Healing with numbers: transforming Pakistan’s healthcare with data

KARACHI:

Imagine the frustration of waiting for hours in a crowded doctor's clinic, your appointment finally arrives, and you have just a few precious minutes to discuss your health concerns. You rush through your symptoms, barely scratching the surface of your worries, and then you're told to come back weeks later for a follow-up. For many, this scenario is all too familiar—a broken healthcare system that leaves patients grappling with delays and uncertainty.

In a world where technology has revolutionized nearly every aspect of our lives, why should healthcare remain stuck in the past? Data-driven and digital healthcare, the innovative approach that's changing the face of medicine worldwide, offers a glimmer of hope to those caught in the cycle of endless waiting.

Globally, data-driven healthcare is revolutionizing the patient experience, granting instant access to medical insights and personalized care. It breaks free from the confines of a traditional doctor's visit, enabling consultations with healthcare professionals anytime, anywhere, and often at a lower cost, thanks to the power of the internet.

Now, let's focus on Pakistan, a nation of 200 million people, where 72% live in rural areas, far from medical facilities. With only 180,000 doctors and 95,000 nurses, Pakistan's healthcare system struggles to keep pace. However, the government, recognizing the need for change, has initiated ambitious digital health (dHealth) programs to bridge accessibility gaps and elevate healthcare standards.

The private sector is also stepping up, with companies like HealthX and Sehat Kahani introducing innovative solutions to reshape healthcare delivery and bring Pakistan's system on par with global standards. In a country where connectivity can be a challenge, the internet emerges as a lifeline, enabling remote consultations, data sharing, and healthcare access like never before.

The Global Landscape of Data-Driven Healthcare

The global rise of data-driven healthcare is reshaping patient care, research, and medical practices. From Silicon Valley to Seoul, digital healthcare is taking various forms. In the US, Teladoc's telemedicine platforms have transformed remote consultations, offering virtual doctor visits. In rural India, healthcare workers use smartphone apps to provide real-time medical advice. Australia's My Health Record initiative grants citizens secure access to digital health records. These examples highlight how data-driven healthcare is making waves worldwide.

This digital healthcare revolution offers numerous benefits. It introduces personalized care through advanced analytics and AI, tailoring treatment plans to individuals. Early detection of health trends allows for timely interventions and resource allocation. It promises cost efficiency by streamlining administrative processes, reducing unnecessary tests, and facilitating global collaboration among medical professionals.

However, significant challenges must be addressed. Data privacy and security concerns arise as sensitive health information is collected and shared. Standardized protocols and interoperability between healthcare systems are needed. Ensuring equitable access and bridging the digital divide are essential to prevent healthcare disparities. Accurate data is crucial to avoid misdiagnoses and ineffective treatments.

In Pakistan, these global examples inspire the country's efforts to harness data's power for healthcare transformation.

Pakistan's Digital Healthcare Landscape

Pakistan's healthcare landscape is marked by significant challenges and disparities, with varying access and quality of medical services across provinces. Public healthcare services in Pakistan face stark statistics: one doctor for every 997 individuals, one hospital bed for every 1,584 people, and one dentist for every 10,658 residents. This paints a grim picture of the strain on the healthcare infrastructure, leaving many without essential medical care.

Provincial disparities in public health spending are pronounced. Baluchistan allocates only 10% of its resources to healthcare, while Punjab, with 53% of Pakistan's population, invests significantly more at 66.2%. Sindh falls in the middle at 33.4%, and Khyber Pakhtunkhwa (KP) stands at 18.7%. Overall public expenditure on health remains inadequate at 0.46% of GDP in 2016-2017, despite a modest 9% increase from the previous year. Per capita health spending falls far below international benchmarks for low-income countries, at just $36.2.

Pakistan's healthcare system faces a multifaceted crisis. Government spending on healthcare is around 0.6% of GDP, with the majority channeled into secondary and tertiary care, leaving only 15% for preventive and primary healthcare. This reactive approach erodes public trust and leads to a meager 20% utilization of first-level care in the public sector. Inequitable access, urban-rural disparities, unregulated private healthcare, and the lack of standardized essential service packages render the healthcare system non-responsive.

Health statistics in Pakistan are concerning, with high rates of first-day deaths and stillbirths at 40.7 per 1,000 births. Punjab fares better than other provinces, while Sindh faces challenges in child and maternal health, with only 27% of rural area deliveries occurring in healthcare facilities. Baluchistan's healthcare system struggles with poor standards, inadequate infrastructure, and a lack of incentives for doctors to serve in rural areas.

