. Vodacom’s extensive telco network will bring Discovery’s network of doctors to mobile devices all over the country.”

Discovery Health Chief Executive Officer Dr Ryan Noach explains that, “Importantly, this initiative means we’re able to protect doctors from continued exposure to COVID-19 and hopefully make their jobs much safer as they deliver this invaluable care.” 

The Discovery Covid-19 information hub contains tutorials on how to use the service and a range of other up-to-date information for consumers and doctors about COVID-19.

With virtual consultations, the location of the doctor or the location of the patient will not restrict access to fast and effective healthcare. With this service all doctors can register to help care for the health of all South Africans while we follow the requirements of safe physical distancing and staying at home.

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