Samir El-Alami has over ten years of international technology startup experience helping to build and scale innovative companies within the finance, insurance, dating, and healthcare industries. His vision of "enabling people to live healthier lives" is the base of doctorly’s product approach to innovating the healthcare industry: support the doctors with practice software, help the patients with an integrated health app, and integrate the wider health industry with an open partner platform.
The healthtech industry is full of innovations.What distinguishes doctorly from other startups?
Before we defined our exact products, my co-founders and I thoroughly researched the wider healthcare industry and met with doctors, pharmacists, health insurers, policy makers, and other stakeholders within the healthcare industry. We had a clear vision from day one, "to enable people to live healthier lives," and we were trying to pinpoint a specific problem we could solve. We saw a lot of top-down, patient-focused, modular innovations (booking tools, chat bots, telemedicine, fitness trackers, therapeutic apps, etc).
However, these weren’t being embraced by the wider medical community en masse. Ultimately, all of the conversations led us back to the same place: the doctor's practice. Within medical practices, doctors and their staff heavily rely on practice management software for the vast majority of their administrative tasks, many of which are mandatory and extensively regulated. The problem is that most of the software in use today was developed in the 1980s and 1990s. As you might expect, by today’s software standards, they work poorly and lack modern functionality. I can’t quite express how bad the situation is. Go and ask any doctor what they think of the software in their practice. I’ll wait.
What will the doctor say?
Doctors are currently spending between 50-70 % of their time on purely administrativeduties; this has a knock-on-effect to the number of patients they can see and the amount of time they can spend with each one, not to mention a distinct lack of job satisfaction for doctors and their staff. The lack of modern practice software also limits the level of care a doctor is able to
provide to their patients.
Take, for example, an elderly patient who has multiple medical conditions, each of which is treated by a different doctor and prescribed medication. If one of these medications stops working, the doctor that prescribed it would need to consider all of the other treatments before prescribing a new medication or dosage. In cases such as this, the doctors would need to have an MDM (multi-disciplinary-meeting). As there is no effective integrated communication tool within the practice software, nor a centralized repository of patient data to access, this coordinating process can take up to a month. Patients die during this time. With our software, we want to change the way practices work. Our first goal is to decrease time spent on admin within the practice by 50 %. It’s certainly not an unrealistic objective considering the lack of innovation over the past 30 years. From there we will build a platform for patients and the wider health industry to collaborate and innovate together.
That sounds great. But why hasn’t such modern software already been made available to all medical professionals?
I know! We live in the 21st century and everyone is talking about blockchain, AI, and vacations in space! Go to your doctor’s practice. You will see a PC from 2007, running Windows Vista, with practice software from 1987.
I’m not exaggerating and it’s a ridiculous state of affairs. To put that into context, I was born in 1986! Despite the fact that doctors know that their practice software is very poor, they simply have little choice when it comes to such a heavily regulated tool. In medical practices, even the smallest technical innovations are often hard to implement because the old technology is incompatible with the new.
So even though it is clear that practice software is a big hurdle for innovation within the practice (and, by extension, for patients), startups haven’t really wanted to tackle this issue. Why not? First of all, practice software is a BIG product with lots of complex functionality, so it’s quite difficult, time-consuming, and resource-intensive to build. Secondly, it is
also heavily regulated, which increases the complexity, build-time and costs greatly. We have been building for two years so far.
Given all these obstacles, how will the healthcare industry evolve in the future? What will a doctor’s appointment look like?
If you ask me what will be "possible" via technology and assertive, innovative governance, I would say: Almost every aspect of a medical visit could be different. But if you ask me what will "actually " change, the answer is: much less than is possible.
Within these large, key-life, bureaucratic industries, change really only occurs when the costs and pain of ‘not’ acting are too great. For example, as we have this interview we are experiencing the COVID-19 crisis, suddenly the powers that be want to spend money on modernizing the health infrastructure. But of course, in the near future I’m looking forward to a future without fax machines in doctors’ offices. A future where people will not be using Google to look up their symptoms (it’s almost always possibly cancer), instead having access to on-demand digital doctor consultations or accurate Artifcial Intelligence or Machine Learning-driven diagnosis tools.
I hope that one day my medical data will be stored in a cloud, with easy functionality enabling me to authorize access to any doctor I want, anywhere in the world. In this scenario, doctors will no longer be burdened with tedious administrative work and will be able to focus on what really matters: spending time with patients, diagnostic work, and treatment.
Data protection activists would object to this idea. Are fully digitized and electronically accessible medical records the price we have to pay for an efficient health system? There’s a lot of hysteria in the media with respect to data protection: "Oh my God, Facebook, Google, they want all my data."
The reality is that "data" has always been necessary for most industries to exist and provide better services to us, whether it is insurance, healthcare, or entertainment. Data drives everything.
Doctors already have access to our health data, it just happens to be in (mostly) paper format, inside drawers, and not particularly secure to be completely honest. The data is not especially useful either. Doctors in Germany have to store your data for a minimum of 10 years, but "how" it’s stored and how accessible or useful it is for your treatment is not defined. If your doctor had two minutes to look over your medical history before beginning your consultation, would you prefer them to be rifling through 10 years of paper, or searching, sorting and focusing in on key information electronically?
Would you prefer your doctor to have a 360-degree view of your health and then treat you, or for data to remain in isolated silos
granting only a partial view? We need to provide doctors with modern tools and software to enable them to evolve with the rest of society and meet modern standards of expected service level.
So, would you say that the privacy debate in relation to health is overblown?
Not at all. Of course, from a safety and infrastructure perspective, this needs to be regulated with the highest data security standards. But on the other hand, we are happy to give away so much of our personal data in so many other (often trivial) circumstances. We unlock our phones with our face or fingerprint, we use apps to record our heart rate, steps and weight fluctuations, we even give away our DNA data to see what kind of interesting, historical genealogy tidbits lay within it.
The fact is that people will always provide their personal data if they can get something in return. I am sure a time will come when a doctor will ask permission from a parent to insert a chip of some kind into a newborn baby. This chip will ensure
that the child has the best chance of avoiding potential health complications throughout their life because key aspects of their health will be constantly monitored and trigger alerts should an anomaly be recognized.
Yes, people will obviously have misgivings about who has access to the data, how it is stored, and potential privacy issues... However, I also believe a lot of parents would say yes.