Numerous challenges further plague Pakistan's healthcare landscape, including an aging population, rural healthcare inaccessibility, a shortage of healthcare professionals, low insurance penetration, inconsistent quality standards, and a mix of public, private, and traditional medicine. A brain drain of doctors and medical professionals exacerbates the issue. Lack of awareness hampers disease eradication efforts, and untrained individuals exploit the healthcare void.

In this challenging context, digital healthcare emerges as a beacon of hope. It aims to bridge accessibility gaps, provide timely services, and alleviate disparities. The adoption of information and communication technology (ICT) and private and government dHealth initiatives offer promise in this complex landscape. These digital healthcare initiatives are reshaping Pakistan's healthcare future, striving to improve the health and well-being of its people.

Government Initiatives: The dHealth Initiative

In an era where the expansion of Information and Communication Technology (ICT) has opened unprecedented opportunities in the field of healthcare, Pakistan's dHealth initiative stands as a visionary effort to resolve issues of accessibility and timely healthcare service provision. This comprehensive program, spanning both national and provincial levels, aims to leverage digital technologies to revolutionize healthcare delivery.

Among these objectives is the overarching goal of eradicating geographical barriers to healthcare access, ensuring that high-quality healthcare reaches even the remotest corners of the country, thus bridging long-standing disparities in healthcare access.

Another pivotal objective revolves around improving patient data management through the creation of a robust and secure patient data management system. This system employs personal identification cards, which serve as repositories for patient health records and data. This, in turn, provides healthcare professionals and insurers with consistent and well-informed patient profiles, ultimately enhancing the quality of care and supporting more accurate decision-making in the healthcare sector.

Expanding health insurance coverage to benefit the underprivileged citizens of Pakistan is yet another critical goal of the dHealth initiative. The program strategically aligns itself with existing healthcare policies such as the Prime Minister National Health Program, with the aim of streamlining health insurance coverage. By leveraging digital health records, the initiative seeks to ensure that disadvantaged segments of the population receive the necessary medical attention, thereby promoting more equitable healthcare access.

The government plays a pivotal role in both promoting and regulating digital healthcare initiatives within the framework of the dHealth initiative. A notable step in this direction is the introduction of e-health services through personal identification cards. These cards securely store patient health histories, allowing healthcare providers and insurers to access crucial information for well-informed decision-making. This not only enhances the quality of care but also streamlines the overall efficiency of the healthcare system.

Furthermore, the government's proactive approach extends to the strategic integration of digital initiatives with existing healthcare policies like the Prime Minister National Health Program. This alignment ensures that digital healthcare solutions extend their benefits to marginalized sections of society, providing them with essential healthcare services and financial support.

The dHealth initiative has already achieved significant milestones in reshaping Pakistan's healthcare landscape. Notable achievements include the introduction of personal identification cards, which have directly impacted millions of families living below the poverty line, providing them with crucial financial support and improving their access to healthcare.

The initiative has also implemented the eVaccs project, a collaboration between the Federal Ministry of Health, the World Health Organization (WHO), and the governments of Punjab and KPK. This project has automated the entire immunization process, expanded geographical coverage, and significantly increased overall vaccination rates, particularly in low-income rural areas.

Private Sector Innovators

Against the backdrop of Pakistan's evolving healthcare landscape, where government initiatives like dHealth are striving to bridge the accessibility gap, the private sector is also playing a pivotal role in driving transformative change. Private companies like Healthx, Sehat Kahani and few others have emerged as trailblazers in the digital healthcare domain, offering innovative solutions to address the nation's healthcare challenges, in radically different ways from one another.

These companies have harnessed the power of digital connectivity to enable individuals to connect instantly with healthcare professionals for consultations. This seamless connection is not only revolutionizing the way healthcare services are delivered but also significantly reducing the cost of healthcare. By eliminating the need for physical visits to healthcare facilities, patients can access timely medical advice and expertise from the comfort of their homes, saving both time and resources. This transformative approach not only enhances healthcare accessibility but also contributes to the overall affordability of healthcare services, making quality medical care more attainable for a broader segment of the population.

Healthx's Data-Driven Approach

Healthx is making significant strides with its innovative data-driven approach to healthcare services. By harnessing data, cutting-edge technology, and a focus on proactive care, Healthx aims to reshape healthcare delivery, making it more accessible, affordable, and patient-centered.

"In the past 9 months, we [Healthx Pakistan], since the commercial launch in Pakistan, have directly infiltrated a universe of 800,000+ lives in Pakistan, who are either enjoying our services or are awaiting in the pipeline. We are set to revolutionize the healthcare system of Pakistan - shifting the paradigm from reactive to proactive," says Khaqan Sikander, CEO of Healthx Pakistan.

