Read the Conversation

EF: 2020 was the year of diagnostics, 2021 the year of vaccines; what will 2022 be the year of?

VM: Fundamentally the future is healthcare moving to the home, but home-based care and healthcare moving to the home are very different positions and perspectives. It is something that is at the centre of the pandemic. The pandemic has accelerated the entire process. Therefore, 2022 will be the year of digitally enabled home-based healthcare.  

EF: Are there any limitations to at-home health that could impact this trend?

VM: Attitude and practices will impact this trend more than infrastructure limitations. By design, the healthcare system is hospital-centric. There is a local and global shift taking healthcare away from hospitals to decentralize healthcare in homes. In countries like South Africa, considerable investments are made toward infrastructure. Each government wants to demonstrate the impact they can leave behind through physical things like buildings. This makes the value proposition of digital healthcare very difficult, especially when the expectation is that healthcare needs plug into the dominant narrative.

The challenge is not infrastructure because digitally-enabled home healthcare is based on telecommunications infrastructure. South Africa has one of the highest mobile penetration rates. We have high speed, high coverage, and highly reliable internet, so our biggest limitation and goal has been creating a favourable reimbursement environment. This means looking at the environment as a whole, creating value, being rewarded for the value, and the environment becoming a place where clinical outcomes are measured, and patients do better.  

Amongst the attitudinal changes, there are interactional changes as well. We see a shift in the chain, regulatory shifts, and how insurance companies view risks. We are seeing a proliferation of models like ours that champion hospitals at home and digitally enable healthcare for the home. Our value proposition is not just delivering convenient care but care that is safe and convenient.

The attitude and practices are all things within our reach to solve. For example, some people believe that litigation risk is highest outside the traditional brick motor facilities. There is no evidence to support this. So, the biggest challenge for us is to shift physicians' and patient perspectives by demonstrating the safety of care as a unique value proposition.  

EF: How did you guide your team through the pandemic, and how did it affect your leadership style?

VM: Many of us come from humbling backgrounds; therefore, the idea of adversity is not something new to us. We use experience from adversity and leverage some of the lessons learned in these experiences. Thus, going through the pandemic allowed us to step into a space we were already used to.  

Resilience, flexibility, quick learning, and adaptation are what we use to navigate through our pandemic experience. I had the unique privilege of leading a well-equipped and trained team through such challenges. We were able to not only absorb and respond, but we were also able to learn quickly, which enabled us to deal with issues before they came.  

Individually and as an organization, the concept of not having access to healthcare is not new to us. We spent most of our lives advocating for access to healthcare. COVID-19 found us at a time we were trying to fix and transform to be able to respond to various challenges. As a result, while the rest of the healthcare system was trying to turn around the titanic that was COVID-19, we were nimble and uniquely positioned to withstand many of the challenges that came with it.  

People need to start thinking about the role they play in healthcare. The pandemic was a demonstration of how healthcare is everybody's problem. It did not matter how much money or access a person had.

EF: How has the company grown in the past four years, and did the pandemic contribute to its accelerated growth?

VM: We were the first company in Africa to pioneer the provision of digitally-enabled hospital-level care at home. We remain the leading and trusted provider. COVID-19 essentially accelerated the acceptance and growth rate of our company. The pandemic happened, and there was a rapid adoption of health regulatory shifts, attitude changes, funder attitude changes, and consumers' and patients' behaviour changes towards delivery at home. It is something we are at the forefront of. A perfect storm could not have been better created for our model.  

However, COVID-19 has been a double-edged sword because the demand for our services has had several peaks that sometimes superseded the supply. When the omicron wave began, we relaunched ourselves to focus on non-COVID patients. We are now starting to see the uptake in those services.  

We have seen the uptake of our model by companies like Medscheme and Discovery Health. It is incredible to see how far we have come, as there were only six people when the company started in 2018. Life Healthcare invested in Quro Medical because they believe in our team and this model. We are at an inflexion point and will continue pioneering healthcare at home and all the other tailwinds that assist us in driving change.

