In a country of 165 million people, where 64 percent of people live in villages, Dhaka has 43 percent more doctors than total positions available, whereas most divisions have major vacancies.
Because of this, people are often forced to travel long distances to cities to access healthcare services, incurring high costs just to waste hours standing in long queues for doctor appointments.
With less than 2.50 percent of our GDP expenditure covering healthcare, the numbers above provide a glimpse of how complicated the healthcare journey is in Bangladesh.
However, in this backdrop, a beacon hope could be a data from the Health Bulletin 2019 that says that till December 31, 2019, Bangladesh had 99.428 million internet subscribers (93.681 million are mobile internet users and five million others WiMAX subscribers). Currently, the country has 159.780 million mobile phone users.
This provides spectacular hope because, according to Fortune Business Insights, the global telehealth market will see an exponential compounded annual growth rate of 23.5% over the next six years, reaching $185.5 billion by 2026.
Bangladesh is also entering the telehealth race, and with millions of our people accessing the internet already, our potential in this sector is at a pragmatic stage of fast growth.
Currently, there are a number of telehealth service providers in the country working on smooth healthcare services to the people in cities, and in faraway villages – thus reducing the burden of the patients from incurring high costs and travelling long distances and standing in queues for hours.
One such patient is Meswana Salam, a banker. She tested positive for Covid-19 a few months ago. Testing positive came as a massive blow for Salam as she was pregnant at that time; a pregnant woman requires regular doctor check-ups. Imagine a Covid-19 positive pregnant woman visiting doctors ploughing through Dhaka streets? A pretty scary journey.
Salam, however, did not have to walk down that scary path. She registered for a telehealth service from Digital Hospital, a social brand of Digital Healthcare Solutions, working towards ensuring quality healthcare service for all at affordable cost, because everyone deserves good health.
"I registered for Digital Healthcare's Ami Gold package. Since I often need to consult doctors, I found the Digital Hospital App very helpful. The doctors are friendly, and I get to contact them anytime I need. This package has allowed me a yearlong service of doctor consultations and discount on various check-ups," she told The Business Standard.
Meswana Salam is one of the 263,553 patients who received such telehealth services in the year 2020 from Digital Healthcare Solutions, a Division of Grameen Telecom Trust.
In its five years-long journey – both as Telenor Health under Telenor Group and Digital Healthcare Solution under Grameen Telecom Trust – this telehealth organisation has provided more than a million doctor consultations, and received more than 16,000 video calls and more than two lakh audio calls from the patients in the last year alone.
When its journey began, it provided services only to Grameenphone's customers under the brand name TONIC.
However, this telehealth opened up for all after it launched the brand Digital Hospital as a social brand of Digital Healthcare Solutions under GTT.
"When our journey began as Digital Healthcare Solutions a year ago, the pandemic hit the world, which inadvertently helped us grow faster," its CEO and co-founder Sajid Rahman told The Business Standard.
At the outset of the pandemic, it introduced an AI-based Covid-19 symptom tracker. Around four lac people used that service. It also launched Free Corona Insurance. Overall, DH has got around six million people insured under its Micro Health Insurance plans covering medical expenses, including one lakh under Free Corona Insurance.
"Free Health Cashback is one of our most significant components. Not a lot of other groups are doing this. During the pandemic's peak months, we provided Free Health Cashback if somebody tested Covid-19 positive, lost his earnings because of it, or even died. During the first year of our new journey, around eight months, we only served Covid-19 patients and that too free of charges," said Sajid.
How does Digital Healthcare Solutions work?
Members usually begin the journey at the Digital Hospital with a call to the toll-free number 08000111000. Someone at customer care guides interested customers through different monthly to yearly packages.
It has separate packages like Ami Gold, Amra Gold, Ami Silver, Amra Silver, Amra Shurokkhito, Amar Daktar etc. The price ranges of different packages vary from Tk49 to Tk 6,999.
For example, in the Amra Gold package, you will be entitled to 24 hours Doctors Call, Doctor Video Call from 8.00 AM to 10.00 PM, Free Health Cashback on hospital services, Free Life Insurance, four family members coverages, etc. Various packages have diverse services that you may know in detail by visiting their website or downloading the app.
After registration, audio conversation with doctors can be conducted through the toll-free number mentioned above. But for video calls, customers will have to download the Digital Hospital app from the Playstore, fill up the necessary information and consult doctors.
It offers free health cashback in different packages. Different packages have different values. Suppose you broke your arm, if you visit a partnered diagnostic centre, you will get a discount. Besides, based upon your admission fee in the hospital, you can claim cashback irrespective of the amount. For this, you will need to submit certain documents in the app.
You will find the app called Digital Hospital in Google Playstore. Both Bangla and English as languages are available in the setting. Depending on your necessity, you can make audio and video calls or can chat with doctors. You will find various membership packages detailed in the app as well. The app has been downloaded over 10,000 times so far, and excellent reviews on Playstore.