Leveraging Data for Enhanced Healthcare Services: Healthx initiates its journey by collaborating closely with corporate clients to gather essential health data about their employees. The data collection process is meticulous, employing state-of-the-art machinery and maintaining rigorous data quality standards. The collected data then undergoes careful cleaning and refinement.

"Data is our catalyst, fueling our mission to change the very essence of healthcare delivery," states Khaqan. This data-driven approach sets Healthx apart as it moves away from reactive care, towards a more sustainable proactive care model, transforming the healthcare landscape in Pakistan.

Technology and Data Analytics Tools: Healthx boasts a comprehensive suite of cutting-edge technologies and data analytics tools. Advanced equipment like Body Analyzer machines and contactless medical devices ensure precise health data collection. An Electronic Medical Records (EMR) system serves as the central repository for this data, facilitating the formulation of tailored care plans.

"Our internationally tested model is dedicated to bringing down disease burdens and boosting savings for our clients," notes Khaqan. This commitment to data-driven excellence ensures that healthcare services remain efficient and patient-centered.

Impact on Patient Outcomes and Cost Reduction: Through its data-driven model, Healthx consistently achieves significant reductions in disease burdens and healthcare costs, ranging from 20% to 40%. These outcomes are influenced by various factors, including gate-keeping strategies, employee engagement rates, the scope of services chosen by clients, and other variables. Proactive monitoring of chronic patients and tailored care plans by Healthx’s in-house, internationally trained, Medical Practitioners result in better health outcomes and substantial savings for clients.

"While the journey ahead is not without its challenges, such as navigating change management, we envision a future where data empowers individuals, preventative care prevails, healthcare costs are minimized, and Healthx continues to lead the way in innovation," emphasizes Khaqan.

Privacy and Security of Patient Data: Healthx places a premium on the privacy and security of patient data. Data is transmitted securely, and access to the EMR system is restricted to authorized clinical staff. Compliance with international data protection standards like GDPR and HIPAA underscores the commitment to data security.

Telemedicine for Wider Reach: Healthx's telemedicine services play a pivotal role in making healthcare accessible, especially in remote or underserved areas. It ensures 24/7 access to healthcare professionals, bridging geographical barriers and providing timely care. Virtual clinics, community engagement, and technology-driven solutions are pivotal in ensuring healthcare accessibility and affordability.

Preventive, Proactive Care as a Cornerstone: Preventive care is at the core of Healthx's healthcare model. By proactively managing health, preventing diseases, and optimizing resource allocation, Healthx aims to significantly reduce disease burdens and healthcare costs while fostering better health outcomes.

Hospital at Home Program and Roaming Doctor Program: Healthx's innovative Hospital at Home program aims to provide acute care services in the comfort of patients' homes, potentially reducing hospitalization rates. The Roaming Doctor Program enhances care coordination within hospital settings, optimizing resource allocation and ensuring comprehensive care. It important to note that both these programs are in the pilot phase in Pakistan.

Overcoming Challenges: Healthx faces challenges related to the prevailing preference for traditional healthcare and resistance to technology. However, the Phygital (Physical + Digital) approach, trust-building through in-person interactions, and promoting preventative care are key strategies in overcoming these challenges. "Healthcare should never be a zero-sum game, where patients have to suffer for providers to thrive," emphasizes Khaqan. "With data-driven, technology-powered, and phygital healthcare delivery systems, we must reinvent ourselves towards models that incentivize keeping people healthy."

Healthx is playing a significant role in transforming Pakistan's healthcare landscape. Through data-driven excellence, a patient-centric approach, and innovative solutions, Healthx is contributing to the improvement of healthcare accessibility and effectiveness in Pakistan. However, it's worth noting that Healthx is not the only organization dedicated to revolutionizing healthcare in Pakistan. Sehat Kahani, another pioneering healthcare provider, is also actively working towards similar goals, collectively contributing to the nation's journey towards a healthier and more accessible healthcare system. Together, these innovative companies are reshaping the future of healthcare in Pakistan, one data-driven and patient-centered step at a time.

Sehat Kahani: Bridging Healthcare Gaps Through Digital Innovation

Two visionary female physicians embarked on a journey to redefine the very essence of healthcare accessibility. Dr. Iffat Zafar Aga and Dr. Sara Saeed founded Sehat Kahani, a digital healthcare platform that has been a beacon of hope for millions, addressing the unique challenges faced by Pakistan's diverse population.

