Choosing a healthcare provider can be a tough call. It is always advised to learn about a doctor first before jumping into this, the most delicate of relationships.
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The main port of call for many a would-be-patient is going on the recommendation of an already trusted doctor or a friend (of a friend) – after all, everyone always has the best doctor or specialist that you “just have to see, no really, he’s excellent”.
Subsequently, the last route people generally seek out is medical directories or ratings sites, especially in less internet-prevalent places such as South Africa, where I would argue that traditional directories such as The Yellow Pages are more popularly used.
Nonetheless there are a few directory websites around, some more populated than others, like Medpages, others with better design such as Map-a-Doc, but they all share two shortcomings: limited information and a lack of direct contact. The most you can expect to get from such a site is a practitioner’s phone number and address, perhaps with an (inaccurate) map to boot. These are essentially phone directories put online and it all feels very dated.
Mark Raa aims to update the whole system with his new, self-funded startup, CitiDoc. Raa is the founder of Trustgate, a web-hosting and website application development service, and also CTO of Moola4U, a LinkedIn-style website that aims to connect informal workers to job providers.
CitiDoc takes the directory mould and extends it into a two-fold platform.
At its core, it allows doctors and healthcare specialists to create a profile for their practice for free and subsequently take bookings for appointments — effectively operating as a cloud-based patient management system (for appointments). Patients, on the other hand, can register to find doctors online, book appointments for free and then rate their experience with those doctors.
It’s startups with the simplest ideas that are often the most brilliant, and there are shades of that with CitiDoc.
It takes the related, but often separated, tasks of a) finding a doctor and b) booking an appointment, and facilitates it into a cohesive online experience. It’s not without its challenges, but CitiDoc literally has the potential to change the way we interact with our doctors in emerging markets, and that’s exciting.
It goes a little something like this
Doctors register on the platform and create their unique profile. Here they can list their qualifications and upload photos of themselves and their facilities. The doctor configures his/her working hours and appointment intervals on a built-in calendar and waits for a booking.
Patients don’t have to register to search for doctors, but they must to make appointments. They can search by doctor-speciality (A-Z) and location. As the startup is based in Cape Town, South Africa, searches are limited to the Western Cape province for now.
Once a doctor is chosen, the patient-to-be is taken to the doctor’s individual calendar with the specified available times, a time-slot is selected and the appointment goes into a pending status. The patient can export their appointment to iCal or Outlook at this stage if they would like. The doctor is then notified of the appointment and they can approve or deny it directly from the CitiDoc console, after this the patient is notified.
The startup is self-funded by shareholder loan, but Raa has confirmed a desire to roll out to the rest of South Africa and parts of Africa — especially in the next five years — and stated he would pursue Angel or VC funding to help accelerate this. Even though the CitiDoc console is fully functional on tablet and smartphone devices at current, a key part of this rolling-out strategy would be to develop a dedicated mobile app.
The core platform (and directory-element) is free, but for its Revenue Model (the patient-management solution) doctors can enlist some paid services come Q2 of 2013.
The first service available will be a pre-paid SMS-module. Doctors can buy SMS bundles that get credited to their profile, and these can be used to send patients appointment confirmations, reminders and time changes all charged at regular SMS peak-prices.
There are plans to launch two more subscription-based billing modules: a customer relationship management (CRM) module which will facilitate the invoicing and collecting of payments and a Hospital Plan module that caters to doctors doing hospital rounds and are in the ER. Raa confirmed that these will be charged in the region of between R250-R500 (about US$28-US$55) per month.
The CRM module will have medical aid support for big dogs Discovery Health but also cover Momentum Health, Fedhealth, Resolution Health, Spectramed and Bonitas. If the doctor enlists the CRM module, they can generate invoices directly through the platform to the patient — either the full amount or the amount left over after medical aid claim — or the patient can settle the invoice directly through CitiDoc with a Credit or Cheque card (Visa and Mastercard supported).
The directory element of CitiDoc is useful, no doubt, but I think the real value for medical practitioners lies in the SMS and CRM modules respectively, because these are what separate CitiDoc from its competition.
Taking medicine into the 21st century
I foresee many challenges ahead for CitiDoc.
First and foremost, it needs to get the site populated as a matter of urgency (there are just four listed doctors on the site at the date of writing). Sure the site only went live in early January so this is understandable, but we believe that a startup should provide maximum value to the customer (or patient in this case) from the moment of launch.
To put this into perspective, Medpages has tens of thousands of registered practitioners across the continent, highlighting the hard work ahead for Raa and his team. Its strategy is to advertise via email and adword campaigns, as well as obtain endorsement from BestMed and Netcare. Personally I would have done this first before launching so that a database could have been in place from the get go, but Raa’s strong programming background indicates that he is playing to his strengths and I can’t fault that.
A second challenge is that of trust, not so much for patients — because practitioners listed on CitiDoc are verified by their HPCSA number — but for the doctors themselves.
Medicine is an age-old practice, and cloud-based management is still quite young. Will a field notorious for relying on strong relationships with colleagues and word-of-mouth referrals be open to a brand new system with no credibility, at least in its initial stages?
Endorsement will solve part of this problem, but opening up one’s reputation to the big-bad internet and online ratings might be daunting to some medical practitioners (perhaps a contributor for the slow upstart?). However, I think doctors could view CitiDoc as a more focused LinkedIn. For example, they could rate and recommend each other and draw value from that, something akin to the referral of old.
It might just be an important step forward, as doctors should be held accountable, so hopefully practitioners do take to the system because its real value lies in the booking-system — without it CitiDoc would be just like any other medical directory.
Another side of the rating’s coin is patients’ apathy to write up reviews. I for one, can hardly be bothered to write up reviews of products I’ve purchased, especially if I’m happy with them, and so the danger of this system is that people won’t engage with a key part of the platform.
However, its nature of being built into the platform might encourage patients to leave reviews. This is up for debate though, is there a responsibility for patients to review a doctor for the betterment of their community?
At the end of the day, reputation is key, especially in the medical field. Just being listed on CitiDoc is not going to be enough, patients would have to hope for a few reviews to get an indication of a doctor’s service, as well as potentially having to verify (or at least check up) a practitioner for themselves. This doesn’t solve the ‘port-of-call’ problem that any directory service faces. People will probably still want to rely on trusted recommendations (read as: not online) when it comes to their health.
In my opinion CitiDoc doesn’t face too many market challenges because it really is a smart combination of services, making it more than a directory. I think it would be in huge demand if it got its database in order.
It might not solve the ‘recommendation’ problem (not necessarily its fault, but more due to the nature of people’s attitudes towards their health) but it does fill a huge gap for medical practitioners through its online-booking service. This alone should provide impetus for doctors to get on board.
The young startup is a work in progress, but CitiDoc remains an exciting idea. It could facilitate a change in the way we look for, and interact with, our doctors.
Now it just needs people to use it. I hope people do.
