Originally launched in the US and Europe late last year - the founders of web and mobile medical tracking application, FOLUP, decided it was time to make the service app available to the African market.

So, at the beginning of 2013 South Africa became their initial foray into the African market.

Simnikiwe Mzekandaba ITWeb Africa assistant editor had a chat with Simon Spurr who heads up FOLUP operations in South Africa.

He also explains how SA is just the beginning of his company’s expansion plans as FOLUP is also looking at other African countries to grow into in the medium-term.

SIMNIKIWE MZEKANDABA: What is FolUp? And how does it work?

SIMON SPURR: FOLUP is a web and mobile application where patients can securely connect to their healthcare provider, track themselves and share valuable information about their health. Essentially build their own, personalised, secure health record. Patients can capture their health information in 2 ways:
1.) Manual capture in the platform i.e. input your glucose reading
2.) Automatic gathering of health information from connected devices.

We developed FOLUP with an open Application Programming Interface (API), which means we can integrate wireless devices to capture data automatically. These results sync automatically into their FOLUP profile i.e. data from blood pressure cuffs, glucometers, wireless bodyweight scales, fitness activity monitors, heart rate monitors and other multi-functional devices.

A problem with all these connected devices is that they collate the user’s data into separate platforms (apps and websites) – i.e. a person using an activity tracker + a blood pressure cuff needs to log into two separate platforms to view his/her data. One of FOLUP’s key value propositions is that we can collate data from a number of devices and platforms and centralise it for the user – making life simpler for both the patient and doctor.

Practically speaking, a person can buy a withings blood pressure cuff and a fitbit activity tracker and the data from these 2 devices will collate into their FOLUP profile – together with all their other health information.

SIMNIKIWE MZEKANDABA: Who can access it? And how does one access it?

SIMON SPURR: Anyone who has an internet connection can access FOLUP. There is no cost to either the patient of the healthcare practitioner. Go to www.folup.com and register there. Patients can immediately start building their own, secure health record and doctors can connect to their patients and monitor them remotely.

In the coming weeks we will launch our new app (for iOS and Android) which will be groundbreaking in both functionality and design.

SIMNIKIWE MZEKANDABA: What was the motivation behind the launch of FOLUP?

SIMON SPURR: Geoffrey Appelboom, one of the founders, is a medical doctor specialising in Neurosurgery. 4 years ago a teenage patient visited his consulting rooms. She was suffering from headaches in the morning and she had nausea every time she woke up (typical symptoms for high intracranial pressure). The problem was that every time she saw her doctor she forgot to mention it – she didn’t think it was important. She was suffering from an inoperable brain tumour. She might well have been saved from an earlier, accurate diagnosis.  

Geoffrey realised that constant feedback from patients is extremely valuable and that technology should help us gather this information to improve diagnostic ability – medical information is dynamic and not static. A lot of things occur between consultations with healthcare practitioners new symptoms, side-effects, mood disorders, and pains to name a few.

FOLUP is able to help medical practitioners in the following areas:

• Identify patients that need follow-up visits
• Improve patient symptom monitoring and treatment compliance (particularly to new medication and / or treatment plans)
• Keep patients informed through group discussions and chats
• Inspire patients to follow-up with their doctor when needed
• Help patients connect with other patients who share the same diseases through circles of care

To do that, we at FOLUP, have over the past 2 years gathered groups of doctors (GP’s), family physicians, surgeons, specialists in chronic diseases, to workshop their clinical needs.

Together with global leaders in technology and healthcare specialists such as myself, in South Africa, we aim to improve the daily practice of healthcare providers and the lives of their patients.

It was clear from the beginning that it was important to understand the needs of both parties and synergize these needs into one platform. Day-to-day information is crucial in understanding the big picture of a patient’s condition. FOLUP gathers patient’s feedback and packages it into valuable information.

SIMNIKIWE MZEKANDABA: How many people were involved in launching FOLUP?

SIMON SPURR: Four of the co-founders, with additional strategic external consultants, were responsible for the launch into SA. We have a small team directly operational in FOLUP at this stage. Through our global development partner, however, we are able to access a team of 300 coders at any time. This is important in terms of scalability and the ability to deploy rapid customisation or new development to the platform.

SIMNIKIWE MZEKANDABA: What was the starting process like, did you experience any hurdles along the way?

SIMON SPURR: When launching into the market, part of our strategy was to only allow patients to enter FOLUP upon invitation from their healthcare practitioner. We ideally want practitioners ‘prescribing’ FOLUP to their patient, at the point of consultation. We have, as of this week, created open enrolment into FOLUP (meaning patients can register freely and start using FOLUP). This is due to the large volume of patients enquiring about using the platform, regardless of who their provider is or health status for that matter. Patients are eager to learn more about their disease and want to connect to other patients who have had similar experiences. We are seeing that many patients turn to the internet for health-related information.

This is a dangerous process, as the internet is filled with unreliable and invalid information. Our aim is to assist these patients in understanding their health better, channelling them to experts who can assist them and connect them to other patients.