Inspiration Unveiled: Sehat Kahani's inception is rooted in a poignant reality faced by many women in Pakistan – the difficult choice between pursuing a career or adheing to societal norms. Dr. Iffat Zafar Aga, the COO and co-founder of Sehat Kahani, recounts their shared experience, "Our story starts somewhere like this where both Sara and I had to choose between having a career or having a family in our lives and we felt the need to create opportunities which let women work while being able to balance their career."

Sehat Kahani is not just about providing healthcare; it's about empowering female physicians, who are often urged to become doctors but discouraged from practicing. This groundbreaking platform bridges the gender gap in healthcare, allowing these highly skilled professionals to optimize their medical practice while addressing the pressing healthcare needs of Pakistan's underserved communities and population in general.

Breaking Barriers, Enhancing Access: Sehat Kahani's digital prowess lies in its multi-faceted approach to patient-doctor interaction. It offers various communication methods, including chat, audio, and video consultations, ensuring that healthcare is accessible to all, even in remote or underserved areas through their unique e-Health centres but also for the more urbanized smartphone user through a mobile app.

"In isolated and remote areas with limited healthcare infrastructure, some people may encounter challenges accessing high-speed internet or the requisite technological resources for video consultations," explains Dr. Iffat. "The inclusion of chat and audio features in the medical consultation app enables persons with limited internet speed or outdated devices to participate effectively in these consultation sessions."

This approach not only increases accessibility but also respects cultural sensitivities and individual preferences. It provides privacy for sensitive issues, promotes timely interventions, and reduces the stigma associated with seeking mental health support.

Data-Driven Healthcare Revolution: Sehat Kahani's commitment to innovation doesn't stop at communication methods. The platform harnesses data-driven technologies for online diagnostics and at-home pharmacy services. "We have partnered with diagnostic services such as Essalab and Chughtai lab, allowing patients to order diagnostics to be done at their own homes," Dr. Iffat shares.

The integration of data analytics enhances patient-doctor interactions by identifying health patterns, aiding in predictive analysis, and supporting data-driven healthcare policies. AI-enabled decision systems even help physicians make informed choices, while patients benefit from personalized health insights.

Challenges and Opportunities: Implementing Sehat Kahani in Pakistan's healthcare landscape hasn't been without its share of challenges. The digital divide, health illiteracy, cultural sensitivities, and linguistic diversity are hurdles they've had to navigate. However, these challenges have been met with determination and creativity.

On the flip side, the opportunities are vast. Sehat Kahani is increasing access to healthcare in a country where traditional healthcare infrastructure falls short. It empowers female doctors, supports data-driven decision-making, enhances health education, engages with local communities, and fosters inter-sectoral coordination.

Sehat Kahani's impact extends to both individual consumers and corporate employees. Their corporate app provides a unique solution, where organizations can offer unlimited access to doctors, specialists, and even mental health experts to their employees. This approach, combined with the newly launched cashless pharmacy services, is revolutionizing corporate healthcare in Pakistan.

Stories of Transformation: Sehat Kahani's success stories are the embodiment of their mission. From identifying life-threatening illnesses in remote communities to preventing heart attacks through timely interventions, the platform has been a lifeline for many. Through partners like the British Asian Trust, they've even brought mental healthcare to remote areas, addressing a critical need often overlooked.

In Pakistan's ever-evolving healthcare landscape, Sehat Kahani stands as a testament to the power of data-driven innovation, female empowerment, and unwavering dedication to improving healthcare accessibility. As the digital health revolution continues to shape Pakistan's future, Sehat Kahani remains at the forefront, transforming lives one consultation at a time.

In an effort to address one of Pakistan's significant challenges, Sehat Kahani has formed a partnership with Zong 4G. The aim is to enhance the availability of telemedicine services across Pakistan. This collaboration acknowledges the critical role of internet connectivity in the effectiveness of technology. Therefore, both elements are being developed in parallel to improve healthcare accessibility without a promotional tone.

The internet has become a pivotal driver of the shift towards data-driven healthcare, not merely as a technological integration but as a means to transform healthcare delivery. It plays a crucial role in reshaping healthcare by connecting patients and providers, fostering innovations, and shaping the future of healthcare.

In a collaborative effort, Zong 4G and Sehat Kahani are set to redefine healthcare access in Pakistan by expanding telemedicine services through Zong 4G's robust network and Sehat Kahani's innovative platform. This partnership, built upon previous initiatives including free online consultations during the pandemic and disaster relief efforts, exemplifies their shared commitment to making quality healthcare accessible to all Pakistanis, transcending geographical barriers through digital innovation.

