Telemedicine Use in Kenya

Telemedicine in Kenya is consultation and management of health issues via phone/video calls. Clients in Kenya register for the services with their email and phone number for account verification.

Once verified, a patient consults by logging in to their accounts when they need to/want to access the services.

How does telemedicine consultation work in Kenya?

Virtual doctors obtain vital signs (temperature or BP) and other essential readings before or during the consultation for clients with medical devices or those who can get access to them quickly.

Proper history taking is enough to get the relevant information with or without telemedicine.

The images shared video calls. And doctors’ critical thinking enables them to get a working diagnosis.

N/B – for lab and radiological services, physical contact is still needed. Telemedicine comes in during transmission, disclosure, and discussion of the results.

Kenya has high internet penetration in Africa, at 85.2%, with several privately-owned platforms and hospitals noted to have taken up telemedicine.

The number of Telemedicine platforms in Kenya remains uncertain as many more fields are still coming up into the healthcare space, which is good for the country, seeing as over 60-70% of medical cases can be handled virtually.

2015- Telemedicine in Kenya launched services in conjunction with Kenyatta National Hospital to link it to Machakos Level 5 as part of a program that would tackle non-communicable diseases. (The initiative was a partnership of Kenya’s Ministry of Health and Germany-headquartered Merck Group)

2018- BMC Health assessed the telemedicine uptake at the outpatient department at the Kilifi County Hospital. The study was conducted in two phases, where 92 people participated.

The conclusion made was that more than half did not understand:

1. Videoconference;
2. Digital photograph;
3. Wireless;
4. World Wide Web;
5. Antivirus or
6. Email in either language (after translation to the local dialect), none understood telemedicine and telediagnosis.

The Ministry of Health has also utilized outreaches in the form of health education in Kenya:

Services for health education;

Contact tracing;

Disease prevention;

Surveillance and management.

Today, Kenya has several Telemedicine platforms for  healthcare digitalization and offers services including:

1. Consultations;
2. Pharmacy and doctor bookings (via text, call, live chat, social media, email, or video call).

Telemedicine use in Kenya has tremendously increased since Covid-19 hit.

Hospitals in Kenya are also offering Telemedicine services.

What are the benefits of using Telemedicine in Kenya?

1.  Cost-effective- The cost of telemedicine in Kenya is less because you only pay for what is required (tests and drugs). You don’t spend on transport/fuel, and insurance premiums last longer.

2.  Saves time- There is no need to spend time moving from one location to another, waiting in the hospital bay, or even taking time off work for reviews. With telemedicine, the entire process takes less than an hour.

3.  Convenience- Consultations can quickly be done from any location in Kenya, at any time, and from the comfort of the office/school/home. It cuts down the disruption of day-day obligations without compromising ones’ health. All that is needed is a phone and internet-connected device and service.

4.  Disease prevention reduces the potential spread of infectious diseases and hospital-acquired infections since the social distance is maintained and there’s no physical interaction.

5. Decongests hospitals- The majority of the health issues in Kenya can be addressed using telemedicine, thus leaving out-patient departments free to handle clients who need emergency attention and admissions effectively

6. Increased reach to doctors- GPs and specialists can see more clients via virtual consultations in Kenya, rather than waiting long to get an appointment. As of 2019, doctor-patient ratio was 25:100,000, while nurse-patient ratio was 25:10,000 (WHO recommends 1:1000 doctor-patient ratio and nurses 3:1000

7.  Telemedicine usage in Kenya reduces the number of absconding patients and no-shows, allowing them to continue their daily activities and still get medical assistance. Follow-up and monitoring compliance to treatment improves by boosting patient participation in their care, giving them autonomy and control over the situation.

6. 24/7 access to a medical journal- The client can use it globally and maintain continuity of care without having to recall past reviews/give conflicting information. You can use your medical journal when visiting your private practitioner in between scheduled checks. Telemedicine usage guarantees that no one other than the client and authorized health care provider has access to these health records

7.  Privacy and autonomy- Many people fear stigma when seeking medical inquiries, screening, or treatment for many reasons. Virtual consultations in Kenya can be like any normal conversation, even when in the company of others because it only takes a few minutes.

8. Telemedicine in Kenya minimized hospital stay, admissions, and re-admissions. It reduces the fear and stress in patients who take flight only to resurface when the condition has gotten out of hand. Those who live in areas with poor infrastructure can get medical assistance without traveling long distances to see a specialist.

9. Improves productivity- Knowing that there’s a qualified medical team that can be reached easily within a short time, even when it’s just health education needed, gives much peace of mind enabling them to focus on their work, family, vacation, and other duties. It also reduces the number of staff who call in sick or spend a whole day seeing medical attention.

10. Extra source of income- Kenyan Doctors can offer telemedicine services based on tailor-made schedules that do not interfere with their regular commitments either in hospital settings/private clinics, by providing their services during specific periods, both them and the patient benefit.