All consultations via call, chat and video calls are kept in records for future references. So if a customer calls the second time, the doctor can access the previous consultation information if required. Customers can have consultations for other family members from the same number. And every person's information is stored even if consultations are made against the same number. All consultation information is maintained with utmost confidentiality, and only the consulting doctors have access to them.
"A comprehensive telehealth service"
Lucky Akhtar, a resident of Tongi and member of Shakti Foundation for almost four years, living outside Dhaka city, where specialised doctors are not easily accessible. This foundation had a project with the Digital Healthcare Solution to serve their members for free.
Lucky Akhtar, has been suffering from chronic headaches for a long time. She has recently consulted doctors of Digital Hospital for both herself and her daughter, who barely eats anything.
Lucky says, "After consulting the doctors of Digital Hospital, I am doing much better and so is my child. The doctors here are extremely well behaved and very patiently listened to my medical history. At the same time, unlike other hospitals, I didn't have to wait in long queues or pay high consultation fees for the doctors. Since Shakti Centre is near to my house, I didn't have to put up with the hassle of travelling long distances like I had to before."
A lot of such patients receive affordable treatment from Digital Healthcare, which covers almost the entire journey, all the way to recovery.
"We are the most comprehensive telehealth service in Bangladesh. Our number of consultations is ten times more than the others operating in the sector. We have conducted more than a million consultations so far. We managed the IEDCR hotline services during the pandemic, and the consultation number I mentioned is excluding our IEDCR service," said the CEO.
Digital Healthcare Solutions is still operating IEDCR hotline numbers and they have served more than 60,000 calls so far. DH also provides B2B packages customised according to the needs of different organisations.
"We are the first and only digital health service that conducts all these services, including doctor consultations via call, chat and video along with digital prescription in the app and SMS. If the doctor prescribes medicine, we arrange the delivery. In our app and web platform we have a health mart section, and we also collect samples from home. Our platform provides a comprehensive health solution," Sajid added.
Not the only player
Telehealth is a relatively new concept in Bangladesh, and Digital Healthcare Solutions is one of the leading platforms in this sector. It provides end to end health care solutions that start from doctor consultation to hospitalisation. But this sector promises a fast rise, and there are a couple of rising stars already.
For example, Daktar Bhai offers an online-based doctors' appointment service with the facility of an electronic personal health record system on both web and mobile app platforms. Their services include Personal Health Record (PHR), asking a doctor, booking appointments, health directory, health insurance etc.
Daktar Bhai has attractive packages like Shuchana, which entails three months service for Tk150, six months for Tk200, 12 months of services for Tk299. Besides, they have packages like Prerona, Protyasha, etc, which would cost you up to Tk1,000, depending on services.
Praava Health has been serving since 2018. Their services in-person or remote appointments, consultants "last at least 15 minutes" as their service brochure reads, membership plan or pay-as-you-go, provides diagnostics services etc.
One of the most popular telehealth services available in the city, Prava has exciting service plans. For example, its Amar Jotno entails services from three months for Tk3,499, six months for Tk6,999 and a year for Tk10,999. If you visit their website, you will learn more about what services they provide under these packages.
Dipto Health focuses on NCD's or non-communicable diseases. Their service offer includes a cloud-based smart health monitoring system bundled with health insurance. They conduct periodic health check-ups using smart devices and keep the data saved in a cloud platform that can be accessed through a mobile application under personal profiles etc.
Together, these platforms are establishing a new avenue in the country's healthcare system, easing the patients' pressure and breeding hope for a better tomorrow.
Is Bangladesh prepared for telehealth?
Saifuddin, a banker from Chattogram and a member of Digital Healthcare Solutions, is a subscriber of Amra Gold package. When his son became ill, he asked the doctors for prescribing antibiotics. But the doctors on the phone did not listen to him.
He insisted on it the second time, and as it did not work, he got the antibiotic prescribed by a local doctor for his son.
"If all my problems could have been solved just on a phone call, no one would visit the doctors physically. They can only give you a solution to primary issues. They cannot give you a solution for critical issues," Saifuddin, told The Business Standard.
Saifuddin is not alone. Many in Bangladesh doubt the effectiveness of telehealth.
TBS asked Sajid Rahman if Bangladesh is prepared for telehealth at all. Sajid sounded optimistic as he explained, "For telehealth, we need mobile connections. In Bangladesh, mobile networks are available almost everywhere, and most people have mobile phones. So, we have the infrastructure."
"Secondly, if we consider the number of doctors per thousand people, telehealth comes in good use since one doctor can help many patients from various locations. Besides, our doctors are not trained on how to consult patients in telehealth; we train the doctors who join us. It is not a huge training. It takes only a few months. And finally, since the doctor-patient conversation is happening over the phone, our data security infrastructure must be stronger to maintain confidentiality. I think we have more work to do here."
But what about the people who find it less effective and only suitable for "primary issues?"
Sajid emphasises social campaigns for them to increase awareness and share knowledge. He said their teams are working at the local level to promote telehealth.
"Our mission is to support you in every phase of your healthcare journey through data, healthcare tips, motivation, customised healthcare services, and health financing," Sajid added.