Considering the importance of internet availability and connectivity, Zong 4G's consistent track record of strong internet connectivity and coverage across diverse regions played a pivotal role in Sehat Kahani's decision to partner with them.

The statistics from the Mobile Network Experience Report 2022 by Opensignal shed light on the performance of mobile network providers in Pakistan, showcasing Zong's excellence in the 4G Coverage Experience, Download Speed Experience, and Games Experience categories. Jazz and Zong's joint victory in the Upload Speed Experience and 4G Availability categories further underscores their competitiveness in delivering reliable network connectivity.

The spokesperson of Zong further explained the contribution to improving healthcare accessibility in Pakistan, especially in remote and underserved areas where connectivity has traditionally been a challenge. "Zong 4G and Sehat Kahani have forged a multifaceted partnership to enhance healthcare accessibility and outreach. Firstly, Zong 4G extended the digital alliance by granting its customers complimentary access to the Sehat Kahani app, where the app's data usage is exempted from charges. This empowers Zong customers to access certified professional consultations seamlessly," told Zong spokesperson to The Express Tribune.

This partnership transcends geographical barriers, as Zong 4G's extensive network coverage enables individuals in remote regions like Gilgit Baltistan to connect with healthcare professionals in Karachi through the Sehat Kahani app. Ultimately, the objective is to revolutionize healthcare accessibility in the country, unburdened by physical constraints.

Considering the importance of internet availability and connectivity, Zong 4G's consistent track record of strong internet connectivity and coverage across diverse regions played a pivotal role in Sehat Kahani's decision to partner with them.

The statistics from the Mobile Network Experience Report 2022 by Opensignal shed light on the performance of mobile network providers in Pakistan, showcasing Zong's excellence in the 4G Coverage Experience, Download Speed Experience, and Games Experience categories. Jazz and Zong's joint victory in the Upload Speed Experience and 4G Availability categories further underscores their competitiveness in delivering reliable network connectivity.

Talking about the benefits of telehealth, the Zong Spokesperson said, "A robust telecommunications network is an indispensable prerequisite for the effective implementation of this particular model of digital innovation. Without reliable connectivity, telehealth medicine may not prove to be a viable alternative to traditional medical practices. Patients would encounter challenges in reaching doctors promptly, while healthcare providers would struggle to deliver accurate diagnoses in a timely manner."

Meanwhile, Ufone's notable Consistency performance, particularly in providing Excellent Consistent Quality, demonstrates their commitment to meeting diverse user needs across various applications and services. These statistics collectively depict a dynamic and competitive mobile network landscape in Pakistan, with providers striving to offer diverse, high-quality mobile experiences to their customers while utilizing the power of the internet to reshape healthcare.

In a country like Pakistan, where healthcare disparities exist across regions, Zong 4G’s mission is to bridge the digital divide in the country by dispensing the most widespread network coverage possible and making sure that everyone is equally connected, explains Zong spokesperson. “This is reflected in its partnerships as well and one of the reasons we partnered with Sehat Kahani is that it is unequivocally committed to bridging the gap in healthcare services across various regions, driven by a straightforward principle: it has no discrimination based on geographical location, financial status, social standing, or religious affiliation,” spokesperson added.

The platform is accessible to all, requiring only a smartphone, an internet connection, and a modest consultation fee, making quality healthcare available to everyone, without exception.

The Future of Data-Driven and Digital Healthcare

As we peer into the future, it's evident that data-driven and digital healthcare are poised to continue their transformative journey in Pakistan and around the world. These innovations, underpinned by the power of the internet, hold the promise of reshaping healthcare delivery, making it more accessible, efficient, and patient-centered. Government initiatives like Pakistan's dHealth program and private sector pioneers like Healthx and Sehat Kahani are pioneering solutions to bridge accessibility gaps, empower healthcare professionals, and enhance the overall well-being of the population.

The integration of data analytics, AI, telemedicine, and secure data management systems will not only revolutionize patient care but also enable early detection of health trends, cost-efficient healthcare practices, and global collaboration among medical professionals. Challenges such as data privacy, standardization, and equitable access must be addressed, but the trajectory is clear – a future where healthcare is no longer bound by the constraints of traditional models but is a dynamic, accessible, and data-driven force for improving lives.

In this rapidly evolving landscape, the internet, with its connectivity and reach, will remain a vital enabler, connecting patients with healthcare providers, fostering innovation, and ensuring that quality healthcare knows no geographical boundaries. As we embrace the future of data-driven and digital healthcare, we do so with the conviction that it will continue to offer hope to those who have long endured the frustrations of an outdated healthcare system, bringing the promise of better health and well-being within everyone's reach.