It is important to note that FOLUP was never designed as an interventional platform and doctors are not expected to react to every notification from a patient. We developed a secure, intuitive environment where doctors are linked to their patients’ and can monitor their health at any time.

We feel this will create stronger efficiencies in the patient-doctor consultation process.

One of the initial questions that doctors always raise is the concern that FOLUP will add another “administrative” layer to their already hectic schedules. This is certainly not the case. FOLUP was developed by doctors, with the doctors view front of mind. The platform allows the doctor to view his / her aggregated patient base in dashboard format, with the ability to drill down to individual patient’s data. This type of reporting will enable the doctor to gain insight into the patient’s life, at any time, therefore giving them key insight prior to the patient’s consultation. The doctor can also have their admin assistant pull a patient’s file from FOLUP. Patients can also actually print relevant information off their dashboard and take it with them to the next consultation with their doctor, all of which drives more efficient consultation.

SIMNIKIWE MZEKANDABA: And how what has the response been like?

SIMON SPURR: Uptake has been very positive and enrolment from both patients and doctors has been steadily increasing. We are one of the fastest growing medical tracking apps globally.  

We firmly believe that self-awareness and patient feedback can save lives. Physical activity is the blockbuster drug of the century – it decreases your risk of breast cancer, osteoporosis, diabetes, hypertension, heart disease and many others. This is the reason why we are forming partnerships with the likes of Lisa Raleigh / Dischem “Well I Am Challenge” – to create a challenge for people who want to enhance their well being, learn more about their health and optimise their medical status. This is a great example of what FOLUP can do for you.

In early October we are releasing many new features in the next version of our mobile apps for iOS (Apple) and Android.
Patients know best about how they are feeling and they are increasingly tracking their key health metrics – from activity to blood pressure to medication consumption. This movement has been helped tremendously by technology becoming smarter and more affordable. We have seen greater engagement in this area due to this movement.

SIMNIKIWE MZEKANDABA: Is it possible to give me some figures of how many people have started using FOLUP since its launch?

SIMON SPURR: At this stage we have over 15,000 users in FOLUP.

SIMNIKIWE MZEKANDABA: How many of those are from South Africa?
 
SIMON SPURR: Of these, approximately 6,000 are in SA.

SIMNIKIWE MZEKANDABA: How would you like to expand this service further?

SIMON SPURR: In terms of the market response, we have a number of large-scale enterprise projects on the go in the US, Europe and SA and we are anticipating strong uptake on the platform in the coming months across all regions.
Our strategy here in SA has been to engage with large enterprises i.e. medical aids, insurers, disease management companies and wellness organisations to help as many patients as possible. Our goal is to improve the lives of patients and make a difference to them.

More recently we have started discussions with patient foundations and medical associations who engage with a large volume of patients, to offer them our platform to assist patients in understanding their disease better and facilitating better communication between patient and doctor.

We have broader growth plans for Africa and the far East. The vision for FOLUP is to offer any patient a mobile tool where they can track and understand their health better.

SIMNIKIWE MZEKANDABA :How would you say is mobile important in the technology space in Africa?

SIMON SPURR: The vision behind our technology is to help patients understand their health better, get better faster, connect with other patients, share experiences, and to help doctors track and monitor them better.

Mobile technology removes obstacles such as geographic distances and time barriers. Doctors can monitor constantly (remotely) and not periodically. We have severe challenges in SA and throughout the continent especially regarding lack of skills, shortage of doctors and nurses, lack of facilities, rising costs of healthcare services etc.

At the same time, stats show that there are more than 20% of South Africans living with a chronic disease the technology has the potential fundamentally to alter the economics of patient care.

We also know that the majority of African families have a mobile phone. Hardware is becoming cheaper and more readily available. Connectivity through network Operators is constantly improving. Mobile phones are the delivery channel for a number of services in Africa, and will become more and more important in the future.

Technology, particularly mobile, has to be the next great ‘enabler’ in healthcare. FOLUP can fundamentally assist in these areas. A major problem right now for chronic patients is securely keeping all the data they have in between consultations with their doctor

SIMNIKIWE MZEKANDABA: Do you think mhealth is the next frontier in application development in Africa?

SIMON SPURR: I think that the delivery of healthcare services has the opportunity to leverage off large market penetration of mobile phones. mHealth holds promise for improvement along the entire value chain.... maximising doctors’ time and productivity, improving quality, increasing access to services, stimulating greater consumer involvement, and potentially decreasing costs.

SIMNIKIWE MZEKANDABA: Would you encourage someone to get involved in establishing a technology start up?  

SIMON SPURR: Within the African context, I think there are massive opportunities for smart technology solutions. The tools (mobile phones and connectivity) are available and in the consumer’s hands. Technology is evolving so rapidly, and consumer demands are constantly increasing, that anyone looking to enter this sector as a start-up needs to have invested a large amount of time analysing the best approach and have a strong plan of action to constantly evolve to meet these demands. Exciting times for technology however.