Agents of Impact | April 12, 2016

mDoc: Prescribing a Tech Solution for Village Doctors in Rural Bangladesh

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People around the world risk their lives by trusting health care workers who sometimes are doing nothing more than shooting in the dark.

Bangladesh faces a critical shortage of doctors, with a doctor to patient ratio of 1:2500. More than 70 percent of the population resides in areas without access to hospitals, absent expensive trips to urban hubs. Instead, rural Bangladeshis seek treatment from untrained, ill-equipped local healthcare providers called “village doctors.” That can pose life-threatening risks.

[blockquote author=”Rubayat Khan, mDoc” pull=”pullleft”]I wanted to solve the challenge of providing healthcare to millions of people. I began obsessing over creating something that I could scale.[/blockquote]

mDoc, founded by Rubayat Khan and Ahmed Bakr, trains existing village doctors to use a tablet to consult with urban doctors, culminating in a printed prescription and the purchase of medication. By leveraging existing relationships in communities, patients benefit from ease of access and a more accurate diagnosis. mDoc’s staff provide tablets, printers, and medical devices like blood pressure cuffs and glucose meters as part of the initial package.

In the first few months of the pilot project, mDoc provided consultations to over 1,500 patients. Khan expects to expand to 30 service delivery points my mid-2016.

“The village doctors make assumptions like, if someone has fever then it’s automatically the flu,” says Khan. “While a useful heuristic for many cases, this can sometimes complicate the situation. There are instances where people die because of the wrong medication.”

In the United States antibiotics warrant a prescription, but in Bangladesh drug regulations are hardly enforced. A person typically walks into a pharmacy and can buy any medication over the counter.

“Once, a pharmacist prescribed a school girl strong steroids to treat a skin condition,” explains Khan. “They favor prescribing strong drugs because it seems cure oriented and due to the higher cost is good for their business.” As a result, the child lost all her hair, became quite ill and dropped out of school temporarily. When she consulted with a trained doctor through mDoc’s telemedicine service, her course of treatment changed and she recovered.

“There are countless instances like that where it’s not necessarily fatal, but still life changing,” says Khan.

In addition to improving access to quality healthcare, the venture has even greater ambitions for the future. For example, mDoc is considering partnering with upcoming automated diagnostics and artificial medical intelligence engines, such as IBM Watson and Enlitic, to facilitate quicker diagnoses without relying fully on doctors. And with the massive boom in objective on-the-spot vitals measurement using simple tools like those from Scanadu, the data crunching could provide ever better and more accurate diagnoses.

“Imagine the pharmacists just record these data and feed into these systems, and the diagnosis and treatment options magically appears for the doctor to simply approve”, says Khan. “This would greatly reduce our costs of delivering quality care, and hence improve the model’s scalability.” As of now, patient medical histories are enrolled in mDoc’s database, along with their fingerprints. Since the record sits on the cloud, it can eventually be accessed from any established hospital.

“Our value proposition is that our service can bridge the knowledge gaps and help serve the community much better,” says Khan. “We divert more patients to the pharmacists, who choose to team up with us because they will provide better treatment and build their own brand in the community as the mobile doctor.”

This year mDoc will test out pricing models with pharmacists and marketing strategies in communities. They are looking to partner with pharmaceutical companies by 2017, which would help spread out costs. “It’s better for everyone to work together,” says Khan.

Khan draws from expertise he gained with his previous company, mPower, which has operated in 12 countries and develops health technology solutions for non-profits and governments. Based on a proposal that won at an MIT business competition in 2008, he began consulting in Cairo and Dhaka before realizing that wasn’t a big enough aim. He wanted to place services directly into the hands of healthcare workers in communities.

“I wanted to solve the challenge of providing healthcare to millions of people,” says Khan. “I began obsessing over creating something that I could scale.”

“We believe our technology and business model can sustainably bridge the distance between doctors and patients in Bangladesh and beyond.”

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logoStory written Cayte Bolser, an Unreasonable correspondent. Cayte collects stories and lessons from and for entrepreneurs dedicated to solving the world’s most pressing problems. She writes on a variety of subjects including science, technology, international development, the environment and travel.

Photo Credit: Flickr