What are the Telemedicine barriers?

Like everything, new and foreign telemedicine has several barriers to overcome.

1. Fear and lack of trust- Some doctors fear that this will take away their patients. There will be no continuity of care because of the different doctors offering the services (the electronic journal can be used anytime and by any doctor reviewing the patient). Both parties may still doubt the diagnostic accuracy of virtual consultations.
2. Health regulations and policies- Kenyan data protection laws, health regulatory policies, and reimbursement policies can contribute to platforms struggling to deliver the services and stay afloat.
3. Funding and sustainability of the telemedicine service provider, it is expensive to set up a platform and keep it running since it’s cheaper than a physical facility and charges less. Most outlets in Kenya struggle with adequate, consistent funding, risk of overuse, and underuse of the services.
4. Lack of digital literacy- People who do not know or understand how to use technology to access healthcare may negatively or discourage others. There are members of our society in Kenya who still do not trust technology which has led to skepticism and slowed down acceptance.
5. Personal preference- Some health care providers and patients fear this will take away “physical touch” from those who prefer physical visits even though they may or may not have used a telemedicine platform.

6. Lack of access to the internet- There are still areas in Kenya with connectivity issues due to one reason or another. Lack of internet access also affects the adaptation and use of telemedicine

7. Lack of health Insurance- Clients think it is too expensive for those who pay ‘out of pocket because of the cost of consultation/medications/tests

8. Lack of awareness and understanding- It is important to have initiatives where the public members are explained to all there is to know about telemedicine in the simplest terms.

Social media (SM) enables interaction, discussion, and highlighting ideas in the market (both globally and locally). Whether propaganda or truth, people interacting on the SM handles can either fast track/hinder acceptance and adoption of any product or service.  SM advertising is a vital marketing strategy for any company today.

Telemedicine services available in Kenya

Curfews, lock-downs, and the need for social distancing in various parts of Kenya show gaps in healthcare where telemedicine services are the best solution.

Doctors are not spared from isolation or quarantine either, thus patients requiring services have increased.

Telemedicine consultations in Kenya can be done for any condition that is not an emergency. The service team will advise the clients on what needs to be handled at a physical facility and why.

Tele-Cardiology- For cardiac/hypertensive patients. Helps with remote monitoring, assessment, and management

Tele-psychiatry- Carried out by counselors, psychologists and psychiatrists take care of mental issues faced by individuals/couples/families and groups.

Tele-Pharmacy- Doctors and clients can send in prescriptions and have them dispensed for delivery /picked up

Tele-Radiology/Pathology- This form of telemedicine, Lab reports, and CT-scan/MRI images are sent to doctors who write a comprehensive essay. The results are then dispatched back to the platform/client for further discussions during reviews/follow-up.

Tele-Dermatology- Dermatologists can manage skin, hair, and nail conditions through video calls and images sent in (rashes/burns/ skin conditions) can diagnose and prescribe the adequate treatment

Tele-Dentistry- Facilitates oral health care and enables a dentist to educate on the importance of suitable oral hygiene measures. Nairobi Dental School tried this in the Maasai Mara community clinics in 2014 using an intraoral camera.

Tele-Neurology- With only 18 neurologists, clients with stroke/neurological issues usually have to travel long distances or wait for long periods to access them. Telemedicine helps them get the support they need.

Tele-Nephrology- Renal physicians can maintain follow-up visits, explain complex recommendations, monitor medication adherence, lifestyle modification, and nutritional adaptation, which play a crucial role in improving the quality of health and slowing down disease progression.

Cost of Telemedicine services in Kenya.

The cost of speaking to a medical professional varies from platform to platform and is unique to the type of service required.

The charges range anywhere from 300-4500KES.

Specialists and Psychologists charge higher than other Kenyan doctors because their management is based on the area of specialization.

Agreements between the service provider and Insurance companies/private companies based on their budget also affect cost. It is advisable for anyone using telemedicine to enquire about the charges before making any payment.

It is important to note that there are telemedicine service providers that are all-inclusive. They have; physical clinics/hospitals, pharmacies, labs, and radiology within their setup. And others are unique and offer booking services, consultations, or pharmacy services only (e.g., MPD, MyDawa)

Use of Telemedicine and prescription of medication in Kenya.

During the consultation, the doctor takes a detailed history of; main concern, drug allergies, medication use, and duration and uses this information to make a final decision.

Doctors who offer telemedicine services are authorized and licensed to prescribe medication upon consultation, including prescription refills.

The duration and nature of the prescription are based on the SOPs and the time authorized by the payer (e.g., insurance).

In Kenya, all legitimate pharmacies require clients to collect controlled drugs for accountability physically, whereas the other prescriptions can be delivered upon request.

At the end of any virtual consultation, all documentation saved on the platform and sent to clients after a tele-consult must contain the following:

1. Company header;
2. Doctor’s correct names;
3. Signature;
4. Date and time for easy reference and identification.