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Abu Dhabi, UAEMonday 22 October 2018

Generation Startup: Ex-banker seeks to "democratise" healthcare with new app

Health at Hand was launched in April to address inefficient primary medical care

"Really Health at Hand was born out of desire to democratise healthcare to putting the patient first and allowing patients to have access to their medical records," says Mr Barlow. Pawan Singh / The National
"Really Health at Hand was born out of desire to democratise healthcare to putting the patient first and allowing patients to have access to their medical records," says Mr Barlow. Pawan Singh / The National

Former investment banker Charlie Barlow has a mission to “democratise” the primary healthcare field in the UAE, which he says is plagued with over-prescribing of medicine, unwanted lab tests and inefficient care.

His solution is telehealth or, as his start-up is called Health at hand, an app that connects doctors with patients to conduct consultations via video. The company, which is licensed by the Dubai Health Authority, was set up last year and launched the app in April.

“I experienced first-hand a number of inefficiencies within primary healthcare, including the drive time to go to a clinic, the wait time to actually see a doctor, and the fact that you are sat in a germ-filled waiting room in a doctor’s clinic,” recounts the 41-year old British founder and chief executive of Health at Hand.

“Something that fundamentally shocked me and really alarmed me … is the awful lot of abusive situations where the likes of lab tests, diagnostic testing is over-tested and where people are pushed to branded drugs over generic drugs. What all of this serves to do is put the consumer very much second in terms of the healthcare relationship.”

Telehealth is gaining traction worldwide and for a reason.

Companies want to lower the cost of medical expenses of their staff, while patients want a quick and efficient way to treat mild ailments.

Meanwhile the proliferation of smartphone usage is making telehealth a popular option for medical consultations.

Globally, the telehealth market is projected to expand at a compound annual growth rate of 13 per cent to reach $19.5 billion in 2025 from $6bn in 2017, according to Transparency Market Research.

Connectivity, advanced analytics and voice assistants are some of the features that will aid telehealth, according to Dr Ken Abrams, a managing director with Deloitte.

"Twenty-four seven mobile connections help expand and engage stakeholders, increase adherence and retention, and improve the overall experience,” he says.

“Processing of large data sets to improve decision making through ‘cognitive computing’ and continuous learning enhances and predicts outcomes. Genetic sequencing, nanotechnology, and biomarker detection technologies lead to therapies tailored to the patient, enabling earlier go / no-go decisions.”

As a resident of the UAE for 12 years and a father-of-three, Mr Barlow says he experienced first-hand the downside of primary health care in the country, especially during his investment banking career, when he spent too much time at clinics getting over-treated, over tested and over-charged.

“There are some inefficiencies first in terms of convenience, price and abuse and we also thought isn’t it about time that we, as patients, have a bit more control over our health and health records,” he says.

“Really Health at Hand was born out of desire to democratise healthcare to putting the patient first and allowing patients to have access to their medical records and upload, download and share their medical records.”

Patients also spend needless time in emergency rooms at night when doctors are not available, another inconvenience for patients with minor ailments.

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“There is a general theme in the primary healthcare space and this region is not adopting technology practices in the same way as other markets,” he says.

The free app, which is available in android and apple stores, was off to a good start and Mr Barlow was “pleasantly surprised by the uptake,” he says, without giving numbers. The service is currently available between 8am and 6pm and the ultimate goal is to have it running 24/7.

Telehealth apps are not just the product of start-ups.

US behemoths like GE Healthcare and Honeywell have lent their technology or collaborated with companies to offer telehealth services.

It is no surprise then that the North America telehealth market accounted for 40 per cent of the total in 2016, according to Transparency, thanks to the many leading players located in the region, expanding research and development activities, and rise in health care awareness.

“The adoption of telehealth in the Middle East has been much slower than other parts of the world,” says Mr Barlow. “Yet there is a real demand for telehealth. You have a high percentage of diseases of affluence in this region that include the likes of diabetes and obesity which can be assisted by telehealth. You have a fast-growing population, and extremely challenging cost ratios for the insurance sector.”

With over 60 insurance companies competing in a country with a population of around 9 million, losses are bound to amass as they compete to offer the same services.

The insurance sector could be one of the main beneficiaries of telehealth, according to Mr Barlow.

“When an insured patient walks into a clinic, the insurer already loses control of the management of those costs,” he says. "Diagnostic tests may happen or drugs might get suggested to a patient. Insurers here are haemorrhaging cash. There is a requirement for insurers to adopt modern technology tools.”

Mr Barlow is currently talking to the top 10 insurance companies in Dubai and the wider GCC to partner with them. Meanwhile, Health at Hand is talking to the DHA to get approval for e-prescriptions. Currently doctors working with the company can only prescribe over the counter drugs, which the company can deliver to patients.

“Primary healthcare is broken,” he says. “Too high a percentage of gross domestic product of healthcare spend is going into building bricks and mortar hospitals not just in this market but internationally. There is not enough money going into preventative medicine.”

This is not Mr Barlow’s first tech venture. Six years ago he set up his own venture capital firm, Rockfirst Capital to invest in early stage tech companies, focusing on the internet of things and consumer devices.

One of the companies he invested in was Chargifi, which this year received capital from Hewlett Packard.

Rockfirst Capital has invested and incubated Health at Hand, which raised $1 million in 2016 from friends and family and secured another funding round in 2017, when it raised $3.1m from investors he has declined to name. The largest non-founding shareholder after Rockfirst Capital is a very prominent family office in Saudi Arabia, he says.

Mr Barlow is eyeing a third funding round this year to raise as much as $6m to help the company grow. This time he is targeting strategic investors.

“We have kept away from private equity and venture capital companies up until this stage,” he says. “So it’s really been private investors and family offices.”

The company is hoping investors will subscribe to the company’s business model which is based on three segments.

The first is the business to consumer model, where individual patients connect with a doctor. This service, currently in the initial stages, will account for 30 to 50 per cent of revenue.

The second segment includes corporates paying for their staff to use Health at Hand or through co-payment.

Ultimately Mr Barlow wants to work with insurers to have Health at Hand incorporated into an employee's insurance package; they can then utilise the app on an unlimited basis through the life of the policy.

“That’s where the game really changes, when you are forced by your insurer to use telehealth before you are allowed into a clinic to see if you can be remotely treated,” he says.

“Ultimately when the company is more mature you will find probably 90 per cent (of revenue) coming from B2B from insurers and corporates.”

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