Mobile enabled access to doctors in Sri Lanka

Kaleniya is sort of a stone’s throw away from Colombo, the capital city of Sri Lanka. But with mild traffic, it doesn’t feel that way, and I’m sure when the traffic is heavy it certainly won’t feel that close. As we drive there, the landscape remains fairly urban, and with the buzz of the day in full gear. This is my first visit to Sri Lanka, and as is the case with many first time visits, there is a lot to learn as we interact with the people, the context and in this case, the health sector.

So far I had learnt that in Sri Lanka, the health relationships are centred on the doctor. Patients access specialist care directly, unlike many health systems where your first interaction is with a general practitioner (GP), after which you get a referral to a specialist should you need one. This creates a dynamic where patients refer each other to specialists, and the reputation of a doctor determines demand for their services. You also find many doctors serving as ‘family doctors’ for a segment of the population. Hospitals seek out doctors to consult at their facilities, as the more popular the doctor, the higher the foot traffic to the hospital. Doctors are equally free to practice in hospitals of their choice in addition to running their own personal clinics.

As you can imagine, the challenge for most patients is figuring out where their specific doctor will be at any given time when they need to consult them, commonly referred to as channelling in Sri Lanka. Channelling a doctor is the process of identifying the doctors practicing location, and booking an appointment. And this is what brought me to Sri Lanka. I’m here to learn about Doc990, an innovative web/app/IVR service that is enabling patients to channel their doctors and book appointments. And that is also why I’m in Kaleniya, visiting one of the agents who helps patients channel their doctors and get appointments.

Despite being senior in age, the agent is very well conversant with the Doc900 platform, and easily guides me through the steps. The patient simply specifies the doctor they wish to see, and the agent searches for the doctor by name. Once the doctor is selected, the platform displays the hospitals that the doctor is expected to be in. The patient can then choose the hospital that works for them either due to distance, or simply preference. The agent then selects the facility to reveal the doctors schedule at that hospital, and assists the patient in securing an appointment. The patient then pays for the appointment plus channelling fees and receives a confirmation code, which they use to access their appointment. Patients who are digital savvy can also channel their own appointments directly via web or mobile app.

Once the demonstration was complete, I enquired whether people are now accustomed to digital channelling and the response painted a complete picture for me. He gave me an example of what it would take to book an appointment manually, including a 4 hour round trip to the hospital, and anywhere from LKR 800 (£3.85) travel costs, just to book an appointment, after which, the patient would need to repeat the same on the day of the appointment. With Doc990 digital channelling, the patients access an agent a few hundred meters from where they live, and book an appointment in less than 5 minutes, at about 34% of the cost or LKR 275 (£1.32). Digital channelling saves patients both time and money, while giving patients a choice of doctors, facilities and visit timing.

Digital channelling has been in place now for 14 years, and Doc990 is re-energizing Channelling by providing a wide array of options to access a preferred doctor, and pay for appointments with convenience that only mobile technology can provide. I would love to blog on and on about this, but that would be a spoiler for the upcoming GSMA Mobile for Development case study on Doc990. So look out for it to read more on what we learnt. For now, I say Ayubowan.

 

This project was funded with UK aid from the British people.

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