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Medical doctors are making the transition to virtual medicine and digitise their practices

South Africa's clinicians have been amazing during the Covid pandemic but they haven't been backed by the same level of managerial, material and logistical support, says Dr Peter Cruse.

Now Cruse, a former chief specialist pathologist at Groote Schuur Hospital and former professor of anatomical pathology at the University of Cape Town, is leading South Africa’s first ever comprehensive telemedicine course to address this gap.

Developed and presented by Henley Business School Africa, the unique six-week course is designed to help medical doctors especially transition to virtual medicine and digitise their practices in the process. It’s the latest innovation from the award-winning business school and the seed of what will, ultimately, become a bespoke healthcare management school, alongside its centre of innovation and entrepreneurship and its research department, according to Henley Africa dean and director Jon Foster-Pedley.

Cruse was speaking on a panel hosted by the British Chamber of Business in Southern Africa, moderated by chamber president Leon Ayo and which included Foster-Pedley and leading British oncologist Naren Basu, who founded and runs the Birmingham Breast Group in England, a partnership of 17 leading healthcare professionals.

The pandemic, said Cruse, had provided an invaluable opportunity to improve the quality of service doctors provide to patients, while lowering costs. The key to this had been the realisation that medical practitioners are not taught the necessary business management skills while they are learning their craft at medical school. The Covid-19 crisis had also opened the door to re-look at the way medicine is currently practiced in the country.

“Healthcare and education are key pillars to the development of any society. This intervention allows us to address both,” he said. “We are currently looking at deconstructing and disaggregating the elements of standard face-to-face medical consultation, in an as yet unpublished, study of ‘time and motion’ in traditional consultations. We wish to see what rate-limiting steps can be reduced or simplified to value engineer any non-essential physician tasks or redundancies out as we pivot healthcare towards a hybrid model, which includes virtual medicine.”

Early results had been very encouraging, suggesting a possible 30% saving in time, increasing the doctor’s quality time with patients and allowing them the administrative space to do other things.

“Some of our practitioners on the course are now using that extra capacity to treat uninsured patients.”

Collaboration and inter-connectedness are other key aspects of virtual medicine, which has great potential. In complex cases like cancer, virtual medicine allows multi-disciplinary teams of specialists to seamlessly provide specialist care with experts literally across the world. This reduces the inequitable access to health care in the process, said Basu.

“Covid-19 hit us hard, especially in Birmingham, where we had the largest intensive care unit in all of Europe, which soon became full to capacity (with pandemic patients). We were (still) diagnosing patients with cancer, but we had nowhere to put them for three weeks. This was heartbreaking and devastating.

“Now when we are trying to restart other normal clinical services, it is very difficult to prioritise between scheduled procedures and it’s creating a very divisive and toxic atmosphere over the equitable access to healthcare.”

Cruse agreed: “We are trying to engineer out unnecessary repetitive, time-consuming tasks in the working life of the average doctor. In Cape Town, there is a massive problem with diagnosing tuberculosis using sputum cytology – up to 2,000 samples per day – which used to be diagnosed manually, with some risk of human error. Artificial intelligence and molecular tests can now be used to do this more efficiently, allowing cyctoscreeners and pathologists to focus on the probable positive cases ”

Henley Africa launches comprehensive virtual pivot course for healthcare practitioners

On 10 March, Henley Business School Africa will present the first class in a progressive, brand-new course that addresses both the realities of Covid-19 and the accelerated disruption of the digital age...

Issued by Henley Business School 19 Feb 2021


Other health providers have imported remote health monitoring devices during the pandemic, which operate like a smartphone. In the UK, Basu said, the Royal Berkshire Hospital had been able to set up a virtual ward, using remotely measured oxygen saturation as the key triage point. In South Africa, said panel audience member Terence Naidu, AI has been introduced not to replace radiologists but to augment them.

The opportunity here was to reduce the workload on staff and on resources, allowing some patients to be treated at home, out of hospital and accordingly making the experience less anxious. “The possibilities are immense, it’s a very exciting time to be in medicine,” said Cruse, “as the borders between countries and technology disappear.

“In Cape Town, radiologists are diagnosing over 100 MRI and CT scans every night for the NHS in Britain. We’re hoping that once Covid-19 is brought under control in SA, we will not revert to the old ways but keep and build on the efficiency gains of telepractice.”

The momentum of change in other aspects of medicine has been as heartening; the SA Health Professional Council has quickly regulated virtual consulting, while health insurance funds have made it claimable for patients. From a medico-legal perspective there have been major moves to accommodate virtual patient consultations, which were formerly not allowed.

“Hybridised medicine is becoming the new normal,” Cruse said; a far cry from the way he had been trained, where medical students were taught that ‘if you don’t put your finger in it, you’ll put your foot in it’.

The model in future, he said, would be that patients would not go to the hospital for care unless it was absolutely essential, such as a surgical intervention. Remote monitoring devices, artificial intelligence and augmented reality would help establish which cases needed hospitalisation or not.

At the moment though, he said, virtual consultation still remained diagnostically inferior to the old physical examination with its important ‘laying on of hands’. Bedside manner was slowly being replaced by webside manner. But, as Foster-Pedley noted, the speed in the development and growth of digital technology would soon bridge this too.

“Every night, watching TV unlocks a range of emotions, there’s more engagement, it’s more captivating than ever before,” he said. “We need to develop the skills of that. There are many technologies, blending the use of language and facial technologies to make contact far better and far more real – even if it's virtual.”

The proof of the pudding perhaps was in the poll of the webinar attendees: 78% would be prepared to pivot to virtual medicine, but just under half remain concerned about the potential for misinterpreting symptoms and diagnoses with 25% still concerned about data privacy.


Henley Business School
Henley Business School Africa, is the only international business school that boasts triple-accreditation status from the foremost accreditation bodies in the United Kingdom, Europe and the USA, along with accreditation by South Africa's Council on Higher Education.
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