Collaboration and partnership are the future; they drive innovation and change. Having a collective vision is one of the biggest lessons from the past couple of years regarding experience.  

EF: How does your portfolio performance look beyond COVID-19?

VM: The future of healthcare means hospitals will become highly specialized centres of care while transitioning from this hospital-centric care to hospital-level care at home. I see hospitals being places where people go for specialised care and surgeries. Everyone else will be treated at home. The future of healthcare is one where healthcare is delivered and centred around the home, and the entire system is reconfigured to support that care. Healthcare access limitations have been administrative, logistical, or infrastructure-related. Moving healthcare to the home rapidly solves all those issues. With our model, the biggest issue would be solving the telecommunications problem. Once the telecommunications/connectivity challenges are addressed, everyone will have access to doctors.  

Data-driven healthcare is the second part. I want to create a future where we democratize the stethoscope. Fortunately, that is where we are heading. We can create more value and focus on the quality care we deliver. With data, healthcare can become less of a black box. In other words, data can be collected in homes by patients themselves using tools like the stethoscope.  

Lastly, the future of healthcare teaches us to be more efficient with our existing healthcare resources. It takes nine to ten years to train and register as an independent doctor. The healthcare burden is increasing at a staggering rate. The healthcare sector is not training enough healthcare professionals to respond to the growing burden. So, unless we find ways to become much more efficient with the existing resources and prevent diseases, we will constantly be chasing our tail. How can we make specialists' knowledge more accessible, and how do we expand the scope of what physicians and nurses can do so that everyone can look after more patients? All these things speak to a value; therefore, the ultimate manifestation of innovation in healthcare is value-based care.

EF: Do Quro Medical have ambitions to extend across Africa or internationally?

VM: If we are not building healthcare systems to enable greater access, we are not doing it properly. Healthcare is a global problem. We are constantly looking at how we can build our solutions for export. We have massive aspirations to go beyond South Africa. Beyond the continent, our focus is on emerging economies.  

One of my biggest frustrations is reverse innovation. It is the idea of something developed in an emerging economy and subsequently taken to developed countries being considered reverse innovation. Sending people to the best institutions globally will naturally produce innovative ideas that solve global problems. Unless we can make platforms and digital solutions that create solutions that are accessible to everyone globally, we have to keep going back to the drawing board and come up with more global solutions. Quro is true to its premium quality mission. Affordability and premium quality care should not be mutually exclusive. Affordability must be cross-cutting.  

EF: Can you elaborate on the company's impact on delivering affordable healthcare and access?

VM: One of the largest telecom companies here is MTN. We recognized a significant disparity and affordability when it comes to telecommunication. Patients enrolled in our care do not have to pay for access to the internet because we provide that through our partnership with MTN.  

Although there is a high mobile penetration rate, not all smartphones are created equally. We provide our patients with customized or locked phones on loan. We solved two critical things. One is the phone's compatibility, and the second is the constant need to worry about data. Our solutions show how we are reflecting on solving these problems. We include a fully charged power bank within our kit that goes to patients so they are not cut off during a power outage. The battery pack is there to keep them charged throughout their period of admission.  

Through our partnership with various emergency practitioners, we can pick up on issues quickly and dispatch the right medical services. We are solving a lot of things that people think are fundamental barriers. Through our collaborative efforts, we have made them more accessible and cost-effective.

EF: Next year Quro will be celebrating five years. What do you think you will be celebrating?

VM: We hope to have covered South Africa and be in at least two other African countries. That is currently our main goal and my biggest project. Right now, we have managed to halve the cost of healthcare for patients in our care. We have also reduced the length of their hospital stay by 60%. We have averted over one-thousands hospital bed days. It is exciting because it means our model can be scaled rapidly which is important given the urgency of our work and our pursuit to reach as many patients as we can.  

EF: As a leader, how would you like to be remembered?

VM: I would love to be remembered as an individual who has an insatiable desire and has been engaged in a relentless pursuit to improve the lives of people.

June 2022
South Africa