As a diabetic, Nomvuyiso Qaba of Mfuleni in Cape Town occasionally gets excessive skin irritations and itchy feet.
“The itchiness on my soles and palms gets so bad at times that it feels like something is crawling under my skin. Most of the time no amount of scratching helps,” she said.
“One day it got so bad my grandchild called an ambulance to take me to the emergency unit as I felt like I was losing my mind and I was stomping all over our home to make it go away.”
But paramedics didn’t take the 74-year-old grandmother to the medical emergency unit because they didn’t deem her condition an emergency. Instead they instructed her to go to the clinic the following day to have it checked.
“I didn’t bother going to the clinic because I had no money for transport and my routine check-up was in two weeks anyway. There was no point borrowing money and sitting at the day hospital the whole day and risk not being treated because of long queues.”
But Qaba will now be able to get medical advice on the spot 24/7 whenever she is worried — thanks to a tele-triage service called “Hello Doctor”, which has been relaunched by the Western Cape health department in partnership with Momentum Metropolitan to ensure public healthcare users don’t go to clinics unnecessarily and add to long queues. The service was first launched in 2019 but had to be suspended due to the Covid-19 pandemic.
Delft community healthcare centre (CHC), where the pilot initiative was launched this week, is one of the overburdened day hospitals in the province. Instead of going to the clinic for their ailments low-risk patients can access medical advice and be triaged at the tap of a finger by sending a “call-back” request and connecting to medics without physically visiting the health facility.
The Hello Doctor application, which was described as “unethical” by the medical regulator, the Health Professions Council of SA (HPCSA), when it first launched , will also be used as a Covid-19 information portal. The HPCSA, which favoured face-to-face consultation over virtual ones until it was compelled by the arrival of Covid-19 to change its stance, said at the time Hello Doctor would breach patient confidentiality.
After SA went into lockdown in 2020 the HPCSA revised its regulations to temporarily allow remote consultations provided there is an already established doctor-patient relationship or, where such a relationship doesn’t exist, medical practitioners may still consult provided consultations are done in the best clinical interest of patients.
Metropolitan Health Group executive head Kelly Manzini said while Hello Doctor could never replace the need for face-to-face interactions with doctors, “they can provide an important service that alleviates pressure in the health system”.
The service also protected healthcare workers as they were exposed to fewer patients and the service was available 24 hours a day, seven days a week, and “at times when many may not have access to transport to ensure that certain ailments are treated faster”.
Due to the alleviation of pressure, clinics can help more patients and have better outcomes while spending less money.
“The HPCSA was concerned about tele-health, and our country’s regulations did not allow tele-health diagnosis and treatment. It did allow for tele-triage and health advice and Hello Doctor was adapted to offer that while we were in discussions with the HPCSA. Those regulations have been altered as a result of the Covid-19 pandemic, and I think the whole health community has experienced their value first-hand,” Manzini said.
Hello Doctor is also being piloted in Soshanguve in Pretoria. In its previous pilot studies 30% of patients who arrived at the clinic were treatable using Hello Doctor.
“If the pilot study is accurate we can free up healthcare providers for more serious cases and ease the burden on some of the centres. Then we start to improve access and quality of healthcare services to all communities. So the main services are medical advice for the whole community, tele-triage and basic primary health services that can be delivered telephonically.
“Patients now don’t have to go to the clinic to obtain the help they require. That should create greater efficiencies at the clinic. If we can treat more people adequately outside the clinic, then resources can focus on the more serious cases,” she said.
Would you like to comment on this article?
Sign up (it's quick and free) or sign in now.
Please read our Comment Policy before commenting.